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  Discussion on Shoulder Sweeny
Author Message
Member:
Mtca

Posted on Tuesday, Apr 22, 2003 - 11:53 pm:

Dr. O

I have read your information on Shoulder Sweeny and that is what I have in a 3 year old gelding. We do not know how he was injured, kicked, etc., but he was not very lame just showed a head bob and no swelling or impact area. About 5 weeks later atrophy of the shoulder. We live in MT and none of the veterinarians have the equipment electromyography or a way to x-ray him in that area of the shoulder. How important is the electromyography as I would have to haul him to WA to a university from Montana and I have concerns on stress during shipping and causing more damage. I am perfectly willing to keep him stalled for the long period of time that is recommended in your reports, is this an option without the testing? Should I discuss corticosteroid (Dexamethasone) with my veterinarian? Here are some photos that I took just a few minutes ago of his shoulder.

Linda





Moderator:
DrO

Posted on Wednesday, Apr 23, 2003 - 4:43 am:

Hello Linda,
I went and read the article twice and fail to see where we recommend electromyography. This would be a diagnostic technique that generally is not needed in this condition as clinical signs are pretty diagnostic. The steroids are helpful during the acute phase to remove inflammation but at this point I do not think there would be much benefit, unless you are still having heat and swelling at the injury site.
DrO
Member:
Mtca

Posted on Wednesday, Apr 23, 2003 - 7:05 pm:

Dr. O

Thank you so much for your reply. My veterinarian said the only way we would know if "Spec" our gelding would come out of this sweeny would be through an electromyography. In your Scientific Reports, Dutton DM, Honnas CM, Watkins JP it discussed the degree of muscle atrophy being obtained by radiography and electromyography. Without knowing the severity of his nerve damage (i.e. torn, electricity on both sides of the collar bone) is it fair to say he should improve with rest even if it takes up to 12 months? With the stall rest will the atrophy get worse or should I be seeing improvements in a certain amount of time? Did you receive my photo of his shoulder? Again, Spec did not have any sign of impact just some mild lameness then the atrophy. So it sounds like stall rest, keeping his feet trimmed correctly. Any other recommendations or things I should be looking for? Thank you!

Linda
Moderator:
DrO

Posted on Thursday, Apr 24, 2003 - 6:25 am:

What Dr. Dutton was doing was a very thorough screening of participants in the study. Radiography was used to be sure that there was not a concurrent fracture and electromyography was used to rule out muscle atrophy not caused by "deinnervation". By doing this they could be sure those included in the study were typical Sweeny cases. Though radiopgraphy is sensible in cases where the trauma is remarkable, I don't see how electromyography is of much use in the field because the clinical signs are so typical. A Sweeny that is not going to recover would look the same early on as one that would, electromyographically. It would help differentiate those with a primary muscle wasting disease (rare) from those with deinnervation injury.

How fast you see inprovement will depend on the severity of the nerve damage. Some get better in several months while in the article you quote above there are cases that required 18 months.
DrO
Member:
Mtca

Posted on Sunday, Apr 27, 2003 - 3:03 pm:

Dr. O

I appreciate all your help on shoulder sweeney. As I explained the gelding is in a stall in the barn. Can he be walked outside on a lead or does he strictly stay in the stall without coming out? Please tell me the basics on the care I need to provide.

Thanks,
Linda
Moderator:
DrO

Posted on Sunday, Apr 27, 2003 - 7:08 pm:

Linda, I went to the site and updated the treatment section to provide the basics a little more in detail, frequently the specifics depend on your situation. Review the article then if you still have questions bring them here.
DrO
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