Pedal osteitis
two types : Acute and Septic
Lameness increases with excercise, Gives rise to corns
Acute:
Caused by inflammation of the bone, often caused by an abscess. This will cause restriction of the blood supply, sometimes causes death of the boneand leaves a crater where the bone was. The blood takes dead bone away, this roughens off causes pain to associate instructures. This also happens with ringbone
Periodic Ophthalmia (Uveitis)
Cause:
Infection
reinfection
migration of microfilaria in the cornea or deeper tissue
Other viral infection
The nature of this disease can vary from weeks to more than 12 months.
chronic changes in the iris and lens
degenerative changes in the retina around the optic disc.
Infectious inflammation is linked to paralysis and the dilatory muscles resulting in constriction of the pupil and the risk of adhesion's
quick vet attention in all cases Uveitis to minimise the risk adhesion's
Infection
reinfection
migration of microfilaria in the cornea or deeper tissue
Other viral infection
The nature of this disease can vary from weeks to more than 12 months.
chronic changes in the iris and lens
degenerative changes in the retina around the optic disc.
Infectious inflammation is linked to paralysis and the dilatory muscles resulting in constriction of the pupil and the risk of adhesion's
quick vet attention in all cases Uveitis to minimise the risk adhesion's
PSD : Proximal Suspensory Desmitis
HORSE OWNERS COMMENT
1 . I had a horse here that had her nerves cut in both hinds and also the ligament sheath cut to make room for inflamation and prevent further pain. She made a 100% recovery and has a full athletic life, though not competing, just schooling, jumping and hacking. She was diagnosed with a bone scan and ultra sound. The operation was done at Rossdales and she was 13 at the time though had had the problem several years. The lameness was evenly bi lateral and so not picked up for a long time and her problems (rearing and falling over backwards etc) thought to be behavioural. The lameness was only finally discovered when she started to lose her back end when being worked on a circle.
2.
My boy was diagnosed with bi-lateral psd of fore limbs in march this year, having only been back in work a few months having damaged his collateral in both fore limbs last may. He was diagnosed by ultrasound and treated with shockwave every fortnight and cartrophen inj every week. He is still 1/10 lame on right fore and he wont have a neurectomy as i dont agree with it in his case. He is only lame when put on tight circle so its something we will avoid, he is happy and thats the most important thing for us! He is only 8 but hopefully given time and continued rehab he may come sound.
3.
Isn't the fasciotomy surgical option for PSD considered less troubling than denerving? Although it is often done in combination with denerving.
For some reason, I seem to recall reading that good images by ultrasound of the proximal suspensory can be difficult - or am I imagining having read that??
An article about fasciotomy etc.
http://www.vetmed.vt.edu/emc/welcome...esmoplasty.pdf
4.
My horse was diagnosed with PSD in one hind earlier this year (after an initial incorrect hock spavin diagnosis so not a fresh injury) the scan showed a small amount of disruption to the ligament but the vets admitted the scan was not very clear so they couldn't be sure but he did nerve block virtually sound to the PSD block.
He went lame again after 3 months back in work, I did then speak to Roger Meacock and as you have said he believes that the surgery is not solving the problem merely stopping them feeling the pain and I was really undecided for ages about what to do. From what I can gather Roger Meacock is likely to say that it is a problem with the feet or the teeth but I have a good dentist and farrier so I just don't think that it can be that with my horse but maybe I'm oversimplifying it! It was also going to be very expensive to have him come out to my horse and I was worried that even if the insurance paid for it it would use up a lot of the remainder.
I was also concerned that I only had a year from making the initial claim to have any chance of having the op covered by the insurance so didn't want to hang around too much trying different things.
In the end I spoke to some friends and also my physio who knew of many horses who had had the op and returned to full athletic work and also had a referral to a second vet (not that I didn't trust the first one I just wanted to make sure) who confirmed the diagnosis and reccommended the op as well so we went ahead.
Now 10 weeks on he is back out in the field as normal and coming back into work feeling good so far.
I had the op at Pool House vets, my vet (Chine House) wanted to refer me to Newmarket as they wanted him nerve blocked under saddle to make sure the op was going to bring him sound and they don't offer this themselves but Pool House can do this so I went to them and just continued with them for the op.
I was also worried about the GA as my horse is a 17hh and 750kg but it all went fine, he was back to normal (other than a big bandage) the next day and handled the box rest and in hand walking OK.
