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  Discussion on Check ligament rehabilitation
Author Message
New Member:
chawley

Posted on Tuesday, Apr 10, 2007 - 5:01 pm:

My horse was diagnosed with a level 2 check ligament injury 13 months ago. We have done the full rehab including rest, walking, shockwave, etc. He has been brought back to work very slowly and his last ultrasound (two weeks ago) was excellent and the vet okayed to start some small Xs (just a few each session). He was doing great, but now has some mild swelling again in the area. I cold hosed, poulticed, wrapped, and buted him and it was back to normal by day two and he's sound. My vet is away on a family emergency and I don't want to bother her. My question is it normal to have little flares up this late in the healing process, and how much should I back off him until I can get another ultrasound? To this point, I've been handwalking him daily. A small amount of swelling doesn't necessarily mean we're back to square one does it?
Moderator:
DrO

Posted on Wednesday, Apr 11, 2007 - 7:50 am:

Welcome Christina,
No it does not put you back to square one and may just be incidental but I would consider this new swelling with suspicion. Not being familiar with the injury it is difficult to give you specific recommendations...how serious was the check injury and how long have you been hand walking daily?
DrO
New Member:
chawley

Posted on Wednesday, Apr 11, 2007 - 8:36 am:

The original injury was relatively minor. There was no core lesion, just some distribution in the fiber alignment with fluid present. He was initially lame, but became sound by the second or third day of stall rest, poulticing, wrapping, bute, etc. We ultra sounded and did three shockwave treatments on it. He was hand walked for four months before she oked me to start riding him at the walk. I began two minutes of trotting in month 7 and worked up to full flat work by month 12. During that time, the leg remained good. We took it very slow with this horse because I wanted to give him every chance to heal correctly. When he had his last ultrasound (2.5 weeks ago) she said he was fully healed and that the fiber alignment looked outstanding. There was also very minimal scar tissue. I rode him for a week after this ultrasound and jumped him over a VERY small X just a few times. He did great and cooled out well each time. Gave him one day off and the following day is when the swelling appeared. He was slightly short at the trot, but not lame. As I said, he responded immediately to poultice and bute. I've been hand walking him for the past week and did lightly walk and trot him last night (he was sound.) I've heard in cases like this to 'back off' for a little while with work. Can you explain what exactly that means? Is it okay to lightly hack him if he's sound and the heat is not present? Should I pay to have another ultrasound or just resume normal riding as long as the leg is cold? My vet (leg specialist) lives three hours away, so it's no easy task to see her regularly.
Moderator:
DrO

Posted on Thursday, Apr 12, 2007 - 6:21 am:

Christina, there is no exact meaning to "back off" and it will depend on the situation and your goals. With the information you have give us including your goals of "giving every chance to heal properly" yet avoid another ultrasound, a practical interpretation would be to return to the level of work you were doing before the swelling occurred. Then spend 6 weeks getting back to the point where swelling occured. If the horse had not been lightly hacking for some time before the swelling occurred you should spend time building to it. If you have continued swelling in the check ligament area you should discuss this with the cease exercise under saddle and discuss this your veterinarian.
DrO
New Member:
chawley

Posted on Thursday, Apr 12, 2007 - 8:14 am:

Thank you for taking the time to respond. The horse had been doing 45+ minutes of flat work 4-5 times a week including lateral work, lead changes, etc. before the swelling popped up. I will back off for 4-6 weeks with him and see what happens. I did lightly hack (walk/trot) him on Tuesday and the leg looked great yesterday. My goal is to hopefully show him a few times at 2'6" this summer. By then, it will have been a year and a half since the injury occurred and he will hopefully be able to handle it. Thanks again.
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