Nuclear Scintigraphy (Bone Scan)

[DJohn]

I tried looking up threads about this, but they all appear to be quite old. I am looking for people’s experience with bone scans as I am thinking of having my horse done.

What was the process like? Did your horse have to stay multiple nights? What was your horse’s lameness before? What did they figure out? What were the next steps?

My horse is a TBx, big shoulder, short back. He has something going on. It is very mild and inconsistent. Sometimes it looks to be hock, sometimes stifle, maybe pelvis and I often wonder about kissing spines. I have some money at the moment and I’d like to get him scanned to have a definitive answer before I buy a house in the near future. It makes the most sense to me rather than a shot in the dark, blocking, numerous rads etc.

Tell me your experiences!
(Also, if you’re in Ontario, let me know where you went!)

Thanks in advance.

[cherham]

Hi DJohn, I live in Ontario and we took my jumper mare a few years ago for a full body Nuclear Scintigraphy exam to Dr. Daryl Bonder at the Toronto Equine Clinic. Located not far from the Woodbine Racetrack in Mississauga.

Our mare was displaying discomfort in her right hind stifle, hock ??? we were unsure what was going on. She also would not take contact on the left rein under saddle and was clearly just “not right”. We had chiro, radiographs, bloodwork done…everything we could think of but our very experienced sport horse Veterinarian Dr. Alan Young (bless his heart) told us outright after exhausting every avenue we could think of to take the mare for a complete NS work up.

So we did…not inexpensive and the horse has to stay overnight due to the possible radiation exposure but you know what? This mare had an abscessed tooth. Well below the gum line. Did not show on rad’s (and we had full head radiographs done too). There was no swelling in the mare’s jaw, no foul smell, nothing to suggest this at all. But there it was a big red indicator on the Bone Scan results…bingo!

Had the tooth taken care within 3 days when she returned home and all was well again.

Grreat diagnostic tool. Highly recommend.

[DJohn]

That is incredible! Thank you so much for taking the time to write that for me. I really appreciate it.

[Whyevernot55]

Definitely a great diagnostic option for those vague, hard to ID “not quite right” horses! Protocols vary depending on the practice - I know some places that will send the horse home the same day, some that keep them 3 days due to the radiation and risk of human exposure. Obviously prices vary too, depending on your area.

Overall it is a very safe, non-invasive procedure, and an incredibly useful tool. I had one done on my old man, and have helped perform quite a few. It’s time consuming to get all the pictures but they keep the horses happily sedated.

[Tee]

I just had my guy done last week. Slight lameness that 3 other vets could not figure out. I kept saying it was in his back, but his back checked out great.

Dropped him off last Sunday, they scanned him on Monday and I was able to pick him up on Wednesday. The scan showed something in his back, which we followed up with X-rays and found two spinous processes that were rubbing. Not a single solitary symptom he had would have indicated that, so I’m glad we finally did the scan. Not cheap, like was mentioned, but as much as I already have in vets, it would have been cheaper to start with this.

[fordtraktor]

Great option when you have mild lameness of uncertain origin. I have not had it done anywhere near your location but have been happy when I spent the $$$.

When I start to go chasing a lameness, I just go to this now rather than spend year(s) trying to figure it out. But it depends, if I think I might have a clue of course I don’t - too expensive. I have no idea, better to cut to the chase. saves money in the long run. Sometimes you just have that “something is off” sense…bone scan is perfect for that.

[SolarFlare]

I’m also in Ontario, and mine went to OVC (the other option in this general area is Toronto as cherham posted). He went in one afternoon, they took his history (I went with him for check-in so was able to be very thorough myself) and after I left, they did some initial exams (jogging in hand, lunging, etc). He got scanned the next day and stayed overnight due to the radioactivity. They did some additional procedures so he was there one more night (I don’t have my own trailer so had to arrange for trailering the next day - he could have come home later that same day).

My horse had a hind end NQR that we had already done fairly extensive testing on - blocks from hoof to stifle, two blocks several months apart of the high suspensory (what the vets thought it looked like, but wasn’t), x rays of stifle, ultrasound-guided SI injections (twice). Even with the negative blocks of the suspensory, vet still requested that area be looked at during the brief soft-tissue part of the bone scan (the beginning).

The problem ended up being a soft-tissue injury of an SI ligament. They couldn’t actually definitively diagnose based solely on the bone scan, as it was soft tissue, but given the very thorough history and all of the testing, they were able to eliminate the other possibilities. SI and hocks lit up, the rest of him was clean.

I highly suggest getting the whole body scanned - the cost difference is minimal compared to having to go a second time in case there was something going on at the other end!

One note too - after the scan, you still may need additional tests to figure out the actual problem. The bone scan points the vets in the right direction, but then often they need to do more precise testing like x rays, ultrasound, etc as Tee above explained. In my case, we had already done everything before the scan so the OVC vets were already armed with all of that. Had I not had all of that testing done, they told me they would have had to start at the beginning with blocks to be able to positively identify the issue.

