Sprained Fetlock: Experiences?

[Satirical]

Okay, so my sister’s Quarter Horse has been lame for the past week and a half. He is a well balanced guy who wasn’t broke until he was four, and wasn’t consistently worked until he was eight. He has no dings on his legs or windpuffs.

However, he came into from turnout one day head bobbing lame. I had the vet come out last Thursday. Unfortunately, he couldn’t come out in the evening, so the BO was the only one there (sister in high school, parents and I work full time). After flex tests, hoof testers etc (but no x-rays), the vet diagnosed that he probably sprained his fetlock. He said to have him on bute for a week, separate him from the others, turn him out in a small pen (you can’t stall him alone, he kicks), and give him two weeks off. If he isn’t drastically better by two weeks, the vet wants to come back out and block him.

So far, he is still extremely lame at the trot. He does have no pain tolerance and has been known to be a big baby even about cuts, but it still is very concerning.

My sister has been cold hosing his leg everyday. But here’s the thing, there is absolutely no swelling…even acute…on any of his legs. There isn’t any heat either. Even the vet agreed with this. But from what I’ve read and what people have said sprains do come with inflammation.

I had the farrier out to check his hoof for an abscess. He couldn’t find anything, but said I still shouldn’t rule it out. My sister has been soaking his hoof in espom salts, just in case as well.

So I guess I’m just wondering if anyone here has had a horse who sprained their fetlock. What was your experience?

[NancyM]

Normally you would expect some swelling in the fetlock, if that is what you are dealing with.

[JB]

I would be doing something more to see what’s going on in the foot. You might be looking at collateral ligament damage

[merrygoround]

No blocks, no ultrasound, no radiographs?

[Ambitious_Kate]

I think I would be getting an ultrasound to find out exactly what ligament damage there is and isn’t. Guessing isn’t good. Who is to say there isn’t a tear? If the damage cannot be found, then I would be going for radiographs. Horses can chip, crack, break foot bones. Not something I would be guessing about, but that’s just me. All this because its not clearing up quickly, so its something like a tear or break, in my estimation.

[gumtree]

[QUOTE=NancyM;8078586]
Normally you would expect some swelling in the fetlock, if that is what you are dealing with.[/QUOTE]

Agree, I have dealt with a few of these and there is always swelling. A blind pig could see it. No different than a human. They can also get what is called a “pastern bow”. Some stick out like a sore thumb and other times much more subtle. A “loose” chip floating around in the ankle may or may not produce much swelling but can and will make them lame. A chip can be present for years before the horse goes lame.

A deep abscess may or may not reveal itself to hoof testers. Depends on the location and the person’s expertise. IME once they go lame an abscess will usually pop in a couple of days. Ones that don’t “test” or only “mildly test” usually come out the top. So, you may save some money by waiting and seeing how things progress. If it is an abscess the horse usually gets lamer by the day once they start showing “signs”.

IME a horse that has tendon or ligament issues will always have swelling associated with it and be reactive when manipulated by a skilled hand. But stranger things have happened. Mild to no swelling may indicate an ankle chip so I would start with taking some pictures. Then move on to an US if nothing is found. Navicular changes can come on suddenly and may or may not show to hoof testers.

The above are just suggestions not advice I don’t have my hands on the horse. If the horse is confined waiting a couple of days isn’t going to change the outcome. But a week after going lame an abscess should have run its course or close to it. If it is working its way out the coronet band it should be pretty sensitive by now in that area.

[Satirical]

Yes, I’m peeved. I think I’m going to haul him up to the clinic to get at least an ultrasound done.

[Showstopper512]

My 3yo just finished recovery from the same thing. He was very lame and sounds like what you’re describing. He never had any swelling!!! We did blocks and ultrasound and verified the sprain. He did modified turnout (basically 12hrs in a round pen) for 2 months. Ultrasound at 2 mo showed full healing. He’s been getting hand walked for gradually growing periods of time and is just now back on normal turnout. Hopefully yours will be similar. I did no hosing or anything. Just bute for a few days and then kept him contained

[Satirical]

He was a little better today, but apparent lameness at the walk, but trotting is still a no go.

He did have some heat below his fetlock on his pastern. I didn’t feel any heat on his hooves though. I still plan on getting him an ultra sound next week. They have been turning him out alone, so that can continue. We’ll see how things go.

Thanks everyone. I reallllyyy appreciate it.

[grayarabpony]

[QUOTE=JB;8078622]
I would be doing something more to see what’s going on in the foot. You might be looking at collateral ligament damage[/QUOTE]

This. I have a pony who sprained her ankle a few years ago and there was no swelling. Likely a collateral ligament injury (vet was Dr. Cochrane who didn’t like using those new-fangled ultrasound thingies). She made a full recovery.

[Kyrabee]

I got this diagnosis on my mare after a lameness exam, blocks and an x-ray. She had some soft tissue swelling but no bony issues. He checked her foot and dismissed that. Didn’t think it warranted ultrasound yet. Yeah…big heel abscess that blew about a week later. I wondered what she shredded though as before the abscess blew, her leg swelled up like a stove pipe…clear above the hock. She had improved with the bute which yes…slowed the process down.
Once the abscess blew, she was much happier :yes:. Abscess was my second thought…I should have had it as my first thought and saved the $265.

Susan

[flyracing]

You will save your self time and money by having the new vet block to soundness. The fact that the vet diagnoses a ankle sprain (a less common injury) just with flexions wouldn’t make me want an ultra sound. Distal limb flexions, flex the entire lower limb, ankle to toe, so it is not a specific flexion to begin with! 90 percent of lameness block to the foot. Without other obvious signs, the next step is to block the foot, then just below the ankle and then the ankle. Other wise, the vet won’t know what area to focus the ultrasound and that expensive diagnostic is not nearly as specific. You may also find the area of pain can not be ultrasounded or does not image well, so an ultrasound wouldn’t be a good use of money.

