Coffin Bone Bruises??

[gotjump1027]

Does anyone have experience with this? Shoeing suggestions?

MRI was done at beginning of May, RF coffin bone bruise. Horse was barefoot on stall rest for 2 months. Previously in pads with equipak since he came up sore in April.

We tried sigafoos with pour in pads and he got worse lameness wise 2/5 circling. He was 98% sound when we took the sigafoos off.

Trying just regular steel with rolled toe and shoe ground down to attempt to improve breakover.

What else can we do? MRI report said back to work in 60-90 days. We are at 4 months now and haven’t been able to even turn out.

[largo]

One of mine had this a few years ago, or something similar although I did not MRI. We treated it similarly. We injected the one coffin, gave time off (a few weeks), and shod with bar shoes w/ rolled toe in front with equipak.

[gotjump1027]

@largo

One of mine had this a few years ago, or something similar although I did not MRI. We treated it similarly. We injected the one coffin, gave time off (a few weeks), and shod with bar shoes w/ rolled toe in front with equipak.

I’m just feeling like I’m not doing enough for him! We did inject coffin joint in April with steroids and I just did prostride in the coffin joint and navicular bursa at the end of June.

How long was your horse off? Did you do primarily stall rest?

[Peggy]

Bone bruises can take some time.

Did the MRI show anything else? I ask bc you said you injected coffins and NB.

My horse stepped on a rock at a show a year ago May. We thought he was just footsore at first at the show bc it resolved with packing his feet. Did MRI ultimately that showed bone bruise, collateral ligament damage, and something strange looking with the DDFT, all lining up to the divot on his foot from the rock. Treated all three–OsPhos for bone, coffin joint injection with ACS for CL/DDFT. Thought was that he’d come sound sooner, rather than later, if it wasn’t the DDFT. Which he did, though it was 5-6 months from the time to injury to when he was back in full work. Started feeling funky in March when we were dealing with non-stellar footing due to rain plus Covid. Ultimately did another MRI that showed pretty much the same things as before, but now the DDFT was specifically in the navicular bursa area. All described as mild and both vets seemed to think “no big deal.” At beginning of June repeated OsPhos, injected coffin joints and NB with ACS because I still had some left over. Vet seriously thought horse would be fully back to work by now. Horse felt amazing when we started back to work, but deteriorated. Did shoeing rads and now shod to keep medial-lateral balance better. Sound on lunge, off under saddle. Two weeks ago re-injected NB with PRP which is vet’s usual go-to for this. Instructions are to tack walk for two weeks and see what we have. That will put us at the end of September, which would give us 2 or so decent months to bring him back into work if he’s sound. I’m not convinced what I will do either way: will probably depend somewhat on what’s going on with feet/angles at that point.

My vet is a big believer in movement and that tack walking is generally OK in situations where hand walking is an option. Depends on the sanity of the horse and the ability to find someone willing to sit on the horse and walk it. So mine gets tack walked by me 30 or so minutes five days a week and hand walked by the barn twice on the days I don’t ride and an additional time on three of the days I also tack walk. Otherwise, he’s in a stall.

[Elouise]

Bruises do take a long time (I personally had one in my hand and it’s now 8 months later and I still get ‘tings’ of discomfort ) and many horses do not like the pressure of Equipak. Now, add the pressure of Equipak on your poor horses bone bruise and I think you set yourself back a few weeks; perhaps the Equipak was just ‘pissing off’ the bone bruise by putting some pressure on it. My favorite blacksmith always said about shoeing a horse ‘the simpler, the better’ and I have never been a fan of Equipak, but there is some logic behind it in this situation.

Did you do any anti inflammatories? Was there any mention of Tildren or Osphos? Was there any talk about how to start your horse back up? My vet advised me to start my horse back up on the softest ground (grassy sand) I could find at the 90 day mark, but we did two weeks of bute and Osphos.

[largo]

@gotjump1027

I’m just feeling like I’m not doing enough for him! We did inject coffin joint in April with steroids and I just did prostride in the coffin joint and navicular bursa at the end of June.

How long was your horse off? Did you do primarily stall rest?

I forgot to add, we actually gave him time off twice. It’s been awhile, so I forgot.

Initially we gave about a month off (hand walking on soft footing), we brought him back to work but was still a bit unsound with that leg to the inside. I believe after that we gave him a whole winter off, probably around 3 months. When we brought him back we were careful to keep him on soft footing for a couple more months after that.

It just takes time!

