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  Discussion on Sprained deep digital flexor - hind leg - outlook?
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New Member:
Taceann

Posted on Saturday, Dec 11, 2004 - 7:05 pm:

Hello everyone, hope you can help a new member from the UK.

I am wondering what the prospects are for my 17 yo gelding. He has been intermittently lame the last two months and after ultrasound last week I have been told he has sprained the DDF in his off hind leg, just below hock, by about 2cm. It may be an aggravation of a previous sprain/strain that I was not aware of.

If all he can do in the future is just let me ride him for a leisurely walk in the woods that would be enough for me - what is the general outlook for this type of injury?

He will probably have the leg rescanned in mid February - is this too soon or should I wait until say April when he has had more rest? When will he be able to start with some handwalking and some ridden work at walk?

He is currently in a very small paddock, about size of three stables.

Sorry for so many questions - hope you can help. Thankyou.
Moderator:
DrO

Posted on Sunday, Dec 12, 2004 - 10:27 am:

Welcome Rosalind,
The prognosis is based on an ultrasonographic evaluation of the severity of the lesion and assessing the conformation of the horse. Unfortunately we can do neither from here but it would take a fairly bad lesion in a horse with fairly bad conformation to not have a good prognosis for leisurely walks in the woods. The one caveat is the suggestion this may be a chronic injury for which the prognosis would be worse. For more on rehabilitation see, Equine Diseases » Lameness » Treatment Methods » Rehabilitating Injuries to the Tendons.
DrO
New Member:
Justin

Posted on Wednesday, Dec 15, 2004 - 8:00 pm:

My 15 y.o. TB has just been diagnosed with tendonitis of the deep digital flexor (hereafter ddf) on the right hind, just above the fetlock. My vet believes this is an aggravation of poorly healed similar injury when he was on the track as a 2 y.o. (he was only raced 4 times).

He is on stall rest for the next three months, with only limited hand walking.

He has always been slight "off" on the right hind. Now I know why. He was probably never given the opportunity to heal completely before I bought him.

His ultrasound was not very informative....no specific lesion, but rather a diffusely thickened DDF. His clinical symptoms included, initially, "toe tapping" lameness, and then about a week after this onset, heat and edema above the fetlock.

Is there a general prognosis for this? For the past four years he has only been a WTC pleasure horse (no trails, only arena). Is there any thing I can do to get a better healing result? I understand that Acell has a new treatment for bowed tendons.

Thanks
Member:
Justin

Posted on Wednesday, Dec 15, 2004 - 8:05 pm:

Oops, I forgot....Hey Ros....sounds like we are in the same boat. Let's keep in touch. I am exploring new and alternative therapies here in Virginia hunt country (although this boy has been dressage horse for the past 10 years).
Moderator:
DrO

Posted on Thursday, Dec 16, 2004 - 7:25 am:

A hind limb ddf strain in a TB race horse is a bit of a oddity, usually this occurs in the forelegs of racing horses. If this is a exacerbation of a chronic lameness problem in that leg suggests a quarded prognosis for complete soundness and fair for return to the previous level of soundness.

With no specific lesion there is no need for the use of these intralesional products, like Acell, designed to increase the normal cellularity of defects in the tendon. In this area an enlarged flexor tendon might be rubbing against the annular ligament as it slides in and out during movement: has this possibility been explored since there is a surgery that can help, for more see Equine Diseases » Lameness » Diseases of the Lower Limb » Annular Ligament Constriction.
DrO
Member:
Justin

Posted on Thursday, Dec 16, 2004 - 8:27 am:

Well, he has all the clinical symptoms described in the article...my vet mentioned surgery but suggested the three-month stall rest regimine. He has never done the surgery, so I am going to explore this option with another vet who does. Even if he went back to his previous level of soundess (he has always been subtley off on that leg) it would not be good enough for competition.

Thanks!
Member:
Taceann

Posted on Wednesday, Jan 5, 2005 - 3:40 pm:

Hello Jane and Dr O - Happy New Year to all.

My 17 yo has been resting in very small area on his own for a month now. However he has got more and more agitated and is now bucking, twisting and leaping around even though the area is tiny. He has also become very difficult to lead as he is wanting to gallop off to join the other horses on the yard.

I have felt this isn't doing any good and I will end up with a leg that will be worse and a psychopath pony. So reluctantly have decided on pasture rest.

He is now in a larger field with just one companion, a steady calm cob mare who he seems to "love" and is crooning at when they meet. He seems much happier and is no longer charging around in a tiny area. He ambles round the field with her and is calm himself.

Do you think I have done the right thing? I only have ambition for him to be rideable for walks in the wood anyway so if it takes longer for him to heal am not too worried, just want him to be comfortable in the meantime.
Moderator:
DrO

Posted on Wednesday, Jan 5, 2005 - 6:41 pm:

Hello Rosalind,
Without knowing exactly what is wrong I cannot know if this is the wrong thing to do. There are many injuries that will worsen with increase exercise if not allowed to heal, there are some that exercise will not hurt. Tendon injuries usually need rest after acute injury. It strikes me you have 2 choices:
1) You could put him back into the paddock and sedate him, for more helpful suggestions see Training Horses » Behavioral Problems » Stall Resting Horses.
2) Since he is out already you might monitor him closely to see if he worsens.
Which ever you do you should talk it over with your vet.
DrO
Member:
Justin

Posted on Wednesday, Feb 23, 2005 - 10:49 am:

Hi,

Sorry for my silence....alot going on. My 15 y.o. gelding is having the same problem...has been in his stall now for 2.5 months and goes nuts with limited turnout in the round pen. My vet comes out on Friday and we will talk about 4 hr. per day turnout with his friends. He is incredibly herdbound with the Freisian gelding next to him on the stall row. When this horse is in, it's okay; when this horse is out, well, he is psycho. In early Jan. the tendon upon ultrasound was *smaller* than the tendon in the opposite leg. I've been using Surpass, too.

In the round pen and in the indoor arena, he has appear sound at all gaits. I'm keeping my fingers crossed.

Ros, what is going on with your boy?

Jane
Moderator:
DrO

Posted on Thursday, Feb 24, 2005 - 8:09 am:

Sounds encouraging Jane.
DrO
Member:
Taceann

Posted on Friday, Mar 25, 2005 - 5:05 pm:

Just to update you all, vet came and rescanned two days ago, last time was early Dec. He is still slightly lame at trot but the scan shows some improvement. He is to continue resting another 3 months and then might be rescanned. Vet has suggested that at this point might try shockwave treatment. Will this be beneficial for tendon injury so long after?

He hasn't been hopping lame since Oct/Nov and is happy out on field rest with his girlfriend. I hope that he will be able to be ridden again as I am missing our gentle walks in the woods, especially now summer is coming. My one ambition is to ride him Christmas Day but in the two years I have had him, he has been lame both times!
Moderator:
DrO

Posted on Saturday, Mar 26, 2005 - 8:51 am:

There is no work on such an injury at this time Rosalind. There have been some positive results reported in more acute injuries but I find ECSWT still experimental, for more on this see Equine Diseases » Lameness » Treatment Methods » Extracorporeal Shock Wave Therapy.
DrO
Member:
Taceann

Posted on Saturday, Mar 26, 2005 - 1:39 pm:

Thank you Dr O, I will have a look at the info about ECSWT. He would have to be trailered to the vet several times - though he is fine in a trailer, but is not a good patient (hates needles) and would probably have to be sedated each time I assume to get him to stand still! If it is unlikely to make much difference then it may be best to hope time will heal??

Best wishes to you all.
Moderator:
DrO

Posted on Saturday, Mar 26, 2005 - 5:10 pm:

It is all still a little too subjective for me Rosalind, I am not actively recommending it in routine cases. Particularly since finding out its temporary local anesthetic effect. I watch the research however.
DrO
Member:
Justin

Posted on Monday, Apr 25, 2005 - 8:40 am:

Hi Ros and Dr. O!

My gelding started turn out in early March and was doing fine until that rear DDF blew up again. Another month in the stall. Sigh....
My vet was very optimistic and thought it was just the tendon sheath.
He is doing well now--all day turnout and very light riding (walk only until May). It has been a long, long haul.
Jane
Moderator:
DrO

Posted on Tuesday, Apr 26, 2005 - 9:19 am:

Glad to hear progress is continuing Jane.
DrO
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