Four year old in light work, restarting under saddle after backed and lightly started at two.
no soundness issues present
bone chip found in one front coffin joint during PPE.
Will be surgically removed
But for those who have experience,
Did you stop working the horse entirely between diagnosis and removal?
What were your rehab experiences/time lines?
anything else you think I should know?
Where is the chip? My mare had a chip off the extensor process of her coffin joint (a very common impact injury). It was discovered when she was about 9 years old and I was xraying for angles for the farrier. It appeared to be encapsulated by tissue (like a pearl) and not moving. I never had any issues with it until she turned 15 and we had an accident (9/22/2015) and apparently it broke off and was floating and irritating all the tissue and bone in the area. So I had surgery to have it removed. Honestly, I don’t know how this part happened because we had so many digital and other xrays by then, but when she had the surgery, which was supposed to be arthroscopic (it is not a standing surgery), they discovered the chip was too large to remove by arthroscope and they had to perform an arthrotomy (the old way, with an incision). I sent her to a rehab facility, where they really deserve alot of credit to her recovery (getting her out five times a day, making a stall size pen for turnout on grass, putting her on a treadmill, using lasers/pemf/vibrating plate and other therapies, walking her over cavalletti eventually, etc.). She had the surgery 12/1/2015. I started riding her again (at walk, a month of walk) 7/1/2016, then added trot and then a little canter and by October 2016, she was back to work. I did do IRAP and OSPHOS and added isoxuprine to get her 100% (we’ve now found that Prostride is more effective than IRAP for her–have done OSPHOS annually). In June of 2017, I did our first show at Grand Prix dressage and by September she had helped me finish my gold medal. I have to maintain her, but she is sound. I just did four clinics and a show (five weeks in a row) and she feels and looks great.
They do end up with arthritis, so you have to maintain them and you have to be VERY diligent about hoof angles. This past winter, my farrier was late about 10 days, two cycles in a row, and she went 2/5 lame. It took 3 cycles to recover her soundness, plus a dose of Prostride.
As for riding her between diagnosis and treatment, here is the timeline: Injury (my leg was broken in two places and she had the fracture fragment detach) on September 22, 2015; I had her at a training stable and asked the trainer to ride her while I had my surgery but she was dead lame; vet tried two courses of bute and a steriod injection over a two month period before deeming that she was surgical; she was being handwalked 10 minutes a day 6 days a week during that time; surgery was December 1, 2016.
When we discovered the fragment at age 9 (I bought her as a foal and didn’t have baselines done until age 9), it was not bothering her and because of the risk of arthritis from the surgery itself, we decided to wait until it was absolutely necessary to do the surgery. YMMV on this. I certainly would be using a top surgeon to do it. There are some studies on this surgery (extensor process coffin fracture removal) and the return to full work prognosis is good (about 80%) but there is that 20% risk. That’s why we waited. Then after the surgery, I’d do everything I could to calm the inflammation (why we did IRAP, but I prefer Prostride now).
My mare is now 18, perfectly sound (she was flexed last week), and working at grand prix dressage.
PPE vet did recommend irap following removal, but I will research prostride. I have no real experience with chip removal, but I do have experience with horses with chips never being off, like teenage horses showing 1.50, but not in coffin joint. Thank you cowgirl that definitely gives me helpful info and food for thought.
Are there any research papers on this?
There are research papers on the removal and the level of return to work achieved by the horses in the study. My comment was based on what my vet (a lameness specialist) told me. There is usually a degree of damage to the joint due to the inflammation caused by the chip (especially if it is not anchored and is moving). They can clean up some of it when they go in for the chip, but the act of retrieving the chip itself causes additional disruption to the area. Arthritis is a very common byproduct for invasive joint surgery.
I asked my vet if it was possible to go back in with an arthroscope now and clean up the joint (since I just had that done for my ankle injury). She said no. Damage is damage. I had cleanup surgery in my ankle and while it did initially help a bunch, the benefits waned after about three motnhs.
My 9-yr old hunter has an old bone chip in the fetlock. He’s had it for many years and it’s rounded and not causing any problem. Vet said we can remove it easily in the future if it starts to bother him but until then, leave it alone.
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