Gelding with Ongoning Vet Bills

[sdowhey]

Hello everyone, I have been a long time reader but first time poster today, as if finally met my match for a very troublesome guy.

I have a coming 7 year old Canadian Warmblood gelding, I purchased him as a colt and had planned to bring him up as a stallion in my area due to his blood lines. Well that wasn’t in the cards for this guy.

As he grew, we noticed some conformational flaws which we knew could impact him as he aged, and we have worked with them as he gives them to us as an issue, we do not change anything that doesn’t need to be changed.

We put shoes on so he doesn’t wear his foot down, and worked with the vet and farrier to find the best trim and angles to keep the skeletal conformation inside the hoof and the leg happy. (Some may think this looks odd but this works for him and keeps him comfortable and sound - minus the new bruise that were seeing).

2021 we found bilateral fetlock chips - deemed OCD we had them removed and then decided to geld him as some say this can be passed down genetically.
2022 January he is gelded.
Two successful show seasons in his books competing up to the 3’6 hunter derbies by he end of 2022 but had a weird hop that we decided to investigate further in October 2022.

October 2022 - lame in the left front and
the left hind limb. The left front limb had a large injury to the superficial digital flexor tendon. On ultrasound the tendon was found to be severely enlarged for most of the cannon region. The left hind stifle was found to have soft tissue injury on ultrasound. There was an injury to the medial meniscus and the medial collateral ligament.

Fast forward PRP and 3 rounds of shockwave on both injuries. We rehabbed him VERY slowly and gradually and he did not do much in terms of more than 4 days a week for work throughout 2023. We got the green light to start very slowly jumping him in January 2024, and we did 3 crossrails one day, he was great, no issues and nothing.

Next lesson we did the exact same to build him back up slowly, he did save me a couple times as I am also out of shape, chipping to the fence, which makes me think he may have stepped on himself quite hard.

After this lesson, I noticed that he was stepping a bit more favourable on that right front foot (remember this is one of the limbs that had no injury other than his conformation issues that he was born with).

We thought abscess, treated like an abscess for 2 weeks (vet came out and xrayed, saw a gas pocket in the lateral heel - no broken bones within the foot, but potentially saying that an MRI may help us to see if it is a tendon on ligament). Nothing burst.

Vet came out again. We tried a week of antibiotics and a week of previcox, to see if it helped. He was also blocked on this appointment and it is located down to his hoof specifically. Which is good to know it’s nothing higher up and we’re in the correct spot.

Horse is the same amount of sore.

Now on the heel bulb, lateral more than medial, he has darkened areas that seem to be bruising coming to the surface. (I have photos from when we noticed the soreness, and the two dark areas on the heel bulbs (left is darker than right).

After this lesson, i noticed that he was stepping a bit more favourable on that right front foot (remember this is one of the limbs that had no injury other than his conformation issues that he was born with).

We have done Right Front Coffin Bone, Hock, and Stifle injections, and he is on supplements helping with recovery and 4Cyte.

Now, those limbs have been amazing, with not one issue or concern with movement or issues on lameness exams since injections.

** I don’t need advice on the shoeing, on our choices for maintenance or anything other than the question I have asked about the darker spot. I gave background information to help paint a photo.

My question is, has anyone seen anything similar, or dealt with something remotely similar.

[jvanrens]

Based off your picture,his hoof is really unbalanced when I look at it. Right side looks different than the left, unless your picture is off.

[Martina]

Hi, sorry you’re having these issues. Your horse is young so that is good. Generally speaking, after going through a similar situation that lasted a number of years, I think a very good investment would be time off. Just light work, hacking, no jumping, low pressure. Then bring him back slowly so he can reset.

When there are injuries in multiple places there’s so much compensation going on, and the horse is over-using here and under-using there.

Regarding the comment about the insurance company hating you and the vet loving you… careful you may just get dropped by the insurance company. (Why did you get those those injections? Seems unrelated to the injuries and lameness you mentioned?)

[clburnham11]

A lot of injections for a 6 year old, wow. I agree in the pic he doesn’t look quite balanced! Maybe needs better shoeing? Was there ever a clear cause for all those soft tissue injuries?

[sdowhey]

Hello, I should add that this hoof is toed out, and clubbed.
He gets corrective shoeing already to correct this, and has had extensive Xrays done on this foot and the vet actually is very happy with the angle we are at right now.

[sdowhey]

I do need to add, he was off from November 2022 - 8 weeks complete stall rest, then started 10 minute daily hand walking for 4 weeks.

