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  Discussion on Significant tear of the superficial flexor tendon
Author Message
Member:
rebeccab

Posted on Friday, Jun 20, 2008 - 5:07 pm:

Hi Dr. O:

My 16 yr old mare, tore her front left superficial flexor while jumping a course about a month ago. She has been on stall rest since May 2, Poulticed when needed, cold hosed daily, walked 2x a day, and my vet suggested using Surpass on her. Her tear was determined from an ultra sound. She was recently re-checked, 50days later, and my vet said there is some improvement and suggested Shock Wave Therapy. I read your information on SWT and it states there is not a lot of data to confirm its ability to help heal. IS there more recent data? Is this a method you would recommend? It is very expensive. $320 a session, 3 sessions needed every 2 weeks.
Member:
stevens

Posted on Friday, Jun 20, 2008 - 5:48 pm:

Hi Rebecca,

For about what you'll pay for 3 SWT treatments, you might be able to get a stem cell injection. Suggest you consult with your vet on that option. BTW it's an either/or situation. If you go the stem cell route, you will not do SWT.

My horse tore his left hind superficial flexor tendon last fall. It doesn't look like he's going to recover, but I had to give it a try.

Good Luck,
Chris
Member:
dres

Posted on Friday, Jun 20, 2008 - 6:59 pm:

Rebecca another thing is to give this a very long time to heal... don't try to do anything to quickly... time is your best friend right now, more so then the SWT or any other treatments..

On the first day God created horses, on the second day he painted them with spots..
Member:
mrose

Posted on Friday, Jun 20, 2008 - 10:23 pm:

Ann is right about the time factor. It takes a VERY long time, even without complications. My mare, Libby developed a bad infection that went into her sesamoid (sp?) bones which was eventually only picked up by an MRI. So, if there was a laceration along with the tear, be aware of this possibility. I'd look into stem cell therapy also. In the right cases it produces excellent results. There has to be enough tissue matrix in the gap between the tendon ends for the cells to adhere to, I know. Libby's damage was too severe. You might also inquire about hyperbaric chamber treatments if you can find a clinic or school that does them within a decent drive. Libby's doctor and I feel they really are what turned the corner for her. In her case, I think they killed the bacteria, but they help get more red cells to the injured area and help promote healing. They ran about $400/treatment and she needed three treatments, if I remember right. The biggest thing, though, is LOTS of patience. Time is your friend. The article on this site about rehabin tendon injuries helped me a lot. I think Ann and I both have been a good year or more with our mares that had tendon injuries. Don't give up yet!
Moderator:
DrO

Posted on Saturday, Jun 21, 2008 - 7:19 am:

Hello Rebecca,
We continually update our articles to include the latest information available and it continues that ECSWT in acute tendon tears is an uncertain treatment modality. You can read the summary of the latest published research summary in the discussions.
DrO
Member:
rebeccab

Posted on Saturday, Jun 21, 2008 - 9:22 am:

Thanks Dr. O:
I do not have any experience with this type of injury.
My vet also mentioned that the tear is in a "good spot" It is up near her knee, with some tissue disturbance around it. 60days ago, it started about the size of a quarter, now it is the size of a nickle.
With time, and all that it takes to heal her, it is possible for her to jump again? (up to 2'6" jumps) The more I read, the more afraid I become that it will not be possible to return her to work again. Do these injuries result in retiring the horse more often than not?
If anyone that has experienced this injury/process could comment, it would be helpful so that I am realistic about what I am dealing with.
Thanks.
Member:
dres

Posted on Saturday, Jun 21, 2008 - 10:01 am:

Rebecca there are no crystal balls to predict how your mare will rehab and recover.. All are very different.. I am in the process of rehabbing a much more sever injury for 1.8 months into the slow program..
All you can do is the best you can do with what resources you have / time you can spend / and of course how well your mare behaves..
I understand your frustration completely... but you just have to wait it out , carefully and slowly..

On the first day God created horses, on the second day he painted them with spots..
Member:
rtrotter

Posted on Sunday, Jun 22, 2008 - 10:02 am:

Rebecca,

I also have a mare that did significant damage to her tendon as a 3 year old, right after she won her first race. The vets prognosis on her was not very good, saying that even if she made it back to the races, she would only last a few starts and breakdown again. I was besides myself when it happened, I get very attached to my horses and she had shown so much promise training down that I wanted to give her the best shot I could to get her back.

I started researching different therapies including stem cell, blistering, tendon cutting, doing nothing ( retirement)etc. which I rejected for a variety of reasons (mainly cost and extended downtime).

What I did decide to do was to invest in a TENS machine for about $110.00 and use a protocol put forth by Tom Ivers for healing bowed tendons.

Mainly, the protocol calls for the use of the TENS machine up to six hours a day, icing the leg and exercise from the very start of the rehab, and listening to what your horse tells you to do. The TENS machine simulates constant moving of the tendon by contraction and relaxation, which in turn keeps the scar tissue that inevitably forms down to a minimum and what does form forms correctly and allows the tendon fibers to heal properly and not in a crosshatch adhesion type of healing. The constant moving and gradual increase in workload eventually retrains the tendon to do what it was supposed to do before it was injured.

My mare was ultrasounded every month for eight months, the only time she spent in her stall was when she had her 4-6 hour daily TENS treatment. She jogged or towed every day increasing her mileage and then the speed at which she jogged or towed, and was turned out every night.

From start (original injury) to finish( back to the races) was eight months and she is still racing now 2 years later. While this mare has had other problems, liver enzymes and mare issues. The tendon has been fine and she has not needed the TENS machine for almost two years. I have shown people the before and after ultrasounds on this mare and they can not believe she ever had a problem although the proof is in the pictures. The leg looks entirely normal.

If you are interested in this therapy, you can find more information at www.equineracing.com.

Rachelle

Please note: I am relaying this information based on my practical experience with this type of injury and to give an alternative to other more costly treatments. In the end, your decision will depend on your research, your common sense and consultations with your vet as to what is the best course of action for your pocketbook and your horse.
Moderator:
DrO

Posted on Sunday, Jun 22, 2008 - 6:36 pm:

Hello Rebecca,
The person who can examine the ultrasound is going to be able to give you your best information on prognosis. Yes horses have recovered from partial tears of the flexor tendons to go on to jump but we cannot judge your horse. If the veterinarian is uncertain you might ask for a referral to a orthopedic surgeon.

Concerning TENS I can find no support for this use of the device. If you run a serch you will find several recent discussion on it.
DrO
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