|
|
Discussion on Muscle/Nerve/Tendon/Ligament Damage or Fracture
|
| Author |
Message |
New Member:
kpscpa
|
Posted on Saturday, May 19, 2007 - 10:59 pm:
Sometime in February (mid to late) my thoroughbred took a hard fall in the pasture being goofy on slick grass. He appeared to be ok. Due to the bad weather we didn't ride for several weeks. Then I noticed the head bobbing while he was walking uphill to come out of the paddock, and at the trot. I called the vet. After examination he felt there were no fractures, just soft muscle tissue, possible tendon/ligament damage in the lower neck extending from the chest on his left side. He recommended bute and no riding for 2 weeks. Nothing about complete stall rest. Due to a late cold/snow spell, it ended up being 3 weeks off. The first warm day I rode. He ended up tripping and coming down on his shoulder again and me, when I first moved him into a trot. I stayed off of him for two weeks, with normal turnouts, waiting for a prescheduled Chiropratic/Acupuncture vet call. The vet performing the service found more issues in his upper right shoulder region, back and hind quarters. He suggested returning to riding after a day. I did, and my horse continued tripping and had noticeable movement changes, moving more like a sewing machine instead of long fluid movement up front. Calling the vets back out, they wanted me to bring him to the clinic for further xrays, etc, and surgery. Through your article and his symptoms, it appears to me to be classic Sweeny, without atrophy. IE, he injured his eye lid this past week and had to be stalled for several days to allow the stitches to heal. I turned him out last night while cleaning his stall and he moved beautifully, along with bucking and tearing around (typical thoroughbred). Today he was horribly lame, very noticeable in the right shoulder. I immediately put him back in the stall, no bute. This evening I carefully walked him out to hand graze and he appeared much better that this morning. Thank goodness I found this website as I am suppose to talk with my vets on Monday. They want to do surgery and my horse has a history of laminitis. My question is does this sound typical of Sweeny or a fracture? What is your opinion on which way I should go?
My horse is obviously accident prone. From what I understand, the risks of surgery because of the laminitis history are not very good. I could care less if he was just a pet the rest of his life. I just want what is best. It appears from your information that stall rest and anti-inflamatories are his best bet. In addition, the costs of diagnosis and surgery are flat out scarry. I have been quoted upwards of $10,000 for the surgery, not considering the possible laminitis complications and the diagnosis of approximately $1,500 to $2,000. Don't we already have a diagnosis?
|
Member:
mrose
|
Posted on Sunday, May 20, 2007 - 12:39 am:
Kathleen, you'll probably hear from Dr.O in the morning. I was just wondering if the vets you had were saying they needed to x-ray your horses shoulder and go from there, and that he might need surgery; or if they were sounding certain that he would need the surgery? It seems to me reasonable to have diagnostic x-rays done so you would know for sure what you were dealing with. If for sure it is sweeney, since it has been so long since his original fall, maybe that is why they are suggesting surgery. It sounds like a long rehab either way; good luck with him.
|
New Member:
kpscpa
|
Posted on Sunday, May 20, 2007 - 8:20 am:
The vets want to do the xrays for diagnostic purposes. After reading my post, I was not very clear on other key questions.
If this is a fracture, how would the treatment differ? Also, can field xrays or a sonagram (spl??) be performed in order to diagnose Sweeny or fracture?
|
Moderator:
DrO
|
Posted on Sunday, May 20, 2007 - 10:20 am:
Welcome Kathleen,
Let's back up: without muscle atrophy I would not diagnose Sweeny. Many injuries to the shoulder region present with a stride that resembles neurological deficit but really is pain during the anterior portion of the stride, therefore they both appear to be unable to advance the leg normally. In fact the somewhat episodic appearance, "normal after a few days rest", suggests it is not Sweeny.
So, prior to proposing a treatment we need a diagnosis. Treatment for fracture and any other disease entity will depend on where the problem(s) are found.
DrO
|
New Member:
kpscpa
|
Posted on Sunday, May 20, 2007 - 10:28 pm:
Thank you so much for your help. I added bute to his stall rest today. He responded very positively. The vets and I are going to have a discussion tomorrow about our direction, as I am hesitant to put him on a trailer with his eye injury. I will for sure keep you in the loop on our course over the next week while his eye lid is healing, and weather the vets feel they can obtain an accurate diagnosis without transporting to the clinic. I will also inform you of the diagnosis and suggested treatment.
Of course I still have a million questions, but most prevalent is can it be possible that a horse can have a life threatening fracture with the "off and on" type of symptoms he has displayed?
Again, my sincere thanks!
Kathleen
|
Member:
quatro
|
Posted on Sunday, May 20, 2007 - 10:59 pm:
Kathleen, sending you positive thoughts for you and your horse. Having an accident prone horse child myself, I can feel for you. Hope things turn out for the best.
suz
|
Moderator:
DrO
|
Posted on Monday, May 21, 2007 - 8:17 am:
If the horse was truly sound for a period, I would say no, a fracture is not likely.
DrO
|
New Member:
kpscpa
|
Posted on Thursday, May 31, 2007 - 11:47 pm:
We've gotten the diagnosis, whew, it took 5 1/2 hours! Nerve blocks from the hoof up to above the knee, sonigrams of the fetlock and cannon areas, and even complete xrays of the neck. It was a very difficult diagnosis.
For a lack of the technical terms, or in plain english, he pulled the ligament behind his knee. 3 months rest with either turnout in a small area he can not reinjure himself in, or hand walk, and he should be good as new!