He was completely rehabbed slowly and gradually and we jumped our first jump in February of 2024.

My insurance company is completely aware of his injuries, and they have stated they will not drop him, but they do no longer offer coverage for the specific joints/areas that have had injury.

the Injections were recommendation of my vet, who I trust very much.

Coffin joint was to help that specific foot (its currently the one with the bruise now), this foot is toed out and clubbed (he has also had corrective shoeing done, and we have done x rays and the angle is exactly where it should be with how the conformation of the foot is now.
Hocks were to help him as when we started moving through his trot rehab, she noticed a bit of a soreness, and we decided to help him.
Stifles were again to help aid him in comfort as we move through the rehab program.

[Kyrabee]

@sdowhey

He gets corrective shoeing already to correct this

Why would you want to correct his conformational flaws at this point? They are what they are. The foot should be balanced to what his skeleton is.

My mare toes out. One farrier that trimmed her last summer “straightened” her out. Why? She is 21 yo. Luckily, being barefoot, she fairly quickly wore her foot back to where it should be.
I am trimming her myself now.

Susan

[sdowhey]

Hello, This horse wasn’t gifted with anything from the conformation gods.

I have a corrective shoeing farrier that sees him every 4 - 5 weeks as that foot is toed out and clubbed, and the angle and balance it’s at is actually perfectly square when he’s standing. But lifted up yes I can see why that would be your initial concern.

I am asking about anyone that has seen this specific bruise. Or had any issues with these types of injuries, the injections were part of our vets recommendation to keep his body happy through our rehab.

[sdowhey]

The shoeing he gets is too keep him balanced when traveling. This is our “corrective” - it helps him to travel and move more comfortably and keeps the conformation happy INSIDE the foot via xrays. We don’t correct the toe out, but the club foot to keep it straight and balanced.

I did not come here to ask a question regarding my choice and my vets choice of shoeing for my horse that had competed for two years without any issues related to THIS LEG, this leg has never been the issue or attributed to his injuries. I just wanted to ask about the horses bruise and if anyone has seen or dealt with this.

[atr]

It surely is a strange-looking bruise. There’s something on the other heel, too. If he’s not over-reaching, or catching himself laying down or getting up, then I’d be watching for an abscess to burst out right there. I might try putting him in bell boots just for a bit of potential over reach protection.

As an observation, I’ve noticed that when I’ve had to put ice caulks on the heels of shoes that I’ve sometimes had an abscess at about that point in the hoof. Vets and farriers have looked at me like I’m from space when I have mentioned this, but it does seem credible to me that they would create a potential pressure point at a susceptible spot.

Its such a trade off as the caulks can be really necessary… this year we used ice nails which have seemed to work pretty well for the minimal exposure to ice we have in our current environment… In the “old days” we’d use a smear of borium which was a larger surface area so distributed the pressure more. No one seems to do that any more.

[sdowhey]

Thank you for responding without trying to look at anything past what I’m asking.

I never thought about that with the ice caulks, he does have only picks right now on the shoes, but I may get the farrier to take that off.

We used to do pads, which were my preference but they switched to these picks recently and I’m not sure if maybe that’s the case.

As far as himself doing the damage, it is possible as he used to pull shoes like crazy, but he’s a special case as he likes to eat and chew everything so bellboots (or any boots) don’t last long but they do work when he keeps them on. He also wears a bib to prevent chewing but can still manipulate somehow. Lol

[IPEsq]

If it was a bad overreach then it shouldn’t take weeks for the bruise to show up on a white foot like that. Unless he overreached sometime after the initial incident. Even if it doesn’t turn into a new abscess and blow out the heel, sometimes those bruises can be very ouchy. I agree that based on the other heel, he probably did hit himself or something of that nature at some point and maybe is prone to repeat impact. The reason for the comments on the hoof balance also is that if the medial-lateral balance is off on the foot, he might be continuing to load the sore side in a way that the bruise is not healing. Same idea as the ice studs causing abscesses. And also potentially contributing to totally separate soft tissue injuries in the foot unrelated to whatever the bruise is (which is possible since you haven’t done an MRI yet).

[sdowhey]

Yes I can understand that, and I 100% know we don’t know what’s going on inside the foot with the soft tissue.

I can bring it up to my farrier but he has never been off on this leg/foot in his 4 years of being under saddle, which I can also understand can cause compensation.

