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Coffin Joint OA?

Horse Care
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#1

I am struggling a bit with my gelding at the moment and wondering if anyone has any similar experiences. He showed up lame right front on the lunge one day, so we took rads and noted that his angles were off. His right front heel was lower than left front, and he had some coffin OA changes in the right front as well. We opted to have my farrier put a thicker pad on the right front to fix the angles. He was sound for 4-5 days, and now has been on-and-off lame since. We were initially thinking if he was lame still after the shoe fix that he would need coffin joint injections-but the fact that his lameness is so inconsistent is worrying to me.

Has anyone had a horse with coffin joint OA requiring injections that didn’t have consistent lameness prior to the injections? One day, he will look totally fine. The next day he will be back to head bobbing. Vet is coming out in a few days, but just hoping in the meantime to hear about others’ experiences with this.

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#2

How old is your gelding?
How long have you had him?
You said the vet did rads. Did the vet do any nerve blocks to isolate the location of the lameness?

My ol’ Red would have inconsistent lameness on his front feet. He has navicular. Now, he never had bony changes until later in life, but obviously the soft tissue was still affected.

When horses have pain in BOTH front feet (which may be true since yours has xray changes on both front feet) they will often be inconsistent because they’ll limp on whatever foot is hurting worse than day; even though both may hurt.

The nice thing is that there are so many options for injections now besides steroids that can be very effective to control inflammation associated with arthritis, such as Alpha2 and ProStride (IRAP, PRP), etc.
I would even ask your vet if Osphos would be a good choice.

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#3

He is turning 11 this year. I purchased him last year and his feet were terrible-we took rads when I purchased him, and put him in pads with glue-on shoes along with a quality hoof supplement to help strengthen his hoof walls (he was really underweight when I bought him and clearly had poor nutrition). Haven’t done nerve blocks yet - probably going to block him at our next appointment. The shoeing was a really obvious change that needed to happen, so we wanted to wait and see if that did the trick on its own before spending a bunch of money with further diagnostics.

He shows OA changes only on the right front, and only shows lameness on the right front as well. He never shows left front lameness-although perhaps he is sore in both and the right front is just much more prominent so we never notice the left. However when he is sound on the right front, he looks completely sound everywhere in his body.

Did you do coffin injections for your guy? I have seen mixed reviews on how well they work-I am nervous that they won’t do the trick, and I’ll end up with a second retired horse.

#4

I think this needs to be your next step. You need to be sure that’s the problem and that it’s not something higher up. Do the nerve blocks.

It is possible that only the right is hurting him. Or, the right hurts WORSE than the left so he chooses to favor that foot. They can only favor one side at a time!

Loaded question. There can be different approaches (coffin injections versus bursae) and there are a huge number of different medications.

But yes, I have historically done injections for that horse, along with special wedge shoes. Pentosan also made a world of difference for him for a few years … until it didn’t.
He has a lot of other health issues, besides his front feet and last year was the first year I couldn’t get him right. There just seemed to be something wrong with his stifles last year, so his front feet were really a secondary problem. I kinda gave up on him last year (he is 18 this year) which is okay, because his new career is KIDS HORSE and he seems to quite like putting forth little effort. :wink:

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#5

A year and a half ago, my mare came up lame on the left front. She wasn’t horribly lame, and it did seem to come and go a bit, although the lameness was always on the same foot/leg. I had a lameness specialist out who took rads of both fronts (she also flexed the hind legs and they both flexed fine). It turned out to be arthritis in the coffin joint.

That vet specifically said it probably wouldn’t be helpful to do blocks because the horse is a draft breed (ID). I don’t remember now what the reasoning behind that was, but this was/is a very highly regarded vet.

Anyway, the vet suggested both trimming changes (to back up the toes more) and ProStride. We did the ProStride in October '22, and my horse has been fine since. (I’m hoping I haven’t jinxed myself!). There were a number of advantages of doing ProStride instead of the usual joint injection and it wasn’t that much more expensive. Overall, I really couldn’t ask for a better outcome.

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#6

frog support pads helped mine

#7

We’ve got the frog pads right now! Seems to help, but not entirely. Looks like it’s going to need further intervention.

#8

Do you jump your horse? I was hoping to event this guy-I will be so bummed if I’m not able to. I obviously won’t ask him to do something detrimental to his body, but he was supposed to be my partner to finally compete with after my first gelding made it clear he didn’t like going to shows.

