Bone scans for potential upper limb mystery lameness?

[luckycricket123]

I have a horse with a likely upper limb lameness that we have been unable to diagnose. After a year of trying to rehab him with my local vet and and at times the help of a lameness specialist (I feel we’ve seen some improvements in the last 3 months), I still feel like we’re stumbling blindly because we just don’t know what’s wrong.

I love this horse, I have the money and I’d be happy to invest in his recovery and diagnosis if it would help bring him sound again or even determine he’d be better off fully retired. I’ve already spent thousands on lameness exams and diagnostics from my local vet ruling out a lot of the more common injuries and I think if I could get an official diagnosis on this horse I’d feel a lot better about the amount of time (and money) I’m investing to try to bring him sound again. I know sending him out for a bone scan would be a sizeable expense, but I think I’ll end up spending more without a real diagnosis.

With my vet we’ve only been able to block and take xrays of the lower limbs. Anyways, does anyone have any insight on whether or not this could help lead me to a diagnosis? Or am I just going to be wasting more money

[Peggy]

I have had good luck with bone scans, in the sense that they have helped to lead to a diagnosis. The two lameness vets with whom I’ve worked in the last 10+ years have both gone to them pretty quickly. IMHO, you are better spending your money on that than dinking around for months paying incrementally for vet visits all while paying board and layup/training fees while not being able to fully enjoy your horse. YMMV

[joiedevie99]

Long and short answer… maybe. Bone scans are great when you are lost. Most of the time, multiple areas of the horse light up. Then you have to do follow-up diagnostics on each of those areas. If you know generally speaking where the problem is, you can skip the bone scan and go straight to MRI or CT.

[MsM]

I didnt have much luck pinning things down with a bone scan. It gave a few areas but exactly what it was and how to treat it remained a mystery.

If possible I would take a deep breath and send the horse and all his records to the best Big Clinic you have access to. They may agree with a bone scan, or suggest other diagnostics. But having a knowledgeable new specialist take a look seems the best chance to get answers.

[IPEsq]

It also depends on the type of problem. For something that sounds like it’s chronic at this point, a bone scan may or may not help if there’s not active remodeling happening. It’s not going to help a lot for certain muscle or other soft tissue problems. Best case, it will narrow down some additional areas to try to investigate with other methods. If you have a reasonably good idea of a general body part where you’ve reached the limits of blocking, ultrasound, x-ray, then you might want to go to CT or MRI for the $ spent because there’s a pretty good chance you’d wind up there anyway if the bone scan confirms your suspicions.

My personal experience is that a bone scan sent us chasing a couple of secondary, less important issues, and seemed to rule out an area we thought was a primary issue (which did later have a better response to therapy once we went full circle on things again). But it has been a useful tools for some of my friends, so I wouldn’t say it’s worthless. But since you have to follow up with another form of diagnostic after and it’s so expensive, I do question in some cases whether it’s worth the expense or if that money would be better put to a different strategy. Of course, if you have to do a CT or MRI under general anesthesia, that carries risks, and if a bone scan would push you in a different direction then that might be a risk you could avoid by pursuing the bone scan.

[EsqEquestrian]

There’s lots of really great advice here. I had my first experience with a bone scan earlier this year for my gelding that was NQR in the hind end. In my case, it did ultimately diagnose the issue, although the unfortunate outcome was that he needed to be PTS. The diseased area lit up on the scan, and we were able to investigate further with targeted x-rays and an ultrasound. I am sure my case is the extreme end of the spectrum, but I wouldn’t hesitate to do it again to know what direction to go in.

[spencerlucy]

I have also had good luck with a bone scan. My gelding also had a lameness that despite multiple vet visits, nerve blocks and all kinds of investigation was difficult to pinpoint exactly where the issue was. In his case the scan only revealed two areas that “lit up” on on both hind fetlocks. I had this done at UW Madison and they were then able to perform a standing CT on just the target area (which was surprisingly reasonably priced) to get a full picture of the issue. The bone scan was also much less expensive (by $1000) at UW Madison than at the other private clinics in the area. If I were presented with another head scratching issue I wouldn’t hesitate to do a bone scan to hopefully narrow the search a bit.

[Mayaty02]

Our horse also had a mystery lameness that didn’t block out entirely in the lower limb so after about a month of trying different things, our trainer took him to New Bolton and said, he stays until you figure out what’s wrong with him LOL. Best money spent. They did a front end bone scan and found a few areas which showed up (nothing in the soft tissue phase) which led to follow up pinpointed X-rays and a diagnosis or two. Much happier to have done that and not wasted more money playing around. Also, we feel like we have a really good handle on everything that is going on, and know how to continue to maintain him.

[Sancudo]

My TB had a mild right front lameness that would never block out from knee down. Did the bone scan- elbow OCD! Pretty rare, and unfortunately surgery did not resolve it, but at least we were able to have a diagnosis. I’m about 50/50 on bone scans and getting a definitive diagnosis from them, and this was one.