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  Discussion on Suspensory injury
Author Message
Member:
Nshull

Posted on Thursday, Sep 25, 2003 - 9:03 pm:

I have a 9 year old Standardbred mare that tore her right front suspensory two years ago. She also had some small tears to the deep flexor tendon. We had her ultrasounded many times and after a year the tendons and ligaments filled in. Her leg looks near normal with a small thicking of the suspensory 2 inchs below the knee. She is sound. She was stall kept for 1 year with hand walking for one hour. She was then in a small paddock for 3 months and since then has been turned out around the clock in a big pasture. I would like to start bringing her back into work now. We do Hunter under saddle and Judged Trail. Do I need to use the rehab chart in the article I wonder? Or, can I move a little faster because she's been turned out without reinjury for so long? Unfortunatly, the vet who was working with us is no longer in the area so I can't ask her.
Moderator:
DrO

Posted on Friday, Sep 26, 2003 - 6:50 am:

The chart is designed to promote high quality healing of the connective tissues while preventing reinjury.

You are past the healing point so I would not start at the beginning However strengthening, remodeling, and careful monitoring for set backs are still important so if you pick up at about day 90 with the "good" exam results that would be about right. The one change on a horse that has already healed would be if his condition has remained good you might start a little trotting after the first 30 days (day 120), working slowly up to the 5 minutes of trotting by 60 days (day 150).
DrO
Member:
Marengo

Posted on Monday, Oct 13, 2003 - 5:17 am:

My 17 year old warmblood presented with a swollen front tendon Saturday morning. He was not worked Friday so obviously did something in the stall overnight. (His legs are checked at least twice a day.) I had the local vet out and ultrasounded his leg. He had mild swelling, mild heat, no lameness or guarding. The ultrasound revealed a core lesion on the medial aspect of the suspensory. We put a sweat wrap on and stalled him. Sunday after 24 hrs, I removed the sweat wrap and his leg looks normal again. I put a standing wrap on and stalled him again. Today I am taking him up to an equine hospital for a second evaluation.
My local vet wants to inject adequan into the injury.
The hospital (over the phone) said they normally inject bone marrow into the injury.
What do you know about these two procedures? Which has the better effect?
Thank you
ps- my horse is working at Grand Prix dressage. He has excellent leg conformation, never had any injuries before nor any tendon problems.
Moderator:
DrO

Posted on Monday, Oct 13, 2003 - 6:04 am:

Hmmm...a ultrasonographically evident core lesion with no lameness that happened in the stall... I wonder, the central region of the suspensory has a normal area of hypo-echogenicity. What if the swelling was secondary to something much more superficial and this is artifact...or an old lesion? This should be considered on the reevaluation and careful ultrasound comparision to the normal leg done.

Concerning the specific therapies you outline these are both experimental therapies with no information available specific to the suspensory ligament that I can find. There has been a small amount of work with Adequan in tendon injuries and there was no improvement in healing with its use when injected into the lesion.
DrO
Member:
Marengo

Posted on Tuesday, Oct 14, 2003 - 1:07 pm:

The second Ultrasound in the hospital showed no lesion or any stress or strain on all tendons of both legs. The hospital thought that indeed what was seen in the field exam was an artifact caused by the use of the ultrasound instrument. Thanks for your excellent consult!
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