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| HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Upper Rear Limb » Overview of Diseases of the Hock (Tarsus) » |
| Discussion on Cunean tenectomy | |
| Author | Message |
| Member: Caymie |
Posted on Thursday, Jan 12, 2006 - 9:11 am: Dr. O.,Does injecting anesthetic into the lower hock joints also block out pain from the cunean bursa? If the cunean bursa were blocked out alone, and eliminated or really improved the horse's lameness, might a cunean tenectomy resolve the lameness? Thanks, Mary |
| Moderator: DrO |
Posted on Friday, Jan 13, 2006 - 6:52 am: Hello Mary,Though not formally studied we don't believe it blocks with any of the intra-articular hock blocks and yes I would think if the cunean bursa specifically blocks out a c. tenectomy is more likely to relieve lameness. But we also know there has been some success with lameness that blocks in the hock itself for more on this see, Equine Diseases » Lameness » Joint & Bone Diseases » Cunean Tenectomy for Arthritis of the Hock. DrO |
| Member: Canter |
Posted on Friday, Jan 13, 2006 - 7:54 am: Uh oh, Mary. What's going on? Your question has me worried... |
| Member: Caymie |
Posted on Friday, Jan 13, 2006 - 10:17 am: Hi Fran and Dr. O.,I just can't get anything past you Fran, can I? Here's the deal guys. Last August my field vet put what we thought was the final piece into Caymann's lameness puzzle. He blocked out Caymann's right lower hock joints and according to the vet, he was completely sound. Or as completely sound as a horse can get from a block. Radiographs of the hock showed a bone spur (what the vet considered mild)on the medial side of the second joint up, not the lowest joint. The DIT joint perhaps? Anyway, the field vet injected the hock, and he had a reaction to the injection. The injection did not make him sound, certainly the reaction didn't help, but he only injected one side of the hock, and Caymann appears to be horse that needs both sides injected. So once we got the flare under control, I had one of the surgeons at the teaching hospital reinject the hock. He injected the bursa as well in case some of the inflammation was coming from there. He had an even worse reaction to the second injection, his hock was very swollen, as well as right down the leg. After we got through that reaction, I rode him and it was almost like I had my horse back. That injection never made him completely sound either, but he was much better than he had been in a long time. Surgeon recommended a bone scan, to determine if there was something else going on as well as to see if maybe the hock was worse off than the rads were telling us. The bone scan was done six weeks after the hock injection. Scan showed inflammation in both hocks, the right worse than the left. and inflammation on the right side of the SI joint. The SI joint inflammation was the hottest according to the radiologist who read the scan. Because he has shown so much improvement from the hock injection and the hock had blocked out so significantly,the surgeon decided to again inject both hocks first. I do not know if he injected the bursa the second time. The vet said he improved about fifty percent. So three weeks later he injected the right side of the SI joint. He was out in his pasture after the SI joint injection which may not have been a great idea as he is not exactly quiet in turnout. The vet said the SI joint injection improved him about forty percent. He is now back in his stall/run for a few weeks to see if he continues to improve or not. I am still stuck on his hock, because just one month before the bone scan, we got an eighty percent improvement from blocking out the hock. The vet is not totally convinced that this remaining lameness is coming from the SI joint. It concerns him that the right hock was showing inflammation on the scan, even though we had reinjected in just six weeks before. The other wierd thing is that this lameness seems to fluctuate from looking worse on a circle,to looking worse on the straight away. If we don't see improvement with him resting the next few weeks he is going to go back and re-block the hock. Any thoughts would be appreciated. Thanks, Mary |
| Moderator: DrO |
Posted on Saturday, Jan 14, 2006 - 9:35 am: I must say there does not seem to be much mystery here to me Mary. While I cannot be sure and I support the reblock to double check, this is a very typical history of a horse with arthritis. The injections bring'em back almost good as new then the horse is used past the point where the joint can stay un-inflammed, for more on this balance see the Long Term Management topic in the article Equine Diseases » Lameness » Joint & Bone Diseases » Arthritis and DJD: An Overview. Let us know Mary how things work out and are you using bute and oral joint protectants?DrO |
| Member: Caymie |
