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  Discussion on Splint in 2 year old she did it on a gate...
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Member:
imogen

Posted on Friday, Mar 16, 2007 - 7:14 pm:

Hello all

Please can I have some advice? I will post a photograph tomorrow. My rising 2 yo has developed a splint in the last two-three days, inside right fore, warm, about 1 inch long by one-third inch swelling sideways. She likes to stick her leg through the gate and bang it to make a noise, I am sure this is what caused it although she might have popped it running around in the field when her dam was being ridden away by me. She is not lame.

Being a 2 yo she is not in work. I do think she is overweight though not much so I will stop all hard feed (it is end of winter, she was being fed due to the weather conditions).

Do I need to bring her in on box rest and go the X-ray/bute/icepack/massage route or is it best to just say oh well horses do these things, it'll probably remodel fairly ok and leave it?

All the best, as I said I will post a photograph tomorrow.

Imogen
Member:
36541

Posted on Friday, Mar 16, 2007 - 11:42 pm:

Imogen, the article on splints was really helpful for this past
november when my 10yo popped a lateral splint. I did some mudding to cool it off, but wasn't really able to do stall rest. Dr O helped me with his return to work schedule. When my young warmbloods pop one, and they almost all have had them, I generally let them heal up as they would naturally, and have had no lasting problems. I have never x-rayed a splint myself, if she is sound maybe you could do the conservative route. best of luck, Stacy
Member:
imogen

Posted on Saturday, Mar 17, 2007 - 5:30 am:

Here's the picture, sorry about the gate being in the way but the others I took aren't as clear.

Luggage splint
Member:
imogen

Posted on Thursday, Mar 22, 2007 - 2:34 pm:

Ok I'm sorry guys I'm totally confused. My reading of Dr O's article is that because it's proximal (I think just under the knee is proximal not distal?), Mc, inside then she needs to go on box rest and be pressure bandaged.

My vet advised me by phone, and his office gave me an iodine blister to be applied with a toothbrush, box rest for 10 days, apparently the blister will hurt and cause it to swell, but it should be cooled off in 10 days.

My vet books say there is no benefit in using a blister. Or anti-inflammatories unless a painkiller is needed which it is not as she is not lame.

My farrier says it can probably be left, as long as she is not galloping about in the field (which unfortunately she did today, first nice warm spring day...)

So I figure I have to bring her in, drat, thought I was finished with stables for this year.

I'm a bit nervous about getting the tension wrong on the pressure bandaging, and I'm a bit doubtful about the blister especially as she will doubtless get pretty rowdy about it being a 2 year old on box rest who does not want painful stuff put on a painful place.

What do you reckon? Any advice on pressure bandaging (doing it right, how often to check/change, use a sofwrap or gamgee underneath?

Or is it all too late now? Noticed it on 17 March but holiday weekend so could not get reply from vet.

The lump is hard but not totally so, slightly warm, does not hurt her unless you put quite a bit of pressure on it.

Thanks as always for any advice. On the bright side, I wanted to spray that pasture for docks...

Imogen
Member:
imogen

Posted on Thursday, Mar 22, 2007 - 3:44 pm:

Also, is it not a "false splint" if it is due to trauma from the gate rather than inflammation of the ligament between the splint bone and the cannon bone? Now I'm wondering should I get it x-rayed... but I would have thought if it is an actual fracture due to trauma surely she would be lame?

Imogen
Member:
paardex

Posted on Friday, Mar 23, 2007 - 5:21 am:

Imogen,
I'm not able to help you with deciding what she has or what to do Dr. O no doubt will do that.
But having had a lot of young horses with these kind of injuries [especially young stallions coming home after being away on pasture] I found that a good fitting leather boot for half an hour a day[fe when lunging] up till a few hours a day in the paddock if possible[some of them ofcourse eat your expensive leather boot]worked wonders and often led to the disappearance of the ugly bump.Needles to say you should not do this in an acute stadium or with a lame horse.
I was taught the blistering was no good at all.
Jos
Moderator:
DrO

Posted on Friday, Mar 23, 2007 - 8:36 am:

That would be proximal with relation to the rest of the splint bone but distal to the knee that you reference Imogen. And you might not be surprised to hear we have an article that explains this and other relative and absolute anatomical terms at, References » Equine Illustrations » Anatomical Orientation Terms.

Whether this splint is caused by external trauma or internal trauma really does not make a difference to treatment. You still have that range from a mild non-painful to full blow out fracture. The article addresses what we think is the wisest method for approaching diagnostic work up and treatment and I believe addresses each of your specific questions. I did add links to the pressure bandaging reference.

For specific information on pressure wrapping see, Diseases of Horses » First Aid » Pressure Wraps, Poultices, Cold and Heat Therapy for Swelling in Horse Legs.
DrO
Member:
imogen

Posted on Friday, Mar 23, 2007 - 3:17 pm:

I know I'm being thick but I still don't understand the distal and proximal bit despite Dr O's message and the reference. The lump is up by her knee. Is that proximal or distal in terms of the article's recommendations?

