This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Lameness » Muscle & Tendon Diseases » Fibrotic or Ossifying Myopathy & Myositis »
  Discussion on FIBROTIC MYOPATHY
Author Message
New Member:
readjoe

Posted on Friday, Jan 18, 2008 - 3:40 pm:

My 12 yo arab gelding has a FM that has been ultrasounded. It is the semitendonosis 15cm X3 cm. I am looking at the surgery, tenectomy of the tibial insertion. I have been told it has only a 65% success rate. Does the rehab have 'alot' to do with this, or just the nature of the surgery itself?

Currently I am giving an alternative therapy, called reconstructive therapy a chance. He has been injected twice with 1000ml of normal saline, calcium gluconate and spinal grade lidocaine. This is injected in several places around muscle and scar tissue. This was done by a vet. It has been about 7 weeks. I am told to continue riding, that that is important part, so I have. Only improvement I can see, is a little less of the 'goose step', and 'perhaps' the scar tissue is no quite as hard, and it was as hard as a rock. The injury is about 6 mos old..occured during a storm. He is an endurance horse and dressage, so am hoping for him to be completely sound for even steps, and the injury not spreading to another area tha may be compensating.

I am prepared to do the surgery. I am trying this first. Has anyone ever heard of RT, or reconstructive therapy. It is more available on the human side.

Thank you for any insite,

readjoe
Moderator:
DrO

Posted on Saturday, Jan 19, 2008 - 1:03 pm:

Welcome readjoe,
I would say the chief reasons for failure on tenectomy are other undiagnosed lesions and some authors believe a progressive neuropathy to the muscles of the hindlimb. Rehab may have a large part on the success by preventing reattachment of a shortened musculotendon unit but specific research into the reasons for failure are not available so conjectural. In the case of adhesions to other muscle bellies myectomy may also be necessary to remove the adhesions.

There is a case report of a endurance horse that improved following myomectomy / tenectomy and went on to race with the milder gait deficit. However that lesion was smaller than than yours. I have not heard of nor can find any information on RT.
DrO
New Member:
readjoe

Posted on Monday, Jan 21, 2008 - 12:32 pm:

Dear Dr. O,

Thank you for your informative response. Are you saying that some tenectomies are completely successful? I am working with Tx A&M and they do not stay in touch with their patients after surgeries, since they are a referral hospital. My understanding, is the tendon is cut, relieving the tension, and hopefully when it grows back it will have the grace of a couple of neccesary inches? Do I understand this correctly? I am a vet tech so I know I will be as keen as possible to the rehab portion. My question. I sure get the impression from many, vets included, to try all avenues before surgery. Why is this? Is there something about surgery I do not know? Now my surgeon, does not give this impression, but many others do. How would I tell, or he tell about adhesions, or neural damage? Is this done on the operating table?


My horse is completely fine about riding. It may be the Arab in him, but he sure doesn't indicate any pain. We even went full out this weekend in a nice stretch..and he was all happy about it. He prefers not to give me his rt lead, and when he does, I feel a stabbing motion. The walk is the main gait where I can 'see it', with the anterior portion being suspended a hair longer. I had an excellent horseman look him over this weekend, and he had me canter both directions in his cutting arena. He measured the foot falls, and they were the same on both sides..! That surprised me. He said the horse was driving from behind with both legs good.

Is there a way for me to see the case study on that endurance horse? I have really wanted to hear of others in my situation, and thankfully, I found your site.

This RT that I'm doing is hard to find info on. When and if I do, would you like me to send it to you? I am suppose to go for another treatment Feb. 11...it will have been 2 mos.

Thank you.
Moderator:
DrO

Posted on Monday, Jan 21, 2008 - 5:21 pm:

Some authors report "excellent" results with tenotomy in small cases that I interpret as meaning returning to normal or near normal. Most report improvement that in 2/3 of the cases allows the horse to return to some level of use. If you use the National Institute button at the bottom of the article under "More Information" it will return surveys of the various procedures.

I have never seen a pathology report of a healed tenotomy site but I believe that in successful cases it reestablishes with a fibrous scar that is a bit longer than the former tendon.

Assuming the horse is unable to meet the goals of the owner and considering the prognosis without surgery I am not sure why someone would advise avoiding surgery. If I thought there was another viable alternative to surgery that offered a better prognosis I certainly would go for it, I just don't know of such an option.

I believe the article on the endurance horse was in an Equine Veterinary Education a British journal. Unfortunately they do not list their summaries in a easily searched database but it was not too long ago. Do you have access to a veterinary library?
DrO
Member:
readjoe

Posted on Wednesday, Jan 30, 2008 - 9:53 am:

Dr. O,

Thankyou again for another thoughtful reply.

I have not been able to access a vet library. I rec'd only a short synopsis of reports by hitting NL button..not computor saavy enough to figure how to order case reports. There are a couple that look quite interesting, tho.

In the past on HA, looks like some have been thru this surgery..sure would welcome knowing their final results.

Thankyou,

readjoe
Moderator:
DrO

Posted on Thursday, Jan 31, 2008 - 6:30 am:

The best way to get and update readjoe is to post a request in their post. The default profile setting is for members to be emailed posts in their discussions.
DrO
Member:
readjoe

Posted on Thursday, Jun 12, 2008 - 5:18 am:

DR. O

I have had the surgery. I did the tenotomy of tibial insertion 3 weeks ago. Very clean surgery, with little to no swelling . My horse has been on stall rest with daily handwalking. His slapping is very diminished, but he is still a tad short on hi stride. Today he will graduate from stall rest to round pen then to pasture. My question: what is the usual time for the tendon to reattach? ie..how much time do I have to play with getting a stretch before the tendon is healed. Iwant to rehab him, but not too fast, or too slow. I am having a hard timepinning this rehab portion down. I am doing cavallettis at walk, and did a trot for the first time yesterday. Do not really know when I should canter. did a hour and half trail walk on neighbors ranch yesterday..first ride out. Feel the trail walking on uneven ground must be the best for encouraging stretching. Your comments welcomed..

readjoe
Moderator:
DrO

Posted on Thursday, Jun 12, 2008 - 7:34 am:

The time for reattachment has not been well studied readjoe. You should follow the rehab instructions of the surgeon who did the surgery. What did he say for rehab?
DrO
Member:
readjoe

Posted on Thursday, Jun 12, 2008 - 12:06 pm:

Dr. O,

This is what my vet has said:


Mary Beth, at 3 weeks his incision should be fine to proceed and become
increasingly aggressive with his rehab - the tendon will take quite
awhile to actually become tendinous again - for about 2 months its just
mush and after about 3 months it begins to become more and more
tendinous. Keep me posted. Take care, jeff


This sounds good to me. What I am curious about is that with the tendon cut..why is there 'any 'residual shortstriding..since in my mind there is not anything to hold back the motion at this point. Is this what is called 'muscle memory'? where the muscle just needs to be trained to move differently over time?

Thanks,
MB
Moderator:
DrO

Posted on Friday, Jun 13, 2008 - 6:06 am:

It suggests that either there is some lameness due to pain present that may resolve or possible there are other sights of fibrosis.
DrO
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC