# Coffin Joint Arthritis - Am I Being Realistic



## sasquatch (8 May 2017)

B was diagnosed just under two weeks ago with arthritic changes in his coffin joint on his front left, has been given the steroid injection to see if it helps and is slowly being brought back into work atm.

He is 16, has always been very sound and wasn't showing any signs of slowing down. Lameness seemed to come on nearly overnight, and was only able to be spotted on a circle. 

Vet came out after he had had his feet done (he was overdue and I wanted to check the lameness wasn't due to that or another issue with his feet first) and diagnosed the arthritis after x-rays. B was sound when trotted on a straight line and after flexions but not on a circle. Vet didn't say anything about him not being able to do things and not being able to do the work he was doing before (he's essentially a RC-type horse, was in work 7 days a week and jumped maybe once or twice a week at most, although it was probably closer to once every two weeks)

I'm meant to be going to uni in September, and sadly won't be able to take him with me as far as I can tell. I know now it's going to be much harder to rehome him full stop, but am I being unrealistic in thinking if the steroid injection works he'll be able to go back to doing what he was doing before? I need to discuss with vet when he is next out, but I've spoken to a few people and some have said horses can come back fine and know some that have, whilst others have said the opposite and had the opposite experiences.

B isn't being the best patient either so probably not helping himself too, but I know he's getting bored and frustrated and it's not his fault


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## ester (8 May 2017)

It's always tricky to know with injecting and of course even if they do work then they tend to work less each time you repeat them, you can only try and see really on that front. I would certainly be careful why I did on what ground after that dx.


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## sasquatch (8 May 2017)

ester said:



			It's always tricky to know with injecting and of course even if they do work then they tend to work less each time you repeat them, you can only try and see really on that front. I would certainly be careful why I did on what ground after that dx.
		
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Rode him today and he's back to being as lame as he was before he was injected. I'm heartbroken. He is mentally raring to go and get back to doing what he was as if he hasn't had a day out but in trot is not sound at all. 

he isn't great to hack so usually would be in the arena or field and occasionally would hack and rarely on the road. Arenas are sand and harrowed and watered regularly. 

I did see my farrier today who said he could try new balance shoes to see if they help him, and I've just had my vets bill in today and don't want to have anything added to it and vet didn't want to see him for what would be another 2 weeks (he wanted him back in full work before he saw him again, but he's not even sound to trot under saddle atm) and it'll be 6 weeks since his feet were done next week so I feel like I might as well try that first. I might ring the vet and see if I can speak to him too. 

It really is not looking good for him if he doesn't come sound, I was hoping I could have one last summer with him before he went to his new home and now it doesn't look like that will be happening. I'd be happy even if he came sound just for the summer so I could do some more dressage and just enjoy him and he had to be retired after that. I at least know he's definitely field sound which is a relief, and he isn't on bute or danilon either.


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## ester (8 May 2017)

The trouble with arenas is circles, which can be problematic. I am a big believer in hacking having really helped mine, slow straight lines. 
do you mean natural balance? The suggestion would be that it would bring the breakover back but I wouldn't be keen to have them on one of mine and think you can do just as good a job of that in standard shoes. How do his feet look?

I do know how you feel, we injected Frank (he had a coffin joint DJD dx, blocked to joint, nothing to see on xray) and he was better for a couple of weeks until the work increased then was back to 2/3 tenths lame. That was when I took his shoes off. In part because if he was retiring to the field (19 at the time) he didn't need shoes on. Of course he then came sound so didn't end up with the retirement he perhaps had planned.


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## sasquatch (8 May 2017)

ester said:



			The trouble with arenas is circles, which can be problematic. I am a big believer in hacking having really helped mine, slow straight lines. 
do you mean natural balance? The suggestion would be that it would bring the breakover back but I wouldn't be keen to have them on one of mine and think you can do just as good a job of that in standard shoes. How do his feet look?

I do know how you feel, we injected Frank (he had a coffin joint DJD dx, blocked to joint, nothing to see on xray) and he was better for a couple of weeks until the work increased then was back to 2/3 tenths lame. That was when I took his shoes off. In part because if he was retiring to the field (19 at the time) he didn't need shoes on. Of course he then came sound so didn't end up with the retirement he perhaps had planned.
		
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Yes, they're natural balance! He was 2 fifths lame (so 4/10s? my maths isn't great) on a circle so he was quite lame, and with nerve blocking wasn't then 100% but was significantly better. His feet otherwise are good, vet said they were very well balanced just with the normal shoes on and I don't know if he'd cope with shoes off as he's a wuss and when he did only have front shoes on he did end up getting footy in his back feet when he was in work.

