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Red Cedar Farm 12-18-2012 10:53 PM

Is this epiphysitis? What can I do?
 
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My 2 and a half year old QH colt injured himself LAST spring by sticking his leg through the top 2 bars of a tube gate, then falling over with it still in the gate. Until recently he was only having intermittent "swelling" of his left knee (see photo below), but now it's always big. Actually, it's not really a swelling, per se, it's more like a synovial fluid filled balloon just under the skin between the bone ends. This doesn't bother him in any way, shape, or form. You can poke, prod, and push on the bump of fluid all day long. He's never been lame and he has full range of motion in the joint. It's never been hot, and the surrounding joint area has never swelled.


The vet said not to worry, try cold hosing it twice a day and to give it some time. Since he was only a yearling, he had the entire year just to grow and relax...and the swelling would come and go. This past spring, since his knee was still swelling, the vet recommended banamine once daily for 5 days and to give him an oral glucosamine/chondroitin/msm supplement. Since the swelling isn't from inflammation, the banamine had zero affect on it.

I would really like to show him in halter this coming summer. I was told that with his knee being like this, halter is definitely out. Other than being horribly hideous to look at, it doesn't appear to be a problem for him, but I worry that as I begin to trail ride and compete (I am an avid team sorter) with him it may begin to lead to calcification, adhesions, and/or arthritis....or worse.

Does anyone have any ideas or experience with this? I would SO appreciate any help y'all might have to offer!
Thanks!!

Elana 12-19-2012 07:55 AM

First thing I would do is get a set of X rays and have them read by someone competent to do so. There may be a bone chip floating around.. or something else. He may need arthroscopic surgery.. and even then he may be sound but have a big knee.

Honestly? after this much time I think this is just what he is going to look like and it won't do for halter. If he is sound and has decent conformation, he will likely make a good riding horse.

wyominggrandma 12-19-2012 11:37 AM

epiphysitis is a too rapid growth issue with young foals. It almost always goes away with grain reduction and slowing growth through feed.
Epiphysitis is not caused by injury.
Your issue is an issue with the knee, and I agree with the above poster. Get an xray and see if there is a bone splint in there. Seems your vet is a bit unconcerned about something that has not gone away after all this time. He/she needs to be more pro active to find the cause or get a new vet.

Red Cedar Farm 12-19-2012 12:16 PM

Thanks guys! I was wondering about that too, and am kind of baffled why he didn't suggest doing radiographs of his knee. He never really gave a diagnosis...which would be hard given he hadn't done anything beyond just palping and getting an external visual assessment on it...He's an equine vet as well as an avid horseman, so now I'm thinking it's time to switch vets? I've been wracking my brain trying to find anything online that comes close to what Elvis has, and epiphysitis was the closest thing I could find.
I totally appreciate the info on this, and will DEFINITELY insist on radiographs to further see what may be the issue.
THANK YOU!!!!!

Saddlebag 12-19-2012 12:33 PM

We were taught to get swelling down as quickly as possible and one of the remedies was the use of Absorbine and massage it in a downward fashion with the heels of your hands. Mix Absorbine with a little water, put some in a cupped hand then wipe it on the area then massage. Apply this two or three times. Do this for a good ten minutes. Your hand and arm will be complaining by then. Do this twice daily.

Elana 12-19-2012 02:50 PM

This is an OLD injury with NO HEAT. It sounds like the synovial capsule has become stretched or enlarged or there is leakage from the joint capsule into the adjoining area.

You can cold hose, massage and fiddle and it is likely nothing will happen OR massage can irritate the area. I have seen fiddling things such as these causing inflammation and abscess. Old injuries like this need a radiograph and then a decision.. fix the issue (if it is fixable) or if it is simply a blemish, train and ride the horse. Fixing a blemish can spend a lot of $$ and lead to more issues than you want to put the horse thru (including becoming lame).

Diagnosis is needed FIRST and for that you need to take a picture of the knee to see what is going on.

Northernstar 12-19-2012 03:28 PM

I'm not an expert, but I definately agree that your vet needs to be more pro-active, and should have had an x-ray done. Keep us posted- and the best of luck! A hearty welcome to the forum as well :)

stevenson 12-19-2012 03:41 PM

Xray .. Xray Xray. Cold hose, that really is not going to hurt, and since it is old, it may not help.

Red Cedar Farm 12-19-2012 04:07 PM

Definitely going to get the xrays done. And Elana, what you're saying sounds EXACTLY what I'm experiencing....it's never been swollen like an injury. There's never been heat, or pain, or lameness, even from the very beginning. I had used DMSO on it previously per the vets recommendation in the beginning along with the cold hosing (forgot about that). Nothing worked. He also had me doing just some light exercises in the round pen to keep the fluid from building up...so I did some basic ground work with him for a few weeks...yeah, that didn't make any difference either. LOL!
You are the first person to come up with anything that sounds remotely like what I'm experiencing with Elvis...I was looking up bursitis and carpitis and synovitis...none of these described what I was seeing. Epiphysitis was the closest thing.
Needless to say, I am SO thankful to you all! I've never experienced this before, and have been at my wits end here.

Elana 12-19-2012 07:23 PM

Anything with "itis" in it means inflammation. No heat + no lameness = cold and old and not an "itis" I have had tendonits. Heat and pain. I have had Bursitis. Heat and pain. Epiphysitis is inflammation of the growth plates and there is usually pain.. and unusual swelling but not that that site. Osteo chondrosis is an expansion of Epiphysitis if you will and often means a lame horse that does not recover.

Like I said.. I am guessing a joint capsule that has been stretched and is bulging (I have had that too.. LOL.. and it does not look pretty but it does not hurt). It could also be synovial fluid associated with a tendon sheath. You just cannot know w/o pictures and if it is all soft tissue then you need to get to a University hospital where they can get things like MRI's or CT scans and so forth.

Your vet may actually be quite correct.. that not a lot can be done and not much will be seen on an X Ray because it is soft tissue.. but he needs to verbalize this to you and/or take pictures if you request and/or refer you if you want to know more of why and long term issues.

Good luck. Let us know what you learn if you take this forward. We can all learn.


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