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Discussion on Carpal valgus in 14 mo old
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Member:
Wolfydoc
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Posted on Saturday, Jun 18, 2005 - 11:28 pm:
DrO,
I had a 14-month-old Kentucky Mtn Saddle Horse examined in KY as a possible purchase. The vet said he had carpal valgus, mild, on the left front, and gave several options for treatment: do nothing; corrective trimming q 30 days; or placing a screw across the growth plate on the medial side. He based his diagnosis on the physical, but has not taken radiographs at this time. He did not feel the deformity was necessarily bad enough to cause future problems as far as limiting usefulness as a trail horse but couldn't guarantee this, of course. The owner of the horse sent me a photo of the foal when he was maybe a month old, as well as current photos. I don't see the deformity in the foal but can see it in the current photos.
His recommendation barring economics, complications, etc. and assuming I wanted the horse was to go ahead with the transphyseal pinning, as he felt it was a relatively simple procedure with a good chance for correcting the problem, even at this age. He has done the procedure himself many times, including in much worse cases. He said it is relatively the newest technique. I've not heard of this, but have heard of stapling.
Questions: is 14 months of age too late to correct uneven growth of the long bone? If not, what's the latest that one would want to do the surgery? It seems obvious that the sooner the better but I'm trying to decide whether I should have the surgery (if needed at all) done in KY or wait till I get him shipped out here (which could take a month or two to get lined up).
Have you heard of placing a screw or pin rather than stapling?
After reading your article on ALDs, I know that radiographs are important, but is it possible for one to get a pretty good tentative diagnosis just on physical that the horse has carpal valgus caused by uneven growth of the physis?
Thanks so much,
Cindy
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Moderator:
DrO
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Posted on Sunday, Jun 19, 2005 - 8:52 am:
Trimming will not help a carpal valgus condition and without radiographs how does one know the deformity comes from the growth plate? Placing a screw across the growth plate to slow growth is not a new procedure and will dependably slow the growth, if done correctly, but considerably more drastic than stripping or stapling. As to the prognosis in your case I think it would be guarded at this age for any significant correction, I have not seen any numbers but 9 to 11 months has always been the published maximum age for effecting these type deformities.
DrO
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Member:
Wolfydoc
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Posted on Sunday, Jun 19, 2005 - 11:11 pm:
DrO,
Thank you so much for your information. I thought it was weird, even before I read your article on ALDs, that anyone could say for sure where the deformity in this colt originated from without rads. Too bad. I have the colt's half brother and he is the perfect example of what the breed is supposed to be like - amazingly calm, willing disposition, sure-footed as could be, smoothest gait in the world, good bone and feet, stout. I think I'll just clone him! (Joking of course)
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Moderator:
DrO
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Posted on Monday, Jun 20, 2005 - 10:06 am:
Cynthia can you post the picture that shows the deformity, while we may not know where it comes from perhaps we can comment on the severity.
DrO
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Member:
Wolfydoc
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Posted on Tuesday, Jun 21, 2005 - 10:31 pm:
Thanks DrO for your persistence in trying to help! I'll try to attach now
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Moderator:
DrO
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Posted on Wednesday, Jun 22, 2005 - 6:57 am:
Hmmmm, if we assume they have made every attempt to get the horse standing as square as possible, I don't see a valgus deformity but a remarkable outward rotational deformity of at least the hoof and pastern. Unfortunately the lack of detail does not allow me to assess how far the rotation goes up the leg. If this is how this guys stands I would have to pass this is not within the range of acceptable for a trail horse in my mind and worry of increased risk of stress injury to all the structures of the fetlock down.
DrO
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Member:
Wolfydoc
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Posted on Friday, Jun 24, 2005 - 1:01 am:
DrO, here's a couple additional photos the owner sent. Unfortunately the lighting in the second is poor and the normal leg is not included much. I'll request more if you'd like.  
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Moderator:
DrO
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Posted on Friday, Jun 24, 2005 - 7:17 am:
In the photo on the left above I think we can see the mild valgus that the examining vet has seen. Nothing in these photos changes my earlier opinion, in fact, the rotational problem is quite evident in that same photo.
DrO
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