[Mayaty02]

Our horse had bone bruising as well in this area. It took time, about 2-3 months for us though, and he was turned out in a very small paddock the entire time. Every time we tried pour in pads on him for at least a year after, he turned up dead lame. Pulled the pads out, much better if not 100%. I’d say keep doing what you’re doing but don’t bother with the pour ins or even pads. We use rim pads.

[gotjump1027]

@Peggy

Bone bruises can take some time.

Did the MRI show anything else? I ask bc you said you injected coffins and NB.

My horse stepped on a rock at a show a year ago May. We thought he was just footsore at first at the show bc it resolved with packing his feet. Did MRI ultimately that showed bone bruise, collateral ligament damage, and something strange looking with the DDFT, all lining up to the divot on his foot from the rock. Treated all three–OsPhos for bone, coffin joint injection with ACS for CL/DDFT. Thought was that he’d come sound sooner, rather than later, if it wasn’t the DDFT. Which he did, though it was 5-6 months from the time to injury to when he was back in full work. Started feeling funky in March when we were dealing with non-stellar footing due to rain plus Covid. Ultimately did another MRI that showed pretty much the same things as before, but now the DDFT was specifically in the navicular bursa area. All described as mild and both vets seemed to think “no big deal.” At beginning of June repeated OsPhos, injected coffin joints and NB with ACS because I still had some left over. Vet seriously thought horse would be fully back to work by now. Horse felt amazing when we started back to work, but deteriorated. Did shoeing rads and now shod to keep medial-lateral balance better. Sound on lunge, off under saddle. Two weeks ago re-injected NB with PRP which is vet’s usual go-to for this. Instructions are to tack walk for two weeks and see what we have. That will put us at the end of September, which would give us 2 or so decent months to bring him back into work if he’s sound. I’m not convinced what I will do either way: will probably depend somewhat on what’s going on with feet/angles at that point.

My vet is a big believer in movement and that tack walking is generally OK in situations where hand walking is an option. Depends on the sanity of the horse and the ability to find someone willing to sit on the horse and walk it. So mine gets tack walked by me 30 or so minutes five days a week and hand walked by the barn twice on the days I don’t ride and an additional time on three of the days I also tack walk. Otherwise, he’s in a stall.

Thanks for your insight! So happy to have others in my situation.

The MRI showed no damage to anything, just the bone bruise and a lot of inflammation in the whole foot which is why we decided to treat the NB as well. So I was really hopeful that he would come around rather quickly. At least to being turned out. My vet did suggest tack walking but unfortunately this horse is particularly naughty while not in full work so it’s not an option right now. (Although I may vest up and try for it) he is getting 30 mins-1hr a day turn out or hand walk in an indoor. I did not do osphos simply because the whole process makes me a bit nervous and this horse is only 5. It does seem like everyone is recommending that so maybe I should have.

[gotjump1027]

@Elouise

Bruises do take a long time (I personally had one in my hand and it’s now 8 months later and I still get ‘tings’ of discomfort ) and many horses do not like the pressure of Equipak. Now, add the pressure of Equipak on your poor horses bone bruise and I think you set yourself back a few weeks; perhaps the Equipak was just ‘pissing off’ the bone bruise by putting some pressure on it. My favorite blacksmith always said about shoeing a horse ‘the simpler, the better’ and I have never been a fan of Equipak, but there is some logic behind it in this situation.

Did you do any anti inflammatories? Was there any mention of Tildren or Osphos? Was there any talk about how to start your horse back up? My vet advised me to start my horse back up on the softest ground (grassy sand) I could find at the 90 day mark, but we did two weeks of bute and Osphos.

We did equiox for a month back in June but now nothing since he is getting hand walked. My vet recommends tack walking but unfortunately not possible with this particular horse. He is also on BoneKare and Triacton. I guess I should have done the osphos but quite frankly was a bit nervous to do in on a 5yr.

[gotjump1027]

@Mayaty02

Our horse had bone bruising as well in this area. It took time, about 2-3 months for us though, and he was turned out in a very small paddock the entire time. Every time we tried pour in pads on him for at least a year after, he turned up dead lame. Pulled the pads out, much better if not 100%. I’d say keep doing what you’re doing but don’t bother with the pour ins or even pads. We use rim pads.

Thanks so much for responding! I think I’m going to steer clear of the pads from now on. What type of rim pads do you use?

[JenEM]

Went through this about a decade ago with my mare. Vet and farrier spoke directly, so I don’t know all the details on what exactly was done with the shoes, but I know there were bar shoes, pads, and equipak involved for several shoeing cycles. The horse was on stall rest for a while, then on limited (small paddock) turnout for a while, then a gradual return to work. It actually took longer to rehab from that than it did from colic surgery.

