# Medicating the bursa/coffin joint



## Moomin1 (9 December 2016)

My 16.3hh 15yr old mare has been bilaterally lame on her fores since May this year. She's been on long term box rest which brought her sound, until she started very gradual work again.  Next step is to medicate the bursa/coffin joints.  Her x rays are all showing clear so it's more likely a soft tissue problem.  MRI is out of the question unfortunately due to finance.  Would be interested to hear others experiences of medicating the bursa and how effective it was long term.


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## Michen (10 December 2016)

Pulled directly from my horses vet report when he had his bursas injected:

The documented success following navicular bursa medication is for 80% of horses to come sound, for 7 &#8211; 12 months, though up to 15 months after six months of rest. 

So frankly it's a sticky plaster on a problem isnt it? I'd be doing a barefoot rehab if I were in that situation again. I assume you have had nerve blocks done to locate where the lameness is coming from in her fores.


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## fairhill (11 December 2016)

My mare had arthramid injected in her coffin joint 6 weeks ago. Her x Ray's were clear too, nerve blocks isolated issue to coffin joint. Unfortunately it hasn't helped her and she is having shoes off and an mri scan next week.


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## Puddleduck (11 December 2016)

My gelding has been diagnosed with navicular bone deterioration, collateral ligament damage, navicular/ coffin bursitis and a tear on the DDFT by the navicular in his right fore. MRI at the RVC confirmed the soft tissues issues and the outlook was pretty grim. 
After discussion with my own vet we decided to medicate the coffin joint with a short term steroid and HA as he had previously blocked about 99% sound to the coffin joint. At that stage we also discussed barefoot as the potential rehab route and agreed a further review after 2 to 3 weeks to see if the medication had any affect. 
At the review 10 days ago he was again 99% sound so we agreed the shoes would come off and we would return a week later to have a follow up medication jab in the joint ( the type of med he had needs 2 doses 4 weeks apart). He had this on Thursday so I can't comment on the long term however I can say that taking his shoes off has made a difference. He was pretty much sound after the first jab but has been walking out better since the shoes came off. His foot has also started to improve - it had become very boxy and upright with a contracted heel and shrunken frog with the prescribed bar shoe.


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## ester (11 December 2016)

We did, it did help, it only lasted a few weeks and as soon as we commenced more work (ie introducing much trot) he went lame again. 
Took his shoes off and he has been sound and hunting for the last 4 years (23 now), stopped this year due to an unrelated hind end issue.

Also nothing to see on xray, given a DJD diagnosis as did block to joint/back of foot but had suboptimal hooves and watching him move I suspect had some collateral ligament damage. Deciding to let him see if he could sort himself out was the best thing I ever did, a decision partly made on the fact that if we couldn't keep him sound he was retiring and there was no need for him to be shod if dossing in the field.


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## Moomin1 (11 December 2016)

Thanks everyone. Barefoot isn't an option.  My OH has very kindly offered to pay up to 2k for further tests and treatments so fingers crossed we will get to the bottom of it


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## ycbm (11 December 2016)

Moomin1 said:



			Thanks everyone. Barefoot isn't an option.  My OH has very kindly offered to pay up to 2k for further tests and treatments so fingers crossed we will get to the bottom of it
		
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Why isn't it an option, moomin?

You don't have statistics on your side if taking the shoes off isn't an option I'm afraid


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## Moomin1 (11 December 2016)

ycbm said:



			Why isn't it an option, moomin?

You don't have statistics on your side if taking the shoes off isn't an option I'm afraid 

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I don't really want to get into a barefoot debate lol.  It isn't an option and it's agreed with my vet that it would not be an advisable course of action.


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## ycbm (11 December 2016)

Moomin1 said:



			I don't really want to get into a barefoot debate lol.  It isn't an option and it's agreed with my vet that it would not be an advisable course of action.
		
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There are a lot of owners of dead and permanently retired horses whose vets and farriers gave them the same advice 

If your mare is unsound when they have run out of options, please let us help you through trying a barefoot rehab before you think of retiring or pts.

I hope what they want to do works for her, seriously. Best wishes.


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## Tiddlypom (11 December 2016)

Moomin1 said:



			Thanks everyone. Barefoot isn't an option.  My OH has very kindly offered to pay up to 2k for further tests and treatments so fingers crossed we will get to the bottom of it
		
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Err, why isn't barefoot an option?

Fair do's if you've got rock solid reasoning which prohibits attempting a bare foot rehab (which has worked for many horses), but it is only polite to reveal your reasoning, rather than clam up and say its impossible, seeing as you are the one asking for advice.


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## Moomin1 (11 December 2016)

Tiddlypom said:



			Err, why isn't barefoot an option?

Fair do's if you've got rock solid reasoning which prohibits attempting a bare foot rehab (which has worked for many horses), but it is only polite to reveal your reasoning, rather than clam up and say its impossible, seeing as you are the one asking asking for advice.
		
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I have my reasons for not wanting to attempt a barefoot transition at this point in time.  I didn't ask for advice on barefoot transitions I was asking for experiences of medicating the bursa.  I'm fully aware of the benefits of going barefoot with many horses and rest assured if I was to attempt it in the future you guys would be the first I would come to for advice.  My mare is extremely well loved and I don't take decisions lightly with her.


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## ycbm (11 December 2016)

My experiences of bursa medication is that two horses had it done without long term success.

I took the first the day after it was due to be put down and he is in full work five years later.

The second went to Rockley and afaik he is sound as a happy hacker (all that was ever tried) four years later.

I hope it works better for your mare.


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## Moomin1 (11 December 2016)

ycbm said:



			My experiences of bursa medication is that two horses had it done without long term success.

I took the first the day after it was due to be put down and he is in full work five years later.

The second went to Rockley and afaik he is sound as a happy hacker (all that was ever tried) four years later.

I hope it works better for your mare.
		
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Thanks


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## CopperhallFrankie (11 December 2016)

My 6y/o Warmblood had the same lameness , X-rays showed nothing but then after 2 months of box rest we had an MRI of both fores which showed navicular, arthritis of coffin joint and inflamed impar ligament (and some DDFT tears but they were the least of our problems) after only having done very limited work up till this point in his life. First steriod injection into the coffin joint brought him mostly sound (plus heart bar shoes) for 6 months till another injection was required, but 2 weeks later went lame again and we booked him in to medicate the bursa, he was on box rest for 4 weeks before the appointment but in the last week I was admitted to hospital so he was put in the field for a few weeks till I came home. 
He went out to rest perfectly sound but when I came home he was lame (after simply mooching around the field for 4 weeks), vet decided that medicating the bursa would not have much of an effect and suggested a neurectomy, which we did not go through and ultimately decided to retire him instead.

Not exactly a review of bursa medication but this was my experience of this type of lameness and the recovery (sort of)
Sorry this probably wasn't the positive reply you'd be hoping for - really hope it goes well for you though


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## MileAMinute (11 December 2016)

Moomin1 said:



			My mare is extremely well loved and I don't take decisions lightly with her.
		
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Having been on the same yard as Moomin1, I can certainly verify this. 
Hope you find a solution that works for you.


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## Moomin1 (12 December 2016)

MileAMinute said:



			Having been on the same yard as Moomin1, I can certainly verify this. 
Hope you find a solution that works for you.
		
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Thanks.


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## Andalucian (12 December 2016)

Well in brief, I lost a beloved horse with this condition after following vet advice. Now I own two barefoot survivors of this condition.


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## Moomin1 (12 December 2016)

Andalucian said:



			Well in brief, I lost a beloved horse with this condition after following vet advice. Now I own two barefoot survivors of this condition.
		
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We don't know what condition she has as of yet. It could be a million and one things.  As I've already mentioned, barefoot is not an option so there's little point in anyone mentioning how barefoot has saved their horse.  If it was an option for my horse at this time I would be doing it. But it isn't.


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## ycbm (12 December 2016)

Moomin1 said:



			We don't know what condition she has as of yet. It could be a million and one things.  As I've already mentioned, barefoot is not an option so there's little point in anyone mentioning how barefoot has saved their horse.  If it was an option for my horse at this time I would be doing it. But it isn't.
		
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Moomin in I'm sorry, but unless you are prepared to explain why, people will keep saying it. They are saying it because it's the overwhelmingly most likely way to return your horse to soundness. And because they've heard a zillion times, from vets, from farriers, and from owners 'the horse can't go barefoot', when it can. 

The fact is, you're unlikely to hear many stories of long lasting recovery by medicating the coffin joint. 

Because it doesn't usually work.


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## Moomin1 (12 December 2016)

ycbm said:



			Moomin in I'm sorry, but unless you are prepared to explain why, people will keep saying it. They are saying it because it's the overwhelmingly most likely way to return your horse to soundness. And because they've heard a zillion times, from vets, from farriers, and from owners 'the horse can't go barefoot', when it can. 

The fact is, you're unlikely to hear many stories of long lasting recovery by medicating the coffin joint. 

Because it doesn't usually work.
		
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I don't need to explain why.  If I want advice on going barefoot in future I will ask for it.  At this point in time, it is not possible for a few reasons.  I don't want a pointless barefoot debate.  But thanks everyone for responding.  The info about medicating the bursa is noted.


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## ohmissbrittany (12 December 2016)

Can you share the radiographs? The angles of the feet may provide some clue as to what's going on. If it's a soft tissue injury, obviously it won't show up and those suckers take a long time to heal (thinking back to a completely sheared collateral ligament in a horse who had very upright feet, only symptom was suddenly uncontrollable when turning right as the response to pain was "SPEED UP!"... horse had a year off and PRP/stem cell treatment and very controlled return to exercise.)


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## AnShanDan (12 December 2016)

Friend's horse, think he was late teens at the time, was on off slightly lame in front. He was MRId with impar ligament inflammation. No other soft tissue issues. He had 2 lots of injections into the coffin joint and came sound and stayed sound for a few years, he never jumped again tho and he'd been out eventing up to 90/100.

He is retired now due to breathing problems but is still sound, however he isn't shod anymore because the heart bar shoes that were prescribed for the ligament damage had basically wrecked his feet when they were left on far too long so his shoes were taken off, feet are great now.


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## Moomin1 (12 December 2016)

ohmissbrittany said:



			Can you share the radiographs? The angles of the feet may provide some clue as to what's going on. If it's a soft tissue injury, obviously it won't show up and those suckers take a long time to heal (thinking back to a completely sheared collateral ligament in a horse who had very upright feet, only symptom was suddenly uncontrollable when turning right as the response to pain was "SPEED UP!"... horse had a year off and PRP/stem cell treatment and very controlled return to exercise.)
		
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Yes the angles of the feet/hoof balance have already had a lot of work done and vet is happy with how they are now, though slight bit of work still left to be done.   X rays otherwise completely clear.  Nerve blocks pinned it down to within the feet. Lami ruled out. Navicular x rays clear.


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## Moomin1 (12 December 2016)

AnShanDan said:



			Friend's horse, think he was late teens at the time, was on off slightly lame in front. He was MRId with impar ligament inflammation. No other soft tissue issues. He had 2 lots of injections into the coffin joint and came sound and stayed sound for a few years, he never jumped again tho and he'd been out eventing up to 90/100.

He is retired now due to breathing problems but is still sound, however he isn't shod anymore because the heart bar shoes that were prescribed for the ligament damage had basically wrecked his feet when they were left on far too long so his shoes were taken off, feet are great now.
		
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Thanks, that sounds hopeful.  If we can so much as give her another couple of years I will be very happy. Not fussed if she doesn't jump again so long as we can do low level flat work etc.


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## ycbm (12 December 2016)

Moomin1 said:



			Yes the angles of the feet/hoof balance have already had a lot of work done and vet is happy with how they are now, though slight bit of work still left to be done.   X rays otherwise completely clear.  Nerve blocks pinned it down to within the feet. Lami ruled out. Navicular x rays clear.
		