Well we are only walking but I have had a few 'test' trots and he does feel sound so far fingers crossed. We've now pretty much done all we can do so just got to build up the work really gradually and see how he goes.
£500 per shockwave seems expensive! I'm sure mine was only £200 each plus cost of visit and sedation (they bought a mobile one to me for the 2nd and 3rd).
5:
My horse was diagnosed with PSD in right hind about 6 weeks ago, following nerve blocks, ultrasounds and x-rays. My vet was fantastic, and gave me a range of treatment options, including e-PET, where concentrated platelets are injected back into the damaged area to stimulate regrowth. This was the treatment I selected, and he had his first post-treatment scan last week, and we could already see the fibres in the ligament returning. OK - he's been on 4 weeks box rest and now has a 9 month controlled exercise rehabilitation program, but if at any time the treatment appears not to be working nay more, we still have time for the op. And - only one more week and he can go back out to his field.
6: mine has been diagnosised with PSD about 3 months ago now by ultrasound and nerve block of the suspensorys. Due to her history she is not a surgical candidate she is also not insured for this problem due to other problems she has so we we are quite limited on options. we have had shockwave and certian shoes on behind to help. other than that she is out in the field and will remin so till next spring. For many reasons this is how we are treating her the chances for her returning to full work is very slim especially with her other problems but its worth a shot.
Kate is also my physio and physio at work and cant recomened her enough if she thinks something else is going on there probably is. Has she spoken to your vet? have they seen the horse together?
If you really feel something else is going on talk to your vet is your vet and orthopedic vet? With the many issues mine has had i would say make sure you have a good ortho vet and and a good rapore with them. gut instinct counts for a lot.
It maybe there is another issue but until you have treated one problem you wont find the original problem or the one you are see the symptoms of if that make sense.
7.
took a 5 year old pony mare to Sue Dyson a couple of years back now. She diagnosed PSD in both hind limbs, and it was already severe.
She said it was very unusual to see this damage in a pony so young and with such a careful workload, and that we needed to think about how it had been caused.
The first thing she noticed about my mare was her straight hind limb conformation. When I look back on old photos of her as a weanling/yearling, I can see the straight hind limb conformation in those photos............. but never noticed it at the time.
The straight hind limb conformation is common in those with suspensory problems.
She had never had a day when I felt she was overtly lame, and it appeared that the condition had just gradually come on.
My belief is that it was degenerative suspensory ligament disease (sometimes called ESPA, equine systemic proteoglycans accumulation). Google it, and you will come up with a website and photos etc on it.
As such, I chose to have my mare put to sleep, because the odds were on it being degenerative, and so there was no light at the end of the tunnel, and she was clearly not the pony that she had been (no joy in movement, either in work or on the yard or in the field).
I remember hearing one vet say that he would never perform the nerve cutting op on a competition horse or on a child's pony, because he felt it was wrong to cut the nerve and then subject the horse to an intense workload. I feel the same way. He said he would be happy to perform it on a horse who was just going to be used as a light hack, with a careful and limited workload.
I'm rambling on like this, because I think it's important that you know that there is a degenerative condition, and old photos may help you weigh up whether you feel your horse has that, if you have photos of them side on, and you can look how dropped the fetlocks are, and how near straight the hock angle is etc.
Had my mare's condition not been degenerative, I may have tried an op.
Oh, SD carried out various investigations including bone scan, and it all came to around £3,000.......... but then we had no idea where the problem lay initially as she presented with a reluctance to go forward under rider. However, it was the ultrasounds which proved conclusive, and SD was able to categorise them as "mild" "moderate" or "severe".
8.
Steroid injections are an option also shockwave treatments sometimes have good results.
Is your boys PSD showed up on xray that means the ligaments started to calcify which usually means vet recommended surgery straight away.
Had two horses both go through the operation and it in itself it is pretty successful and they recover well.
Remember that it's a branch of the nerve that is cut not the whole nerve so the horse can feel other parts of it's leg just fine including the foot and the lower part of the suspensory.
So any major suspensory damage and the horse would still be able to feel it.
The de-nerving is so the horse doesn't feel the pain and hence can start moving correctly again which actually help heal the suspensory more than when they are compensating for it hurting.
There's some very detailed posts on it , on here if you have a good search about.
Good luck what ever you decide to do.
Both my boys were successes post operation but then came down with other issues that meant they were retired.