Posted on Saturday, Jan 14, 2006 - 10:58 am: Hi Dr. O.,Well, that makes two of us. I have always suspected the hock based on the blocking history and the dramatic improvement under saddle after the second injection. I'm sure that it is quite possible that he does have some inflammation in the right side of his SI joint, perhaps from going around on a sore hock for so long? I don't know. But when you have an area that blocks out that dramatically one month prior to the bone scan, I think that's where you need to focus your efforts. I think that the vet, who is also not convinced that the pain is coming from the SI joint, is just trying to eliminate that as a possibility. I think we are also confused as to why the injection only gave him six months of relief. That was the first time that hock had been injected, but I now know in retrospect that it has been bothering him for a long time. I mean years. The other confounding factor is why is that right hock lighting up on a bone scan when it was injected six weeks prior? Does that mean that there is a lot more inflammation in there than we think and the injection tempered some of it? Or should we have waited longer to do the scan, and was that the injection showing up? They are grading him a 2 out of five on the lameness scale. Is it possible that there could be much more damage to that joint than the radiograph/bone scan is showing? His left hock appears to be fine. One of the helpful things I did glean from the scan was that other than this hock issue, Caymann is in great shape. He has no other issues/arthritis in any of his other joints. That is one of the reasons I would consider surgery for him, if we reblock that hock, and it blocks out. The surgeon I am working with does do the laser arthrodesis. What is your opinion of that method vs. the drilling? Do you know of any horses that have been returned to soundness via surgical arthrodesis? I suppose we could try the cunenan tenectomy first, but I will go with what the vet thinks would be best. I think it is pretty clear at this point that management with injections alone is not going to do the job. He is on a joint supplement and has been receiving monthy Adequan and Legend injections. He had OCD in both hocks and stifles and had surgery at age five. The surgery was a success but I don't wonder if this hock problem is a related DJD issue as well. This has been a long, frustrating ordeal as my previous posts can attest. I will definitely let you know what happens and what we decide to do. He is going to rest for a couple more weeks to see if he improves. If not, I am going to let him out, and wait for the vet to reblock the hock. And I might add, the fact that this is the same lameness/weird hopping behavior that has been going on for several years, leads me to believe we are dealing with a bone pain issue. Thanks for your advice. Mary |
| Member: Buddil |
Posted on Saturday, Jan 14, 2006 - 7:44 pm: Mary, I had the same issues with my gelding, but he did have significant arthritis in the lower joint with a bone spur in that joint. I did a cunean tenectomy in August 2005 and his range of motion in the hocks really increased. When they cut the tendon the surgeon said they just snapped due to the pressure. He has been ridden daily in straight lines with large circles for a few months now. He came up very stiff in the left hock (the one with the spur) last week. Tried blocking the lower joint only to see if that was where the problem was coming from and bent 4 needles in half trying to get in. On the 5th try vet "thinks" she got in, he was a grade 1 at that point upon lunging, previously was a grade 2. Thinks the back of the hock is fused, will do xrays in Spring when he is further along. I do think that the cunean tenectomy did help him tremendously and the fusing is happening much quicker than before the surgery. |
| Member: Caymie |
Posted on Saturday, Jan 14, 2006 - 10:19 pm: Hi Cathy,Thanks for the information-how old is your gelding? Did his radiographs show extensive/severe arthritis? Did you try to manage him with intra-articular injections first? It is helpful to know that sometimes the cunean tenectomy does work. If in fact all of this pain is coming from his hock, then managing it with the injections is obviously not working. If the pain is coming from his SI joint, then that would explain why he is still lame even though we have addressd the hock issue. If he is not improved after a couple more weeks of rest, the vet will reblock the hock and we will go from there. I often have wondered if his hock is trying to fuse. If so, I would have thought there would be radiographic evidence, but maybe not. If his hock is in the process of fusing, I may consider surgery for him to help it along. We'll see what happens in the next couple of weeks. If we do determine that the hock is the problem, it might be worth it to try the tenectomy first. I always want to try the more conservative approach before resorting to a major surgery. Just out of curiousity-was your horse's lameness more evident on a circle or on the straight away? Thanks for your help-I'll keep you posted. Mary |
