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Discussion on Soft swelling and enlarged blood vessel at top of lower leg - no lameness.
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Member:
cathyb1
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Posted on Monday, May 5, 2008 - 6:55 am:
I have a 2 1/2 yo that I am working very lightly - twice a week, 20 minutes of mainly walking, with a bit of trotting and cantering, very easy stuff - no drilling or wearing his legs off, no circles. I've been doing this for the last month since breaking him in. He is very calm and easy to train, and I am very aware of the risk of overdoing things at this very young age, so mainly we just have a bit of fun and play with things, and he is developing a very nice work ethic.
However; a couple of months ago he was a bit lame in the paddock one morning. He had a bit of swelling, 2 inches below the knee, between the flexor tendon and behind the cannon bone - perhaps related to the suspensory? He had a few days off with anti - inflammatories, as I assumed a bruise; he was mildly lame in this leg. The blood vessel that runs across the inside of the lower leg was enlarged compared to the other leg. He still has this, although there is no lameness at all, and he still has the bit of puffiness in the area. It seems to pit slightly on pressure, but is not a tense swelling but just a diffuse thickness in the area. It is not the flexor tendon, rather in front of it, which is why I wonder if it is the suspensory. He is a horse that goes lame if he has a stone bruise, or stands on stony ground (he has shoes on at the moment, in case I walk him over gravel etc. They will come off in a few weeks, when I turn him out for a few months.) Could this be some sort of mild tendon or ligament problem? I can't detect heat in it; then again, I am bad at feeling heat at the best of times. IF I leave my hand over a site for a few moments, it feels hot, wherever on the body it is! I am not working him hard, as I said; but I do not want to make it worse.
Is there any way I could establish whether it is damage to tendon or ligament, or just a left over from a bruise? I haven't taken him to a vet, as there is hardly anything to show them!
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Moderator:
DrO
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Posted on Monday, May 5, 2008 - 8:54 am:
Hello Cathy,
Probably the most diagnostic test would be a carefully conducted lameness exam to rule out very mild lameness and if present localization and a ultrasound. Without lameness it is hard to get too excited about this and you can treat this mild edema with poultice. However when you ask the open ended "could this be?" almost anything is possible.
DrO
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Member:
cathyb1
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Posted on Wednesday, May 7, 2008 - 12:55 am:
Hi again,
I took him to my local equine vet hospital, and they assessed him. He showed up slightly lame on a small circle. Then they ultrasounded him, and sure enough, there is damage to the suspensory ligament, high up. They are treating it today with stem cells collected from the sternum. I do not know much about this treatment. They suggested a success rate of 70%. He is a big strong warmblood, really fantastic and talented horse, worth spending the money on. What else can I do to aid the repair process? I understand he has to be stabled for a few weeks, then in a small yard, and finally spelled until he is 4. I am fine with this; that was the plan for him anyway. But if there are any other treatments that might help to strengthen and repair the ligament, I'm happy to use them! Although if anyone suggests hanging crystals around his stable during the full moon and painting his leg with dew, then I would probably not do it...
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Member:
cathyb1
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Posted on Wednesday, May 7, 2008 - 12:56 am:
I should also mention that they regarded the damage as significant, and pointed out to me that the ligament was distorted, compared to the other leg, and there was a large darker area, perhaps 1/4 the area of the whole ligament cross section.
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Moderator:
DrO
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Posted on Wednesday, May 7, 2008 - 8:04 am:
Cathy can you give us the exact description of the ultrasound findings. It should be written down and available to you.
DrO
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Member:
stevens
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Posted on Wednesday, May 7, 2008 - 11:44 am:
Hi Cathy,
My warmblood had a the same treatment for a 50% tear of his superficial flexor tendon. It's been 6 months and he's doing well. He's not 100% yet, but is dramatically improved. You can find out more about this particular treatment at the Alamo Pintado Equine Hosptial site; I believe they pioneered this treatment. You can also do a Google search on the topic and find several published papers.
All of my research/investigations have pointed to the importance of controlled exercise during the recovery period. There is a good description on this site, your veterinarian should also provide a recovery protocol, other good resources include the University of CA, Davis web site and a book titled "Back to Work" on rehabbing horses.
It was recommended to me to put my horse on a silica/silicon (can never remember which) supplement to aid in healing. I haven't found any substantive research to support that, however, am doing it on the advice of my vet. I'm using a supplement from SmartPak Equine called Smart Flex Repair.
Lucky you to have the injury visible on ultrasound. You'll be able to monitor the healing progress by having periodic recheck ultrasounds.
Good luck!
Chris
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New Member:
healthy1
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Posted on Sunday, Jun 8, 2008 - 10:44 pm:
Cathy: was your horse's Vein Distended Constantly even before work and on stall rest, or did it only distend when exercised
because My horse has the SAME Vein !
after work the blood vessel ( i think is the Medial palmer Vein) enlarges on one leg.
which i read could be a sign of High Suspensory, like your horse was diagnosed with.
However
overnight when my horse rests His vein goes down to normal (also if i cold hose him to cool him off) and only Distends after work or in HOT heat.
it doesn't stay up 24/7 ( and usually goes down once he is cool) also isn't lame
Just wondering THANK YOU!  Dr.O i would love your opinion on this also
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Member:
cathyb1
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Posted on Monday, Jun 9, 2008 - 3:52 am:
I think it was always distended, compared to the other leg. It didn't seem any different after work, but then, I wasn't looking at it. I only looked at the leg when there was a bit of extra puffiness and heat.
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Member:
cathyb1
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Posted on Monday, Jun 9, 2008 - 4:00 am:
The treatment recommended for this horse is 3 months rest in a yard. The yard is 7x5 metres, so he can walk around. He can even get a couple of canter strides if he is feeling frisky, but my vet reckons that at such slow speed, it isn't going to stress things too much.
We are going to ultrasound the leg at the end of 3 months, then work out a rehab program. My concern is this: how on earth am I going to hand walk a 2 1/2 yo that has been confined for so long? As it is, he occasionally jumps around his yard from sheer boredom. He is a quiet sort of horse, but I can just tell I'll be uselessly holding the end of the rope while he jumps up and down. It would be better if I could ride him but would the extra weight do extra damage? Has any one got any ideas for this? Would a mild sedative do any harm over a long term?
And Dr O, the rehab schedule you've included in this section - does it require the horse to be stabled/confined to small yard for the duration? Where does paddock rest come into it? Can the horse undergo the rehab program whilst paddocked, or is the risk of redamaging the ligament too high? The "hole" that showed up in the ultrasound at the time of diagnosis was probably a third of the whole ligament cross section, and extended 8cm down from the top of the ligament. The ligament was distorted and enlarged. The lameness was very small - 1 in 5 was the rating, and that only on a very small circle.
Has anyone got a success story for this type of thing?
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Moderator:
DrO
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Posted on Monday, Jun 9, 2008 - 6:54 am:
Hello Cathy,
During the times of restricted exercise, yes the horse must be kept restricted as described in the blue sections and text of the exam findings. As to handling the behavioral problems that come with stall resting horses see, Training & Conditioning Horses » Behavioral Problems » Stall Resting Horses.
DrO
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New Member:
healthy1
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Posted on Monday, Jun 9, 2008 - 10:13 am:
Thank you cathy:
i should have said: since you noticed the Heat,puffiness, has the Vein Always stayed Enlarged 24/7 or went down with rest.
i'm thinking if an ultrasound should be in my horse's future :S
Hoping your horse has a Quick recovery!
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