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HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Hoof » Navicular Disease / Chronic Heel Pain SynDrOme »
  Discussion on Mare with Heel Pain
Author Message
Member:
mokuc

Posted on Monday, Apr 22, 2019 - 11:00 pm:

In 2017 my 19 year old Stb mare was sore in both front feet and was helped a lot by shoes and pads. She was doing well until I changed farriers and there was an increase in the length of her toes. She went lame on the left front rather suddenly and was diagnosed with CHP in May, 2018. Radiographs did not show anything and a nerve block helped significantly. I changed to a barefoot trimmer who took her toe back and allowed her soles to grow more in July, 2018. Her soundness improved about 50% but she is still not sound (April 2019). Currently she is lame at the trot on the left front when this foot is on the outside of a circle. She is better with boots and pads and on soft ground, and improves with Equioxx, but is still not sound. I read the navicular article and it mentioned that long toes and toeing in can contribute to this. She was a rescue 5 years ago and she had minimal hoof care and she toes in badly. Coffin joint injections did not help at all and the vet has suggested injecting the bursa. So here are my questions. I am thinking about getting an MRI so I can finally understand what is going on but I'm not sure if it would be cheaper to just try different treatments. The article didn't give a lot of options that would help except a balanced trim (done), and drugs or nerving. I would like to ride this mare again very lightly but her long term welfare is much more important. Would an MRI provide any knowledge that would help this mare or would it just give me a bunch of issues that I won't be able to fix anyway? Would injecting the bursa be of any value ? Is getting an MRI better than just trying the limited number of treatments that are available? Also people are using shock wave for this. Is it of any long term value? What is the best thing to do considering I want her to be comfortable for several more years and I'm not sure what the right thing is to do. Thank you very much.
Moderator:
DrO

Posted on Wednesday, Apr 24, 2019 - 7:27 am:

Hello Maureen,
CHP (chronic heel pain) is not a diagnosis but a general description of the duration and area of pain. There can be many causes of CHP. Not knowing what costs are in your area I cannot say which would be cheaper but there is nothing wrong with calling all parties and have then tell you what the charges would be. In most situations the MRI would be more expensive however I do think it would be much better at helping you understand why your mare is lame. Best is to have the lameness reevaluated (take your radiographs and records) with the understanding that if the cause remains unknown you wish an MRI.
DrO
Member:
mokuc

Posted on Wednesday, Apr 24, 2019 - 2:26 pm:

I have had my mare evaluated by 2 different excellent vets and they both wanted new radiographs, new nerve blocks, and new lameness exams $$$. I understand them wanting to see for themselves, but I don't want to repeat this yet again and they don't seem to have anything else to offer. I think I will call the most recent vet and ask about an MRI. Cornell is about 3 hours away and if my vet can work with Cornell that might be the smartest thing to do. Thank you!
Member:
lsweeney

Posted on Wednesday, Apr 24, 2019 - 2:38 pm:

Hi Maureen. When I have something that might be nebulous, I go immediately to UC Davis. While I believe the local vets are great, there always seems to be a point where it needs to go to the next level, and then they don't have the equipment or something, and we have to start all over again. If I start at UC Davis, then they have all the latest veterinary tools, and they also get fast results with lab work, etc. Additionally, there are a lot of vets and specialists wandering around that they can grab to collaborate with if they are challenged by something. So I would concur that Cornell might be your best bet.
Member:
mokuc

Posted on Thursday, Apr 25, 2019 - 11:58 am:

Thanks Laurie. I haven't had good luck with Cornell over the years. They totally missed that a horse I brought there had EPM. They said he just had "Standardbred gaits". My local vet figured it out. They also took in my boarder's horse with a broken jaw, kept her 3 days, charged her a fortune, and did nothing except administer antibiotics and IVs. They sent the horse home not eating and the owner couldn't get the vet who worked on her to call her back. It turns out he had rotated out and no one was up on the case. Again, a local vet figured out it was the drugs causing the problems and made adjustments. You don't get to see the most experienced vets. You get the ones who are newly qualified. I am not thrilled about taking this mare to Cornell, but they charge the least for an MRI and are the closest. I hope they will consult with my local vet about the results and something can be learned. Vet hospitals may have the equipment but there is nothing like having an experienced local vet who knows your horse.
Member:
lsweeney

Posted on Thursday, Apr 25, 2019 - 12:50 pm:

That's too bad. At UC Davis, you are dealing with students and interns, but there is typically a senior vet overseeing. Additionally, they tend to see more difficult and varied cases. I had a horse with an irregular heart condition, and every vet in the place including those visiting from overseas came to listen to her heart.

I recently helped fund-raise for my sister-in-law's puppy who was keeling over regularly with partial paralysis. The sticker price on spinal surgery was significant. I got everyone and their brother to kick in along with UC Davis. It ended up that the dog had a congenital problem where there was a bone missing in the neck. The neurologists were fighting over who would do the surgery (rare). I think they had the whole neurology department in there observing. The surgery went from 10AM to 8:30pm. They had her strapped to a board so that the spinal cord in the neck wouldn't be accidentally severed. :-O

We are lucky in that we have lots of competent vets around. Our local vets are good too. I've just had very good luck with UC Davis when the issues are either difficult to diagnose or require specialty services, 24 hour care or high-end diagnostic equipment.

I am also noticing a tendency now for Vet hospitals and specialists vs the one-stop shop for veterinarians. Our local vets are no longer trying to be open 24/7, and they refer out various surgeries, ultrasounds, etc. to specialists, and after-hour emergencies to hospitals that are quite pricey.

Good luck.

Please post the results.

Laurie
Moderator:
DrO

Posted on Saturday, Apr 27, 2019 - 6:47 am:

Echoing Laurie, please post the results.
DrO
Member:
mokuc

Posted on Wednesday, May 29, 2019 - 12:42 am:

I am saving up for my mare's MRI and it looks like I will be able to do it in about 6 weeks. I have an additional question. After looking at some pictures of Katie's feet recently, I was wondering if she has club feet. Your article on club feet mentioned sore heels as a possible contributor to this. Does it look like she has club feet to you or am I just assuming the worst? Thank you.RFLF side
Moderator:
DrO

Posted on Wednesday, May 29, 2019 - 8:44 am:

No, they appear to have normal angles in the photos.
DrO
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