| Member: Caymie |
Posted on Saturday, Jan 14, 2006 - 10:21 pm: Hi Dr. O.,I replied to your post from earlier today. I wasn't sure if you would see it since there have been postings since. It is right above Cathy's post. Thanks, Mary |
| Member: Buddil |
Posted on Sunday, Jan 15, 2006 - 5:20 am: Hi Mary, my gelding is 11, his left hock had extreme narrowing of joint space in the lower part of the joint with a bone spur. The bone spur has been there since I bought him 7 years ago when he was 4, but at that time his hocks had great xrays except for the spur. Over the years the arthritis progressed, joint injections helping for a very short time. Where the spur is the cunean tendon laid right across it, so that was definately a problem. Before having the tenectomy done injections didn't do diddly squat anymore. After the tenectomy he was 99.999% better, just stiff in the left hock. He seemed to work out of it after 15 minutes of walk for a few months. Then he started to take lots longer to work out of it so a little bute for a week helped him get through that phase. After a few weeks he was fine again, but then it started to return but not as drastic. His lameness shows on a circle, sound straight. Just last Friday we blocked and with the block put a small amount of steroid in it to calm down the inflamation. For a few days he was grade 1 lame still, but just the past couple of days he is very sound on it. The surgeon said that since he had such a narrow joint space back when we did the tenectomy he did not want to opt for performing arthodesis at the time, thought the fusing process would continue since he would be working more comfortably with the tendon released. The right hock has some arthritis but not like the left, so that one hopefully will fuse also. That one really doesn't give him much of a problem, he is on Adaquan and Conquer. |
| Moderator: DrO |
Posted on Sunday, Jan 15, 2006 - 8:43 am: Bone scans and radiographs, as a localizer of pain, can be unreliable which is why they should be double checked with other localization techniques and radiographs will not discern soft tissue damage, like the cartilage and synovial membrane, of the joint. For more on this see Equine Diseases » Lameness » Localizing Lameness in the Horse. Whatever the evidence of the past imaging done, if the pain has returned to the joint previously treated the horse himself says that the amount of work for the last 6 months was a bit more than the joint could stand up to.DrO |
| Member: Caymie |
Posted on Sunday, Jan 15, 2006 - 9:13 am: Hi Dr. O.,The problem is that Caymann has hardly done anything the past year. Except have a thousand lameness exams. All I was doing with him after the joint injection that did give him some relief was walk/trot him on a loose rein for six weeks since he is so out of shape. So, if that's all it took to make the injection wear off, I'd say we have a much bigger problem in that hock than either the radiograph or bone scan is telling us. I too am suspicious of a bone scan as a localizer of pain, especially for the SI area. I will always trust a joint block more than anything. I am very much looking forward to the next couple of weeks when I at least think we will have our answer. I will let him rest a little longer per the vet's request-if we do not see improvement, then we go back and reblock that hock. I'll keep you posted. Thanks again, Mary |
| Member: Caymie |
Posted on Sunday, Jan 15, 2006 - 9:21 am: Hi Cathy,My horse is ten, but I know that whatever this is, has been bothering him for at least a couple of years. You wouldn't believe what we have gone through trying to get him diagnosed. But I very much believe in the surgeon that we are working with, and I am confident that will have our answer sometime soon. Your experience is very interesting to me because I was discussing this very issue with the vet the other day. He said there is some blocking we can do to try and isolate where in the hock the pain is coming from if it turns out to be his hock. It would be interesting to see what happens when the cunean bursa is blocked. Did they block the cunean bursa on your horse prior to doing the tenectomy? Caymann takes this strange sort of hopping step sometimes, almost like he is sort of lunging forward and slamming down his front end. Then he just continues on. But your story gives me hope that maybe we could try that instead of surgical arthrodesis. I will probably go with whatever the vet recommends. My understanding is that with the laser fusion the recovery time is much less. I would very much like to be able to have my horse back in work as soon as possible. Of course step one is to make sure where the lameness is coming from. What type of riding do you do with your horse? I'll keep you posted. Mary |