#9

Every horse is going to be different.

I ran barrels with my horse, and also did a little jumping. Both of those events are quite strenuous on the body. But I did what I needed to do to keep him comfortable and happy. I didn’t compete on him every weekend - I picked and chose where he liked the pens or the set up. And he got the winters off.

So I think you have some time to decide on if your horse is going to hold up for what you want, but I think you ultimately need better diagnostics first.

#10

How much did the shoeing set up change? How long have you given him in the shoes (looks like 4-5 days but want to make sure I’m reading correctly)?

He may be adapting to the new angle still - if he has had NPA for a long while, he will have compensation patterns that will (likely) “unwind” with time with the hoof at a healthy angle. It could also be that this particular pad or set up isn’t exactly what he needs. There are several ways to address a low angle and most of it comes down to the farrier and horse’s preferences (my horse prefers pour ins over DIM or other pad styles).

I do think you need to block to know for sure what is going on.

I have not had (or even hear stories of) good luck with coffin injections. Nothing bad, just no change - may as well have lit the money on fire. Same for Osphos.

#11

I jump my horse a little bit (like once every two weeks) and over very small jumps, nothing like what you’d be doing if you’re eventing.

So, I don’t know whether I’d have had such good results if I were jumping more, or competing more. There probably is a lot of variation, though, horse to horse, as one poster suggested.

Good luck!

#12

For whatever it’s worth, my old GP dressage horse had his front coffin joints injected several times in his later teen years and it did help. I would have to look at records to see how often but I think it was just 2-3 times total as needed over a few years. Nothing fancy, just the standard steroids and HA I believe. Interestingly, his LF was clinically worse but when we xrayed, the RF had much more severe OA. The vets always recommended injecting both.

I did have another horse who got coffin joint injections once (for mild bilateral foot soreness and inflammation—he had thin soles) and frankly I didn’t see a difference, so clearly it is hit or miss.

Last summer a friend’s horse got her front coffin joints injected along with shoeing adjustments and it did help but only short-term (weeks/a few months). She ended up doing a CT and the horse has enthesopathy where the DDFTs attach to the coffin bones. Now that there’s a true diagnosis they’ve been doing rest, rehab, and shockwave.

#13

you need an mri if the blocks confirm foot

#14

Not everyone can afford to do an MRI or is near a facility that has capabilities. It’s ideal, yes, but for many that’s not an option.

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#15

Going to block him this week and see how that looks and go from there. Either way he will probably get the coffin injections in addition to whatever else he needs, since the coffin OA is confirmed already.

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#16

I think that is smart, but for what it’s worth, I have known a few horses with OA in coffin/pastern joints who do not read the books about what their feet should look like, and shoeing to the xrays makes them significantly worse compared to just letting them have the feet that they have. If you feel like after injecting, it’s not getting better, you might try splitting the difference on the shoeing changes and going a little back to what his feet were looking like when he was sound.

#17

Could be for sure that he needs different shoeing again-the concerning thing is he went lame before any shoeing changes at all.

#18

I understand- I think the blocks will help you a lot but if treating the joint doesn’t fix it, it may be a situation where he just needed the joint treated and the shoeing changes are bothering him if he was sound with those angles for a long time until the arthritis started causing issues.

#19

We blocked the foot a couple of weeks ago-he was sound again with the hoof blocked. Opted to inject his coffin joint since the OA was evident in the radiographs. He was sound for about a week but is back to being off again on a circle. He feels great trotting straight lines under saddle for the most part, but a couple wonky steps here and there made me pop him on the lunge just in case and he was clearly off again. Not sure whether he just tweaked something out in the paddock (we are trying to keep it under control but he does have a tendency to romp around) or if the issue is something else still untreated.

My vet couldn’t rule out a soft tissue injury without further diagnostics, but did say the lack of any heat or swelling indicated it most likely wasn’t the case. However, it is my understanding that there could be a DDFT issue closer to the coffin bone where swelling wouldn’t be present. Looks like our next step may be an MRI…

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#20

Agreed. You need the MRI based on this record. I disagree with your vet here. I think it’s rare to see heat or swelling with these soft tissue injuries in the hoof - especially like here, where it’s obviously not acute since the lameness didn’t start in the last 48 hours.

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