This is the video of Dr. G analyzing the x-ray images. He compared the images took this year in 2010 to the images we took in 2006. This is just part of the reason why this man is so amazing.
Since I'm suspicious of the left front splint bone, I had Dr. G take some images of that area too. He compared them to the 2006 images. I don't have video of that analysis (I'm kicking myself for not getting that video!), but the end result was that the bottom part of the splint bone has fused to the cannon bone. This is both a good thing and a bad thing. It's good because the bone can no longer move and cause pain. But the bad thing is that if the bone can't move on the bottom, but can move on the top, it could possibly fracture if there is excessive pressure on the bone from the top. Everything looks fine now, and there is not much that can be done about it at this point, but it's something we need to be aware of in the future should Kaswyn come up suddenly very lame in the left front.
Here is the deal - changes in the navicular bone could be causing pain. Or there could be injury to one of the tendons in the foot. From the exam and the x-ray Doc has no idea of knowing what exactly is the source of the lameness. He gave me three treatment options, and one more diagnostic option.
Treatment Option #1 - Assuming the navicular bone is causing pain, treat with corrective shoeing and medications while continuing moderate work. This did not work last time, and if it's actually a tendon injury this could make the tendon worse.
Treatment Option #2 - Assuming the navicular bone is causing pain, repeat the neurectomy procedure, this time a little higher up to take care of any nerve regrowth in the area. This is not something I want to jump into quickly, or will take lightly. I already feel I was too hasty with the first neuroectomy. And this will not solve a tendon problem.
Treatment Option #3 - Assuming it's a problem with a tendon in the foot, put Kaswyn on stall rest and allow the tendon to heal. This would be very hard on my horse to be stall bound, and wouldn't be the best option for his arthritis. Keeping him moving keeps him from getting stiff, and a horse his age is better off working, at least lightly, than they are standing around. However all that time off will not help navicular pain, and would just result in Kaswyn simply standing in his stall for no reason, getting stiff and having his foot hurt.
Diagnostic Option - MRI
Yup, I could repeat the MRI. This would tell me exactly what's going on with the tendon, and therefore helping to decide what treatment option to choose. I'm not really gung-ho to spend the money, but it's important to do the right thing here. One good thing is that we have MRI images from 2006 to compare them to, if that will be helpful.
As we were discussing the MRI, Doc said "I know MRIs are expensive, and if this were just any old horse I wouldn't be recommending it at this stage. But this horse is special, and it's clear that you have a very special relationship with him. He's given you a lot, and he loves you, and I know that he's not just a horse to you. He means more to you than that. So I think the MRI will give you the best chance for success."
He almost made me cry right there.
We also discussed the fact that we had to heal the back, then the hocks, and then we were finally able to find this foot pain. I said "If he would just limp when his foot hurts, then I would know about it. But instead he manages his pain so he can keep working, and eventually he hurts his hocks, then his back, and that is when I finally feel it."
Doc said "That's because this horse has a lot of heart. Let's schedule that MRI."
So we did. I had my blacksmith pull his shoes the day before the MRI, and we went back to the clinic four days later.
To be continued...
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