I’ve used the forums to research my horse care problem-of-the-day for years; first time poster. My horse’s current lameness situation has perplexed me and all of the many professionals involved … so I’d love to add more opinions of strangers to the mix 
9 year old warmblood showing in the hunters. Clean PPE, have had her for a year, regular aluminum shoes up front and steel behind, had zero lameness issues until February. Apologies in advance for the long saga that follows:
Two days before the trailer was leaving for two weeks of showing in Florida, she came up lame. Vet looked at her same day and thought brewing abscess in the RF. We soaked and packed the foot with MagnaPaste. Sure enough, had drainage in the RF heel in the morning and she was sound. We continued to pack with MagnaPaste and treat the abscess. She was mostly sound but had the occasional funny step. We showed because we were down there to do just that. She continued to have days with some ouchy steps even 2 weeks after the initial abscess. Vet looked at her as soon as she got back home from Florida. Sensitive to hoof testers in the RF toe – made sense with the abscess in the heel. Gave her a week off with limited turnout only in ideal footing.
Vet jogged her; she was sound. We had two weeks of flatwork where she was sound in our softer indoor footing and mostly sound in the outdoor bluestone with the occasional NQR step. She then turned up lame. Vet looks at her same day, and this time it’s the LF. Sensitive to hoof testers in the LF toe and has thrush brewing in the sulcus of the frog. Begin treating thrush and put her on stall rest. No change after 5 days. Vet does blocking to confirm it is the LF hoof, and it is. Once blocked, she switches to a mild lameness on the RF, where we had had issues just weeks prior. At that point, she was much more lame (3/5) on the LF on hard ground and lunging on a circle. The lameness was mild (1/5 if that) on normal soft footing jogging straight.
She does not improve with two more days of stall rest and thrush treatment, so we send her for radiographs and MRIs (if radiographs didn’t show anything) of both front feet. Radiographs did not show anything. MRIs showed only mild inflammation of the coffin bone and thin soles. Research hospital vet recommended just pour in pads. They did say we could inject the coffin joint to try to speed along bringing the inflammation down, but stressed that it should not be needed. Should be good news! But:
That was a week ago. She got the pour in pads (the hard kind) the next day. She’s stayed on stall rest at the farrier’s recommendation. If anything, she is more lame now – but it appears to have moved back to her RF, it looks shorter and stabbier, and it’s now more noticeable (2/5) jogging on soft footing. My vet just started her on Equioxx and Pentoxy yesterday (previously didn’t want to interfere with the other diagnostics, shoeing change, etc.).
At long last, here’s the question: do we give her more time to adjust to the pour in pads? (It’s been a week.) How long? Do we think she is very sensitive (yes, that seems clear at this point) and just may not be able to tolerate the hard pour ins? Separately, do we move forward with coffin joint injections in the meantime? Does that risk masking new problems that the pour ins may be causing (in addition to the standard risks with any injection)?
I am of course working with all my professionals on these questions (and they are all wonderful!). But they think that there are a range of approaches given that we have a lot of information and no big diagnosis but a still quite lame horse. Any thoughts/opinions/comments/questions are appreciated!