So, while it’s frustrating to start over, the first vet did basically nothing except confirm the horse is lame. Save your self from chasing down this supposed sprain and begin again with a proper lameness vet.

Good luck!

[asterix]

I agree with flyracing. If it’s a soft tissue injury in the foot they can be hard to image, but blocking will help you localize it.
I have had lots of front foot and lower leg issues - had a horse prone to them- some produce visible swelling and sensitivity to palpation and some do not. If it’s in the hoof you may get neither.
It could still be an abscess, of course, but the longer you go with no increase in lameness the less likely it is.

[findeight]

Since its been real lame for 10 days now, its time to block and X-ray/US as indicated.

You want to block to isolate the affected area, if you are lucky it should block out from the fetlock on down. That saves you money imaging areas not affected trying to figure what and where.

I had the sprained ankle diagnosis once. Very little swelling or heat. Bute and rest for a week resulted in signifigant improvement, from a 3/5 to a <1/5 so opted not to do any imaging. Continued the Bute for another week and rest for another 4 weeks. Then another month slow rehab and horse returned to regular work schedule as a 3’ Hunter without further incident.

IMO its OK to cold hose, bute, rest, wrap, poultice etc. instead of pushing the panic button for things like this but if there is no improvement in 5-7 days you need to spring for the diagnostics. Since its been 10 days? Id be loading up tomorrow.

[Satirical]

Thank you everyone.

He has an appointment later this week at a clinic which has more specialized vets and better equipment. It’s comes with a bigger price tag, but at the end of the day, I’ll have more answers. So I’ll be hauling him down there.

I received a $200 dollar bill from the last vet and just an estimation off of a flex test and a hoof tester what it may be…but it could be a dozen other things as well. I wish they would have done the block the first go around, but instead they did the “wait and see” approach. Since I’m not a vet, I don’t really know what approach was the best option. However, I’m always willing to put money out for my horses when it gets me somewhere. Essentially now, we are at the same place as we were last week. I’m just starting off all over…as someone stated.

He is a bit better soundness wise. However, there isn’t a huge amount of improvement.

Wish us luck.

And thanks again.

[4beats]

I’ve been treating my horse for a sprained fetlock on the right rear for almost 2 weeks now. Ice pack 1xday, kept in small paddock with an older horse because he won’t tolerate being in a stall for a long period of time. He also got 1 gram of bute/day.

He’s off the bute now, gets hand walked for 10 minutes then cold-hosed. I also put Arnica rub on the fetlock.

He had a small lump on the inside of his pastern but that was all that was noticeable and that has since gone away. I trimmed his long winter leg hair to not only see the fetlock and pastern better but to treat for scratches thanks to the wet winter and spring.

Vet is coming out on Monday to do an ultrasound.

Like you, my horse is better but there’s not a huge improvement. I’m not going to rush this as I know it is very easy to do permanent damage.

Good luck with your horse!

[silverdog]

At least I’m not the only one. My horse has been lame - slightly - looks great at walk, off at trot - for about 3 weeks now. Seemed to block in foot and then more so when fetlock joint infiltrated with local. Injected fetlock. Seemed better but back to where he was in the first place. Has had 2 days of quiet turnout in the last 3 weeks due to crap weather (has been in stall the rest of the time). Rest seems to make no difference. No swelling, no heat, no sensitivity to palpation. No sensitivity to hoof testers. No pulses. Horse is happy and clearly not in pain except when he trots. The kicker with this horse is that he often has problems that cause him to need prolonged amounts of time off. I am reaching my threshold of spending money at the vet on him. Having a frank conversation with my trainer this week. The farrier wants to try one cycle of pour in pads and see what happens. If that doesn’t work then I’m turning him out and letting Dr Green do it’s magic! I have a lovely horse to ride instead so am not really in a hurry with him.

[Jackie_amp_Starlette]

Add me to the list…my mare “sprained” something in her left front (it seems like shoulder to me as she does not seem to hurt until she is fully on it at a walk) but it is getting better slowly. I am in awful wet clay that they were galloping around in one day two weeks ago that has finally dried out, and I just dragged/leveled my pastures and she was moving much better with just that help, but if it goes on much more I’ll have a vet in. Damn mud!

[Scribbler]

The horse has no muscles below the knee or hock, just bones, tendons, and ligaments. Tendons and ligaments are a lot harder to heal than muscles, because they have less blood supply.

“Sprained fetlock” makes it sound similar to a human sprained ankle, but humans get to sit on the sofa with an ice pack for a week or two, and take the weight off while the ankle heals. Horses can’t.

I haven’t dealt horse ligament or tendon injuries myself (knock wood) but have been watching barn friends struggle with rehab from lower-leg problems, and have been following the COTH threads on the topic. From what I’ve seen and read, I’d encourage getting a more sophisticated and specific diagnosis at this point, and if it is tendons or ligaments, starting a coherent rehab program that might involve some stall rest. But also as other posters point out, the problem could be further up the leg, or in the hoof.

x

[AKB]

It is always hard for me to decide when I want an aggressive work up for a lameness and when I am content to wait a couple of weeks to see if it resolves itself. I always try to think of the worst case scenario. If it could be a fracture, a severely bowed tendon, an infected joint or an infected tendon sheath, I want a vet to come out ASAP to rule those things out. If the problems that would require immediate treatment are ruled out, I am usually content to wait a couple of weeks. If the horse is still lame, I then want nerve blocks, X rays, and often an ultrasound. OP, you are doing things the way I do them. You had a vet make sure there was nothing that needed immediate treatment. Now, since the horse is still lame, it is time for a work up.