8 Yr old WB hunter came up lame 4 wks ago LF. Farrier came, found bruise, looked around but found no abscess. We poultice, wrap,hand walk almost 2 weeks, still no abscess, no improvement. Take to esteemed vet college for hoof xray. They couldn’t find anything conclusive,(other than its def in hoof) told to take home, continue to poultice,stall rest, hand walk 10 min and have our reg vet out to re-xray. Done -no bone issues. Back to college for MRI a week & 1/2 later. (General anesthesia). Now they say MRI cannot be done due to rt hind lameness now. (His RH has always been a bit weak, but with exercise & training has not been problem).He has been on a sedative all this time with obviously no turnout.
This is where we are at this minute. Can anyone give some advice, feedback, suggestions, ideas- anything to give us any direction and hope? Practical wisdom?
The LF could be a classic diagonal compensation for RH. Once LF is sore, RH gets worse. What’s his issue on RH?
Honestly I’d be tempted to put him on a nice field for 6 months or a year and see what you have after that. I do see horses that seem to just go off and NQR all around and the ones that seem to recover are ones that get a long vacation rather than being “managed.”
Thanks Scribbler for your reply. (can you tell I’m sitting here waiting-ugh)
LF (first problem)was so lame, it looked broken which is why vet thought might be abscess. Then came xray to rule out coffin, navicular and now the MRI for soft tissue -collateral lig etc. If it is soft tissue, would turnout be right for that kind of issue? I think with time and exercise the right hind will come back but not knowing what the LF problem is, is scary. Thoughts?
What exactly did they find in the hoof? I guess I would look higher unless there is no doubt that the LF issue is causing problems now for the right hind.
Candyappy- He is there now for soft tissue MRI as abscess & fracture have been ruled out. But they don’t want to do it because the RH is now lame. Worried about coming out of anesthesia.
Catch 22 situation.
Tough situation, you have my sympathies, it’s awful when you can’t get a diagnosis.
Did the LF nerve block to the foot? - just to rule out that it’s not higher up the leg
Do you have a diagnosis on the RH? - again, I’d be interested in nerve blocks to pin point where it’s coming from.
If it is a soft tissue injury turnout is a controversial subject. Really depends on the horse’s temperament, the injury severity etc. My laymans’s understanding - you have to be able to gently stretch the fibres to realign and then strengthen them. Too much confinement is bad, but too much movement is also bad. Exactly where the perfect amount is - well that’s the tricky part 
I rehabbed a mild front suspensory issue without any stall rest at all with a sensible horse (though of course he still had the odd yahoo moment even in a small paddock). And I took the rehab plan very seriously, didn’t jump at height for a year after the diagnosis and was very conscious about deep surfaces for a long time afterwards.
My first thoughts when multiple limbs start to be affected with no apparent cause is to look HIGHER such as neck and back. If they won’t do MRI, you could always do xrays of neck and back. At least, if you are grasping at straws.
This is coming from someone who had to suddenly retire a main mount due to a severe congenital neck issue with my horse, which affected multiple limbs including RF and both hinds. So call me paranoid.
Can you do a standing MRI? Assuming the lameness blocks out to the foot.
Seconding the standing MRI. My horse has had two! 
Nerve blocks to try to get a better handle on al the problem areas. Followed by standing MRI.
Yes, nerve blocks to the LF foot indicated the original problem is there, not higher up.Vet college is afraid coming out of gen anesthesia could be catastrophic with RH not right. We originally opted for this MRI (at 2x the cost) as the only standing MRI is 5hrs away. This is 1 1/2 hr away.
Some options include:
Try to figure out what’s going on in RH and then evaluate whether coming out of the anesthesia for the MRI is going to exacerbate it.
Get a bone scan and see what body parts are involved. Maybe just RH and LF. But maybe more. I have been advised to get a bone scan (nuclear scintigraphy) before proceeding with an MRI, at least a standing MRI, so that you have a better idea of what area to look at with the MRI.
Trailer horse five hours and do standing MRI.
Try to determine if whatever is going on with LF and RH is going to make turning out for a period of six or more months a viable alternative.
This early in the game I would tend towards the scintigraphy in an attempt to rule various body parts in or out as the source of the problem. After that it depends on how much of the rabbit hole you want to go down with diagnostics and/or treatment.
If he is able to withstand it, I would definitely haul to the standing MRI. Arrange an overnight stay and book a motel for yourself. Still may be cheaper and less risk than with general anesthetic. Good luck!
I would talk to the vets about what the MRI could possibly tell you - provide a diagnosis that would result in surgery or invasive treatment or…? I’d think that xrays would catch most of the issues that would require surgery to treat, but I might be wrong.
If the MRI is likely only going to provide a soft tissue diagnosis, I’d just rest the horse and then rehab as if it were a DDFT or collateral ligament injury in the hoof. The question is stall rest versus pen or turnout for the healing period. Having had a horse do very, very poorly on stall rest (but the fetlock ligament injury healed), I would look for an outdoor pen or small turnout.
The RH could get worse during rest and then you’d have something significant to look at for a diagnosis there, or it could come back to “normal” during the long, slow rehab for the LF injury.
good point! For my horse, we were looking first at navicular issues but found the main issue was the DDFT. If we had just treated it as navicular, we likely wouldnt have rested him enough.
So one approach might be treating it like a soft tissue injury. No way my horse would put up with stall rest, even tranq’d so he had small paddock turnout. I opted for another MRI after 6 months to verify healing before increasing rehab.
For a relatively short term lameness, rest and see can often work. The danger is in working too soon/too hard when he seems healed. So either commit to the longest rehab based upon possible problems, or perhaps do the MRI after the rest to see where you stand.
Block and image the right hind before you spend money on the MRI. If the horse is lame enough in the right hind that they are worried about laying him down, you need to figure out what that’s about first.
Depending on what’s going on in the right hind, the horse might be in stall rest anyway, need an MRI in that limb also, or any one of a number of things. If the horse still needs an MRI when you get to the bottom of the right hind, ship him to the standing magnet or to a place where he can be dropped and recovered in a pool.
Ditto this advice!
Sorry if this is a dumb question… can someone explain why they think it would be catastrophic to be lame on the RH and do the MRI? Is it just because of the waking back up process?
The scariest time of most surgical procedures where the horse is not left standing is when they are waking up, trying to get up. If the horse has a lameness issue that makes them getting up harder when fully aware, there is an even more serious risk of injury when they are getting up and still not fully aware and stable on their feet.
Ditto. Lost one of my mares at 5 coming around from colic surgery. Fractured her right femur by simply standing up.