I brought her in and did a hot kaolin based poultice (antiphlogistine) last night and that improved it quite well but there is a pretty obvious lump. I cold hosed the poultice off in the morning.

I had intended to keep her in. Unfortunately when I put her dam in the field she decided to run round the box like a lunatic (this is normally a very quiet animal). I left her 20 minutes to calm down but she wasn't going to so I put her out, she was then fine and did not gallop but the lump was up a bit again tonight, mainly from running around the box I think.

I cold hosed it tonight although I think it's much too late for that, and I'm going to poultice and bandage again and bring her in each night for at least 10 days and not leave her in the field when her dam is being ridden.

I'm not going to try the blister, I think it's too late there again and I can never understand why one would do something that clearly causes pain unless there is good evidence for it.

If anyone thinks I should be doing it differently please say...

All the best

Imogen
Member:
imogen

Posted on Friday, Mar 23, 2007 - 3:21 pm:

PS my friend who teaches stable management thinks pressure bandaging should always be done with an old tail bandage that's lost its elastic so you can't accidentally put it on too tight though I would wonder if this would lead to a bandage with no effect.

She also said you've done it too tight if there are any lines from the bandage on the flesh of the leg when you check it and it must be changed every 12 hours minimum. I thought those were useful pieces of additional advice to the article which is also very good.

All the best

Imogen
Moderator:
DrO

Posted on Sunday, Mar 25, 2007 - 1:13 pm:

Proximal and distal are relative terms Imogen, they only have meaning when used in reference to another point. Anything closer to the body than the reference point is "proximal" anything further away from the body that the reference point body is distal.
DrO
Member:
imogen

Posted on Monday, Mar 26, 2007 - 2:58 am:

Hi Dr O

I thought that for limbs the reference point for anatomical terms was actually the spine. If a splint is a problem with a bone which is anatomically analogous to a finger phalange in a human, then the proximal (near) end is the "top" and the the distal (far) end is the "bottom".

If the reference point is the bone itself, how can you tell which way up it is? As I understand it these are triangular shaped bones - is it the finer bottom part which is proximal or the thicker top near the knee?

Thanks and sorry for going on about it - my understanding of the article was "worry more and consider stronger management than rest if the problem is near the top of the splint bone closer to the knee". But I was confused when you said proximal and distal refer to the bone as I could not then understand how to orientate it.

I know for example that the finger joints closer to your palm are the proximal interphalangeal joints as opposed to the ones closer to your finger tips which are the distal ones.

Anyway the splint goes up during the day when she walks about and goes down after poulticing/rest at night. The other problem I have is the spring grass is flushing and she is putting on weight not losing it unfortunately.

So I want to know the answer because I will consider moving her to a yard where she can be on box rest 24 hours but have constant company and have her diet better controlled.

Thanks!

Imogen
Moderator:
DrO

Posted on Monday, Mar 26, 2007 - 8:31 am:

If you would like to substitute the spine for the body that is fine and makes more sense for the bones of the shoulder. But to get back to your question about the splint bone, if the bone is the reference then the part closer to the body is proximal and the part further away is distal.
DrO
Member:
imogen

Posted on Saturday, Apr 21, 2007 - 5:17 pm:

One month after it happened the splint is still large. I was up at the vet's getting my mare AI'd today and asked whether there is anything to be done for the 2 yo at this stage (she still is not lame but it is a big splint near the knee and it's not going down). They have not yet actually seen it - I am thinking I will take her up on Monday when the mare has to be scanned again so they can look at it.

They said pinfiring (no thank you unless absolutely necessary) or they have had good results with sonic therapy. Is there any evidence for either or is that the sound of my wallet emptying? At least now most hunt horses have gone out so there is some space in the livery yards to get her onto box rest if needed.

Thanks for any further advice anyone may have.

Imogen
Member:
imogen

Posted on Saturday, Apr 21, 2007 - 5:27 pm:

Sorry I should have said they called the second option "shock wave therapy" which Dr O in another post in this section says nothing is published about, but when I queried what exactly was meant and if it was a type of ultrasound they said it was sound waves.

Imogen
Moderator:
DrO

Posted on Sunday, Apr 22, 2007 - 9:49 pm:

I would not have expected much change in a month Imogen, it may take 6 months or a year for the bone to finish remodeling once it has stabilized but that is the question, is it stable or is there ongoing problems?
DrO
Member:
imogen

Posted on Monday, Apr 23, 2007 - 5:52 am:

Yup, I think I need a vet visit to establish that (whether stable or not) - I presume I need to take her to the clinic because they will need to X-ray to find this out?

They previously told me that blistering would sort it out (stabilise it) in 10 days which I also found surprising as I thought that it would take longer. Thanks for the info.

Imogen
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