Saga was doing really well earlier this week. His limp was barely noticeable. He was going out with Cash during the day into the tiny barn area, hanging out, and eating hay. He even had two whole days without standing wraps on – the first time since this all started! I had a post planned entitled “Look Ma, no wraps!” and everything…
… and then he got worse again.
First there was a little swelling, and the limp was more pronounced. Cold-hosing and Surpass didn’t help. The limp and swelling both got progressively worse. My vet recommended putting him back on 2g/bute/day and keeping him in. It didn’t help. This morning, he was sweating from the pain, despite it being in the low 60s. His limp was very bad. I called the vet, stuffed him in the trailer, and off we went.
The good news is that the fetlock joint is not infected again, just inflamed. We injected it with steroids to try to calm things down some. The bad news is that there are two cysts on the pastern that now show up on radiographs. Likely they were caused by some sort of blunt force trauma, but of course there was never a mark on him. Still, we finally have a reason for what’s causing the irritation and inflammation in the fetlock joint.
I didn’t know anything about bone cysts, so I did a little digging on Google. Conservative treatment, especially in older horses, is generally useless. They improve with box rest but as soon as more motion is required, the cyst irritates the nearby joint. In Saga’s case, “more motion” appears to be hanging out in a tiny paddock. I found one article that said only 35% of older horses return to work with surgery. That’s not good, y’all. He’s not a surgical candidate, and he’s got a ton of other stuff going on around that joint – bone lesion, lesion on the sesamoid ligament, and of course the arthritis in the joint itself, caused by the infection.
We opted to inject the joint with steroids, in hopes that would calm the inflammation and improve his comfort level. In some cases that seems to help; in other cases it does nothing. We’ll reevaluate in a week and see where he’s at. If it helps him AND it lasts for a reasonable amount of time (~6 months), that’s something I’m willing to do. If it doesn’t help him, or only helps for a short period of time… well, I’m not going to let him stand around in pain.