# Steroid Injections into Coffin Joint



## lizzy&flipper (14 June 2017)

Really didn't expect my first post on here to be to a lameness issue, apologies for the length in advance! 

Horse came in from the field actuely lame 03/05. Turned 10 on the same day, had him since a 3.5yo and never any issues with anything till now. 

Treated as a bruising and monitored, kept in our small school surface type turnout paddocks and in a night. Vet came out 09/05, and took the shoe off and advised to now treat as abscess and will revisit after the weekend. No change in lameness by early next week so decided to get an appt to xray/nerve block. Kept on box rest since 16/05. He's never had any swelling or heat on his leg/foot since this all started.

He came sound after nerve blocking the foot out and didn't change lameness to offside at all. Xrays showed mild changes to navicular and pedal bone, but nothing alarming could just be him. Decided to MRI at Dick Vet to check tendons etc as nothing much had shown up. 

Had the results from Dick Vet yesterday and the conclusions are below:

Conclusions: 
- Mild deep digital flexor tendinopathy 
- Mild collateral sesamoidean ligament desmopathy 
- Navicular bursitis 
- Mild distal sesamoidean impar ligament entesopathy 
- Effusion of the distal interphalangeal join

My own vets have come back wanting to inject the coffin joint with steriods, went onto Danilon last night as anti inflam and get him up on Monday AM to inject with a view to re MRI higher up if no change. 

He is insured but due to the worst luck he went lame 4 days after I had insured and therefore it is not covered. I have savings that were meant for a new box so I am slowly just working my way through that at the moment. 

I won't pretend to be clued up on any of this at all. I have had him since I was 15, and like I said I have been very lucky and have had no issues with him and this type of injury, hence I have been feeling v in the dark about it all and I have done a lot of reading past threads on here. 

I asked my farrier about shoes last night and whether he would leave them on/off it was him and he said that really it was the vets decision, a stupid question I forgot to ask last night, they are currently off from the MRI last week. From what I read shoes/barefoot seems to be split in this case. 

Has anyone ever had any issues with injecting the coffin joint/any views on the shoe scenario. I basically feel like I am floundering along currently not knowing what way to go with it all. 

Any help would be greatly greatly appreciated! 

Thank you very much


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## ycbm (14 June 2017)

Www.Rockleyfarm.blogspot.com


All these horses have issues similar to your own. The success rate of returning to full work with a barefoot rehab is hugely greater than using remedial shoeing and medication.


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## ester (14 June 2017)

^^^^ what she said


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## ester (14 June 2017)

Oh fwiw I injected coffin joints after horse blocked to them, nothing much to see on X-ray, they worked for a few weeks, remedially showing made his feet look much better on the outside so shoes came off at 19 and he hunted his 22/23 season. Semi retired due to totally unrelated issues now.


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## Ceriann (14 June 2017)

I would go barefoot if possible.  I have front feet issues with mine (you can find my recent posts) and also looking at options.  Mine has had lameness issues in both fronts after shoeing (I've had her just 2 months) and whilst I was aware of a developing underrun heel issue when I bought her (flagged at vetting which she passed) this wasn't planned.  Basic X-rays indicate pedal bone balance issues and v thin soles.  I would love to take her shoes off and might but The thin soles mean both vet and farrier cautious about doing this now.  I will change her management (only slightly as she's already on a v simple diet etc) and put her on a good feet based formula (to grow some foot).

I have passed on next steps to investigate further and/or medicate at the minute to see whether we can manage this with better balance.

Best of luck


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## Andalucian (14 June 2017)

Gosh, carbon copy of my first horses history. I followed the vets advice, joint injections, remedial shoeing, etc. lost the horse 

My next two went lame at 10 similarly, I took off their shoes, trained as a trimmer......they're now 22 and still sound and in full work.

10 is the age when constantly shod horses start to show long term issues IMO.


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## Puddleduck (14 June 2017)

Very similar case to mine. Diagnosed by MRI last October. 
We started with a bar shoe but I could see it wasn't helping so we opted for barefoot with the blessing of my vet. As he had blocked to the coffin joint when we did the original work up we decided to injection the coffin joint with steroid to try and help the bursitis as this was impeding the DDFT healing, shoes had been off a week when we did this and there was already a marked improvement in soundness. 
Horse has been back in ridden work since end of March and has been doing a few minutes of trot on 45 minute hacks. Vet is delighted with progress from what was originally a very poor prognosis. 
My original threads are here http://www.horseandhound.co.uk/foru...Navicular-torn-DDFT-amp-barefoot-rehab-update
We did consider Rockley early on and he would have gone there however I decided to start him myself while we were waiting for a space and by the time we got to the end of the wait list time we didn't need to go.


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## lizzy&flipper (15 June 2017)

thanks for all your replies! 

I had looked at the Rockley farm blog after seeing it on here a few times, I will read into it a lot more today. I think that is the general consensus of the way to go, I talked briefly about barefoot last night to my farrier and sent him the link to Rockley to have a look into. Vets are next on my list to have a chat with. 

A slight over haul of his diet is about to happen, hes on very low sugar and starch to start with as he doesnt cope well with it. Next step is to find a good feed to grow his hoof as they are probably the worst they have been in a while due to shoes then shoes off then on then off every couple of days it seems due to investigations, which really wont be helping anything. 

