Clinic Visit - Part 4

Part 1
Part 2
Part 3

My friend Z brought me and Kaswyn back to the clinic four days later for the MRI. We had a wait a bit while they finished up with the last MRI. Then they doped my poor pony up and brought him into the MRI suite.

It's a really cool setup. Here is the outer room. The floor is all rubber matted, and there are warning signs all over.



This is the MRI machine. The whole room is temperature controlled because changes in temperature affect the machine.



The metal cuff thing is what goes around the horses foot, and the leg is positioned between the two blue padded sides.



This is not part of the MRI suite, but it's a recovery room with a hoist in it. From the outside it just looks like a room where naughty ponies are sent to have time outs.



We were not allowed to watch the MRI process, because Kaswyn would remain standing but needed to stay absolutely still. If we were in the room or even looking through the window we could distract him and make him jump or twitch, which would make them have to start that series of pictures all over again.

Z and I went out to get some mexican food (which turned out to be very good!), then headed back to the clinic. When we got there, Dr. G and Dr. B were discussing the results of the MRI. Here is what Dr. B wrote down.

Diagnosis
LF Foot:
1) Large cystic fluid accumulation of the navicular bone at the doistal aspect.
2) Injury to the lateral collateral ligament of the distal interphalangeal joint. There is bone resorption at the insertion of the later collateral ligament. Done adema is detected in the laster aspect of P3.
3) Injury of the lateral aspect of the impar ligament.

RF Foot:
1) Focal area of fluid accumulation at the distal border of the navicular bone.

Diagnostic Exam Notes:
LF Foot:
1) LargeLarge Cystic accumulation distal aspect of the navicular bone
2) Injury of the lateral aspect of the impar ligament.
3) Bone adema involving the proximal lateral aspect of P3. This inflammation of the subchondral bone adjacent to the articular surface of the later aspect of P3.
4) Injury of the later collateral ligament fo the distal interphalangeal joint.

RF Foot:
1) Focal area of fluid accumulation at the distal border of the navicular bone.

So basically Kaswyn has two different ligament injuries, and some bone swelling. Both vets think that this is completely recoverable from. However, the navicular changes are an unknown. The tendon injuries are causing deep foot pain, which is not covered by the current neurectomy. Further changes in the navicuar bone could also cause deeper foot pain, which the neurectomy would not cover either.

So here is the treatment, as written by Dr. B.

Sugery, Therapy, and Expectations
Shockwave:
1)2000 hits LF foot later collateral ligament of the DIP joint every 14 days for a total of 3 treatments.

Exercise:
1) April 27 to May 26 - stall rest and handwalk only
2) May 27 to June 26 - can ride at the walk
3) June 27 to July 26 - can start adding yrot 3 days a week
4) July 27 - slowly return to normal work

Medications/Treatment
Shoeing:
1) Bar shoe and raise heels 2 degrees. Achieve medial to lateral hoof balance.

Medications:
1) Give 15 isoxsuprine orally am and pm for 120 days
2) Give 2 grams of bute orally once a day for 10 days, then 1 gram once a day for 10 days, then 1 gram every other day for 10 days.

I had to ask again if it was time to retire my horse. Again, Dr. G said no. The ligaments are not badly injured and they will heal, and if that takes care of the lameness then great. If it does not, then we have to assume it's the navicular changes that are making him hurt. In that case Dr. G will have to decide if he wants to repeat the neuroectomy or not. He would rather not, so we'll treat the ligaments and see.

The bad thing is that Dr G said he should not get turned out in the big pastures for quite a while. I don't know if that means while he's healing or ever again. I will clairfy this when we take Kaswyn back over for his second shock wave treatment.

Here is Kaswyn getting the shock wave treatment on his lateral collateral ligament. He got 2000 hits with the machine on the ligament.







Dr. B also said "Lets put 1000 hits on that navicular cyst and impar ligament, going up through the frog. I want to see if I can reduce or eliminate that cyst and treat that impar...it's worth a try!" They didn't bill me for that part of the shockwave. Yay!

Then I paid my bill (huge OUCH!), and we got Kaswyn back home. Fourteen days from that day we'll bring him back for another shock wave treatment, then another two weeks after that. By that time he'll be on light riding duty, at the walk only.

So right now I just have my little Albert to ride. And Kaswyn to hand walk, which we both hate!

To be continued...