We don't have hacking that isn't up quite a steep hill and it's quite rocky/boggy and he isn't good to hack anyway so I'm not sure if it'd be the best option for him. From what I can remember, vet said he had slight arthritic changes in his coffin bone when x-rayed but didn't say anything about it being significant and said if injections work he should be able to be back as he was in work. I've never had a problem with him before, and he went from sound to unsound overnight and the arthritis was what was diagnosed.

I am absolutely in bits because it makes what I'm now doing in terms of my academic year really in question and it makes what's happening with B an even bigger question, I was hoping if the injections worked I'd at least be able to get him out on loan for a few years before he'd be able to come and join me and be retired/semi-retired which was always the plan. 

I'm going to speak to my boss tomorrow as undoubtedly she'll have experience with something like this and will probably be able to point me in the right direction - she spotted the lameness in the first place as when ridden on a harrowed arena it didn't appear too bad, but on the carpark/hard ground it did. That said, when he escaped and ran over the hard ground he apparently looked really sound but I'm not sure if it was just adrenaline


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## Red-1 (8 May 2017)

I worked with one with a  coffin joint issue, it was injected and the horse had shoes pulled and started with in hand walking and built that up to half an hour before swapping to ridden work. The horse did about 8 weeks at walk only, in straight lines, before starting a very small amount of trot, also in straight lines. He went back to dressage type work (still barefoot), but it was 4 months before he was even doing light schooling. 

I think this sounds like it is very close to the initial treatment, and it may well take more time. I also think removing the shoes helps with internal concussion, and doing a steady transition allows time to heal.


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## ester (8 May 2017)

That's interesting Red, F didnt canter until 4 months in (straight line), schooled at 5 did a prelim at 6. But I generally took it very slow compared to some others - mostly cos at his then age I figured one shot . 

However I do suspect with him, given the subsequent lack of detioration too that we were dealing with in part a soft tissue issue. His lateral landing made me think some collateral element anyway even though it definitely blocked to joint. 


Sasquatch are you able to turn him out 24/7 without him getting too fat and without restricting his movement? I say this as I think you are going to lack the time (with regards to heading to uni) and the set up (I know what you mean about hills too that is why F is now several hundred miles away from me, great things when you need them, not when you don't!) to go through that so I am inclined to say shoes off, turn him away and if he comes back sound at some point then great.


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## Red-1 (8 May 2017)

ester said:



			....However I do suspect with him, given the subsequent lack of detioration too that we were dealing with in part a soft tissue issue. His lateral landing made me think some collateral element anyway even though it definitely blocked to joint.
		
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This does sound similar, it did block to the joint, but the vet also suspected collateral ligament involvement. As I was not prepared to fund an MRI for what would be similar treatment, he had an injection into where it blocked to, whipped of the shoes and started walking.

I think we stayed out of the school for so long partly because I was so enjoying re-modelling his feet! It was fascinating how just one walk would change the appearance. We did not do more then 40 minutes on the road though, as this is when he seemed to feel it.

He has been on/off somewhat since, but generally sound and not needing pain relief, standing up to hacking and some dressage. This is now 6 years on, it has not progressed and he is an older teenager.


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## ester (8 May 2017)

I had the same view on MRIng, it was never suggested but would have been pointless for the outcome anyway. We did a couple of cycles in bar shoes in which time farrier got the feet looking much better on the outside but didn't really help beyond that.

We never had a school . F had some reverse rotation of his pedal bones but the same in both so that didn't really explain it  but did mean he was very flat footed so not a shoes off and go job. Given his landing the vet pondered sidebone but nope. He still moves welsh ( bit dishy ) but stopped the lateral landing on the bad foot, started it a bit on the good! 

He is 24 now, it is his hock (s?) annular ligament on the other side of the hock and funky liver that have caused him to require a relocation and slow down nothing to see up front at all. He was hilly (wiltshire) hunting and perfecting our half passes stressaging better than ever (because we then had a school) at 23.

I'm sending myself for a work up tomorrow


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## Accidental Eventer (9 May 2017)

I could have written the same post last year. My mare went from being slightly off one day in a lesson, took her to the vet where flexion tests and nerve blocks showed lameness in all 4 legs, in the coffin joint. Radiographs only show so much in the coffin joint because of the type of joint it is, and where we are we have only very recently gotten MRI facilities so that wasn't an option at the time. Radiographs showed her coffin bone was not in alignment with the rest of her bones (think opposite to laminitis) which was putting pressure on all her joints, tendons and ligaments. 

