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  Discussion on Sesamoiditis in yearling.....
Author Message
Member:
Oscarvv

Posted on Tuesday, Aug 16, 2005 - 9:22 am:

Hi Again DrO,

I am very disappointed with the diagnosis we received on our homebred filly. She is 18 months old. It's been about a month and a half since we noticed her intermittently lame up front.
Since she didn't improve we brought her in for digital x-rays. Much to our dismay, and the vets, she was diagnosed with sesamoiditis.
Here are the findings - LF - mild proliferative sesamoiditis both sesamoids, RF - moderate proliferative abaxial sesamoiditis both front, with lateral bordering on severe. The US showed both suspensory branches to be normal. She was not lame at the trot on asphalt. She was very positive to flexion of the RF. No joint swelling except for slight effusion of RF (which was missed before the x-rays), no pain on palpation.

This filly is a Warmblood and has not been started. She has not been lunged or free jumped etc... She was living fulltime out in a ten acre field with two other horses. They are 2 and 11 years old and there was not a lot of tearing around. Although they did come galloping up for breakfast and dinner everyday. She is trimmed every 5-6 weeks by a very competent farrier.

My questions - was there anything we could've done to prevent this?

Could it be conformation related or growth related?

Any idea on a prognosis for future soundness? She was bred to be a show hunter.

She is now on stall rest for 60 days with Adequan being given every four days for 7 doses then every other week thereafter. She is not wrapped and we were told we can hand walk her.

Thank you very much for your help.
-Barbara
Moderator:
DrO

Posted on Thursday, Aug 18, 2005 - 12:53 pm:

Hello Barbara,
Sorry this took so long, every time I came to it I was uncertain how to approach your problem and finally decided there was not enough information. Can you describe in more detail what was seen on the radiographs? Where these proliferative changes more representive of entheseophytes (bone creation at the point of attachments of the suspensories) or along the margin of the bone?
DrO
Member:
Imogen

Posted on Thursday, Aug 18, 2005 - 2:13 pm:

Breakfast and dinner and pasture? How much were you feeding her?

I always worry about this, you want them to get the right nutrients if any are missing but if you feed 'em too much it can cause all kinds of problems. Not suggesting any direct link between breakfast and sesamoiditis, just wondering how much feed they were getting... and unfortunately warmbloods love their grub.

All the best

Imogen
Member:
Oscarvv

Posted on Thursday, Aug 18, 2005 - 9:41 pm:

Thanks DrO,

The changes were seen along the margins of the bone from what I understand. I will see the vet tomorrow, would you like me to ask for copies of the radiographs? They are digital, so I would think they could email them to me easily. Is there a specific question I should ask? If you'd like hoof/leg ankle pics I can post those as well.

She was getting 1 quart of grain 2x a day. The grain is 12% protein by Buckeye. She has free access to a mineral block which was not used much. No hay except in Winter and then it was straight Timothy, 1-2 flakes a day. The filly is tall, 15.3hh, but so are her parents. They are 17.2hh and 16.3hh. I have always kept her on the lean side.

From what I understand sesamoiditis is a result of too much work too early in life. It is very common in young TB's in training.

-B
Moderator:
DrO

Posted on Friday, Aug 19, 2005 - 7:33 am:

Well it is certainly diagnosed often barbara but the incidence is controversial. There are a number of different conditions labeled "sesamoiditis" with different causes. What caught my attention about your post was the "proliferative" descriptor. The race horse form is usually not described so but instead is best diagnosed by pain on palpation, anesthetic localization, and radiographic changes described as enlargement of the vascular channels and more subjectively decalcification of the bone. Your condition is starting to sound more like degenerative joint disease of the articulation between the sesamoids and metacarpal but I will wait for a more complete description.
DrO
Member:
Oscarvv

Posted on Friday, Aug 19, 2005 - 11:38 am:

DrO,
Just back from the vet clinic. I did not give you correct info in my reply.
The vet went over the radiographs with me today. There are increased vascular channels and the new bone growth is at the point of the suspensories....or not in the joint.
I hope that info helps.
Thank you,
Barbara
Moderator:
DrO

Posted on Saturday, Aug 20, 2005 - 9:46 am:

Prognosis would be based on the number and size of the channels that are enlarged and the appearance of the entheseophytes: are they reactive or unreactive. If you can get a good description I would be glad to comment.

Assuming they have the diagnosis right many experts in this field think that Shockwave is the best therapy though there is no concrete research on this.
DrO
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