[Texarkana]

In a past life, I used to have to hold A LOT of horses for nuc med. I can’t tell you how many times something totally unexpected lit up. Like, most times. I doesn’t necessarily lead to a diagnosis, but it will certainly point you to the location of the problem.

[riopony]

I had one done on a horse a year ago. I dropped him off the night before (could have done morning of but with distance and weather it was better to leave him), he had scan done in the am, and had to stay overnight due to radiation exposure.

We were trying to confirm SI injury as we had spent some time trying to figure out what was wrong in the hind end. It was expensive but if you do it early enough in the process it would be cheaper than many separate x-rays/ ultrasounds.

The SI did “light up” as well as his front feet (low angle problems) and his withers. We did a separate x-ray of the withers and that was deemed the lowest on the list of issues.

We injected the SI right then and continued addressing the feet. My vet cut me a huge break on price so it was a little more reasonable!

[horsepoor]

Over the years, I’ve had 5 done. I think it can be a very useful diagnostic tool, but also caution against hanging your hat on just the bone scan. It is always possible that you might find absolutely nothing, or have the horse light up like a Christmas tree with multiple hot spots. Even when you do have a good finding, it usually requires further diagnostics (x-ray, ultrasound, blocks, etc.) and eventually treatment so those costs need to be considered as well.

With mine, I’ve usually dropped the horse off the night before to avoid morning traffic. They do the bone scan the next day and the horse remains for another night. The next day, they can do any other diagnostics and treatment, and I pick up the horse either that day, if time allows, or the next day.

For the 5 that I did, 3 of them came up with pretty distinct areas to further explore (ended up finding stifle OCD requiring surgery in one, collateral ligament injury in another, and kissing spines in another). But all of those required significant further diagnostics to arrive at those conclusions, so not like you pay the bone scan fee and have your answer. The other two were not as revealing – one sort of pointed at an area we were already concerned with but wasn’t all that conclusive. Another was a total bomb - nothing really jumped out to steer us any specific direction, but I guess it was useful in ruling out some things we suspected.

Even with those odds, I still would do another if I felt it was warranted.

[DJohn]

Thank you to everyone who has commented.
It is really helpful to read all of your experiences, and to help me decide where to go with this.

[SBrentnall]

I had one to find out why my horse hadn’t recovered from what my vet diagnosed as a “back strain” 6 months after he fell out of a trailer. Trainer and vet said i was just babying him, but something didn’t feel right. I did a bone scan, and the clinic vet said his SI ligament “lit up like a Christmas tree” with multiple tears.

We did stem cell and another 6 months rehab, then another bone scan. Vet said if he didn’t have the first bone scan to compare to, he wouldn’t know there had been any injury because the stem cell had worked so well.

Alamo Pintado generally keeps them for three days to be sure no one’s exposed to any radiation.

[Weluvhaha]

How much was the stem cell therapy and what was involved with that? Will it have to be repeated?

[SBrentnall]

The stem sell was about $3000 and didn’t need to be repeated. The overall bill for the stem cell, two bone scans, hyperbaric treatments (recommended after stem cell) and meds was close to $10k (thankfully paid by my insurance).

[SecondInCommand]

I’m also in Ontario and had a full body scan done at OVC. Like other posters above, my horse checked in the night before the procedure, had it done the following morning, and then stayed the night. He was quite pleased his accommodations.

The scan itself wasn’t as conclusive as I had hoped, but it did find a problem that I was not aware of at all, and I had them do injections the day I picked him up, as well as rads on a different area of interest.

My total bill came to less than $2K CAD, which I thought was very, very reasonable.

20/20 hindsight: if I had the whole thing to do over again, I’d have done the bone scan months earlier.

Good luck with your horse!

[otisrider]

OP what did you end up doing?

[Tee]

One thing to add - make sure whoever does the bone scan (if you do/did) is in contact with your regular vet. In talking to my regular vet about a month after the bone scan (which we followed up with back and hock injections), my horse’s right hock lit up major, but his back was barely a shadow on the scan. But, he talked to Aries’ regular vet and she told him again the symptoms and that it most likely was his back. He was doubtful, but did the xrays anyway. Sure enough… I’m not sure that he’d have gone that route if he hadn’t talked to her first. Even when we went back to do the nerve block, he still wasn’t convinced his back was the issue. He was after. LOL

[Dee-Vee]

We are in eastern Ontario. Cornell University in Ithica NY is within reasonable distance. A friend had a very good experience with NS there. I have heard amazing things about Cornell in general. You will have to check pricing, especially with the lower Cdn $$, but what I understand it is reasonable.

[otisrider]

FYI I got quotes $2500 - $3000 in Denver area (full body and including keeping the horse for 4 nights)

[Personal_Champ]

My mare is at Furlong right now getting a bone scan today.

I was quoted $700-$2600 before the exam, depending on areas to be done. $2600 is for whole horse, and that’s what we’re doing as we aren’t sure where the problem is sourced at, just where it’s manifesting.