Broken coffin bone, bone spurs, lightening of navicular. Osphos - good for 2....

But what will it do to bone spurs?

This is a bit of a long story, so bear with me, or skip to the end and read the summary (in bold).

My upper level jumper is a TB with stereotypical TB feet. We’ve come up with a plan for shoeing that has worked quite well for the 7 or so years he’s been doing the 1.40m - 1.50m jumpers, and he’s been remarkably sound during that time. Horse will be 16 this coming year, so he’s no spring chicken. Currently sound.

This summer my farrier came out and did the horses the week before a set of 3 shows in a row. Over the next few days this horse became mildly and inconsistently uncomfortable acting on his LF when it was on the outside of a small circle or tight turn.

My suspicion was that his toe nails were bothering him. We had switched to copper nails a couple of cycles prior and the difference it made in his foot quality was surprising. My farrier had commented during that most recent shoeing that it was the first time he’d ever been able to truly clinch the nails in that horse’s feet. Long story short, we reset the shoe with 4 very low nails midway through the week of show 1 (and scratched everything). It took another week, but the horse got progressively better from that point onward. For week two of the set of shows he felt great on the flat, but was still pulling to the right over jumps (only did small jumps in the warmup during that time to gauge how he felt). Midway through the week he started feeling normal over the jumps again so we did the GP at the end of the week and he felt normal. Week 3 we went back to the FEI classes (he passed the FEI jog) and he did a full set of Welcome Open/GP/GP that week.

He definitely didn’t feel “stellar” in the big classes. But he didn’t do anything particularly odd, just had a few rails in each class, and I didn’t suspect anything out of the ordinary…or IOW, it seemed like one of those horseshowing weeks where we just weren’t “on it.”

Fast forward through the fall and up to this week. 2 more shoeings in that time and again he’s had issues with the LF medial nails (we narrowed it down to only those nails bothering him). Had a vet come do x-rays so we could see what we’re dealing with and…(drum roll)…

Looks like there’s a recently healed fracture in his coffin bone in the medial wing down in the toe. Vet’s estimate is that he was likely dealing with it within the last few months. :eek:

Our assumption is that August is a reasonable guess given that it’s the only time he’s ever been lame on the LF. If we’re correct, he jumped around that month with a broken coffin bone. He was very clearly diving right to avoid landing on his LF during the acute phase. After that it was business as usual. To make me feel like a complete and total schmuck, he received zero bute in that timeframe because of FEI rules.

We also discovered that he’s got pretty big bone spurs on the lateral side of the navicular bone in both front feet. Vet’s comment was that “those don’t usually mean nothing.” Also, he mentioned there is some lightening of the navicular in the RF.

So now with that background laid out, the vet’s suggestion (quick side note that this is not my normal vet - she has recently started farming out the x-rays) is to do a round of Osphos.

So here’s my real question:

TL;DR - Horse jumped around a show or two with a broken coffin bone (unbeknownst to us). Still sensitive to medial nails in that foot (the nails that go right over where the break was). Vet suggested Osphos. Complicating the suggestion (in my brain) is the presence of navicular bone spurs.

Will the use of Osphos impact the bone spurs at all? The idea of giving the horse something to help bone develop/mineralize worries me in the presence of not insignificant bone spurs. Recommending vet hemmed and hawed a bit and didn’t answer the question.

My vet is not an immediate fan of the Osphos suggestion, so is researching and I’m waiting to hear back from her. So while she’s talking to her colleagues I thought I’d put it out to those of you here who have experience with any of the above issues to see what collective wisdom COTH can provide while I wait for my vet to come back to me with her recommendations.

On a relatively random side note, the vet who suggested the Osphos said that there are really no downsides to it. But the last time a vet said that to me it was in regard to omeprazole usage, which led to a couple of bad colic episodes to the tune of about $10k in vet bills before we figured out that my guy couldn’t tolerate long-term omeprazole use. So I fully acknowledge that I might be a little gun shy to the idea of “drugs that really don’t have a down side.”

Osphos can definitely cause colic, so there’s that. I know that my boss feels that it can stress the horses a bit and times it carefully (although AFAIK none of them have had colic issues at this point.) That said, she is a big believer in it and all of the UL horses got it once or twice this year as part of their regular maintenance. Bone spurs causing osteoarthritis are one of the conditions it’s indicated for.

Decades ago we had an 8 year old that had a crack on the front of the coffin bone on x-rays.
He was a bit off on and off, why we had the vet look at him.

We don’t know when it happened, we had just bought him and was sound when we did, but may already have been there then.

It took a good three months before that was healed.
The vet said just turn him out and recheck every month to see where we are and that is what we did.

He healed fine, developed an abscess at the end of that time in that hoof, from that remodeling, as per the vet and never again had trouble after that.

Maybe your horse will also heal without trouble.
Our vet said, for that break, the hoof was as good a cast as we could have.

Don’t know on the Osphos and side effects, that would be hard to use, when he is already healing on his own and your vet is tentative about it.

