Ok, so. Keeping in mind that my brain is absolutely mush from being at overcapacity, and the fact that I am enjoying what I feel is a rather deserved glass of wine at the moment, I am going to do my best to explain what we think is going on. Sorry in advance for the long post, though I promise this is the condensed version. You want a summary? Skip to the bottom.
[First things first- you remember Foster’s diary that I keep? That has been invaluable during this whole process, and if your type A-ness needs an outlet and you have an accident prone horse, I highly recommend it.]
The Bone Scan
Let’s start with the bone scan. The bone scan really frustrated me at first, in that the results seemed inconclusive to little-old-not-a-veterinarian-me. Basically, the areas that “lit up” (actual term: increased radiopharmaceutical uptake) were his hocks, slightly FL navicular area (which had me saying WTF- that’s the good leg), and slightly outside cannon bone HL. That troubled FR, and really lame HR? Nada.
But from the bone scan we were able to rule out anything really active in the FR, the stifles, and the SI area (which we thought would be the problem). The hocks, after getting 2 radiologists’ opinions, are likely bone edema/remodeling and though a source of discomfort, not likely to cause the acute lameness we are seeing.
The Lameness Exam
Fast forward 3 days to tonight’s vet appointment. We had chatted yesterday about the results, and were thinking probably suspensory issue in the RH but also the possibility (though small) of neurological disease such as EPM or Lyme. So the plan was to ultrasound the leg and/or do nerve blocks to pinpoint the lameness.
We trotted him up the concrete aisle and threw him on the lunge to get a baseline lameness, and saw that the RF seems to have resolved itself, and we were still looking at a definite RH, slight LH lameness. After much discussion, we decided to ultrasound the leg first and then nerve block after (not the typical way of doing things, but I was getting anxious). But first we would block the foot just in case, since that wouldn’t interfere with the ultrasound and we could rule it out if it didn’t improve.
And what do you know, it looked better. A lot better. Now knowing that the lameness was in the foot, we could consider 3 causes:
- The palmar angle is too low and is making him extremely heel sore
- Deep digital flexor tendon injury
- Injury to any of the ligaments in and around the navicular bone
So we blocked the left hind foot, since that was also still showing lameness.
And that looked better, too.
More walking
In Summary
So, while we don’t have a definitive answer, we have a location(s) on the body to concentrate on. The vet thinks that the palmar angles in the hind feet are likely the key to all this, and so we will be doing X-Rays and having a discussion with my farrier a week and a half from now, basically as soon as we can squeeze him in. Ideally the X-Rays will confirm terrible palmar angles and we can begin with corrective shoeing to sort it out.
It may take as long as two shoeing cycles to allow Foster’s feet time to heel and react to the changes, in which time I can work him but must keep all concussion to his feet at a minimum- in other words, walk only. I can do whatever I want at the walk, which is great news to me, but trotting should be at a minimum and cantering and jumping are definitely out. If, after those 2 shoeing cycles, we bring him back in to work and he is no better or still lame, then we will have to look at getting an MRI done to determine soft tissue injury. I would also assume that if the X-Rays show awesome palmar angles, an MRI will be more quickly in our future.
I can’t tell you how relieved I am just to even know where the problem is, and even more so to be hopeful that it can be resolved with corrective shoeing. I’m actually hoping to see some pretty terrible x-rays at our next farrier appointment, and I’ll certainly be posting an update when I have it.
Until then- bring on the walk suggestions! What fun walk exercises can we do?
Red on the Right 
I was worried it was a suspensory, this seems like good news! You can do laterals and halts and spirals and all sorts of stuff at the walk 🙂 Hope those angles are jacked up and shoeing fixes everything.
I’ve gotta get my guys stifles back up into exercise (we’ve been couch potatoes all summer, and he’s moved from a boarding barn where he had tons of buddies to run with and chase to.. being alone, but still on 24/7 turnout) so we’re doing raised cavalettis at the walk and hill work all at the walk!
Also, what about teaching him to ground drive?! That might be fun.
maybe all horses are allergic to grass or something because seriously I feel like every horse in the world has had terrible issues with NQR the last year. UGH. But I hope you have a solid diagnosis and can go forward! I can’t tell you how frustrating it’s been with Wiz and not really knowing what the heck is going on or where it hurts or what to do about any of it! I’m considering just pulling his shoes and throwing him out in a field for three months and letting him figure it out. Good luck!
That sounds like SUCH a relief!!! So glad to hear it :)!!!!!
That’s not exactly good news, but it isn’t totally bad news either. Fingers crossed.
I once had a horse who was confined to walk only for a good two/three months. We had lots of fun learning how to ride reins-less, and ultimately brideless! 😀
Keeping my fingers crossed for crappy x-rays too! What a relief to finally have a path forward
Glad the news isn’t worse and that you have an plan of action. As to the walk, you could really perfect the medium walk, free walk, and transitions to really nail those parts of dressage. You could do trail class obstacles. And I’d remove your stirrups just for funsies too.
Hopefully it’s primarily his feet and shoeing changes fix the issue. Thanks for the thorough breakdown. I find the diagnostic process fascinating so it’s appreciated!
Sounds like a good prognosis. Can you go trail riding at the walk or do you have to stick to soft arena footing.
Wow it sounds like you have so much information to process and work through! It would so much easier if they could talk and tell us exactly where it’s hurting 😓 At least you have an area to focus on now and have a path forward.
What a relief! Shiloh has struggled with lameness issues frequently and it’s funny how I sometimes we sometimes pray for a hoof abscess or hoof conformation problem in hopes that it’s not a serious tendon or joint problem.
I was on vacation, but I wanted to check in on Foster! So glad you got something to go on, even if it’s not one hundred percent pinpointed. Fingers crossed it’s something as easy to fix as shoeing, and that you’ve got a good team working on it. You can join Bobby and I in perfecting the old rein back. Walk championships, here we come!
Narrowing it down is SO helpful. I’m sorry Foster has sore tootsies — him and Miles can commiserate together. I’ve been doing walk-only with Miles this month as he heals, and so far we’ve practiced: lateral work, collected / working / extended walk, walking through mud puddles and grand prix walk ground poles. Good times, haha
omg i am so late to this party, but honestly still read the whole thing with held breath anyway. that it could potentially be as simple as adjusting the angles of his feet and poof, he’s better? you must be so relieved!!! my fingers are seriously crossed that you can put all this worry and anxiety behind you after the next one or two shoeing cycles!! definitely keep us posted!