11 year old Warmblood x Thoroughbred mare that we originally assessed in February 2016 when her owner reported tendencies to ‘nap’ when turning on a tight circle to the left. She also favoured the LF after landing when jumping. There were some additional areas unrelated to lameness which were also to be assessed so a full body scan was completed.

Numerous areas on interest were reported on but the most significant finding was identified as inflammation of the RF foot. Inflammation significantly increased post exercise on dorsal and palmer views so assessment of the feet to rule out deep foot pathology was advised by our interpreting Vet, alongside other observations.

T1 HR transverse scans of the right fore foot showing a core lesion of the medial lobe of the deep digital flexor tendon.

At the time of the first scan in February 2016, the horse was sound so the findings in the RF were not considered significant but in in May 2016, her owner noted she was not comfortable weight bearing on the RF for extended periods of time, eg when putting studs in. In June 16 she became lame in front, seemingly both front feet, corns/bruising was suspected but it didn’t improve with treatment.  Her owner arranged to have her front feet x-rayed in July 16, these were clear so a period of rest followed.  By mid August 16 she appeared sound so gentle exercise was commenced.  However after a successful start, by early Nov 16 she was lame again following her first dressage competition.  The treating Vet then completed nerve blocks which were inconclusive so in Dec 16 an MRI of the forefeet was completed.  This identified a 10cm lesion of the RF DDFT, the LF was normal.

Further Investigation

In Jan17 a RF Navicular Bursoscopy was performed by Bruce Bladon at Donnington Grove Equine Hospital which revealed a synovial mass in the medial navicular bursa, associated with a long split of the medial lobe of the tendon, and an erosion of the lateral lobe of the deep digital flexor tendon.  The synovial mass was removed and the torn fibres debrided from the deep digital flexor tendon. Bone marrow was also collected for culture of stem cells which would be injected into the Navicular Bursa 1 month post surgery.

Following a period of box rest, then in hand walking and restricted turnout the horse was allowed unrestricted turnout in Apr17.

Further stem cells and some steroids were injected over Jul/Aug17, however a routine appointment found the horse still 1-2/10 lame in Nov17 so an MRI  was booked for Dec17 which showed guarded improvement.

Conclusion:

Pathology was detected with physiological infrared imaging during the early stages of investigation when the patient was presenting subtle changes. Isolating abnormality for further investigation was a success. Thank you to Bourton Vale, Donnington Grove and this horses owner for sharing data and reports, allowing us to better understand how vital IR imaging can be in early detection.