But again, at this age, and this point, I am not very keen on changing anything in the foot angles. It’s a hard foot to trim, trust me I’ve had endless chats with my farrier (and he’s had a few) about the foot is clubbed, so it grows more up and the heels are harder to change - we have changed the foot over time, and it’s gotten to a comfortable point for him.

Originally there was nothing on the bulbs. And he wasn’t sound. And then this started to appear darker.

We soaked the foot for 12 days straight and poultice pad wrapped it. No foul smells, nothing came to surface and the vet said let’s stopped wrapping and soaking and do some X-rays.

Once we stopped, the spot got darker. If it is an abscess that is taking its sweet time, then amazing! But I am not rushing to do an MRI right yet, I want to see what the bruise/dark spot does.

I’ve attached photos of the progression.

[IPEsq]

Medial-lateral balance doesn’t have anything to do with the club deformity and the angle of P3. Just to be sure you are checking not only the lateral view on radiographs. With toed in or out conformation, one side may be a little more upright and one a little more flared, and so that needs to be corrected also. The upright side may be more prone to bruising, quarter cracks, and the like and would make sense on a more upright foot for that pressure to be more back to the heel area versus the quarters on a more normal foot.

In the 2nd picture (chronologically) he wasn’t missing the hair on the other side of the heel that he is in the last picture. So he had at least one more interference in those days. A bruise will take a little time to mature of course, but while a bruise on the horn of the hoof may indicate an issue that happened some time ago, not so much on the sensitive heel bulb—should be pretty fast just like if you bruise a fleshy part of your body, unless maybe it is a bad abscess tract moving that way. But in my experience, even abscesses that blow out the top on a white foot don’t look bruised. You might get a defect in the horn that has to grow out. You may get a squishy or wet spot in the coronet band or heel but it usually isn’t dark.

[sdowhey]

thank you for the info!

In 30 years of owning many show horses (16 to be exact) this guy has thrown injuries and things I’ve never experienced before.

I appreciate your response.

[Libby2563]

I think it looks like an overreach injury. Does he react if you press on the bruised-looking area?

Even if that’s what it is, maybe it’s not the cause of the lameness? Or not the only cause? He could have more than one thing going on in that foot. Maybe he even stepped on himself in the first place because he was sore. Hard to say! Since blocking isolated the pain to the foot, I think your choices are either to keep waiting and hoping it’s a bruise or abscess, treat it like a soft tissue injury in the foot, or pursue additional imaging. Hope you can figure it out!

[sdowhey]

Thank you!
He has overreached in the past, and when we compete in the jumpers he wears Veredus heel protectors.

Fingers crossed that’s all it is, I’ll give it a bit more time and then potentially get some more imagine of the soft tissues even for peace of mind if he is sound.

he wasn’t intended to stay with me forever but I think he will haha

It’s a good thing he’s stinking cute!

[sdowhey]

So I wanted to update here, and hopefully get some insight because I am trying to figure out what to do with this guy.

In April we decided to do an MRI to rule out any soft tissue issues as we would have just retired him and said enough is enough. The imagine showed that he had a moderate to severe coffin bone bruise, and that there was a mild bit of inflammation in the area. (This foot is clubbed and toed out, and he’s over reached previously and pulled shoes off). He wears bell boots usually, but we didn’t have any on at this point, and I knew that was daring. (Lesson learned even though we don’t know for sure if this was the cause).

He’s been on paddock rest for 8 months (vet said this was fine as he was not going to romp and play). We’ve been doing pads with dental impression, and have started light rehab back (25 minutes walking with intention and 10 min trotting). He is still a bit off, but is not getting any worse. The first couple minutes of trotting he is pretty tender, and short - but he’s always short on that front due to the toe out and clubbed foot. But then will work out of it and moves pretty nice.

I’m trying to decide if I get the vet out to do a possible infection into the coffin bone, or if I just keep waiting and see what’s going on, he’s very out of shape, and stiff which I know is from the time off, I would love to keep riding and see what he looks like in a month.

Just asking for thoughts and ideas on if anyone has dealt with a bone bruise, specifically coffin bone.

[ThreeWishes]

Are you sure it’s purely the coffin bone? Horses can damage the ligaments and tendons inside the hoof capsule supporting the coffin bone rendering them quite lame … perhaps always so. The impar ligament. Collateral ligaments. The flexor tendons. Etc etc.

[sdowhey]

We had an U/S, Xray and MRI done. No damage to any soft tissue, ligament, or cartilage. Only a bruise to the coffin bone.