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Discussion on Suspensory ligament injury
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Member:
Arvane
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Posted on Wednesday, Apr 23, 2003 - 10:48 am:
Hello Dr. O,
I have tried to locate an article on your website on suspensory ligament injury (not related to surgery). I haven't found one, perhaps I am looking in the wrong place?
My 11 year old TB came down lame at the trot 3 weeks ago. There was never any heat or swelling in his leg but the vet palpated it and diagnosed him with "sore suspensory ligament" (the vet guessed he was sore due to jumping on hard ground, and we decided to hold off with the ultrasound for a while since she thought he would make a quick recovery). I have kept him in the stall, handwalked him twice/day (he was never lame at the walk) and given him bute (two 5-day treatments), used DMSO, Sore No More and standing wraps.
I trotted him this morning and noted that his recovery so far is minor. I am very disappointed and have been trying to find some guidelines for how long horses are normally lame. From what I understand, when it comes to soft tissue injuries there is no such thing as "normal" but would you be able to tell me if it is out of the ordinary that the horse only makes a slight recovery after 3 weeks? Also, if you ahve any suggestions on my treatment described above, I would be very grateful.
I will have the ultrasound done next week but would like to know if you have any input (or could point me to an article?) I'm very down and discouraged after trotting him this morning..
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Member:
Cara2
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Posted on Thursday, Apr 24, 2003 - 7:54 am:
Hi James,
Your horse's injury sounds very much like my mare's which she did in November - and she is still on rest although I hope to start some light lunging with her at the end of this week. Give him plenty of time, and don't keep testing to see if he is lame. Mine was sound after 3 months of box rest and walking in hand which she hated then pratted about and went lame again. I decided that I couldn't make her do another 3 months in solitary confinement so turned her out in a small paddock with a quiet companion. I'd rather have her lame and happy for the summer than sound and miserable frankly, especially as she is now 21 years old. My plan seems to have worked well though as she is very content and completely sound with no heat in the fetlock at all ( I think the injury was exceptionally low down, the part of the ligament which wraps around the fetlock). I suspect we are in for a quiet summer together, ie no shows, but that's a small price to pay.
Incidentally, do you find your horse is sore when he pivots on the hoof? Mine was only lame in trot at first but then she aggravated the problem (not her fault) and although she was ok in walk, she struggled on the turns and wouldn't use the leg to push herself up after a lie down for several weeks so it must have been pretty sore.
Don't be depressed, be patient and enjoy doing other things with him while you can't ride.
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Moderator:
DrO
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Posted on Thursday, Apr 24, 2003 - 10:07 am:
Hello James,
Suspensory injuries are evaluated and treated very similarly to flexor tendon injuries. So see » Equine Diseases » Lameness » Diseases of the Lower Limb » Flexor Tendinitis.
DrO
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Member:
Arvane
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Posted on Thursday, Apr 24, 2003 - 11:47 am:
Thanks Dr O for the guidance, I knew there had to be an article on this site!
Helen, Thank you for your extensive answer, I actually feel much better knowing that it took so long for someone else, so I'm not completely out of the norm. I too have a hard time with the solitary confinement but will keep it up for another month, then turn him out in a small paddock (if he is better). I guess you took ultrasounds (or not?) If so, did that help you in any way in determining treatment? Did you do the standard care with bute/liniment/wraps or do you have some other suggestion? Someone suggested ice and hyDrOtherapy, and perhaps massage...
As for the turning and getting up, I need to check that. At the beginning he did something funny with the foot at the walk, sort of taking the weight off, but now he seems completely sound when I handwalk him.
Thanks again for the support!