| Member: Buddil |
Posted on Sunday, Jan 15, 2006 - 7:39 pm: Hi Mary, we did not block the bursa at all. The vet was very familiar with cunean tenectomy's. He said that the first step with him doing the drilling type of arthrodesis was to do a cunean tenectomy anyway. So we went ahead with that first and if fusion did not happen then we could always follow through with the rest of it. He is a dressage horse so using the hocks is important to his career. Through all of this he has always tried so hard, but as of late it is starting to really be easier for him, so I am confident that the hock will finish fusing soon. Want to do xrays but I want to take him to the clinic for digital xrays, they show things so much clearer, but I want to wait till Spring when he is even further along. The cunean tenectomy was so very easy and the down time was minimal. He was on stall rest for 10 days with some walking allowed, so we grazed for an hour per day, which kept him happy. I had to wrap his back legs everyday till he was able to go out so he did not stock up. The insision was small but large enough to take 4 stitches in each hock. He never had any swelling at all. There is a very small knot at the bottom of the hock but just looks like bone to me. After 14 days we were allowed to walk under saddle for 1 hour per day and he was then turned out. He is very quiet in the pasture so running was not done, too much grass to eat too! Straight line trotting at 21 days, then after a week or so big circles. Then allowed to do full work. He was never sore. Funny thing is after this was done that day and from that point he has walked flat on the foot instead of it cocked to the side and rolling from outside to inside when he walked. The tendon was putting so much pressure on the hock spur that it was full of scar tissue the vet said. It took some time to find a vet willing to do this procedure. They have a newer way of doing it now, they do it in Colorado, but my vet in Wisconsin was familiar with it and was very open to doing it. I must say it was the best thing I have ever done for him, but each horse has a different situation. Vet said either it would help him a tremendous amount or do nothing so I had nothing to loose but $800! Hope all goes well, keep us posted!Cathy |
| Member: Caymie |
Posted on Sunday, Jan 15, 2006 - 10:02 pm: Hi Cathy,Dressage is what we do too. And we live in Colorado, which is kind of funny since you mentioned it in your post. Your experience is encouraging. Our first step here is to make absolutely sure where the lameness is coming from-either the SI area or the hock. He is going to rest for one to two more weeks and then we will reevaluate him. If there is no improvement-we will reblock his hock and go from there. Has your horse been able to continue working throughout the fusion process? We'll let you know what happens. Mary |
| Member: Buddil |
Posted on Monday, Jan 16, 2006 - 5:43 am: Yes, he was a little more uncomfortable about 2 months ago so I gave him a gram of bute a day for about 2 weeks. Then he seemed better, now he has no stiffness at all starting out and is very willing to work. I keep it simple, no lateral work at all for that is what started soring him up. Will continue with straight line work for a few months to hopefully finish the fusing process. I throw a circle in there once in a while in a ride and he is fine with it, actually stretches down nicely. He is worked for 45-60 minutes in trot 5-6 days per week with a little canter work on the straight line. |
| Moderator: DrO |
Posted on Monday, Jan 16, 2006 - 7:48 am: Mary are you also using anti-inflammatories?DrO |
| Member: Caymie |
Posted on Monday, Jan 16, 2006 - 9:58 am: Hi Dr. O.,Caymann is currently receiving treatment fit for a professional athlete. The plan for Master Caymann is as follows: He is on stall/paddock rest. While he is resting he is having a massage and acupuncture treatment weekly. I am considering a four week course of Legend, as it certainly won't hurt either his hocks or SI joint. If we see improvement in the SI area, we may add shockwave treatments. However, the vet wanted to make sure this is the area the lameness is coming from before we shockwave it. There is also some question as to whether the shockwave would penetrate since he is such a heavily muscled horse. I have spoken with the vet about Bute. If the lameness is coming from the SI joint, this is a chronic injury as it has been going on for so long. I figured since he injected the SI joint on the right side with Depo and Serapin, that that would be enough to deal with the inflammation. However, the vet did agree with me that a two week course of Bute couldn't hurt. I haven't started it yet because I wanted to be able to evaluate him to see if he is improving which would be harder to do if he is on Bute. Do you think I should go ahead and start him on Bute? Mary |
| Moderator: DrO |