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I hope your vet has explained to you that the condition of the navicular bone on radiographs usually bears no relationship to whether a horse is lame? In any case, the radiographs are clear, so you know you are dealing with a soft tissue problem, which is normal for long term foot lameness.


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## Moomin1 (12 December 2016)

ycbm said:



			I hope your vet has explained to you that the condition of the navicular bone on radiographs usually bears no relationship to whether a horse is lame? In any case, the radiographs are clear, so you know you are dealing with a soft tissue problem, which is normal for long term foot lameness.
		
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Yes. Im fully aware of that. I was just pointing out what tests had already taken place and shown.   We have been aware its a soft tissue problem since day dot.


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## googol (16 December 2016)

Sounds slightly similar to my sisters horse.  Unfortunately she's still lame.  Nerve blocked lame to the foot.  X rays clear (a little issue around coffin joint but no improvement when medicated) started off with bar shoes which made her worse. She's had shoes off for over a year now.  Still lame and on daily danilon until this no longer works for her. It's heart breaking. Ultimately, we don't know what is wrong with her except that it's soft tissue. She needs an mri  which is probably just going to reveal some deep tissue damage with guarded, if any prognosis, after all, she's had years of field rest at this point.  I hope you have better success, I think ours is a particularly bad example!


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## ycbm (16 December 2016)

Field rest does not work for some of these horses. The problem is usually caused by weakness in the heels, which does not improve without stimulation.  I took on one that had been extensively field rested, then retired completely and he was still lame. I got him out on the road, walking walking walking, and he came sound in three months.

Is your sister's horse toe first landing?


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## Moomin1 (20 December 2016)

googol said:



			Sounds slightly similar to my sisters horse.  Unfortunately she's still lame.  Nerve blocked lame to the foot.  X rays clear (a little issue around coffin joint but no improvement when medicated) started off with bar shoes which made her worse. She's had shoes off for over a year now.  Still lame and on daily danilon until this no longer works for her. It's heart breaking. Ultimately, we don't know what is wrong with her except that it's soft tissue. She needs an mri  which is probably just going to reveal some deep tissue damage with guarded, if any prognosis, after all, she's had years of field rest at this point.  I hope you have better success, I think ours is a particularly bad example!
		
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Thanks Googol.  Sadly I think it's very much similar.  I've decided to retire her gracefully and she's going to be moving to grass livery round the corner from my house which is lovely.   I won't be riding for a long time anyway due to personal  circumstances so I will reassess her lameness issues in a years time when I'm personally able to ride again and take things from there.  (And before anyone mentions it, I won't be taking her shoes off lol)


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## ycbm (20 December 2016)

LOL???

You think it's funny that you have a horse which can't do a year field rest with no shoes on?


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## Hexx (20 December 2016)

My boy was diagnosed with navicular at 18 - he was medicated with hyaluronic acid into bursar and coffin joints.  He then had three months off (over winter, so not really missing much) - started work back in March and we were back competing in low level dressage by the end of the summer - completely sound.  We carried on competing until he semi-retired at 24.


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## Moomin1 (20 December 2016)

ycbm said:



			LOL???

You think it's funny that you have a horse which can't do a year field rest with no shoes on?
		
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No I don't.  I think it's funny that some people just don't seem to comprehend that taking her shoes off is not an option for me or my mare.  I usually like your posts and agree with you ycbm but on this occasion I feel you are being a bit obnoxious.  My mare is as loved as my own child and I will not be made to feel guilty by a complete stranger on the net for not taking her shoes off when only I  (not you or anyone else) know the facts as to why it's not an option.  I also didn't say she can't.  I said I won't be.


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## Moomin1 (20 December 2016)

Hexx said:



			My boy was diagnosed with navicular at 18 - he was medicated with hyaluronic acid into bursar and coffin joints.  He then had three months off (over winter, so not really missing much) - started work back in March and we were back competing in low level dressage by the end of the summer - completely sound.  We carried on competing until he semi-retired at 24.
		
