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  Discussion on Suspensory sensitive but looks healed on ultrasound
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New Member:
mokuchta

Posted on Friday, Mar 13, 2009 - 8:41 pm:

In Sept. 2008 my 13 yr old gelding strained both branches of his LH suspensory as well as the area up higher where the suspensory attaches to the bone on both hind legs. He was confined to his stall and a connecting 12x12'paddock and appeared to be improving. After 3 months there was no sensitivity but still some signs of problems in the ultrasound. I started walking him under saddle but didn't do much with him all winter except turn him out. Yesterday - 7 months later I had another ultrasound done. There is no sign of ligament damage however the vet says my horse is sensitive in both branches of the LH leg - again. Since the horse hasn't done anything except be turned out my vet feels this is a chronic condition. He is suggesting ultrasound as an occasional treatment for this chronic condition.
He speculates that this could be a hereditary weakness. Anyway, is there anything else that is reasonable to try? Are support bandages for riding of any use? I don't see my horse running around his paddock but he is turned out 12 hours/day. Any ideas on how to manage this?
Thanks!
Maureen
Member:
3chip

Posted on Friday, Mar 13, 2009 - 9:05 pm:

The first question is, what is the horse doing, how are his actions pointing out to you that he still has or has this problem with the left hind leg sensitivity? What if anything is he doing that is reflective of a sensitivity or pain problem?
New Member:
mokuchta

Posted on Friday, Mar 13, 2009 - 11:45 pm:

The sensitivity was felt by the same vet who has been monitoring him for the last 7 months by palpitating his legs. In Sept. he was very slightly lame with ultrasound changes and sensitivity. After rest and turnout he appeared sound with ultrasound changes and no sensitivity. Now his ultrasound looks good but he is sensitive. I did not have a lameness check this time. I assumed he would be fine since I haven't ridden him. If this horse is sensitive just from turnout and no riding this is a problem even though he looks OK walking around his paddock.
Moderator:
DrO

Posted on Saturday, Mar 14, 2009 - 12:16 am:

Hello Maureen,
Palpation and interpretation of sensitivity is a very subjective finding. Normal horses often jump when squeezed or prodded and they can do this in a irregular manner. What was OK to squeeze today may not be tomorrow in the sound horse.

Because of this we cannot evaluate the findings of a horse that jumps when squeezed or prodded. Considering there are no lesions right now I think the next logical step is to evaluate if your horse is still lame at a trot on lunge. This is a far more accurate way to evaluate your horse for soundness than a reaction to squeezing a structure, a structure known for horses not liking to be squeezed even when healthy.
DrO
New Member:
mokuchta

Posted on Saturday, Mar 14, 2009 - 1:57 am:

You mean you can't calibrate a squeeze?:-). I just had to see what would happen so I tried this on 5 horses in our barn. I got no reaction unless I really drilled into the skin with my finger. With Finn I got a reaction when I depressed the skin a little. I didn't get a reaction on the other leg.
I didn't have a lameness exam done since I assumed everything would be fine after 7 months:-(. Also there were 45 mph winds the day the vet came out and a lameness evaluation is easier when the horse's feet actually touch the ground.

The vet suggests riding Finn at a walk for 30-45 minutes a day for a month then starting a few minutes of trotting. He is going to schedule a lameness evaluation in 6-8 weeks. Finn also has some hock issues so if he isn't sound I'm not sure if it will be clear which issue is bothering him. Is is possible that he re-strained his suspensory running around in the paddock? Would the damage take a few days to show up in the ultrasound or would it show up as soon as the ligament was inflamed?
Thanks!
Maureen
Moderator:
DrO

Posted on Saturday, Mar 14, 2009 - 1:18 pm:

Your findings would be considered unusual: horses normally resent having the suspensories palpated Maureen so much so this phenomenon is discussed in texts on lameness. I would also point out after having an area palpated that was previously painful may alter the horses response. We are still left with the unanswered question of the significance on the response.

If I understand your question there is no good answer as it would depend on the amount of damage. For example on one end is the possibility to localize lameness to suspensories that appear normal on ultrasound on the other end obviously a torn suspensory would be immediately evident.
DrO
Member:
mokuchta

Posted on Saturday, Apr 11, 2009 - 8:49 pm:

Last month Finn's ultrasound was normal but he was still sensitive to palpitation (done by the vet). We've been walking for 30-45 minutes for the past month and I just started trotting Finn for < one minute. He still seems sensitive on the left hind leg. Since you have told me how easily this can be misinterpreted I'm not sure whether to increase his work or not. I can't afford to make a mistake and assume he is OK. If I cause additional damage it's unlikely he'll be much use again.

I was reading your information about the study where horses have chronic suspensory issues although the suspensory appears to have healed. It would be interesting to see if Finn has bony growth on the back of his cannon bone. Unfortunately CT and surgery based on new research are probably unrealistic in terms of availability in my area.

I haven't decided how to proceed yet.
- I could restrict Finn's turnout and see if the sensitivity to palpitation improves.
-I could get a second opinion.
-I could base my riding on how sound the horse looks that day and take a chance that the riding could make him worse.
-I could inject Finn's hocks (a known issue) and assume that any lameness in that area is then due to suspensory problems.

Maureen
Moderator:
DrO

Posted on Sunday, Apr 12, 2009 - 10:12 am:

Maureen, I would continue to follow the recommendations of those examining the horse. It is not my intent to over turn those findings but to inform you of the difficulty with this type assessment as a positive indicator of disease but just because he jumps does not mean he is well. In your last post you hint he still has some lameness. Time and repeated exams will help define whether this is a pain reaction or not.

Getting back to your original questions we discuss the treatment and prognosis of suspensory injury at Diseases of Horses » Lameness » Diseases of the Lower Limb » Suspensory Desmitis, Strain, & Sprain. And yes it is believed that the sports medicine boots that have the elastic strap that goes under the fetlock helps support the suspensories and superficial flexor tendon.
DrO
Member:
mokuchta

Posted on Monday, May 25, 2009 - 10:08 am:

I have continued to ride this horse mostly at a walk (per the vet's directions). From what I can see when Finn is turned out, he is moving very well. Last week the vet did another ultrasound and ligament check and Finn now has a clean bill of health:-). Finn is also on Legend and he isn't showing any sensitivity to hock flexion. So I now have a sound horse and it was worth waiting for. I'm planning to stick to trail riding this year and to stay away from small circles and long periods of ring work. If Finn stays comfortable we'll just keep on doing this. Thanks for your help.

Maureen
Moderator:
DrO

Posted on Tuesday, May 26, 2009 - 7:19 am:

Great news and thanks for the update Maureen.
DrO
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