Posted on Tuesday, Jan 17, 2006 - 8:14 am: I don't think this sounds like the care of professional athletes that I know Mary. The very first thing a professional athlete does when he is injured, whether acute or a reinjury of a chronic problem, is get on a regular regimen of NSAID's. On the other hand the use of acupuncture would be considered at best controversial with no clear benefit.The problem is that you see bute as only pain relief and nothing could be further from the truth. Inflammation not only causes pain but can cause damage and set up recurring cycles of damage and pain. Whether it is the torn muscle in my back or the arthritis in my hands, when the inflammation and pain becomes active I have two choices: lay around for days or weeks and do very little or take some naproxen. Sometimes one or two doses and the pain is gone in 20 minutes and gone for months. DrO |
| Member: Caymie |
Posted on Tuesday, Jan 17, 2006 - 8:24 am: Hi Dr. O.,Perhaps I did not explain my reasons for not using bute clearly. The vet did tell me that usually in the case of chronic SI injuries, Bute is not prescribed. That may be his point of view, others may disagree. The other two reasons for not giving Bute are the fact that the right side of his SI joint was injected, we assumed that that took care of the majority of the inflammation. He was on a course of Bute for a few days following the injection. It is because I do feel that anytime (or most times) there is inflammation, that Bute should be given that I inquired about using it while he is resting. I understand that acupuncture is controversial. However, I do know of some who have had success in treating back pain by using it as a complementary therapy. He does appear to enjoy it, as well as his massages. It gets him out of his stall twice a week which is also important for his mental health. I certainly do not expect it to restore him to soundness alone. We'll keep you posted. Mary |
| Moderator: DrO |
Posted on Tuesday, Jan 17, 2006 - 10:02 am: Did I misunderstand above that the last time the horse displayed these symptoms, it blocked out almost 100% in the hock and that we don't have any proof that this still is not the most likely diagnosis?DrO |
| Member: Caymie |
Posted on Tuesday, Jan 17, 2006 - 10:25 am: Dr. O.,He did indeed block out significantly to hock pain. The field vet felt that there was no other lameness showing up after the block. The surgeon at the hospital felt as though the block improved him quite a bit, approximately eighty percent. To me, that is still a significant block. I agree with you that the hock is the number one suspect here. Especially based upon the dramatic improvement that I felt under saddle after the first injection. (Although, he never did go completely sound after the first injection). I am not all that happy about locking my horse up in the dead of winter, both for his mental and physical well being. And I would really hate to think that he is being confined for a hock problem that may eventually need surgery anyway. However, I am trying to give the vet, who I respect greatly, the chance to make sure that we eliminate the back as a source of lameness based upon the fact that he did not come fully sound from the hock injection, (only made him fifty percent better), and it showed up on the bone scan. I am not a big believer in bone scans, expecially for a lameness that has not been localized. And believe me, I have been suspicious of it from the get go, given the dramatic improvement with the hock block. At this point in time, both his hock and the right side of his SI joint have been injected. The other reason I am keeping him off of the bute for a week or two, is that I want to be able to accurately assess whether he is improving. Because if he is not, he's going back out in his pasture, and we're going to reblock that hock. And if it is his hock, we're going to have to find another solution besides constant Bute if he is going to be made sound. I do not want to put him on Bute for an extended period of time for several reasons. Now, if it turns out we are seeing quite a bit of improvement with his back, I may put him back on the bute. If it turns out to be his hock, I may put him back on it until we decide how we are going to treat it, or in conjunction with the treatment if the vet advises it. It is not that I do not understand that Bute controls inflammation, believe me, we have had more experience with controlling inflammation than I care to think about. I'm sure that others might have a different approach, but I am going with the approach that has been recommended by my vet, which I happen to agree with for the moment. Mary |
| Member: Caymie |
Posted on Tuesday, Jan 17, 2006 - 10:28 am: Dr. O.,I forgot to add that the vet is not entirely convinced that the lameness is coming from the SI joint either. However, he is trying to systematically eliminate the SI joint as a possibility. There are some things about the way this lameness has presented itself that are very unusual. Mary |
