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My heavy weight cob has been lame since May, diagnosed in…

Hi there, My heavy weight cob...
Hi there,
My heavy weight cob has been lame since May, diagnosed in June with a pedal bone fracture had quarter clips for two months ongoing, but last week after not much improvement got a second opinion.
Now it shows he has bone fragments growing behind the sesamoid bone via xRay, and scans show its within the DDFT so surgery isn't possible.
His coffin joints are effected because of the ongoing lameness and he has early stages of arthritis in his back leg. He is 7/10's lame and on 2 bute a day currently. I've been told it's very unlikely he'll ever come back into full work maybe just a walk around the block in a few months...
Just wondering your opinion
Many thanks
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Customer reply replied 1 year ago
I want to know how painful it must be for him without pain killers, is it fair to keep him retired in a field needing so much medication for pain relief as he's only 8. Will this bone growing near his tendon grow into his tendon or damage them?
I've been advised I'd be lucky to medicate it all every 3 months but it may not work. I've been told to prepare for the worst.
He's my first horse and I'm devastated but need to do what's right by him as its it fair to have him highly medicated for he rest of his life? Please help
Answered in 1 hour by:
8/30/2016
Doctor.A
Doctor.A, Veterinarian
Category: Horse Veterinary
Satisfied Customers: 323
Experience: I am licensed to practice Veterinary Medicine in multiple states, as well as Board Certified In Equine Surgery.
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Hello. i am Dr A and would love to help.

the first thing, we have to establish that the pain is coming from there. Your veterinarian will perform "blocks" at certain levels, to make sure that the mineralization in the tendon is the source of the pain. If it is, then unfortunately, medicating the tendon and/or systemic antiinflammatories are your only option. If the pain is coming from below (caused by the coffin or the navicular) then you have other options. The changes up higher at the fetlock look old, and as such i would want to make sure they are actually causing trouble.

Does this make sense?

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Customer reply replied 1 year ago
Yep he's done blocks and established that the pain is coming from the front of the leg. If I medicate the tendon and antiinflammatories would this work in terms of healing and coming back into full work? My vet believes with such a issue and the amount of lamness he's in he will only ever be a Happy hacker as in walk around the block. What do you think? Can horses come back from such a injury and how often would it need injecting?
How painful is this injury? I don't want to drag him through it all if he's in a lot of pain? 2 bute a day and he's still lame in Trot
I don't understand the comment about the fetlock? Thanks

If he says the pain is coming from the "front of the leg" then it is not from the DDFT which is in the Back of the leg.
If it is truly from the front, then we need to find out where the pain is coming from and address that! Its a good sign if its not coming from the tendon.

Calcification will not go away with antiinflammatories, but it does not always cause discomfort.
if the pain is determined to be coming from the tendon, then unfortunately he is correct, and the pain will be persistent. If on 2 grams a day, and the pain is coming from the tendon, then i would consider that too much pain.

The comment regarding the fetlock is in regards ***** ***** images you sent. The calcification is not at the navicular bone (in the foot) but up at the fetlock (ankle).

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Customer reply replied 1 year ago
From memory it looked like when he did nerve blocking he did one injection on the out side of the fetlock waited a while with no difference on the trot up, then he injected the front area waited a while and dos a trot up which did improve it from 7/10's lame to just 3/10's lame.
I think he's also tried injecting the inner fetlock too (sorry I'm trying to remember everything as I was very emotional at this point)
From the images I have sent does it show calcification in the DDFT or have I got that wrong?
How will I know of the pains coming from the tendon? I plan to do a trot up in 3 days as he will be turned out tomorrow on still 2 bute a day, if he's still lame then I guess I have my answer as to wether he'd be comfortable being retired.So many horses after having calcification ever come back into full work? Thanks

yes, the mineralization looks like it is in the DDFT (back of the leg). The blocking pattern is not clear though, and will likely need to be redone. I would start with a tendon sheath block specifically. You may need a different vet specializing in lameness if your vet is unable to do this block.

yes, some horses are able to return to work with a lesion like this, but the odds are low.

even if he shows a bit of ahead nod, it does not mean he cannot be out in pasture. Many of us have a sore hip or knee, but live every day just fine! we dont enjoy hikes, or having grand kids piling on us, but we sure enjoy life!

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Customer reply replied 1 year ago
Thank you so much for your help.
I will ask for this block specifically and go from there, I will try medicating and any treatment available and hope he can remain comfortable if retirement is an option
Is there anything else I can ask about in bullet point form? Ie treatment, name of medication etc?
That would be really helpful
Thanks

no, no particular drug. just a steroid and HA will do it, injected into the tendon sheath

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Customer reply replied 1 year ago
just to clarify if my vet can determine the pain is coming from the tendon and two bute a day isn't helping then other treatment such as steriod or HA won't work either or it's something worth trying first?
But if the pain is coming from the coffin or the navicular (however you've agreed the scans show its from the DDFT area) then that's better news and I could treat that easier with antiinflammatories
Sorry just want to make sure I get this completely right :s

I would still try it as if you dont, you will always wonder. But you are right, if the bute isnt doing it, likely the inj wont ether.

If pain is coming from coffin or navicular, treatment trial is the same, but unfortunately, the bute is also not helping there either so resolution is just as likely.

Regardless, you have to know where to treat, before you can apply treatment to even try.

Good luck!

Doctor.A
Doctor.A, Veterinarian
Category: Horse Veterinary
Satisfied Customers: 323
Experience: I am licensed to practice Veterinary Medicine in multiple states, as well as Board Certified In Equine Surgery.
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Hi Charlotte,

I'm just following up on our conversation about Merlin. How is everything going?

Doctor.A
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