Bone chip: Is my OTTB destined to be a pasture ornament? Talk me off the ledge, please!

Obviously, I don’t post very often, but I felt I needed to ask as many people as possible for their honest opinion and experience.

Here’s the story: I purchased a 3yo gelding from the track last October. He was sound at the PPE, very sound. No rads done at the time (wouldn’t make that mistake again). Fast forward almost one year later: he’s just debuted at the BN level in eventing, going really well, bright future ahead of him. Former Olympic riders–now clinicians–are asking about his pedigree and saying nice things about him.

Then, one morning this September he exits his stall with a puffy left hind leg. OK, I think, he just knocked himself. He’s 4, these things happen. Ice, rest, poultice, etc. Take him to the vet after 3 days and it hasn’t resolved, vet finds him sound, but still a little puffy and says stall rest, ice, bute. Once week later, still puffy, return to vet. Rode the night before, he was ostensibly sound. Now, at vet, he flexes 2/5 on the left hind after fetlock flexion. Vet takes rads, finds old, round, very small chip that appears to have come from the front of the fetlock and migrated around to the back. Ultrasound reveals the chip may be in the lining of the joint, but hard to tell. Inject with steroid and HA, 7 days stall rest, images sent to university vet for consult. Uni vet says no, no reason to operate, too hard to find in the synovium. Maintenance is prescribed. Return to vet after the 7 days for re-check. He’s cold, mostly tight, and sound.

After a bit of tuning up I take him to another little BN derby. He’s great, but I’m still seeing this tiny bit of puffiness, like windpuffs, just north of the joint. Vet says that’s probably normal. Leg is staying cool and he’s staying sound, so all is well. Two days ago I take him to a dressage clinic. We walk and trot, not hard, not too many circles but some, and a little tiny bit of canter–like 3 circles each way and we’re done. He didn’t break a sweat, I can say that. Next morning I’m preparing him to go x-country schooling and he comes in from pasture with one very cool right hind, and one very warm left hind. A little more puffy than usual, too. I lunge him and he looks wobbly to me. What in the actual ____!!! Call vet and set appointment for next Monday. Throw him back out into pasture. Cry a little. Trainer says he needs 6-8 weeks of pony jail (stall rest), that’s what her money is on. Who knows what vet will say.

What am I dealing with here??? Will he ever be sound again? Will stall rest really help if there’s a bone chip aggravating the joint?? Do I get a second opinion on surgery? Do I throw money at PRP and IRAP therapies? Do those things even work? Does he need to be bubble wrapped and kept in a stall for the rest of his competitive life? Please tell me some of you have had similar problems and they got fixed and now your perfect little baby horse is eventing at the advanced level. That’s all I really want to hear (OK, not really.) But seriously, what do I do? WWYD?

I’d get a second opinion on the surgery. Although they might get in there and find there’s not a lot of cartilage left, and that’s why he’s off.

In my experience, and I’ve had a few with chips, you want them out asap to avoid the chip grinding away at the articular cartilage. Once the cartilage is gone, it’s gone. If the chip is well outside the articular surfaces of the joint, NBD, but if it’s not…well, it’s just a matter of time before the horse is lame and bone on bone.

Here are some pictures of what a joint looks like with chips. This mare came off the track sound, was sound in work for awhile, and then started taking some slightly off steps and had some filling. Radiographs showed two chips in each front fetlock. Prognosis was good until they got in the joints and found deep grooving–she was bone on bone in a couple spots. She was never sound again.

Another mare of mine had one chip in a front fetlock, caught early, very light grooving, removed early, did need IRAP to be comfortable after surgery, but never had another problem on that joint.

Slightly different situation, but I had a friend with a horse that they purchased with a bone chip (knowing about it), they had it removed, and he was healthy and never had any bone-chip-related soundness issues for the rest of his life (and he lived into his mid 20s). Another situation, bone chip in the front ankle in a young mare, removed she hasn’t had issues with it since (admittedly only 3 years have passed, but she’s held up to heavy work). I echo the above thought: consider getting a second opinion on removal. If a bone chip doesn’t need to be removed, that’s great, but if it’s the source of issues then obviously removal should be reassessed (and if it’s not a candidate for removal then boo, but I think this surgery has greatly improved since I was last aware of it, so odds are decent it can be taken out?)

Fingers crossed for you!

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Here’s the rad and location of the chip. Just north of the fetlock.

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If you haven’t already, engage the services of a top surgeon to help you navigate through this situation. Local vets, generalists and trainers mean well, but they don’t see 100’s and 100’s of cases annually like a specialist. You don’t have to commit to surgery, just get the specialist on board as a consult so you know what you are dealing with.

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OneTwoMany, thanks for the suggestion. Problem is, and perhaps you can suggest a solution, the only orthopedic surgeon I know of in Oregon is the same one that doesn’t want to operate. Compared to where I came from on the East Coast, we’re practically in the sticks.

We are on the East Coast as well. Why not contact a top vet in the NE you trust, send him the rads and the medical history and see what they recommend. You are only looking for a second opinion at the moment.

If you decide to take it to the next level, you may have to ship out to a University or a specialist, but I wouldn’t go to that place in my head just yet. Get a second opinion and see where it takes you.