On the vets suggestion we remedially shod her to no improvement (she was already shod), then injected steroids to no improvement. She then rested for 8 weeks, before we re-injected with steroids and joint fluid and again she showed no improvement. She is currently spelling barefoot to see if this will improve her, but at this point I would not say she is paddock sound. 

She seems ok in a straight line but not 100% and she is obviously lame on a circle. I was hoping to get her sound enough to hack however I don't think that is going to happen.

It is horrible to have to go through and my mare is not happy being in a paddock without work, she very much seems to have lost her spark and at 9 she is still young. At this point I don't quite know where we are going to end up.

It sounds like you haven't run out of options yet, so my fingers are firmly crossed for you, I only wish I had a more positive story to share. My vet was confident that should the injections have worked she would have been back out eventing this season to the equivalent of BE100 (and above!).


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## taraj (9 May 2017)

Watching with interest! My horse was diagnosed with hock arthritis last year which we injected and followed a strict fitness plan. His hocks were doing pretty well and he was enjoying work again when he went lame on the front. X-Rays show slight inflammation of the coffin so steroids injections were suggested again but having asked around they don't seem to be as successful in the coffin joint. Also this would mean box rest for a bit and back to the strict fitness program, that's without the risk of lami due to the steroids.
After a lot of thought, I have taken his shoes off and turned him out for a bit, strangely he seems sounder without his shoes. Although 1/2  tenths lame still but happy to have a run around! Its hard to know what the future will bring, he is only 7 and loves to work, if he comes back in lame then we can try the injection.
Even if they do come sound its a condition that will always need managing carefully, personally I wouldn't want to put a horse out on loan with it unless I could 100% trust the loaner.


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## Andalucian (9 May 2017)

taraj said:



			strangely he seems sounder without his shoes. .
		
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Not strange to me, I own two coffin joint arthritis survivors. Took both barefoot at 10, now 22. Going hunter trialling this weekend on both.........


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## sbloom (10 May 2017)

Agreed, not strange at all to be better with no shoes.  I had a horse like this years ago, he was a lot better in NB shoes, after bar shoes for years supposedly expertly applied, but I lost him for another reason too soon afterwards to know if it would have been successful long term.  If I went through this again?  I'd go barefoot, no question.


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## taraj (10 May 2017)

Andalucian said:



			Not strange to me, I own two coffin joint arthritis survivors. Took both barefoot at 10, now 22. Going hunter trialling this weekend on both.........
		
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That's good to hear!.

I was slightly worried about taking hinds off due to his hock arthritis but so far it doesn't seem to have made a difference.

The vets do seem to push at getting shoes on/heel supports rather than taking shoes off but I would be happy to try him barefoot if he comes sound.


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## Andalucian (10 May 2017)

taraj said:



			The vets do seem to push at getting shoes on/heel supports rather than taking shoes off but I would be happy to try him barefoot if he comes sound.
		
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My vets also wanted bar shoes, raised heels etc, I laughed, I've done it before and failed. These two horses I took barefoot INSTEAD of following vets advice and I'd do it again every time. In shorts remedial shoeing makes things worse, although they temporarily appear to provide some pain relief......don't be fooled.


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## ester (10 May 2017)

taraj if your has hock arthritis I would also say let the hooves be what they want to. Mine generates his own small lateral extension on his bad side


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## sasquatch (11 May 2017)

So small update, as I'm feeling a bit more positive.

Our fields opened on Saturday, B is not out 24/7 yet but is out from about 9/9.30 until around 5.30-6.30 atm (although he'll sometimes come in a bit earlier). Monday he seemed as bad as he was before injections when asked to trot in the arena on the long side, but yesterday I decided to get on him not expecting much and whilst he didn't feel 100%, he felt sound on his 'good' rein (he had a bit of a moment too and decided to do his head swish and try and leap into canter when asked to trot) and on his 'bad' rein he seemed to be a bit hoppy at first, but after a trot on his good rein and then back to his bad he seemed nearly back to normal. I've yet to actually get the farrier out but I texted him a few days ago and I'm waiting to hear what he says - I am totally open to trying natural balance shoes, and if they don't help, I am also happy to try barefoot too. 

We did 2 short trots on each rein around half the arena, so essentially a big rectangle as the arena is square. 

I'm not sure how much of his 'bad' rein (the rein he looked lamer on) being worse is due to being unbalanced as he hasn't been rode much in about 6/7 weeks or if he still isn't completely 100%. He is more than happy to trot round his field and whilst he's a good doer, atm I'm keeping an eye on the grass and his weight and the size of field he has is big enough he can have a canter if he wants but not too big. He felt much happier to move forward when asked too under saddle in his walk and I got a much better walk, including him starting to actually hold himself and use his back end whilst I was able to feel a very light contact with his mouth so hopefully this is the start of things starting to work. I'm telling myself not to be too hopeful as I think sometimes it's when things start to seem to be going well you end up more disappointed when they don't. 

