Bone cyst, arthritis in fetlock

[Alliekat2012]

Last year it was EPM…now this. I am posting the summary from New Bolton Center because it is too many big words for me to try to decifer. Sorry so long. This is my 6 yr old AQHA mare. We do the Hunter Under Saddle…not a fence horse.
She started with just a very mild short striding in right front.

X-ray findings:

RIGHT FRONT FETLOCK: A small, circular area of subchondral lysis of the
dorsal articular surface of the medial condyle of the distal third metacarpal bone
was present. There was also a small area of subchondral lysis at the adjacent
aspect of the medial aspect of proximal P1. There was evidence of moderate to
severe arthritis of the right front metacarpophalangeal joint characterized by
periarticular osteophytosis.

CT scan findings:

Robotic Computed
Tomography
To gather more information regarding the extent of bony injury within the
metacarpophalangeal joint, a standing robotic CT was performed under
sedation. This revealed more obvious lysis of the subchondral bone of the
dorsomedial aspect of the medial third metacarpal condyle and a very small
fissure of the lateral metacarpal condyle, in addition to slightly larger
subchondral bone lysis of the mid-aspect of proximal medial first phalanx than
was observed on radiographs. There was additionally evidence of moderate to
severe osteoarthritis of the right front metacarpophalangeal joint, and cortical
thickening of the proximal to mid-aspect of the medial third metacarpal bone
(likely secondary to the mare’s conformation).

Diagnosis

1. Subchondral bone injury, dorsomedial third metacarpal condyle
2. Subchondral bone injury, medial proximal first phalanx
3. Osteoarthritis, right front metacarpophalangeal joint
4. Osteoarthritis, right hind proximal interphalangeal joint

Summary:

Summary In summary, diagnostic imaging including radiographs and standing computed
tomography revealed subchondral bone injury of the right front fetlock (both of
the third metacarpal bone and proximal first phalanx), with secondary
inflammation and osteoarthritis of the fetlock joint. Options for treatment of the
lesions within the right front fetlock include surgical debridement of the
dorsomedial subchondral bone lesion of the third metacarpal bone, though
unfortunately the lesion within the first phalanx is not accessible surgically for
debridement. The prognosis for return to work after this surgery is uncertain,
however, would give the mare a chance to return to work. Surgery would
require a prolonged (at least 1 year) period of rest post-surgically.

After discussing these options, it was elected to proceed with arthroscopic
debridement of the right front dorsomedial third metacarpal condylar lesion.

Surgery is scheduled for Dec.10th. So my question is…any oral supplements (OCD Pellets, Osteon, Smart Pak options) that may help during her recovery? Particularly with area of the first phalanx that cannot be surgically debrided??

Thanks in advance for any ideas/opinions.

[Zu_Zu]

no advice just sending

Jingles & AO for your mare ~

((hugs)) laced with strength and patience for you during this long and difficult time period ~

[IPEsq]

I think I’d just look at recovery and rehab nutrition generally since this will have such a long recovery time. So, if you have to cut feed, make sure to give enough vitamins, minerals and amino acids. I’ve used Osteom a few times and am not sure how much it helped but it didn’t hurt, and it’s relatively inexpensive. If you can give fats without a weight problem, I would also give a higher omega 3 fat during this time as well.

I wonder if something like Legend may also be worthwhile?

[spencerlucy]

OP - how are things now? My gelding was just diagnosed with similar findings in his RT hind fetlock however due to the location surgery was not presented as an option so I’m interested in learning more about supportive care.