Whew, I really was nerve wracked! The vet said we are very lucky it was not the suspensory ligament. I guess it was just all of your prayers and the the good man upstairs!
FYI - my interpretation of the actual medical diagnosis told to me (can't remember), and from my trying to read the handwriting, "palmazca...l ligament stran... palmar 3rd carpal bone"
Can anyone correct or "finish" my interpretation?
Again, my sincere and heartfelt thanks to all!
Kathleen
|
Moderator:
DrO
|
Posted on Friday, Jun 1, 2007 - 9:00 am:
I am afraid there are a plethora of ligaments behind (palmar) the knee (carpus) Kathleen so we will need some help from the diagnosing doctor but would really like to know what it is. It sounds most like one of the palmar intercarpal ligament but there are a few of these.
DrO
|
Member:
frances
|
Posted on Friday, Jun 1, 2007 - 10:40 am:
What a relief Kathleen! So glad the diagnosis has such a good prognosis.
|
Member:
kpscpa
|
Posted on Friday, Jun 15, 2007 - 11:13 pm:
I have the exact "name". Unfortunately this doctor talks way too high for my common business world communication style, so my interpretation is still quite vague. "Palmar carpal ligament strain of the palmar 3rd carpal bone". Does this ring a bell with anyone?
As for progress, it's zero since the May 31 diagnosis.
I was told "restricted turnout for 90 days then reassess the carpal lameness". He is stalled during the day, and at night, we put up a very small turnout so he could get fresh air. It's 8 - 8' round pen panels + gate panel fastened outside a 12x12 stall (in case of evening thunderstorms).
Keep in mind, although he is quite calm and easy to work with when you have your hands on him, he is a thoroughbred. When you don't have your hands on him he canters circles, bucks and rears in his 12x12 stall when he feels the need, especially at feeding time right now... I cut his feed back knowing extra weight will not help his situation. He get's a 6 gallon bucket of low starch forage and 1 cup of low starch pellets twice daily, plus free feed PA orchard grass hay. One feeding we add 1/2 cup corn oil, cosequin and omega horseshine. He is noticably losing weight. I don't think he needs anything else, but welcome suggestions!
I am beginning to think that with his "goofiness," he is in for a longer haul that the vet originally gave.
Don't get me wrong, I am relieved it is not life threatening. But I need to keep my expectations realistic, and I am having a difficult time communicating with my vet. I am a CPA, and speak in total black and white. Can anyone say in plain english what this is and what the outcome is for a difficult horse that could possibly be continuing to aggravate the injury? Would it be better to just turn him out in pasture (private), let him get his boogers out, but leave him out, so he stays calmer?
Thanks!!
Kathleen
|
Member:
kpscpa
|
Posted on Friday, Jun 15, 2007 - 11:17 pm:
Dr. Oglesby:
If you could give me exact questions, I can ask the vet and let you know. I really appreciate your ability to communicate. I have no hard feelings, I just understand it's communications issues. I think you may be able to help me bridge this small problem.
Thanks again!
Kathleen
|
Moderator:
DrO
|
Posted on Monday, Jun 18, 2007 - 10:22 am:
Well I guess the real question is how serious are the lesions of the ligament on the ultrasound? What do they see?
There is very little published about the smaller palmar ligaments of the carpus. I do suggest you follow your veterinarians advise on rest but express your concerns to him to see if it changes his therapy.
DrO
|
Member:
kpscpa
|
Posted on Thursday, Jul 5, 2007 - 10:36 pm:
One month later and the therapy had to change. There has been no improvement, only getting worse. My farrier went to the clinic to see the xrays and speak with the vet.
Although it was hand written on the discharge sheet, I think it may have been a small mistake on the "restricted turnout." Now we are stall rest only for a minimum of 3 months, and yes, we are still at square one.
My next concern is keeping him quiet. I've got a post going under Medications/Sedatives, . We are not going to use the Reserpine or Fluphenazine unless it get's vital. I'm going to try the supplements, and if nothing else, there is always ace!
Thanks for all the support and advice, and please do continue to give me any suggestions you may have! 
Kathleen
|
Member:
kpscpa
|
Posted on Thursday, Jul 5, 2007 - 11:03 pm:
Sorry Dr O, forgot to mention that they never did ultrasound the ligament area, only the suspensory. They took 18 xrays of his knee, all the way around and back again, on every angle. I "think" I heard someone call it the suspensory ligament.
BTW, I've got some great friends here in Richmond, VA! The farrier took his time to go to the clinic out of concern for my horse. He and the vet reviewed the xrays. He then told the vet he did not feel the horse should be turned out at all, and the vet agreed. We won't go back to the "why did you right it down issue." Just move forward with what we have.
My other issue I am facing is moving him to the new barn we are all going to, Close in and overall just a much nicer facility, it's the type of barn you dream of. He will have to be trailered. How much ace should I load him up with before loading time. It will be a 20 minute drive. The move is planned for September.
Give me some advice, it's truly appreciated!
Kathleen
|
Moderator:
DrO
|
Posted on Friday, Jul 6, 2007 - 7:23 am:
Kathleen,
I wish I had a crystal ball that would tell me how much ace to give your horse but the only answer that works is enough to keep him calm without causing remarkable incoordination. The range of dosages is given in the article on ace but different horses need different amounts depending on how excitable they are. I would recommend you trailer this horse with the horse faced backward to minimize stress on the front legs.
DrO
|
|
|