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That's fantastic, thanks Hexx. Can I ask how often you have them done?


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## ester (20 December 2016)

I am curious as to why, I think there are plenty of reasons for shoes at times I am just wondering which one, party as it made part of the decision to go that way with F cos I said if he was retiring he wouldn't be shod anyway.


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## Moomin1 (20 December 2016)

ester said:



			I am curious as to why, I think there are plenty of reasons for shoes at times I am just wondering which one, party as it made part of the decision to go that way with F cos I said if he was retiring he wouldn't be shod anyway.
		
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Ordinarily I probably wouldn't have an issue answering that. However given the tone of some of the posts on here I really don't feel inclined to share the reason for my decision on here.  I made it quite clear from the start I have no interest in barefoot transition at this time yet a particular poster has been determined to wind the tone of the thread up. Real shame as this whole situation is hard enough for me to come to terms with and I didn't come here to be made to feel guilty.


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## Hexx (20 December 2016)

I only had them done once, and they lasted until he passed away at 25 - he stayed sound all that time - we did dressage, showing and lots of hacking up until he was about 23 and then had a couple of years mooching around being a happy hacker.

I think I was lucky as he was diagnosed early and that did help with the treatment.  I didn't take him barefoot and kept him shod with new shoes every 5 weeks - we started off with bar shoes, but he didn't get along with those, so went along the natural balance route , as long as he was shod short in front with an early breakover point, he was good.  I have to say, I did have an exceptional farrier!


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## Moomin1 (20 December 2016)

Hexx said:



			I only had them done once, and they lasted until he passed away at 25 - he stayed sound all that time - we did dressage, showing and lots of hacking up until he was about 23 and then had a couple of years mooching around being a happy hacker.

I think I was lucky as he was diagnosed early and that did help with the treatment.  I didn't take him barefoot and kept him shod with new shoes every 5 weeks - we started off with bar shoes, but he didn't get along with those, so went along the natural balance route , as long as he was shod short in front with an early breakover point, he was good.  I have to say, I did have an exceptional farrier!
		
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That's very interesting, thanks Hexx.  That's definitely given me a more positive take on the situation.  Perhaps it's worth a shot once I'm personally able to ride again in a year or so.  Lots of food for thought.


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## ester (20 December 2016)

Tbf I don't think you mentioned not bare footing in your OP so the replies probably did drift off that way just on the basis of people's experiences including my own when injecting failed so what do you do next- the two rather go hand in hand. I could have just said it failed but given that I ended up with a sound pony later on I wouldn't have felt that was very helpful or constructive.  
As always not knowing the full story does make it tricky to comment helpfully and in way that is appreciated!


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## Moomin1 (20 December 2016)

ester said:



			Tbf I don't think you mentioned not bare footing in your OP so the replies probably did drift off that way just on the basis of people's experiences including my own when injecting failed so what do you do next- the two rather go hand in hand. I could have just said it failed but given that I ended up with a sound pony later on I wouldn't have felt that was very helpful or constructive.  
As always not knowing the full story does make it tricky to comment helpfully and in way that is appreciated!
		
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I said very early on that I wasn't interested in barefoot and that I only wanted to hear experiences of medicating the bursa/coffin joint. Yet the barefoot posts continued and in a somewhat aggressive and accusatory tone from one poster.  I do appreciate barefoot helps many horses.  As I said before if I change my mind I will definitely take advice from HHO


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## ester (20 December 2016)

I was only saying that because you said above you made it clear from the start, you didn't, it was post 6, after I had replied and mentioned bare footing because you hadn't made it clear from the start at all so please don't get stroppy at people for mentioning it when you asked for experiences when many people will have done both if they've had a foot problem! Contrary to popular belief we aren't sat here typing it for our own benefit.


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## Moomin1 (20 December 2016)

ester said:



			I was only saying that because you said above you made it clear from the start, you didn't, it was post 6, after I had replied and mentioned bare footing because you hadn't made it clear from the start at all so please don't get stroppy at people for mentioning it when you asked for experiences when many people will have done both if they've had a foot problem! Contrary to popular belief we aren't sat here typing it for our own benefit.
		
