Finally, we have answers!
I was rather tired getting home last night so forgive the belated update.
Firstly I suppose I should reveal that the diagnosis is Medial Collateral Ligament Desmitis, coupled with an astonishing case of seedy toe.
Quadi was slightly sedated as is standard for these things, but I'd heard he'd been an angel since being dropped off on Sunday night. So clearly I bring out the worst in him *lol*
The shoe was removed and the vet had a good look around, since what we knew at this point was that it was a foot problem and probably something at the front. No reaction to hoof testers and then the vet had a good look at the sole and white line, whereupon he found a gaping hole and very clear separation of the hoof wall :( I didn't have the presence of mind yesterday to take a photo but it was hard to miss. It wasn't there when Quadi pulled the shoe the day he had his first x-rays, but the infection has to have been grumbling away for some time.
With that in mind, the next step was x-rays. I donned lead vest and my job was to hold Quadi so that the vet nurse could run back and forth with plates. He was such a poppet, very compliant (must drug him more often!) and at one point when the vet was out of the room he stood with his foot on the block for the entire time.
Once all the images were taken I was invited through to have a look at them on the computer. Digital images are so much easier to look at! Firstly, the infected hoof wall. It was clear as day, and it tracks very far up. Quadi doesn't have strength in the stuctures of his heels yet and as such doesn't really cope with heel-first landing. So toe-first landing coupled with this infection has meant he's now got a very sore foot. The special set-back shoes he wears, by their very design, can trap dirt and much under them so it's just plain bad luck. I guess I could have been disinfecting them when he was being shod but it wasn't apparent from the outside there was anything untoward in there.
He also has a few niggling changes of the various bones in his foot. Mostly the pedal bone. He was a sidebone in that off fore, and a few little ossifications but they appear incidental and as a result of previous bad foot balance most likely. Not surprising. He notably has some changes over the face of the pedal bone, where it runs parallel to the hoof wall. They denote laminitis, so he's definitely suffered from that at some point. Again, I'd assumed this was the case. It's just really good to know that both myself and Kate are spotting indicators of these things from the outside!
Just to be super-safe, we pressed on and also looked at his lower leg with ultrasound. Belts and braces and all that. At first everything was looking very healthy but a problem was spotted with the medial CL. The vet explained that there was some thickening at one side of the top-third but that two-thirds of this ligament are in the hoof below where the ultrasound machine can detect. He also explained that this was perhaps an issue but we should compare it to the CL on the near fore. If they matched, then they were probably healthy but if not then this would fit with the lameness pattern we've seen.
The other ligament looked much healthier I'm told. I say I'm told because although I could see the images, side-by-side, and had a vet showing me what to look for, for all I know Quadi could be having a baby because ultrasounds all look the same to me! But the medial CL on the off fore just wasn't looking as 'pretty' and healthy, and overall was harder to get a clear image of.
In order to see the bottom two-thirds of the ligament, he would have needed and MRI which would mean a trip to one of the vet hospitals down south. But the examining vet here said that the treatment would be no different. He also said that it could be a chonic issue that has been exacerbated by something. A knock or jarring, changes in foot balance, walking oddly on account of the seedy toe, etc. And that he'd be very disappointed if Quadi didn't come sound once we'd treated both issues.
So, rest is what the doctor orders. 4 weeks on total rest, then another two weeks with walking in-hand, then onto a small paddock for another few weeks. At that point he recommended a rescan. Oh, and we'll have to remove the infected hoof wall but the good thing is he'll be in anyway!
He loaded up really well to come home. Wasn't really interested in food at all so we used the lunge line, and he walked in! At least we have a tool we can use now, we know where the buttons are.
I was, prior to all of the veterinary diagnosis, feeling blue about the prospect of Quadi not working. I was told he must be in work to have a healthy back. But he looks GOOD for a horse doing no work, so everything Kate was doing with him agreed with him immensely, as well as the farrier, the physio and the equine massage therapist. I am more positive that this is merely a moment to treat water, not a step back. And he will be doing stretches and will be strapped and groomed, and will have access to stable toys. Frankly, I feel that as long as there's hay he'll be happy enough!
At the moment he's stood in his stable at the livery with one and a half shaved legs and three shoes on! I'm away for a couple of days so not much to report until the weekend....when we move yards! It'll be nice and quiet there for Quadi to rest and convalesce. And Fin will have a lovely broodmare as a companion until we're all back to turnout. Very exciting!
I, on the other hand, developed a cough, tight chest and sore ears when I got home so I feel a little ragged today. Didn't realise quite how stressed I was before, but I'll survive!