Finally a diagnosis 15/5/17

It's been over 6 weeks now since Jack first went lame.
Following 2 vet visits and numerous x-rays last month we were unsuccessful in identifying the cause of his lameness.  It was very frustrating as I had a similar experience last time he was lame, and it took 3 visits wasting weeks and £££ before we got a diagnosis and the correct treatment. I really didn't want to be in the same position again but there didn't seem to be anything more I could do so once again he was prescribed 2 weeks off on bute and then see how he was.  As we didn't know the cause, along with the fact that being stabled made the lameness worse, the vet agreed he could do the 2 weeks rest in the paddock rather than being stuck on box rest.
Jack at this point had been barefoot for about a week as the farrier had been due just after Jack had gone lame so when he came we decided to leave his shoes off until he was right again and back in work, no point wasting money on shoes that wouldn't get used! Sadly this ended up causing a bit of a problem as he became so footsore on hard ground in all 4 feet while he was on rest that it became impossible to tell if he was actually still lame! He seemed ok in the ménage but on the yard he was very uncomfortable. After discussion with my vet they requested his shoes go back on before we did anything else, unfortunately my farrier couldn't come for over a week so this ended up delaying his reassessment and hopeful return to work and he had 3 weeks off rather then the 2 in the end but I reasoned the extra rest would be better for him, at any rate it certainly wouldn't do any harm. He got the shoes back on last week and the next day I lunged and rode him in the ménage and on the car park. I was so pleased to find Jack looked and felt good. I updated our vet and they were happy for me to begin bringing him back into work however we did book an appointment for them to come back as wanted to try to get a diagnosis for insurance claim purposes as much as anything and for my own peace of mind as there was still some swelling to his fetlock which was bothering me a bit.
The vet said it would be ok to start riding him for short hacks, in walk only, until they saw him later that week so I hacked him out for 20minutes the first day and he felt great, very keen and forward and most importantly sound! I continued to take him for hacks the following few days building up to 30 mins while waiting for the vet visit on Friday but as the week went on I started to feel the odd bit of unlevelness from Jack, mostly while on a turn, and wasn't sure if I was just imagining it or if he really was still not right. I didn't worry too much as the vet was coming anyway. On the Friday 2 vets came, the original vet who gave him the nerve blocks and x-rays, plus a lameness specialist. They looked at him trotting up and turned on a tight circle where the lameness I had been feeling showed. They then performed flexion tests which made it much more obvious. At this point it was decided to scan the ligaments and tendons as he still had the swelling above his fetlock which has been there from the start, its not got any worse but not improved either. First job was to clip the area to be scanned around this fetlock and pastern, the vet asked me if he was ok to clip to which I replied "yes he's fine" (He has always been easy to clip and I clipped all his legs myself a few weeks ago when he first went lame to be able to see any swelling more easily). Jack was not fine, he wouldn't hold still even when I held up the other leg to stop him snatching the foot up! As he was clearly agitated even just by the clippers he was sedated. I don't think he has in anyway forgiven or forgotten the last vet visit when they tried to block the coffin joint. Once sleepy they began to scan the leg finding a lot of fluid in the synovial capsule and after a very thorough scan, which meant more sedation as Jack still wouldn't hold still, of all the ligaments and tendons in the area finally we had a diagnosis of Tenosynovitis.
At this point the vets wanted to nerve block again to see if he responded completely but despite the 2 lots of sedation Jack was not co-operating at all and after a couple of attempts this plan was abandoned. Instead they decided to just go straight for steroid injections into the affected area. As this involved another needle and needed to be in a specific area they gave poor Jack yet another dose of sedation! I was holding his head, one vet holding up the good leg and the 2nd vet administering the injection and we still struggled despite him being doped to the eyeballs feisty little monkey! They were quick though and managed to get it done without too much drama.  Jack was then bandaged up and prescribed 2 weeks of strict box rest before they return to reassess him. I hate box resting him and he hates it too but at least now I know it is the best thing for him so I can justify doing it to him.
As he was so heavily sedated he couldn't have any food until he was properly awake again so I had to stay with him for a while.  The vet advised soaking his hay to help avoid impactions and he is allowed some hand picked grass. I am also to keep up carrot stretches twice a day to help keep his back supple. That night when I left Jack in his stable on his own he was not happy and as I walked away I could see him rearing in the stable - naughty pony! He was the same the next night then on the Sunday a new pony arrived which caused some excitement so I have been using my instamag instant spray on calmer to help keep him from getting too loopy. It's been working well and the other girls at the yard give him a spray on his neck just behind his ears before they turn out their horses and he does calm down - I have to say I am impressed with this product and so are they having seen the results so one or two of them are thinking of purchasing a bottle themselves!
It has been 3 days now since their visit and I am pleased that Jack has settled down, the swelling has also gone down so it looks like the injection is working.
I'm looking forward to the vets returning when, hopefully, if Jack responds as well as he did last time to the injections he can begin to be brought back into work - keeping everything crossed!