[Peggy]

@gotjump1027 The bisphosphonates would also make me nervous in a horse that young. I don’t know if a regional perfusion would be any safer, though likely not as it would probably still impact the whole foot.

[foursocks]

As others have said it might just take more time than you think or want, unfortunately. Mine had a (non-coffin bone) bone bruise in his LH from smacking his pastern into a heavy pasture gate (he was being stupid with a neighbor, of course), last fall. He was off from November to March, most of that time on stall rest and the rest in a small paddock. It was extremely painful for him, although after about Week Three of stall rest, even with ace and reserpine, he was not above leaping straight up into the air and other dramatics during our hand walking sessions on the grass. Dummy.

Luckily nothing else was involved, but there was a ton of remodeling in the area; an injection of Osphos really seemed to help calm everything down. He is sound and back to the stripey poles again, thankfully. I was surprised at how long it took for him to come sound and for everything to get back to stable on the rads. My farrier didn’t do anything special for this, but it was on his pastern, not the coffin bone.

[gotjump1027]

@foursocks

As others have said it might just take more time than you think or want, unfortunately. Mine had a (non-coffin bone) bone bruise in his LH from smacking his pastern into a heavy pasture gate (he was being stupid with a neighbor, of course), last fall. He was off from November to March, most of that time on stall rest and the rest in a small paddock. It was extremely painful for him, although after about Week Three of stall rest, even with ace and reserpine, he was not above leaping straight up into the air and other dramatics during our hand walking sessions on the grass. Dummy.

Luckily nothing else was involved, but there was a ton of remodeling in the area; an injection of Osphos really seemed to help calm everything down. He is sound and back to the stripey poles again, thankfully. I was surprised at how long it took for him to come sound and for everything to get back to stable on the rads. My farrier didn’t do anything special for this, but it was on his pastern, not the coffin bone.

I’m just relieved that it’s not just mine taking a long time. I was getting nervous after he was not better within the time the radiologist gave me.

Thankfully, he has never been that painful. Always sound on straight and circling right but he has been off circling left.

So far nothing is visible on rads. All WNL. We just retook a set to check balance on Friday.

[Mayaty02]

I forgot we did also do Osphos, but our horse was 8 at the time. Our horse goes in Tenderhoof shoes now.

[IPEsq]

I did regional perfusion of Tildren on mine at around age 6 due to pedal osteitis. The dose is much lower with that administration though of course it doesn’t completely stay in the one area. Might be an option.

Having had a couple of bone bruises myself, they can take many months. Last one I had in a non-weight bearing area (shoulder) diagnoses by MRI took 9 months before I was pain free.

[gotjump1027]

@IPEsq

I did regional perfusion of Tildren on mine at around age 6 due to pedal osteitis. The dose is much lower with that administration though of course it doesn’t completely stay in the one area. Might be an option.

Having had a couple of bone bruises myself, they can take many months. Last one I had in a non-weight bearing area (shoulder) diagnoses by MRI took 9 months before I was pain free.

This looks like something to explore with my vet. How old is your horse now? Still competing?

[tabula_rashah]

Not a H/J rider but my Morgan mare bruised her coffin bone several years ago. It turned into basically a dead spot on the coffin bone that started to break up into little fragments which worked themselves out of the hoof by way of abscess at the coronary band. Vet didn’t feel like surgery to remove the pieces was our best option so we did a lot of heavy duty antibiotics, a lot of farrier work and a lot of xrays. It took about a year for her to be 100% sound- most of the year (unless she was 3 legged lame) she was turned out 24/7. She is now actively competing in endurance again and trots out sound for miles on any type of footing. I’d say leave it alone and give it some more time, you cannot rush proper healing.

[IPEsq]

@gotjump1027

This looks like something to explore with my vet. How old is your horse now? Still competing?

He would have just turned 10 …I lost him to colic over the winter. He had a variety of other problems that kept us from competing much, but this one had resolved. And his other issues were not related at all to the Tildren use, so I think that treatment was successful in his case without adverse effects. But of course it was a different bony problem, so for sure check with your vet.

[gotjump1027]

@IPEsq

He would have just turned 10 …I lost him to colic over the winter. He had a variety of other problems that kept us from competing much, but this one had resolved. And his other issues were not related at all to the Tildren use, so I think that treatment was successful in his case without adverse effects. But of course it was a different bony problem, so for sure check with your vet.

Oh no, so sorry to hear that!!