| Member: Buddil |
Posted on Tuesday, Jan 17, 2006 - 2:29 pm: Hi, Mary, I have to say that when I had hock injections in my boy they never never even lasted 4 months, let alone 6 months. With a spur in the 2nd joint, does the xrays show any narrowing of joint space? My geldings spur is in the lower joint but extreme narrowing of the joint space was happening also, which caused him discomfort. Bute helped him minimally but it did help him work through the pain. With fusing they need to continue to move as much as possible. Is he too lame to be out using himself? Even just walking under saddle an hour is great exercise, for mind and body! |
| Member: Caymie |
Posted on Tuesday, Jan 17, 2006 - 6:21 pm: Hi Cathy,This is part of the diagnostic dilemma. The radiographs are telling us that he has mild arthritis in that right hock. The bone scan is telling us that as well. The hock injection never even made him sound from the get go. It improved him fifty percent according to the surgeon. And the improvement that he did get lasted only six weeks. All I was doing was walk/trot on a loose rein for those six weeks. So that means one of two things-there is another concurrent issue going on, which is why we did the bone scan, or that hock is much worse off than we think it is. As I recall, the surgeon did not feel that there was any joint narrowing on the x-ray or evidence of attempted fusion. I will inquire about this again if he has not improved with the SI injection and rest. Throughout all of this, Bute has never made him totally sound, it reduced him to a grade 1 lameness. I am in agreement with the surgeon that this is most likely a bone pain issue as it has been going on for so long, and has not gotten markedly worse or better. It has certainly worsened over time, but not like you would expect a soft tissue injury to really get worse if it went on unchecked. No, he is not too lame to be out marching around. As a matter of fact, he can look quite impressive out in the pasture. He is however, too lame to be ridden because it does cause him pain. The vet is coming out tomorrow to take a look at him. We are four weeks post injection of the right SI area, and he has been resting in his paddock for a week now, in addition to the "resting" he was doing out in the pasture prior to this week. And you would not believe some of the strange things we have seen throughout the presentation of this lameness. This has been a most challenging diagnostic dilemma for all concerned. I sure do appreciate your thoughts on the hock situation. Even though the hock is the number one suspect in my mind, that does not make it so. I think we will have our answer very soon. I'll let you know what happens. Mary |
| Moderator: DrO |
Posted on Tuesday, Jan 17, 2006 - 7:07 pm: I see no unusual circumstances in your posts, horses with arthritis are going to have recurrent episodes of pain. Particularly if you rule NSAID's as a therapeutic tool. Instead of all these expensive tests and therapies for unknown problems why not reblock the hock? Though I certainly do not know the actual cause of your current problem, it appears a very simple question is being handled in the most difficult way possible: let's rule in the hock, which historically has been the cause of this problem, by ruling out every other possibility.Also I don't remember whether you are using oral joint protective nutriceuticals. Where I use to have to inject my horse once a year since beginning glucosamine / chonDrOitin supplements I have not had to do this. But all of my point of discussion, the bute, the oral supplements, the controlled exercise, are in the arthritis overview article. Perhaps this would be a good time to review this. If my post seems a little pointed Mary it is because I think you are getting a bit of a run around but then again I am not there so perhaps I misunderstand something...but when this odd therapeutic regimen is substituted for treatments that have know efficacy against the most likely diagnosis I have to wonder. DrO |
| Member: Buddil |
Posted on Tuesday, Jan 17, 2006 - 9:14 pm: With my geldings hock issue he had other issues that did arise due to over compensation on the other limbs. The main problem we have had is that he tore his suspensory branch on the same leg as the arthritic bone spurred hock. Suspensory healed but the lameness was still "just there". After the cunean tenectomy he became quite sound for some time but with the 6 days per week work at lots of straight line trotting inflamation took over. After finally being able to block the joint and see that it really is his main problem we injected the joints with a touch of steroids to calm the inflamation down. Walla, a very sound horse after a few days. I do feel that a lot of his problelms were the tendons being so full of adhesions over the spur in the hock, but he also has significant arthritis. Work on an arthritic hock definately equals inflamation, which in my case is a "good" inflamation because something is happening there for the good. It is painfull to a certain extent for him to work on but in his case no pain is no gain! I do feel a block would really clear up confusion for you. It may not make him 100% sound but he also may have other things going on because of compensation. Please keep me posted!Cathy |