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Member:
Cara2
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Posted on Thursday, Apr 24, 2003 - 12:03 pm:
Hello again James,
No I decided against ultrasound. My horse can't have bute and I couldn't see the point of spending ££s having the vet tell me she needed rest and cold therapy! Does that sound awful mean?? I borrowed a cold therapy wrap which you soak for 20 minutes and it stays cold for ages and used that morning and evening. I also used (Dr O I can hear you grinding your teeth  ) homeopathy and after the first week, magnetic pads bandaged onto the lower leg. She still has the magnet on at night. Like your horse she went lame on hard ground but I thought at first she had stood on something as we weren't doing anything at all unusual. I now believe she initially strained the fetlock two weeks before when galloping terrified around a boggy field and it finally gave up the ghost on the hard surface which was uphill and probably led to the pastern flexing back too much.
As yours is a TB, it might be wise to sedate him when you first turn him out. I put Cara in a weeny paddock not much bigger than two average rooms and she still managed to canter around it. I then only put her out for an hour or so after dark at first so that no horses would come by for her to chase. She really is her own worst enemy!
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Moderator:
DrO
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Posted on Friday, Apr 25, 2003 - 6:39 am:
Nonsense Helen, if it makes you feel better it is OK with me. It is not my money you are spending.
DrO
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Member:
Arvane
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Posted on Friday, Apr 25, 2003 - 9:22 am:
Helen, I sort of agree with you: Seems that even if I do an ultrasound the cure will be the same.. I have actually been thinking of trying magnets and "alternative" therapy (he's on devil's claw right now). To make him happier I try to turn him out in a small paddock for 1h early in the morning, before all the other horses go out. Thanks again!
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New Member:
Lennon
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Posted on Tuesday, Feb 3, 2004 - 6:22 pm:
Would appreciate RNO's take on this: 6 yo QG reiner. Horse subjected to nuclear scintigraphy to diagnose pain in front left foot. 8 wks prior to scan, hoof wall cracked vertically just at/below coronary band (outside qtr/heel area). Crack appeared 5 days after poor shoeing; horse uhappy right away (resisting circles to left by surging off circle; rearing when asked to push off round into right lead lope with haunches to inside; ran off slide). Reshod 10 days later by another farrier: take pressure off crack and provide heel support. 10 days SMZ's (foot hot) and overall, 3 weeks stall rest. Still seemed stiff and unhappy (but willing) to lope circles.Seems to prefer lope on left lead. No limping or bobbing of head observed.
LF has history of run under heel and long toes w/long sloping pastern; right front foot/ankle more upright. LF cracked in same area in late 2002 (prior to my ownership). This crack cut out in June 2003. Thereafter, for several mos, horse sore in FL showing head bob and positioning of FL forward and slightly to outside at halt/rest, keeping full weight out of left leg (often loose at knee). Light work thru Oct., when horse went sound with pads in front. Bad shoeing in November produced new crack.
Last week, horse went soud with FL foot blocked. Scan showed mild uptake in quarters; nothing significant in right leg. SURPRISE: left knee showed significant hot spot where suspensory ligament attaches to bone. Digital X-ray showed no bony remodeling. Flexion test to left knee revealed no reaction (Lameness), heat or swelling.
Questions: Could ligament be aggrevted due to the recent hoof crack? What could cause a hot spot in this area other than from injury? Why wouldn't the horse show head bob or other sign of lameness from flex test? Could this injury show only in pivot or circle? If related to crack, which was beveled open, drained and is being treated with epson salt soak with bedadine for infection, be continuing to cause aggrevation to ligament as long as the crack is painful AND CAUSING MOVEMENT IN HOOF WALL? (How shod w/pads, heel support and asperin daily for mild foot pain coming from quarters). Would rehab for ligament be same as for clinically observable injury? What would you recommend?
THANK YOU
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Moderator:
DrO
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Posted on Wednesday, Feb 4, 2004 - 6:27 am:
The significance of the hot spot is at best unknown and probably has "none" considering the nerve block findings. Hot spots on sound horses are very common and the reason scintigraphy is a poor tool for localization of lameness. As long as the problem blocks out in the foot: continue to look to the foot for solving the problem.
DrO
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Member:
Lennon
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Posted on Wednesday, Feb 4, 2004 - 8:08 pm:
Dr. Oglesby - thank you so much for the most encouraging words I've received in many days. God bless you!
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