Monday, 29 November 2010

Research - comparing treatments for hoof pain (AND more snow pics...!)


More on research - I feel that the themes for this week will focus almost exclusively on rehab and snow, because I think those will be the boundaries of my world for the next few days :-)  The horses, as you can see, are quite happy but its bizarre weather...especially for November.... :-0

I came across an interesting article in the Equine Veterinary Journal this week  - it was actually published earlier this year  - the abstract is here:  http://onlinelibrary.wiley.com/doi/10.1111/j.2042-3306.2010.00081.x/abstract  

The research looked at horses who had been diagnosed with foot pain and undergone MRI.  It was a retrospective study, looking at 56 horses who had been given prescribed remedial farriery, a period of box rest followed by hand-walking and anti-inflammatories.  The researchers then followed up the horses a year later, using an owners questionnaire, to find out whether the horses had returned to their previous level of work.  

You won't be surprised to learn that most horses did not return to their previous level of work, and horses who had DDFT and collateral sesamoidean ligament lesions were the least likely to improve: 78% of the horses with DDFT lesions failed to return to work; 83% of the horses who had collateral sesamoidean ligament damage failed to return to work.  

Here are the conclusions in the researchers' own words:
"Horses with multiple foot lesions managed with conservative therapy have a guarded prognosis for long-term soundness. Deep digital flexor tendinopathies negatively influence prognosis."
Two things leapt out at me out from this.   

Firstly, that the Project Dexter research is a lot more credible - even without veterinary re-assessment - than I had previously realised; if follow-up data based on phone calls to owners can be published in the EVJ, then there is surely hope for the Dexter data?

Secondly, given that our results - even on a preliminary basis - are significantly better than conventional therapies, perhaps we can start to really interest vets in what we are doing...?  I am redoubling my efforts to get someone interested in reviewing and publishing the Dexter results - its been an uphill battle so far, so if any of you have suggestions or advice on getting this done, please let me know!


5 comments:

Kate said...

I couldn't get the link to open - but a question - did they distinguish between DDFT lesions/damage in the foot and DDFT problems higher in the leg? I recently had to retire a 13 yo mare due to scarring/adhesions in the DDFT (and suspensories) disagnosed by ultrasound of the lower hind legs. We never had an MRI of the feet, but she had foot problems in the past as well. Her issues were largely conformational - heavy body, relatively straight hind legs and long sloping pasterns. She had always been barefoot behind.

Nic Barker said...

I just tried the link and it worked on the 2nd attempt...but the research was on foot pain confirmed by MRI so DDFT damage within the hoof not in the limb.

I am sure that foot problems can later lead to limb problems, though, so the issues with your mare would make perfect sense :-(

Cristina said...

Interesting - when Frankie was first MRI's the study they referred to was one with 20 horses where 12 came sound which means the vets give you a 60% positive outcome.
Not sure how it would have affected the decisions I made if I'd been told 17% instead.

Nic Barker said...

Cristina, they refer to previous research - not sure if the one you are thinking of was one of them - but most of those tended to look at short term outcomes, whereas this one was looking at horses a year down the line.

Cristina said...

Well a friend's horse is possibly about to be MRI'd (clean x rays and nerves blocks to the back of the foot), it will be interesting to see whether their prognosis takes into account this new research.
It doesn't give you much hope if you are going to go down the tradtional route :-(