| Member: Caymie |
Posted on Tuesday, Jan 17, 2006 - 11:35 pm: Hi Dr. O.,Don't worry-I take no offense at your post at all. I understand why you are taking the approach that you are. You would have to meet Caymann to understand why he is such a challenge. And believe me, I have had some of the same questions you have. The reason that the bone scan was suggested was that because after injecting that hock three times over a period of four months, (remember we had the complication of the reactions to the injections thrown in there as well)., the horse never went completely sound. He was only improved fifty percent. Based upon his grade of lameness, combined with the radiographs, it did not make sense as to why the injections were not restoring him to soundness.And the vet and I discussed the possibility that there could be much more damage to the joint than the radiograph showed. I agreed to the bone scan so that we could determine if there was indeed more inflammation in the hock than the radiographs were telling us, and also to see if there was something else going on. Over the past year this horse has had a hoof abscess and a slight SDFT injury from trauma in his right hind, an osteochondral fragment removed from his right hind fetlock, as well as the diagnosis of arthritis in his right hock. He has been blocked, reblocked, flexed, poked and prodded enough to last both of us a lifetime. They also blocked out and radiographed his stifle to eliminate that as well. Instead of subjecting him to further blocks, we felt that the bone scan might be a better way to go. As we have peeled away the layers, we are still left with this chronic, mild lameness that we cannot seem to get rid of. If he is not vastly improved tomorrow when the vet comes out to look at him, we will reblock the hock in a couple of weeks. Because of the difficulty we have had with reactions to the injections, I think we were trying to avoid going back in there again. But if we have to, so be it. Don't worry, Caymann is on a joint supplement called Reitsport HA. It has higher than normal amounts of chonDrOitin and glucosamine as well as HA in it. I know the jury is out on the oral HA, but I figured it wouldn't hurt him to have it in there. I am going to read your article on arthritis again . The one thing I can say with certainty is that we know we have some arthritis in his right hock. Perhaps it will help restore my sanity. I think that Caymann has both the surgeon and I feeling a little nutty........... Stay tuned, Mary |
| Member: Caymie |
Posted on Tuesday, Jan 17, 2006 - 11:39 pm: Hi Cathy,Hopefully, your horse's fusing is progressing and will eventually result in a sound boy. In watching Caymann go through all of this, it is indeed amazing to me how horses cope/compensate for pain in their bodies. One of the reasons I love this site so much is the opportunity to hear about other's experiences. I find it fascinating, as well as very helpful and encouraging. The vet is coming tomorrow-I'll let you know what happens. And certainly even if the SI joint does prove to be part of the problem, your information on the cunenan tenectomy may be helpful to me in the future. Mary Mary |
| Moderator: DrO |
Posted on Wednesday, Jan 18, 2006 - 7:38 am: Thanks Mary, I will be watching.DrO |
| Member: Caymie |
Posted on Wednesday, Jan 18, 2006 - 4:27 pm: Hi All,The vet came out today and couldn't believe the improvement in my horse. In the week since we brought him in from pasture rest to paddock rest, he has improved dramatically. He is no longer dragging his right toe, which he has done consistently throughout this entire time. He looks really, really good on a circle, the remainder of the lameness is seen only on the straight away. We are going to continue resting him for another week or two. I am going to start him on Bute tonight, and will continue with that until a few days before the surgeon sees him in a couple of weeks. Interestingly enough, I went to a talk last night given by a vet who is now at the Orthopaedic Center at Colorado State University. His research focus is SI injuries/back pain in horses. He actually came over and examined my horse a few weeks ago, prior to his hock injections. He told us that approximately thirty percent of SI problems/lamenessess also have a concurrent hind limb lameness as well. They are just starting to try and explore this relationship. I am convinced enough at this point to continue to rest him until the surgeon takes a look at him in two weeks. I guess normally after an SI injection, a minimum of two months rest is required. I'll keep you updated. Mary |
