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  Discussion on How can I be sure its Suspensory Injury?
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New Member:
ridewell

Posted on Thursday, Jul 3, 2008 - 8:40 pm:

My 14 year old irish sports horse, has always been harder to ride on the right rein. At the beginning of this event season, the physion thought he wasnt moving straight behind, he wasnt lame just not straight, winging slightly. she recommended the vet look at him, which he did. he did flexions on both hocks, right hind was very poitive. we discussed his stiff history, and the vet felt the hyaurolinc acid injection might ease what appearaed to be a arthritic joint.

As this horse has been my teaching schoolmaster, and i wanted him to be as healthy as possible, he has the injection two weeks later. Had two weeks off then resumed work, within 6 days of riding him, he went suddenly in the middle of a med trot about 5/10s lame. The vet was called and he thought he had prob tweaked it, overused it a little as his hock was feeling good ( by the way vet came to look at him lame and flexed him asgain on both hocksm this time he was negative on right hind hock, but he was now lame?

a thorough lameness investigation followed, and nerve blocking the upper suspensory made him 100% sound, thus he has been rested for 3 month in small paddock, and given shockwave therapy twice.

He may have improved fro 5/10s to 4/10s lame but not much better. Vet is disappointed, and has suggested 3 months in field, just forget about horse, let him be, then reexamine and operate doing the fasciotomy etc that has had some success with horses.

all this makes sense and i can now see thickening on upper inside area of right hind and slightly enlarged vein on leg, apparently this is classic symptom. It would appear he has chronic inflammation of upper suspensory. ( ultrasound found no tears)...how can i be sure thats really the only problem? why might he have flexed on that hock sound after ha injection? might it be still hock as well?, even tho x rays show fairly clean right hock, ironically left hock is v spurred.

I think i created this lameness by having him injected with ha? is that likely?

I cant bear to do nothing, so im renting a cold laser next week, and going to try daily sessions with thast. I also hear of something in the usa called runner relief. has anyone heard of it, or used it, aparently tubbing leg in warm water with herbal concoction reduces inflammation....

lastly is there anything I can feed to help the old boy. He is so miserable doing nothin in his fied. He stands there without his shoes on, ( to make him less desire running around)looking very sorry for himself.

Vet had hope to have me ride him by 2 months in walk, but he now does recommend riding even at walk until we get hin to 2/10s lame or less.

Many thanks for any comments or information regarding these queries and thoughts.
Moderator:
DrO

Posted on Saturday, Jul 5, 2008 - 9:21 am:

Hello Lisa,
I am sorry to hear about your horse, the article describes a very accurate technique for just blocking the upper suspensory Lisa and it can better define the lameness if in doubt. I don't see how the HA injection could have possibly caused this problem, unless you think by creating a sound hock you worked the suspensory lame but that really does not make sense.

Proximal suspensory desmitis of the hind limb in older, larger, horses does not have a good prognosis I am afraid and continued rest the best treatment and other recommendations are given in the article. Also a rehab plan can be found at Diseases of Horses » Lameness » Treatment Methods » Rehabilitating Injuries to the Tendons and Ligaments.
DrO
New Member:
ridewell

Posted on Sunday, Jul 6, 2008 - 3:52 pm:

Thanks for your comments. I hate to think I caused his lameness. It seems odd that in this day and age we cant do something to help PSD, my vet has said if he's no better in three months, we should consider surgery (that would be after a total of 6 months paddock rest) I have the awkward situation of having to operate before December so that treatment is still covered by the insurance. Personally I hate the idea of surgery, but as he has no future lame, maybe its worth trying as a last resort?

Meanwhile I am considering tubbing his leg everyday to increase circulation and also hiring a cold laser, to see if those treatments make a difference. Do you think I am probably wasting my time with such treatments? Is there nothing nutritionally that is supposed to help?
Moderator:
DrO

Posted on Monday, Jul 7, 2008 - 8:41 am:

The problem with these hind limb problems seems to be a degenerative disease going on rather than simply trauma lisa. What type surgery is he recommending? I don't know of any indication the laser is unlikely to be of any benefit but anything to that helps increase circulation like tubbing with warm circulating water may help.
DrO
New Member:
ridewell

Posted on Wednesday, Jul 9, 2008 - 6:17 pm:

I believe he is looking at neurotomy...de nerve of the suspensory or part of it and fasciotomy. interesting you doubt the laser might help,its supposed to be anti-inflammatory. On people i think they are used on carpel tunnel etc, which to me is similar to compartmental inflammation of suspensory. You use the word degenerative...no one has put it that way to me....i was convinced he had djd....rather than psd....so maybe i was right in some ways he had degenerative suspensory disease rather than hock disease.
Member:
ekaufman

Posted on Wednesday, Jul 9, 2008 - 9:02 pm:

Hi Lisa,

I have no idea if this product has been tested for hind suspensory conditions like you describe, but it may be worth checking into. I tried to get one for my old stallion during the clinical trials, but we couldn't make the logistics work. It seems like a useful tool for some situations:
https://www.simviation.com/dalmar/treatment.htm

Good luck with a tough situation.
Member:
stevens

Posted on Thursday, Jul 10, 2008 - 12:14 am:

Hmmm, neurectomy doesn't make sense to me; but hey I'm not a vet.

My horse had a tendonoscopy to examine his tendon injury and clean up any adhesions, but we never discussed a neurectomy. But then, he was never quite as lame as your horse seems to be.

I've found that icing his leg really seems to make him comfortable. I used Game Ready boots during the first part of his recovery.

Good Luck.
Moderator:
DrO

Posted on Thursday, Jul 10, 2008 - 7:40 am:

lisa, I am not diagnosing your horse so much as explaining how you go about diagnosing proximal suspensory disease and some features of this disease in the hind limb. There are many important differences in horses and humans with respect to the structures you name. The most important being that the horses suspensory is much deeper than the trans-carpal tendons. Checking the Mayo Clinic site the alternative therapy for carpal tunnel subtopic says laser and laser acupuncture have not given reliable benefits.
DrO
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