9:
My mare has just had the op for PSD and is also young like yours OP. She's 7 but has been a broodie since breaking in germany as a 3yr old and had only been in work 3 months when diagnosed. Also only 1/10th lame but not willing to go forward under saddle. Diagnosed with nerve blocks and scan, her damage is also chronic, probably done when she was being prepared for her mare test as a 3yr old. We tried shockwave with her which improved her movement but the scan remained the same. So I went down the neurectomy and fasciotomy route as I felt I had to try and even if she has no competition career ahead of her, at least she'll be comfortable. We are now into the 3rd week post op and walking out twice a day inhand. Another few weeks and we'll see if she's sound enough to start ridden work.
All I can say is this, if the damage is old, no amount of shockwave, rest, physio or steroids will help. The ligament has already mended scarred and uneven and no longer sits comfortably in the space it should fit in. This is why an op is probably the only chance your horse will have of coming sound. If the injury had been acute, I would say go for the shockwave etc as it helps to heal the fibres of the ligament in the correct way, but it sounds like your is too far past that now. Believe me, I have broken my heart over this mare and making my decision, I have cried and cried, but I'm glad I went for the op. Only time will tell if it has worked. My vet has said that often bone pain, joint problems, sacro-illiac pain etc etc can be associated with PSD due to the way in which the horse has been carrying itself to compensate for the discomfort.
10.
My horse had the operation in both hind legs seven weeks ago. He had nerve blocks, xrays and scans to reach diagnosis and referral for second opinion of the vet who did the surgery. He was on a programme of box rest with in-hand walking starting with 10 minutes and building up to 30 by the end of the 6 weeks. Vet then came to review him and said he could be turned out for couple of hours a day, sedated initially with view to building up to going out for couple of weeks before having physio and then starting ridden work.
He is now lame again and back on box rest, thought it was infection, but didn't respond to antibiotics so hoping he has just clonked himself in field. Will be reviewed in 10 days. I am not entirely sure that in his case op will have solved his problems, but decided to go for it incase insurance ran out and alternatives e.g. shockwave didn't work. Do think about what you want the horse to do after, won't be able to compete under FEI rules and may effect if you want to show, mine has currently got what looks like two curbs on hocks
11.
Right everyone, vet and physio saw my horse this morning and some positive news. Since his last physio session 2-weeks ago (under vet sedation) he looks much better apparently, so pleased with that. Vet did ultrasound scans and has confirmed it is PSD (in right hind mainly but bit in left hind). No tears or anything apparently it’s at top as is fine further down. She has confirmed it as chronic.
We spoke about options and she can totally understand why I am not keen on the operation (due to my horse being a total wimp! It took me about 1.5 weeks until he would be normal again after nerve blocking, as he was petrified every time I picked a hoof up!). Anyway, final 3 options are:
1. shock wave: only 40% successful so I’m going to forgot that option as it isn’t worth it
2. Cortisone injections: 50% successful
3. Equidronate (Tildren): 50% successful
Vet and physio said that the 3rd option might be good for him because it would help his whole body out (as he is sore from over compensating elsewhere). There is a risk of colic with it apparently, so he would have to go to the vets to be monitored (as it is via a drip).
2.
My boy was diagnosed with bi-lateral psd of fore limbs in march this year, having only been back in work a few months having damaged his collateral in both fore limbs last may. He was diagnosed by ultrasound and treated with shockwave every fortnight and cartrophen inj every week. He is still 1/10 lame on right fore and he wont have a neurectomy as i dont agree with it in his case. He is only lame when put on tight circle so its something we will avoid, he is happy and thats the most important thing for us! He is only 8 but hopefully given time and continued rehab he may come sound.
3.
Isn't the fasciotomy surgical option for PSD considered less troubling than denerving? Although it is often done in combination with denerving.
For some reason, I seem to recall reading that good images by ultrasound of the proximal suspensory can be difficult - or am I imagining having read that??
An article about fasciotomy etc.
http://www.vetmed.vt.edu/emc/welcome...esmoplasty.pdf
4.
My horse was diagnosed with PSD in one hind earlier this year (after an initial incorrect hock spavin diagnosis so not a fresh injury) the scan showed a small amount of disruption to the ligament but the vets admitted the scan was not very clear so they couldn't be sure but he did nerve block virtually sound to the PSD block.
