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  Discussion on Front end lameness
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New Member:
bbthur

Posted on Wednesday, Jan 20, 2010 - 6:33 pm:

I took my 9 yr. old TWH to an equine sports specialist recently to determine why my horse is short striding on his right front. The vet diagnosed a very mild white line in his RF last year and found that my horse has a bone chip behind his coffin bone on the right front as well. The dr. also had found my horse has very mild arthritis in his hocks.
He injected behind his coffin bone to lessen or alleviate that problem, and it did help until recently. In the last few weeks, my horse's stride at a flat walk has been very "gimpy." I took my horse back to the vet thinking that my TWH might need another injection into the coffin bone area where the bone chip is located. But after he blocked that area, the horse was still lame. So he blocked the RF abaxial sesamoidean, RH Tarsal metatarsal, RF suspensory (high), RF fetlock, RF radiocarpal, and the RF carpal metacarpal with no improvement after each.
The vet then injected his right bursa with Hyvise.vetalog and said to wait a day or two and then ride him normally to see if there was any improvement. Three days later there seemed to be a slight improvement; not as short of stride with his RF. But each time I rode him after that, there was no improvement. I rode him lightly yesterday for an hour, and he was very "off" on the RF, short striding and looking very gimpy.
The vet told me to call him this week to let him know if there was any improvement, but I have yet to talk to him. He sends messages via his secretary, so I can't discuss what he thinks we should do next. He told me, via his secretary, to give my horse 2 gm of bute for 7 days. No further comment. I am wondering if this is a temporary solution to my horse's problem, and what is to be gained? I want to know, IF POSSIBLE, what is causing my horse to short stride, in other words, what is causing his discomfort. The bute may mask the discomfort, but I would like to know what should be the next step. He had mentioned a possible future "treatment" with an injection into his shoulder, the bursa, since he seemed to think the blocks indicated a shoulder problem. I am mystified why we don't pursue a treatment or further tests, but instead he has prescribed giving my horse doses of bute. Does this course of action seem to be the expedient thing to do after all the blocks were done with no conclusive diagnosis? Am I trying to rush the diagnosis or being too impatient with the vet? I would greatly appreciate an opinion on this matter. Thank you!
Moderator:
DrO

Posted on Thursday, Jan 21, 2010 - 7:30 am:

Hello Betty,
As to whether pursue empiric therapy instead of an exact diagnosis is really your call and based on your goals and resources. Sometimes when a diagnosis does not present itself with routine testing a course on anti inflammatories and rest is prudent as many acute lameness problems fix themselves. The longer the horse has been lame the less likely this course is to succeed. How long, in total has your horse been continuously lame on the RF?

Assuming the blocks were done correctly and by blocking the suspensory you mean a high 4 point volar block was done it does seem likely that you have a lameness above the knee. The description of the lameness being characterized by a shortness of stride is consistent but not diagnostic for the shoulder.

Betty it sounds like to move forward with a diagnosis you need to find another veterinarian that has better diagnostic skills than the current one you are using and just as important better communication skills.
DrO
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