I'm still not sure what I'll do with him when I'm at uni, because sticking him in a field for 4 years may be easier said than done. I may be able to bring him down with me for grass livery, depending on where I go, but atm it depends if he does come right and how right he comes. If he does come right when out 24/7 and is sound to do local/RC-type things I might not have to worry as much. So atm I'm taking everything as it comes and building it up slowly, but also hoping he comes right with enough time that I can plan what to do next year. 

He was only lame in the one leg and seems to only be arthritic in the one leg - he can get stiff when he's not in work which tbh doesn't help when trying to feel if he seems normal or not, but that's usually behind and he does come out of that after he's been  given a long warm up. 

also ester, reading your earlier post about your horse dishing - interestingly in the 6 years I've had him he has always dished. I'm not sure on which foot, but I think it may actually be his front left which is the one he's been diagnosed in. He does have an odd way of going as he's got trotter in him, but it never seemed to bother him but you do wonder 

I didn't have the option of MRI as I have no box and vet came out with portable x-ray anyway. He was 100% on a straight line and after flexions, just not when put on a circle on hard ground, so I'm hoping that in itself is a good sign too as it has only ever been on the circle that he's really looked lame.


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## ester (11 May 2017)

If you are interested it might be worth getting some footage from head on and then slow it down and see which part of the hoof hits the ground first. This was the only noticeable thing that was different on Frank's lame side in person or on xray.

Can I advise sticking him on some boswellia too? It definitely helped Frank's back end, not as much as a steroid injection did but it isn't expensive and is a general anti inflammatory.


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## sasquatch (12 May 2017)

ester said:



			If you are interested it might be worth getting some footage from head on and then slow it down and see which part of the hoof hits the ground first. This was the only noticeable thing that was different on Frank's lame side in person or on xray.

Can I advise sticking him on some boswellia too? It definitely helped Frank's back end, not as much as a steroid injection did but it isn't expensive and is a general anti inflammatory.
		
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Haven't heard of boswellia, but I'll look into it, thank you ester 

atm, it might be a bit hard to get head on footage of him hehe, but I'm fairly sure you can actually see it in photos at times. that said, all the recent photos I can see it looks like he's actually stopped dishing or isn't doing it as much, so I'm not sure if that's a good thing or not!


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## ester (12 May 2017)

It's not the dish that is the problem per se, as a lot of that movement is in flight/affects break over more. So Frank for instance rolls off the outside of his hoof (say 10/2 position) and this is why he has never been self trimming. He will then have a dishy limb flight but now when the hoof hits the ground it does so square (and heel first as he wears no shoes). Compare this to previously he was landing on the outside of the hoof and flat that is a lot of impact for just one side of the hoof to take. 

It can be hard to see, we only spotted it by videoing and slowing down and doing frames on the landing in walk on a hard level surface. I suspect he had been like that for a few years so had developed some chronic issues because of it.

https://rahiiq.com/products/1kg-boswellia-horse-feed


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## sbloom (16 May 2017)

I think you've realised what was meant by the barefoot recommendations, not that it's a good way to be once he's cured, but that is much more likely he'll be cured if you GO barefoot, now or asap.  With the right knowledge and the right support, lots of reading needed .


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## cobwithattitude (18 May 2017)

Reading this with interest, as my mare was diagnosed with coffin joint arthritis in both fronts. she already has arthritis in her patella and mid spine, as well as SI disease.  I have retired her from competing and decided I am not going to have any more injections done - I am now wondering about barefoot.  She is only lame on a small circle.  I can manage her with Danilon but just wonder when enough is enough.


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## sasquatch (24 May 2017)

To give another update on him, am having a few issues as he is being a maniac and back to his normal self of wanting to go as fast as possible.

He's a trotter, who was possibly road raced when he was young and I do think this could well have contributed as he does have a more unusual trot.

I had a lesson with him yesterday (first one in ages) and instructor said he is looking much better. He's 100% on a straight line on both reins, looks pretty much 100% on his right rein (which was previously his 'bad' rein when he was lame) but on his left can look a bit hoppy on tighter turns but when I balance him it isn't as noticeable. Instructor says it's a big improvement, as he was quite lame. We are only doing trot, and trotting big circles/nothing tight atm but starting to up the trot work and he seems to be getting better. Instructor has also said to keep an eye on him and if he keeps getting better then good, if not this might be as sound as we can get him. 

