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  Discussion on Weird Lameness
Author Message
New Member:
Maryanne

Posted on Monday, May 22, 2006 - 5:29 pm:

Dear Dr. O,
I have a very funny/silly 11 yr. appendix that is more TB than quarterhorse in temperament. He relaxes with me, but he tends to be flinchy when others at the barn touch him or when chiropractic work is done. He has an old "superficial" bowe(as described to me) injury to right fore. Three & 1/2 weeks ago, after a lesson in a flat field, he came in looking fine (moderate but normal sweat, was mostly willing to work during lesson, and had free lunge time in indoor ring. He doesn't engage his hind end as he should so my trainer had me work on during the lesson with lots of leg. We did a lot of walking, some trotting, moderate cantering. Afterwards his fore legs were shaking a bit, but he had a big time free lunging and was excited. He came in "fine" but was DEAD lame a couple hours later. Lameness is in the left fore. There is no heat in the leg (some edema near ankle but not much) and he does not have pain reaction when tendons are "pinched", but there has been consistent heat in the top of the hoof. He doesn't react when I apply pressure to the coronary band either. The farrier has seen him twice and says no abscess. I've been soaking daily anyway and cold hosing the leg for 15-20 minutes. I figure it can't hurt to cover the bases. Rectal temp is normal. Trainer says digital pulse is strong, but not sure how I can tell since I've never checked and have no baseline to compare to. Done the bute routine...given "SMZ" for 7 days. He was on muscle relaxers for 5 days (thinking he was crampy - and I have to say while he was still lame - he was a happy boy!) I kept him in the stall for a week and grazed/hand walked daily. He's back out at night, but still pointing his left toe in the stall. I've tried to include as much information as I can. Any idea what's going on with him? I'm not giving him any other meds now.
P.S. I just found out day before yesterday that he had no salt block in his stall - and there probably has not been one for a month - at least! Not sure if part of problem or not. Thanks!
Moderator:
DrO

Posted on Tuesday, May 23, 2006 - 9:01 am:

Hello M-A,
There is nothing diagnostic in your post about what the cause of the lameness is or even where in the left fore it might be located. I find the digital pulse often misleading as a single factor as it changes even within a horse during the day depending on conditions. We have an article on localizing lameness in the leg see, Equine Diseases » Lameness » Localizing Lameness in the Horse.

You should note I have seen 2 horses die with acute colitis secondary to SMZ administration, these or any antibiotic should not be used is such a casual manner.
DrO
New Member:
Maryanne

Posted on Wednesday, May 31, 2006 - 12:08 pm:

Hi Dr. O -
The vet was out yesterday and has diagnosed him with DJD. I was in shock, so I have to call him back with questions. Anyway, we're going to look into tildren as a possible treatment. Have you ever used? What is your opinion of this drug? If he responds to treatment, would it be safe to jump a horse with DJD? What does tildren do? I am heartbroken and very concerned about his quality of life. Any answers are appreciated. I have read your articles on ringbone.
Moderator:
DrO

Posted on Thursday, Jun 1, 2006 - 8:54 am:

What the horse can do will depend on the location of the DJD and it's severity. I am uncertain what the indication for the Tildren (tiluDrOnate) is in DJD but has been found to be effective in some types of navicular disease:

Equine Vet J. 2003 Jun;35(4):407-13. Related Articles, Links


TiluDrOnate as a new therapeutic agent in the treatment of navicular disease: a double-blind placebo-controlled clinical trial.

Denoix JM, Thibaud D, Riccio B.

CIRALE/ENVA IPC, Goustranville, 14430 Dozule, France.

REASONS FOR PERFORMING STUDY: Bisphosphonates, such as tiluDrOnate, are used to normalise bone metabolism via inhibition of bone resorption. Areas of increased bone resorption and formation are typical lesions in a diseased navicular bone. OBJECTIVES: To determine if bone remodelling changes occurring in navicular disease may be corrected with therapies regulating bone metabolism. METHODS: We designed a double-blind, placebo-controlled clinical trial to compare 2 doses of tiluDrOnate, 0.5 mg/kg and 1 mg/kg bwt administered via daily i.v. injections over 10 days for the treatment of navicular disease. Seventy-three horses, split into 2 subpopulations of recent and chronic cases, were enrolled to be followed-up over 6 months. Of these, 33 recent and 17 chronic cases meeting the selection criteria were maintained in the final efficacy analyses. Clinical examinations were videorecorded and reviewed blindly by an independent expert. RESULTS: Horses treated with the higher dose showed optimal improvement of lameness and return to normal level of activity 2-6 months post treatment. The more recent the onset of clinical signs at the time of treatment, the greater the efficacy. The treatment did not modify the response to extension and flexion tests. The lower dose failed to significantly improve the condition. CONCLUSIONS: TiluDrOnate efficacy is demonstrated in the treatment of navicular disease at the dose of 1 mg/kg bwt. POTENTIAL RELEVANCE: Our results support the clinical relevance of bone remodelling changes in the outcome of navicular disease.

We have had discussions on Tildren run a search in the discussion search engine for more on this. There have been some changes since that post with the most important being there is now a approved product in the US for humans but available to veterinarians.
DrO
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