The vets at New Bolton are very approachable as is Rood and Riddle, Cornell, etc. So many fine options.

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His former trainer at the track gave me the name of the doctor in Washington State that does her chip removals. I have sent an email and will start there.

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I agree with the suggestion to contact a specialist, no matter where.

If the chip is causing the lameness, ignoring it is very unlikely to have a positive outcome. It may be worthwhile to really investigate, though, if the lameness IS actually due to the chip, or something else. Does the horse go sound when blocked to the fetlock?

Not for nothing - here’s my story:

June 2015 - I had a totally sound horse on Friday. Come Monday I had a totally lame horse. Had the vet out and he did rads. Declared it nothing other than arthritis and there was nothing to be done, even though I pointed out that he was totally sound two days ago. I was devastated. I was already planning on a light summer due to other commitments, so he had tons of time off. By the fall he was sound. Had a perfectly fine 20ish months.

Come June 2017 I could look at him and know he was not quite right. Since I knew my regular vet had already made up his mind, I sought the opinion of the orthopedic vet at the university vet school. He found a chip that had settled in the middle of the knee joint. Removed it, and after recovery he is fine. In retrospect, obviously what happened in 2015 was the initial chip and he was lame from that trauma. The joys of being turned out with a perpetually hormonal mare…

Moral of the story for me is - never settle for a gp vet’s opinion on a orthopedic issue with a sport horse. You might get exactly the same answer from a specialist, but maybe not.

In addition, there is also some other treatments available - IRAP, PRP, and one more that is like IRAP but is done faster that I have blanked on the name of right now - that might help if there is a joint issue that is not surgical.

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You’re thinking of ProStride :slight_smile:

Thank you!!! - it was bugging the crap out of me that I couldn’t quite come up with the name…

Bingo, sometimes chips disolve, reabsorb or migrate eelsewhere or so I’ve been told. Once had a PPE reveal a chip near the coffin bone, 1 month earlier x rays ( buyer backed out) did not show it and horse had a bit of exterior hoof wall missing that looked recent. Horse was also jumping 3’ courses soundly and frequently. Took a chance and bought it anyway feeling it was recent trauma not a chronic condition and might be worth the risk with a price reduction.

Showed it for 11 years and retired it at age 21 due to a DDFT in the other front foot. Now near 30 and failing due to effects of age, still never took a lame step on that foot.

Since your chip has apparently migrated and horse has been off on that leg, IMO you need to persue all options including second opinions from bone chip specialists.
And maybe it will migrate elsewhere too, you never know. Keep your chin-up.

Simkie, my thoughts exactly. My vet (the whole practice, actually) breeds, trains, and races TBs, so I trust and respect what they do. They KNOW Thoroughbreds. But, I worry that perhaps the chip was seen, focused on, and something else was missed. Either way, something is wrong and I need to know what it is. Because rads and ultrasound images were taken, I think it’s likely to be the bone chip, but the cyclic nature of the inflammation indicates that maybe it’s moving around, or there’s another factor in play. It’s frustrating to hear that the University vet doesn’t want to mess with it, because, while I understand his/her reasoning, I’m left without a treatment plan. My GP vet said to bring him back when/if it becomes an issue, so here we are, bringing him back, when all along I could have had him in his stall instead of continuing to train/compete. I guess I just feel like a crappy mom.

Findeight, thank you. I have a hard time believing that a bone chip will just magically disappear, but it did just magically appear, so maybe it will keep on moving.

My little mare with all the chip damage presented very much like your horse. Surprisingly, they don’t just go dead lame. I know that’s not encouraging, but if the lameness wasn’t blocked sound to the fetlock, I’d definitely pursue that line of inquiry to confirm before making any big decisions.

Simkie, noted. I will advocate for blocking out the fetlock on Monday when he’s seen again. I just now brought him in from pasture. Hate to do it, but I now have images of the bone chip gouging huge bits of his cartilage out… thanks for that :frowning:

Here’s a pic of the boy in better days…

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My OTTB that I got off the track had several chips on his knee. He had the chips removed and I did a very slow and methodical rehab. We are talking about follow to the letter rehab. He is 100% sound and only a very trained eye can see the knee had surgery on it. We didn’t jump for a long time and built up strength. He is now 9 and jumping like a pro at his new home. I had a VERY good vet that did the surgery and again didn’t rush the rehab.

SP, everyone here has given you good advice: the location of a chip will determine whether it affects soundness. Another opinion is definitely warrented for your nice horse.

My own experience involves disovering a large (big as the end of my pinkie finger) chip in a hock that we xrayed as part of a soft tissue injury workup.

This chip was very old and round like a pebble, and clear of the joint. It was never a problem for my guy ( in spite of my horrified reaction to the rads).

My horse was 10 or 11 at the time, my vet’s opinion was that he’d probably sustained the chip at 3 or 4 during his racing career but it had never been an issue. We left it alone and after rehab he competed through I-1 and got me to my USDF silver medal.

Like yours, my vet saw a LOT of racehorses, on and off the track, so he was familiar with the problems involved. Don’t give up, go for another opinion and good luck to you both!

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This might already be the vet you contacted in WA but Bob Schneider at McKinlay and Peters Equine Hospital would be a good one to contact. I believe he splits his time between the clinic in Spokane and coming over to Emerald Downs on the west side.