He went lame again after 3 months back in work, I did then speak to Roger Meacock and as you have said he believes that the surgery is not solving the problem merely stopping them feeling the pain and I was really undecided for ages about what to do. From what I can gather Roger Meacock is likely to say that it is a problem with the feet or the teeth but I have a good dentist and farrier so I just don't think that it can be that with my horse but maybe I'm oversimplifying it! It was also going to be very expensive to have him come out to my horse and I was worried that even if the insurance paid for it it would use up a lot of the remainder.
I was also concerned that I only had a year from making the initial claim to have any chance of having the op covered by the insurance so didn't want to hang around too much trying different things.
In the end I spoke to some friends and also my physio who knew of many horses who had had the op and returned to full athletic work and also had a referral to a second vet (not that I didn't trust the first one I just wanted to make sure) who confirmed the diagnosis and reccommended the op as well so we went ahead.
Now 10 weeks on he is back out in the field as normal and coming back into work feeling good so far.
I had the op at Pool House vets, my vet (Chine House) wanted to refer me to Newmarket as they wanted him nerve blocked under saddle to make sure the op was going to bring him sound and they don't offer this themselves but Pool House can do this so I went to them and just continued with them for the op.
I was also worried about the GA as my horse is a 17hh and 750kg but it all went fine, he was back to normal (other than a big bandage) the next day and handled the box rest and in hand walking OK.
Well we are only walking but I have had a few 'test' trots and he does feel sound so far fingers crossed. We've now pretty much done all we can do so just got to build up the work really gradually and see how he goes.
£500 per shockwave seems expensive! I'm sure mine was only £200 each plus cost of visit and sedation (they bought a mobile one to me for the 2nd and 3rd).
5:
My horse was diagnosed with PSD in right hind about 6 weeks ago, following nerve blocks, ultrasounds and x-rays. My vet was fantastic, and gave me a range of treatment options, including e-PET, where concentrated platelets are injected back into the damaged area to stimulate regrowth. This was the treatment I selected, and he had his first post-treatment scan last week, and we could already see the fibres in the ligament returning. OK - he's been on 4 weeks box rest and now has a 9 month controlled exercise rehabilitation program, but if at any time the treatment appears not to be working nay more, we still have time for the op. And - only one more week and he can go back out to his field.
6: mine has been diagnosised with PSD about 3 months ago now by ultrasound and nerve block of the suspensorys. Due to her history she is not a surgical candidate she is also not insured for this problem due to other problems she has so we we are quite limited on options. we have had shockwave and certian shoes on behind to help. other than that she is out in the field and will remin so till next spring. For many reasons this is how we are treating her the chances for her returning to full work is very slim especially with her other problems but its worth a shot.
Kate is also my physio and physio at work and cant recomened her enough if she thinks something else is going on there probably is. Has she spoken to your vet? have they seen the horse together?
If you really feel something else is going on talk to your vet is your vet and orthopedic vet? With the many issues mine has had i would say make sure you have a good ortho vet and and a good rapore with them. gut instinct counts for a lot.
It maybe there is another issue but until you have treated one problem you wont find the original problem or the one you are see the symptoms of if that make sense.
7.
took a 5 year old pony mare to Sue Dyson a couple of years back now. She diagnosed PSD in both hind limbs, and it was already severe.
She said it was very unusual to see this damage in a pony so young and with such a careful workload, and that we needed to think about how it had been caused.
The first thing she noticed about my mare was her straight hind limb conformation. When I look back on old photos of her as a weanling/yearling, I can see the straight hind limb conformation in those photos............. but never noticed it at the time.
The straight hind limb conformation is common in those with suspensory problems.
She had never had a day when I felt she was overtly lame, and it appeared that the condition had just gradually come on.
My belief is that it was degenerative suspensory ligament disease (sometimes called ESPA, equine systemic proteoglycans accumulation). Google it, and you will come up with a website and photos etc on it.
As such, I chose to have my mare put to sleep, because the odds were on it being degenerative, and so there was no light at the end of the tunnel, and she was clearly not the pony that she had been (no joy in movement, either in work or on the yard or in the field).
I remember hearing one vet say that he would never perform the nerve cutting op on a competition horse or on a child's pony, because he felt it was wrong to cut the nerve and then subject the horse to an intense workload. I feel the same way. He said he would be happy to perform it on a horse who was just going to be used as a light hack, with a careful and limited workload.
I'm rambling on like this, because I think it's important that you know that there is a degenerative condition, and old photos may help you weigh up whether you feel your horse has that, if you have photos of them side on, and you can look how dropped the fetlocks are, and how near straight the hock angle is etc.
