Hock Injury, no improvement, what next?

I went on vacation for a week in late May and came home to a call from the barn saying rear leg was swollen, horse being cold hosed and vet coming out. She x-rayed and found nothing chipped or broken, declared a strain, sweated, wrapped and gave a dose of Exceed for possible cellulitis. He improved and then got worse. This has gone up and down since then. Twice he was sound enough to go back into work but it the lameness would mysteriously reappear. So Aug 6th I brought him home on stall rest. He got steadily worse on stall rest to the point of being 3 legged lame and refusing to put any weight on leg at all.

So we went to the vet hospital and did a full work up. The injury is too high for a standing MRI, Sonogram inconclusive due to him being non weight bearing even under sedation although possible lesions noted on short medial collateral ligament. X rays show the joint is thickened and a shadow is present that was not there in the previous 2 sets taken since May. Joint tap showed no infection so they injected steroids. Diagnosed “soft tissue injury” Sent home 10 days ago on bute (which tears his ulcer prone stomach up) for 3 days and then back on the equioxx.

Ten days today and I have a horse barely eating, hobbling on three legs and on small paddock/stall rest. He is getting small feedings 5 times a day, has access to grass hay, alfalfa, TC safe starch and Hifiber forage (all free choice) he is getting down 5lbs ultium gastric care per day. He is offered more but that is all he will eat. He eats the alfalfa the best and will take about 2 flakes of that a day. Water intake is fine. Still eats apples and peppermints ( he gets his meds in apple slices). I have tried both TC and Purina Senior but will touch neither. He is on 1x equioxx and omeprazanol. Laying down seems to aggrevate the hock the most. The nights he has been down, he is extremely uncomfortable the next day. His stall is bedded in 8" fine shavings over mats and banked in corners.

He is standing wrapped in no bows both sides and has his hock wrapped with a padded Back on Track hock boot at night. Polo wrapped hock over a compression bandage during the day. I am also using Voltaren 2x daily on bandage reset after ice wrap.

Not to mention that this is exhausting, what is next? This guy is finally not getting worse but there is no improvement. I keep waiting for him to founder or blow out the hock on the other side. No one has mentioned exploratory arthroscopic surgery, but I am about to bring it up.

I know his career is over, but I still want him here as a pasture pet. I think I am mostly frustrated and worried. He is still fighting and trying. Am I holding on for no reason?

It sure sounds like an infection… somewhere. I can hear your frustration and worry in your writing. I know that this is the worst of it… not knowing, and not knowing what the future holds. If you have good vets, your trust has to be in them for your best chance of success. As long as your cascade effects (laminitis etc) remain at bay, you continue on as your vets have advised, and do your best, and hope for the best. As my dear old vet told me when in a similar situation, " Sometimes they surprise you, and live". Listen to your horse, he will tell you how he’s doing. Good luck.

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Had a horse that was kicked on his hock.
Regular trainer’s vets could not find anything wrong, horse lame, hock size of basketball, tried all kinds of stuff for two months, then I took horse for one more opinion, that specialist operated and found a whole bunch of damage in the joint, cleaned it out and crossed fingers.
Horse is sound for light riding, hock still big, vet checking him out keeps saying light riding and exercise is best, so he is not retired, yet.

Maybe you ought to ask for that extra opinion, maybe go in there and see what is happening is worth it?

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As I’m sure the vet hospital told you, it’s possible your horse has a serious soft tissue injury. Some of those they CAN come back from. I’d consider laying this horse down to get the MRI.

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I think that is the frustrating part. None of the vets are suggesting anything else. Just " oh poor guy, let’s put him back on bute". Is one answer I got or " wait the full 14 days for the steroids"

Three vets and the best advice I have gotten is " soft tissue injuries go up and down, take it a day at a time". I just want to make sure I am not missing anything.

As for infection, if it is there we have not found it. 3 doses of Exceed since May. We also suspected a subsolar abcess but have not found any evidence.

I would be happy if he was pasture sound. I would be ecstatic if he was sound enough to do walk trot for the under 10 set. He likes kids, he has had a long career. It was planned for him to step down after next season anyway. I have a youngster that is lovely and coming along nicely. He is only 13 but he has been there and done a lot.

Sorry, maybe you can get someone else to look at him.
Our horse didn’t show anything much, until the specialist went in the hock with an endoscope and found big chunks of cartilage, some still attached on one end, all over the joints.
He cleaned it all best he could and after rehab horse has been ok, could have gone either way and still will affect him when he is older.

Whatever is in there, no one can tell without explorative surgery, if they can determine where to go look.

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So I had to get a little pushy, but had a talk with my vet, the vet hospital and with the surgeon. He has a firm surgery appt for lying down exploratory arthroscopic on 10/3 and since we are close by the hospital, we are first in line if an earlier date comes open.

My vet has added gabapentin to his pain regime to keep him a comfortable as we can.

It really comes down to they did not want to tell me “the bad news” that this might not work or that he has no future soundness ahead. Really? Come on people…I am no star struck ponyclubber.

Either way if there is something that can be repaired in there, repair it. If not then he will be euthanized on the table. God, I pray he comes home.

Jingles please!!!

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Jingling.

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Sounds like a good plan.

Jingles.

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