Its lovely to hear some success stories mixed with Rockley I am feeling much more postive. Andalucian, sorry about your first.


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## Ceriann (15 June 2017)

I'm putting mine on formula4feet asap - opted for this and not farriers formula simply because both get very good review a but f4f better value for money.  I've already started using a topical too (silverfeet).  

I'm one foot in each camp with mine at the minute and talking to vet and farrier lots!


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## ester (15 June 2017)

I think the F4F and FF formulas are the same, neither would be preferred by a barefooter, low/no iron so suggestions are:
Equimins adv complete (I use this but mag is quite low so add extra)
Forageplus
Pro earth
Equvita 
And there is def another on here that gets mentioned

Plus some micronised linseed


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## lizzy&flipper (15 June 2017)

After research this morning I have gone for pro feet from progressive earth and micronised linseed from Charnwood Milling. He's currently on fast fibre, healthy tummy, top spec lite balancer and magnitude from equine america. So I'll use up whats left of the healthy tummy and balancer and keep the fast fibre. 

I am presuming that the mag in his magnitude wont be enough for his feet now? Could I get him mag ox/cal mag and keep him on a calmer or will the 2 together just be doing the same thing/too much of it all? 

Am I missing anything else from his diet? 

thank you!


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## ester (15 June 2017)

good plan  also with the pro feet you will probably get some human sweets (I find that funny while we are low sugaring our horses  ) 

IIRC magnitude is just expensive mag ox? I wouldn't change anything till you start the pro hoof TBH. I am just aware that the equimins one is a bit lower than some of the other recommendations and because my previous yard and home nearly as much are tested as high calcium (and it is the Ca:Mg ratio that matters rather than absolutes) I needed more Mag, interestingly going into this spring I wasn't adding the extra because I stripped his diet back due to liver issues. When I visited (he is at mum's 200 miles odd away) even on limited grazing he had developed some fat pads so put him straight back on it! (and starved him a bit, - first spring with him semi retired and on clay grazing which gets a bit much) and they have gone. 

fwiw a lot of barefooters have anecdotally found although the ingredients list isn't bad on topspec balancers it makes their footy so if you have a lot left I would probably try and flog it elsewhere.


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## skint1 (15 June 2017)

I'm beginning to think that my boy needs to go back barefoot. When I bought him he was, but we have such hard stony ground, we put fronts on him when began to struggle, and this was followed up with back shoes after a bout of similar lameness last year. I am told he can't have steroid injections because he has had some laminitic symptoms in the past. 

He's been on/off lame since March. He's had both fronts x-rayed with no obvious issues found, he's had 2 nerve blocks which have isolated the issue to "something in the hoof capsule" so he can't have ultrasound.  My vet at this stage doesn't think MRI is needed. He goes along fine for a bit, we just walk out a few days a week, but inevitably at some stage he'll come up lame again. It's the front left, he sort of sticks it out to the front and side of himself when it's bad.

I'm now turning him away, farrier coming end of the month, going to talk to him about pulling his shoes. He has nice big soles/walls, he already has mag ox and linseed oil in his diet. I think with boots he might be ok. He is kept in pen during the day and out in normal field at night, but I could further restrict him if I had to, but this problem started well before the grass came through and vet and farreir didn't think it was related to sugar back in March

His old owner actually gave me very detailed records of his barefoot trimming, I should probably read them, I would like to ask her if he'd ever had problems like this in the past, but I don't want to worry her


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## ester (15 June 2017)

I think now there are so many boot options compared to a few years ago it has made it a more viable option for many than it was before (unless they have huuuge feet). It does sound like you have something soft tissue going on.


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## lizzy&flipper (15 June 2017)

haha I look forward to the sweets if they arrive! 

I'll leave that alone for now, hes normally on a calmer for most of the year to take a slight edge of him, otherwise he is just too much work for anyone handling him/me trying to ride him. Top this off with 6 weeks box rest I need to keep him on something, it should do for now as you say. 

I'll be shipping the balancer off to a friend asap then! 

Vets have just emailed and advised that he needs to be shod in heart bars with a gel pad on the back third of the foot for 1-2 shoeings, I feel like I am going against all advice the experts are telling me to do. At the end of the day, hes my horse and I have looked into this and believe its the way to go - however, I am not sure how well this conversation will go down with either.


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## skint1 (15 June 2017)

It's hard to go against what they're saying, but there does seem to be a lot of evidence to support what you're doing, and at least the farrier is on your side.


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## ester (15 June 2017)

essentially that is almost doing the same thing, but forcing the back of the hoof to be engaged. There is a fairly nice pad+3/4 shoe set up which is a bit of a half way house but I suspect that if you have something that can go barefoot that still gets better results longer term. 
http://www.equinefootclinic.co.uk/Collapsed_Heels.html

Some vets are getting it now, always helpful when they have written one off and it goes to rockley then goes back jumping . Mine wasn't convinced but happy for me to try (he had sent a couple to rockley but different diagnoses). They get very used to owners wanting a sound horse ASAP, and for the majority there is no skirting round that it will be a bit of an undertaking so the owner needs to lead/be fully on board. 

At the end of the day something Nic said to me (I bar shod first) shoes can always come off again, or go on again the decision you make at a given point in time usually isn't permanent.- I agreed to give it 2 cycles of shoes.


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