Had my mare's condition not been degenerative, I may have tried an op.
Oh, SD carried out various investigations including bone scan, and it all came to around £3,000.......... but then we had no idea where the problem lay initially as she presented with a reluctance to go forward under rider. However, it was the ultrasounds which proved conclusive, and SD was able to categorise them as "mild" "moderate" or "severe".
8.
Steroid injections are an option also shockwave treatments sometimes have good results.
Is your boys PSD showed up on xray that means the ligaments started to calcify which usually means vet recommended surgery straight away.
Had two horses both go through the operation and it in itself it is pretty successful and they recover well.
Remember that it's a branch of the nerve that is cut not the whole nerve so the horse can feel other parts of it's leg just fine including the foot and the lower part of the suspensory.
So any major suspensory damage and the horse would still be able to feel it.
The de-nerving is so the horse doesn't feel the pain and hence can start moving correctly again which actually help heal the suspensory more than when they are compensating for it hurting.
There's some very detailed posts on it , on here if you have a good search about.
Good luck what ever you decide to do.
Both my boys were successes post operation but then came down with other issues that meant they were retired.
9:
My mare has just had the op for PSD and is also young like yours OP. She's 7 but has been a broodie since breaking in germany as a 3yr old and had only been in work 3 months when diagnosed. Also only 1/10th lame but not willing to go forward under saddle. Diagnosed with nerve blocks and scan, her damage is also chronic, probably done when she was being prepared for her mare test as a 3yr old. We tried shockwave with her which improved her movement but the scan remained the same. So I went down the neurectomy and fasciotomy route as I felt I had to try and even if she has no competition career ahead of her, at least she'll be comfortable. We are now into the 3rd week post op and walking out twice a day inhand. Another few weeks and we'll see if she's sound enough to start ridden work.
All I can say is this, if the damage is old, no amount of shockwave, rest, physio or steroids will help. The ligament has already mended scarred and uneven and no longer sits comfortably in the space it should fit in. This is why an op is probably the only chance your horse will have of coming sound. If the injury had been acute, I would say go for the shockwave etc as it helps to heal the fibres of the ligament in the correct way, but it sounds like your is too far past that now. Believe me, I have broken my heart over this mare and making my decision, I have cried and cried, but I'm glad I went for the op. Only time will tell if it has worked. My vet has said that often bone pain, joint problems, sacro-illiac pain etc etc can be associated with PSD due to the way in which the horse has been carrying itself to compensate for the discomfort.
10.
My horse had the operation in both hind legs seven weeks ago. He had nerve blocks, xrays and scans to reach diagnosis and referral for second opinion of the vet who did the surgery. He was on a programme of box rest with in-hand walking starting with 10 minutes and building up to 30 by the end of the 6 weeks. Vet then came to review him and said he could be turned out for couple of hours a day, sedated initially with view to building up to going out for couple of weeks before having physio and then starting ridden work.
He is now lame again and back on box rest, thought it was infection, but didn't respond to antibiotics so hoping he has just clonked himself in field. Will be reviewed in 10 days. I am not entirely sure that in his case op will have solved his problems, but decided to go for it incase insurance ran out and alternatives e.g. shockwave didn't work. Do think about what you want the horse to do after, won't be able to compete under FEI rules and may effect if you want to show, mine has currently got what looks like two curbs on hocks
11.
Right everyone, vet and physio saw my horse this morning and some positive news. Since his last physio session 2-weeks ago (under vet sedation) he looks much better apparently, so pleased with that. Vet did ultrasound scans and has confirmed it is PSD (in right hind mainly but bit in left hind). No tears or anything apparently it’s at top as is fine further down. She has confirmed it as chronic.
We spoke about options and she can totally understand why I am not keen on the operation (due to my horse being a total wimp! It took me about 1.5 weeks until he would be normal again after nerve blocking, as he was petrified every time I picked a hoof up!). Anyway, final 3 options are:
1. shock wave: only 40% successful so I’m going to forgot that option as it isn’t worth it
2. Cortisone injections: 50% successful
3. Equidronate (Tildren): 50% successful
Vet and physio said that the 3rd option might be good for him because it would help his whole body out (as he is sore from over compensating elsewhere). There is a risk of colic with it apparently, so he would have to go to the vets to be monitored (as it is via a drip).