The cost is painful but you need answers and it should give you a plan and the relief of knowing that what you are doing is the right thing for whatever is going on.
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BTDT, For me and my horse it was definitely worth it. Jingles for something definite and treatable. Know that if Dr. Mitchell is not in the clinic it can take a couple of days to get his reading of the MRI.
Fingers crossed
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Totally worth it. Jingling for good news.
Late to the party but after reading the OP I thought DDFT too and had to bite my tongue until I read thru the rest of the thread… I dealt with a DDFT strain and hoof wall separation last year in my mares RF. Same lameness issues you described. There was definitely a shoeing element too as my normal farrier had retired and a new one had come on to take over resulting in uneven heels. She too was sound to walk- lame at the trot and blocked to the heel so off for an MRI she went. I was also told it was better to do the lay down than the stand up because of image quality- ultimately she was put back in her shoes with a leather pad (different farrier 
) to stabilize the hoof wall. DDFT rehab was 16 weeks hand walking and then another 6ish weeks under saddle, turnout allowed when she was cleared to jump. She made a full recovery and competed 1.20 the same year.
Jingles to you and your horse!!!
ETA- we also did a round of shock wave for her during rehab. Stem cells were an option too but we started with shock wave and didn’t feel the need to progress to stem cells.
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Has your horse had the MRI yet? I hope you will get some answers to what is causing the lameness.
To summarize a very long story - no, I cancelled the MRI appointment and decided to wait.
The vet was out on Friday to affirm the blocks before going for the MRI and the “lameness locator” indicated that he was both substantially less lame in that front and substantially more lame in the right hind.
Without being certain what we were looking for, I wasn’t comfortable spending the money on the MRI especially since the actions we could take based on it were all basically the same - rest, tack walking, and the things that we already have access to like ice, PEMF, etc.
The vet was okay with this approach.
I tack walked him today and a few steps of trot in a straight line felt almost sound - the farrier is coming tomorrow to make another adjustment to the shoes and we will just wait. He’s on pasture rest, as the vet felt that him not moving at all was not necessary, and under orders to tack walk 20 minutes a day and keep him working over his back and building muscle.
So we are just being patient right now and seeing if there is positive change over the next few weeks before blowing out for the MRI.
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Hopefully you will see improvement soon!
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Oh, also, we x rayed everything and can confirm that there is no fracture, navicular changes, etc. except for the negative palmar angle (which is improved) the hard structures all looked great.
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Damage to the DDFT can be a precursor to navicular bony changes so getting the caudal hoof healthy is going to be very important in his rehab. Is he negative behind as well as in front? Negative angles all the way around can really jack them up all over.
Here are a couple of good articles and Dr Bowker has done a lot of research in this area as well
https://www.hoofrehab.com/NavicularSyndrome.html
Don’t know what you mean by behind and in front - the front feet and hind feet or within one foot? His palmar angles are only negative in the front feet and are currently about 0 degrees, working on getting them positive without putting him on his toe.
I’m not sure what the rest of the post was about, I am aware that x rays don’t show soft tissue. The point was that there is no fracture of the coffin bone or other bony structure injury causing this.
I am asking if the horse has negative plantar(hind) angles as well as in front. You say only in front so that’s good 2 less feet to worry about. Without an MRI you don’t know if there is soft tissue damage so rehab as if you do have soft tissue damage. Did he block the right hind to localize the pain there?
The articles linked have a lot of information about building up the back of the feet and get them healthy so that you aren’t looking at bony changes in the future… I think I remember something like 85% of the navicular horses they looked at who also had MRI images had soft tissue damage before bony changes occurred. This is caused in part by negative palmar angles, toe first landings etc. because the caudal foot isn’t healthy/uncomfortable so the horse does not use it properly. Sorry if my post was confusing… when sorting out lameness I always start with the feet and work up… sore feet can cause a multitude of issues that’s like peeling an onion.
Good luck.
Based on the lameness not being localized to a finite area, I wouldn’t have done an MRI either. Generally my vets have advised getting a bone scan (nuclear scintigraphy) first to localize the area. Most of the instances of non-useful MRIs I’ve heard about have been when a bone scan wasn’t done first; the lameness source was probably not in, or not localized to, the area scanned by the MRI.
Good luck! I know all too well how frustrating this can be.
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