| Member: Angel77 |
Posted on Sunday, Jan 22, 2006 - 3:29 am: Dear Mary,During my horses bout with hock problems for the first two years I had them injected. It seemed to help but not as much as the supplements I found through friends and different show barns. I did a lot of research on hocks and how to help strengthen and prevent problems in the future. I realize we have two different stories between our horses being that mine did not have a reaction to the injection as yours did. And it sounds like your horse may have more of a severe problem then did mine. For three years now I have been using Legend, Cosequin,and Rapid Response T(www.amerdon.com). I have now stopped the Legend and the Cosequin recently as the Rapid Response people told me I really did not need to continue either the Cosequin or the Legend as long as I am using Rapid Response T. I guess I was trying to cover all the bases and ended up in over kill. But something worked. In any case my horse has been sound ever since. It was not that he was really lame just slightly off apparently enough to warrant injections. The xrays showed a degeneration of his left hock more than the right. Two years later his xrays were normal and better than the first xrays. He can jump gymnastic lines of 4-5 fences at 3'9 oxers and he will be 12 this year. Even though he is bilaterally blind as of June 2005. There are so many supplements on the market these days one practically needs a degree to choose from the various products. I thought I would share with you what works for my horse. That would be Rapid Response T. I have no affiliation with this company. All I know is my horse is happy, healthy, stronger than ever, and full of jump. Good luck. God bless all the animals and the people who care for them. Sincerely, WTG |
| Member: Caymie |
Posted on Sunday, Jan 22, 2006 - 10:35 am: Hi WTG,Actually, as it turns out, we may have successfully treated my horse's hock with the injections. Due to the marked improvement in his lameness post SI injection, we now believe that this remaining mild lameness is most likely not coming from his hock. He may in fact have less of a severe problem than we had thought. It will be interesting to see what happens over the next couple of weeks. However, I too am a big proponent of using a joint supplement and would obviously like to keep the need for his hock injections to a minimum. I have my horse on a supplement called Reitsport which has much higher than average amounts of chonDrOitin and glucosamine in it. He also receives monthly Legend and Adequan. I will check out the website of your supplement. I actually read something recently about it, as I remember the publication recommended not giving up on using a supplement until trying Rapid Response. I think they had had some success using it with difficult lamenesses. You and your horse must have a very special relationship to be able to continue jumping together with his vision loss. Thanks for the info- Mary |
| Member: Aannk |
Posted on Monday, Jan 23, 2006 - 1:33 pm: WTG,I looked at the product, and only saw Glucosamine listed. It didn't say how much per serving either. Is that all it has joint wise? No chronDrOitin or HA? I give my mare Hyaluronex which is a HA oral supplement. She is fine on it, but I never saw a big difference when she went on it. She is weak in the hind from EPSM and is a bit hocky, but not bad at all. She has had two hock injections in 6 years, and I see a slight improvement with them, but not large. I guess I want to know more about the ingredients before I would go with a different supplement. Dr. O. I do know that it isn't proven that oral HA works, but I have spoken to so many folks who this worked for, I figured it was worth a try. Alicia |
| Member: Angel77 |
Posted on Monday, Jan 23, 2006 - 10:14 pm: Dear Mary,I am so glad to hear Caymann is doing so well. I have heard of Reitsport from this website. People say they can see a difference in their horses and that is great. I always say whatever works for your horse, stick with it. As horses have various individual needs, different supplements can produce different effects for each horse. There is a group out of San Diego, Calif who are currently lobbying the government to make companies producing supplements pass some kind of FDA (or equivalent) approval. Should be interesting to see the out come. So glad to hear your horse is better. Sincerely, WTG |
| Moderator: DrO |
Posted on Tuesday, Jan 24, 2006 - 7:31 am: WTG I have moved the above relevant discussions about the email problem to hereto Member's Services: Suggestion Box: Ideas and Critiques: Post Your Ideas and Critiques Here: Have quit receiving emailed discussion posts.DrO |
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