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  Discussion on Synovitis of Left fore Fetlock
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Member:
Canter

Posted on Monday, Aug 15, 2005 - 9:07 am:

Dr. O,
On Friday night, my mare was suddenly and acutely lame. I rode Thursday night and she was fine; the barn owner noticed no problems with her as late as 5 pm on Friday, but when I went to get her from the pasture at 7pm, she was hobbling badly.

It was obvious that the problem was in the front, but I don't have a good eye and was unsure of which leg. I put her in cross ties and checked out her legs--no obvious swelling, no heat, no racing digital pulse. There were no rocks or sticks in her hooves, no lacerations. She was standing funny, so I started to panic, thinking founder (although she didn't have the "classic" stance)and called the vet. While waiting, I got maybe 1 gm of bute in her and cold hosed her on & off for over an hour.

The vet arrived and my horse was walking better (reacting to the bute or the hosings?). He removed the shoe on the left and used the hoof testers. At first he was thinking an abscess, but upon further exam, said it was her fetlock. After he flexed the joint, she was VERY reluctant to put weight on her leg. At that point, he graded the lameness a 3. And recommended the following:
~1.5 gms bute 2x/day for 7 days, decrease to 1 gm twice/day for additional 3 days
~Cold Hose 2-3 times/day for 20 minutes for 5 days
~Wrap legs
~Complete stall rest for 10 days, handwalking 5-10 minutes after 3 days
~Radiographs in 4 weeks
~When she shows relief, have farrier replace shoe (vet felt that the farrier banging on the shoe would make for a very uncomfortable horse). I've got duct tape over the hoof to prevent damage and to protect her soles (they are quite thin--I knew this at time of purchase but they have never caused a moment of lameness)

My questions:
1. Is the diagnosis of synovitis a "generic" diagnosis. In other words, should I be requesting more specific info? From reading the articles, this terms seems indicative of a process rather than a specific disease or injury?
2. I've had no chronic lameness history with this horse (she badly injured her left hock last summer, but that was trauma induced and with carefull care, she became completely sound again). So, what the heck happened here? Can you explain the sudden onset of this? She showed no sign of trauma (it has just rained and she had no mud on her like she would had she fallen or even raced around the pasture)
3. Does the treatment as outlined above seem reasonable? Anything else I could or should be doing?

Sorry for the lengthy post...

Thank you,
Fran
Moderator:
DrO

Posted on Tuesday, Aug 16, 2005 - 6:39 am:

1) It is a specific diagnosis and a form of arthritis, specifically inflammation of the joint capsule. What I don't understand is that synovitis of the fetlock should be accompanied by swelling of the ankle, something you don't describe.
2) Injuries without a known cause happen all the time with horses. This could have been a hit or miss-step.
3) If there is remarkable pain in a joint or uncertainty to the diagnosis I would want a joint tap and radiographs to rule out the presence of infection and establish the presence of a chip or nondisplaced fracture. Treatment would depend on what I found on the above exam.
DrO
Member:
Canter

Posted on Wednesday, Aug 17, 2005 - 8:27 am:

Thanks so much for your response DrO.
Based on your comment that synovitis should be accompanied by swelling of the fetlock I now wonder if this is what we truly have here. There was no swelling or heat and there continues to be none at all. In fact, the mare's walk has HUGELY improved and I can't tell now if she is still lame or just "off" because she hasn't had that shoe replaced. I'm refraining from trying her at the trot until I have a couple more days of stall rest in (although vet said to hand walk after 3 days, I'm waiting for tonight, hoping an extra day or 2 of complete stall rest would be best) My vet recommended waiting 4 weeks for xrays, but it sounds like the prudent thing to do would be to get them sooner rather than wait? You mention a bone chip or fracture...wouldn't one of these types of injuries show heat and/or swelling?

Ugh! Nothing's ever simple with these critters!
Moderator:
DrO

Posted on Thursday, Aug 18, 2005 - 6:03 am:

Yes I would expect such changes but am relying on the fact that the vet found something that localized it to the joint. The flexion though it helps localize it to a region is pretty non-specific for a diagnosis. If the injury is that much better I am uncertain you need radiographs but am a bit perplexed by the 4 week then radiographs suggestion.
DrO
Member:
Canter

Posted on Thursday, Aug 18, 2005 - 8:04 am:

Thanks so much for clarifying, DrO. I too was a bit confused about the 4 week wait on the xrays. When my mare injured her hock last year, we waited about a week to radiograph as the entire leg was grossly swollen. That's not at all the case here.
I think I will have the farrier put the shoe back on as soon as he can come out and then call out the vet again for the xray. Although it may not be neccessary, probably better safe than sorry and by the time all that is done, my mare will have completed the 10 days of stall rest (plus some) and the vet can evaluate her soundness before I turn out or start riding again.

Thanks again!
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