He is still 100% field sound so semi-retirement or full retirement is still an option if it comes to that, although he is getting that excitable and as he is feeling better, he's now getting bored and being silly when he's ridden too so he may not be suited to semi retirement lol. 

He's had his back shoes off, and now has the natural balance shoes on in front. If they help keep him sounder and he keeps improving then I'll keep them on him, if they don't make much of an improvement I'll try barefoot. He's had back shoes on for a good 3-4 years so he's still getting used to not having them on. He isn't tripping as much in front when he's ridden, but occasionally will trip behind if he's not picking his feet up. 

He did manage to trip when leaving the indoor yesterday after our lesson, I wasn't riding but was walking and I don't know if he tripped behind and then struggled to save himself in front or spooked then tripped but he nearly went down on his knees. It was his good leg he tripped on (I did have an oh **** moment when he tripped as I just saw legs going and thought it was his 'bad' leg) but he kept himself upright and did take a few lame steps in walk so I am hoping it was just that he'd tripped and gone ouch, for a bit. There were no cuts or bleeding and I couldn't feel any heat so left him out last night anyway, so hopefully he hasn't damaged himself and if he's out he's less likely to get stiff at least. 

I should really have got the vet out for his check up this week, but the vet had also said he wanted to see him after he was in full work and we haven't introduced canter yet so I don't know if there would be much point in him coming out until canter has been introduced or when he's at least in more regular w/t work (so it might be better to wait until next week) as he's only really just started to do more than a few trots on each rein after a lot of walk, and being ridden more than every other day.

I've had one of his previous sharers get in contact too, she had been interested in him when he was advertised for full loan before, however due to lameness and diagnosis I haven't even really been thinking of even putting him up again until I know how sound he will be. I've told her what's happening with him, but have my concerns as to if he'd be suited to her at all. Whilst she's said she'll be happy if all he can do is light hacking, she's also very young and has only had her new horse for a few months and my biggest concern is that he'll possibly and probably need further treatment down the line, as well as keeping an eye on how he's being managed and she's relatively inexperienced.


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## hopscotch bandit (25 May 2017)

A friends horse was diagnosed with moderate to severe arthritis of both coffin joints in about 2009 in his early teens. Since that time he has only had three steroid injections and the vet says some horse may only ever need one, on the flip side of the coin some horses need them every six or twelve months.Initially he had this special stuff like a sealant under his soles to help with the concussion but extra £20 or something stupid for each foot fromt he farrier, so she put rubber pads underneath which lasted longer.Only needed if for four or five shoeings if my memory serves me, never looked back since.


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## sasquatch (27 May 2017)

hopscotch bandit said:



			A friends horse was diagnosed with moderate to severe arthritis of both coffin joints in about 2009 in his early teens. Since that time he has only had three steroid injections and the vet says some horse may only ever need one, on the flip side of the coin some horses need them every six or twelve months.Initially he had this special stuff like a sealant under his soles to help with the concussion but extra £20 or something stupid for each foot fromt he farrier, so she put rubber pads underneath which lasted longer.Only needed if for four or five shoeings if my memory serves me, never looked back since.
		
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will ask my farrier about this next time I see him, actually! hadn't thought of that.

I have a not so positive update, we've had very warm weather and B hasn't felt as forward but I've attributed that to the weather as 24 degrees is a bit much for most of them when they're not used to it. He's been out pretty much 24/7 as it's been so nice, which is fine. He's seemed sound, I've felt that he's maybe felt a bit off, but asked people on the ground who've said he seems okay and once you get him moving forward he seems to feel much better. 

Rode him today, however I really am not feeling well, so a friend got on him after I'd been on for about 15 mins or so as I have a bad headachey-migraine type thing and rising trot made me feel worse. I did ask if she thought he looked right from the ground, and she and another livery said he looked fine. Then she got on, and it became obvious quite quickly he didn't look 100% and looked a bit hoppy when asked to bend. She noticed it straight away when she was on him as the last time she rode him he was 100% so she knows what he feels like sound. He didn't look incredibly off, but looked like every few steps there was a bit of a hop. I'm gutted, as he was doing so much better.

When I went to bring him in, he decided to canter to the other end of the field and looked absolutely fine as he went. I haven't seen him canter much in the field either, as he seems to be happier to trot so the fact he decided to canter I thought was at least a good sign. He's definitely field sound, so I'm holding that as a positive at least. There was no heat and swelling in any leg, so I think it's most likely the arthritis again. 

Although, I also do wonder if the fact today its a bit muggier/wetter/low pressure has something to do with it? because my bad knee was aching as well. I've started him on the Horse First My Joints supplement too so we'll see if it does anything. Just not feeling as positive as I was earlier


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