Maybe ask your vet about doing a regional perfusion of Tildren. It’s a low dose delivered locally and so the systemic side effects (e.g. Colic) are much less likely. I don’t have an answer on the spurs.

My guess, the spurs would only be relevant if they are where they impinge on the function of the joint and/or soft tissues there.

Depending where they are, maybe they don’t bother anything?

No exact answers for you, but I had a similar situation, but it was the fetlock partially broken on the hind end, jumping around the A/O at 3’6" hunters. Was missed by one vet, when found the vet recommended either osphos or Tildren, I can’t remember, as he felt it had never healed properly. Took her home (she was in another state), had my equine hospital look at it (who the other vet also had recommended to do the infusions), and they felt there was other damage - MRI later, and yes, she had ligament damage in the same leg, likely from compensating. So we ended up not doing the osphos because of the other damage, and did stem cells. She seems to be sound, but we made the choice to retire her to broodmare and she is just ridden for fun.

A friend of mine, a barrel racer, had her 17yo 1D horse fracture his coffin bone. And his was displaced. The did not do any of the osphos or tildren, instead did proper shoeing, rest, and a very long rehab, and now he is back running the same as he was before.

No good insight but sorry your fellow is having a hard time, PNWjumper. What a trooper he must be!

No suggestion for you, just a comment on my experiences. My mare was on/off lame and x-rays indicated some bone loss in both navicular and coffin bones. Did a regional perfusion of Tildren, which didn’t do much. Then a few months later, Osphos which definitely helped. She’s been sound with Osphos injections every six months. Re: colic w/ Osphos, she had slight discomfort for a few minutes, but kept her walking and no other problems.

Ugh that sucks. No personal experience but I think it might be worth calling a major vet hospital for a second opinion, given what a valuable horse this is and the fact that there are multiple complex issues. What a trooper!

This is off topic, but PNW, I’m wondering about the colic related to long term omeprazole use. I am not aware of this. What is the relationship?

I have done osphos on a horse with intermittent lameness that could not be diagnosed directly other than perhaps some slightly odd xrays that were not definitive answers. I believe it helped him. You do have to observer them for 90 minutes to ensure they don’t get colicky. My vet told me it is because of sudden change in the calcium levels in the blood (can’t remember if it is up or down) which can cause them some gas colic. My horse was lucky not to experience this side effect.

Thank you all for the information and suggestions! Very interesting to read that people are doing Osphos in the manner Highflyer mentions. After talking to my vet yesterday it sounds like our game plan is to shockwave his feet and then do the Osphos.

Bluey - the bone spurs are in a place that per the vet “don’t look like they wouldn’t affect him,” but with that being said, he hasn’t had issues up to this point, so it may just be “one of those things” that doesn’t actually cause issues despite looking like they should.

Fordtraktor - Oh my gosh, yes! I feel terrible that I made him jump around on his foot and am absolutely blown away by his heart and the amount of try he has to never stop at a jump with me…not even in the acute phase of the injury when he was trying so hard to not land on his LF foot! I mean seriously? If ever there was a reason to stop, that’s it!

EmilyM - short story is that we suspect that with my guy the long term omeprazole use (we were on month 4 or 5 of a maintenance dose) shifted the balance in his gut to cause a lot more stress on his hind gut (presumably because of the decrease in stomach acid) and led to hind gut ulcers which in turn let to Right Dorsal Colitis and two bad gas colic episodes before we figured it out and pulled the omeprazole out of his diet. He’s been fine in the 3 years since, as he was for the 7 years prior to the incident. It was scary, and particularly because the vet hospital in his second visit kept telling me that it “couldn’t be the omeprazole” and refused to take him off of it.

Longer version of the story is here: http://www.chronofhorse.com/forum/showthread.php?369237-Hind-gut-ulcers-colitis-right-dorsal-displacement-and-all-it-entails

The way later P.S. is that I still use omeprazole when we go to shows, just never for more than a couple of weeks at a time.

I tried Osphos for sidebone, no luck there. But my horse didn’t have any discomfort from the Oshpos.

It really would be nice if they could talk and tell us these sort of things. Don’t beat yourself up too much; those are very mild symptoms for a fracture and many, many people would miss it. Really; the pulling to the right could have been so many things before it was a coffin bone fracture. Sorry about your guy… you’ve shared pix of him on COTH over the years and I have to say I just adore him. Jingles for a smooth and uncomplicated recovery.

We’ve used Osphos at the barn I managed the same way Highflyer mentioned, but it was also used to treat a horse that had a really bad case of navicular. I did not have any issues with it, but we always kept banamine & vet on hand – we’d have the vet do the “Osphos horses” first on the vet rotation and then do the routine stuff; that gave us about ~2 hrs where the vet was still on the farm in case there was an episode. It really seemed to help the navicular horse; we noticed changes in comfort almost immediately.

re: bone spurs… IDK if they would worry me given his age and the fact that up until the coffin fracture, they never caused issues. I’m a firm believer in not putting too much stock into the x-rays on an older horse that has up until that point not complained. They don’t read the x-rays!