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No stroppiness, just fed up with repeating myself lol.  Thanks for all your help anyway.


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## ycbm (20 December 2016)

I understand why you are cross, but seriously Moomin, consider what your reaction would be if someone posted - 

My horse is lame and the lameness is originating in his back. I am thinking of retiring him if injections into his spine don't sort him out. Don't tell me to consider changing my saddle. My saddle fitter says I can't change the saddle, and I refuse to tell you why.

That's exactly what you have done, only with feet. All you needed to do to shut me up was tell me why your vet says your horse cannot even retire to a field without shoes on. I would probably have made one comment, offered to help if you changed your mind, and gone away.

That's your prerogative not to explain why your vet says that your horse cannot go unshod even on field rest. And unfortunately for you,  my prerogative not to let that go unremarked. Not for your sake, for others reading the thread whose vets are saying the same thing but are wrong. I'm not saying yours is wrong, I haven't, of course, any idea what he has said. I just know that few vets I have heard of so far who say any particular horse cannot go without shoes have actually been correct.

I wish you luck with the horse. I won't annoy you by commenting again.


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## Moomin1 (20 December 2016)

ycbm said:



			I understand why you are cross, but seriously Moomin, consider what your reaction would be if someone posted - 

My horse is lame and the lameness is originating in his back. I am thinking of retiring him if injections into his spine don't sort him out. Don't tell me to consider changing my saddle. My saddle fitter says I can't change the saddle, and I refuse to tell you why.

That's exactly what you have done, only with feet. All you needed to do to shut me up was tell me why your vet says your horse cannot even retire to a field without shoes on. I would probably have made one comment, offered to help if you changed your mind, and gone away.

That's your prerogative not to explain why your vet says that your horse cannot go unshod even on field rest. And unfortunately for you,  my prerogative not to let that go unremarked. Not for your sake, for others reading the thread whose vets are saying the same thing but are wrong. I'm not saying yours is wrong, I haven't, of course, any idea what he has said. I just know that few vets I have heard of so far who say any particular horse cannot go without shoes have actually been correct.

I wish you luck with the horse. I won't annoy you by commenting again.
		
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I didn't say I was basing my decision on advice from my vet. I am basing my decision on my own knowledge of my horse, her past, and her and my current situation.  My vet happened to agree with my decision as we have discussed it.  I am not simply writing it off because i cannot be bothered.  As I have said numerous times now, should I change my mind I will come to you for advice. In the meantime, I don't owe you, or anyone, an explanation as to the basis of that decision.


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## Sheep (20 December 2016)

My horse was diagnosed with arthritis in coffin joint a few years ago. At the time I went with vet recommendation and shod with wedges and he had injections. He came sound initially but it only really lasted weeks. We did I think two or three rounds of wedges and then I decided to cut my losses and turn him away for a couple of months.
I won't go over the same ground re: how he is now back in work, but hopefully my experience of the injection answers your original question.


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## Moomin1 (20 December 2016)

Sheep said:



			My horse was diagnosed with arthritis in coffin joint a few years ago. At the time I went with vet recommendation and shod with wedges and he had injections. He came sound initially but it only really lasted weeks. We did I think two or three rounds of wedges and then I decided to cut my losses and turn him away for a couple of months.
I won't go over the same ground re: how he is now back in work, but hopefully my experience of the injection answers your original question.
		
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Thanks.  We haven't and aren't going to be trying wedges as my vet does not recommend them.


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## Sheep (20 December 2016)

Moomin1 said:



			Thanks.  We haven't and aren't going to be trying wedges as my vet does not recommend them.
		
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That seems sensible, I wouldn't do it again myself either, benefit of hindsight. Regardless of what course of action you choose I wish your horse a happy and pain free recovery, and as you've said yourself, there's plenty of support / resource here if you decide to consider an unshod approach. 

In any case, I hope (s)he is more comfortable soon.


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