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  Discussion on Gastrocnemius Muscle damage
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Member:
gr8care

Posted on Friday, Sep 18, 2009 - 9:43 am:

Does anyone have experience with this in a weanling foal?

The following is what was determined yesterday:
Lameness exam--Left hind extended stifle with flexed hock upon weight bearing. External rotation of limb upon weight bearing (YES, the leg would give and have an ugly rotation to it!)

Diagnostic--Left ileum and hip joint ultrasound scan shows no signs of fracture; scan of left hind caudal stifle and proximal crus show rupture of the origin of the gastrocnemius muscle. Radiographs show no fractures of stifle.

Treatment--Confine to box stall for next 8 weeks; keep in Robert Jones bandage (thick, multi-layered, heavy bandage as close to a cast without being a hard cast) for next 4 weeks; re-evaluate in 4 weeks

Does anyone know the prognosis of a full recovery? The vets who worked with her yesterday say she should make a full recovery at best, and at worst may have a mechanical 'hitch' that would cause a slight irregular gait.

Anyone???
Member:
crobin

Posted on Saturday, Sep 19, 2009 - 2:12 am:

Hi Grace, 3 years ago my 2-week-old filly ruptured the gastrocnemius in her right leg. Her poor little leg was just dragging. The vet wasn't optimistic, but because of her small size he thought her good legs might be able to bear the weight while the injured leg healed, especially if I could get her to lie down alot. He didn't suggest any bandaging or a cast. I kept her and her mama as quiet as possible in a 12x24 stall for several months. It was very tempting to let them out for some play time after a few weeks, but he was afraid she would get excited and re-injure the leg. She is 3 now, and has recovered nicely. The hoof on the injured leg grows long in the heel and short in the toe, which I think is because she still doesn't quite stand normally on that leg, but a lot of that can be controlled with regular filing. I haven't started riding her yet, but she's a pretty mover and seems sound. I will use her for light pleasure riding - nothing strenuous - and I think she'll be fine. Good luck with your foal! I certainly would give it a try!
Moderator:
DrO

Posted on Saturday, Sep 19, 2009 - 9:52 am:

Hello Grace,
The characteristic "more collapsed" appearance of the hock during weight bearing is certainly consistent with a ruptured gastrocnemius. A ruptured gastronemius should never be able to "extend" the hock normally during weight bearing, at least till it heals. Outer rotation of the leg on weight bearing is not a usual feature however and may indicate there is injury elsewhere.

This is a uncommon injury and yours has several unique features. Most often reported in foals delivered by forceful extraction it is also reported in older horses. Another difference is the rupture usually occurs distally at the insertion of the gastronemius tendon onto the point of the hock (tuber calcis) and not proximally at it's insertion on the femur. Robin where did your horse rupture his tendon? I wonder if this location is more common in older foals.

The age is in your favor, the complete rupture proximally is against you I believe. The treatment seems reasonable as long as it is applied for at least 6 to 8 weeks. But the individual features of your case make it impossible to give an accurate prognosis. The splinting may help avoid Robin's experience of a permanently DrOpped hock by opposing the torn ends. Most often these are given a guarded prognosis for soundness.

Tomorrow when I am back in my office I will see if there is more in by library on this condition. In the mean time images, taken from the side and back, might help us visualize the changes in stance (particularly the rotation) you are describing and help others identify this problem.
DrO
Member:
crobin

Posted on Sunday, Sep 20, 2009 - 2:03 am:

Hi Dr. O,

In answer to your question, my filly ruptured her gastrocnemius by rolling underneath a flatbed trailer that was parked in the pasture, and getting her back leg caught up in the tongue. I don't think my vet said exactly where the rupture was, but it seemed to me to be slightly above the hock. Would that make sense?

Robin
Moderator:
DrO

Posted on Sunday, Sep 20, 2009 - 10:28 am:

Robin, I figured it must have been something odd and yes the point of the hock is the site of attachment and I believe the most common site of rupture.
DrO
Member:
gr8care

Posted on Monday, Sep 21, 2009 - 10:12 pm:

Dr. O,

Thank you for the honesty on a guarded prognosis. Of course, we would love to ride this filly in a few years. However, that's not most important to us.

The pasture involved is a pipe fencing on 3 sides and woven wire on the other. Since she had a few small puncture wounds on the inside stifle of the left leg, the hair rubbed off the top and back of the left hock, in addition to the loss of use and rotation of the left leg, I suspect she became cast in the pipe fence. YET, with all of our rain and her youthfulness, it is completely possible that she fell with the leg extended. So???

The local vets were not capable of a diagnosis. I hauled the filly an hour away to a vet who handles racehorses. She could not find a fracture, but was limited to just above the stifle and lower leg. All the growth plates looked fine. She was not able to determine damage in or around the pelvis, so she referred me to a medical/surgery center almost another 2 hours away. The vet that made the diagnosis is described as the following: "primary practice interests are sports medicine, lameness of performance horses and diagnostic imaging. His abilities for producing radiographic and ultrasound images are recognized by his peers for excellence."

It has been 5 days since the incident and today the filly did not have the rotation when bearing weight on the impaired leg. I'm hoping it's an honest improvement. She is doing relatively well. My stalls are 13 x 18, but she is not pacing, uses the walls to brace herself to relieve the good leg as much as possible, and goes to the center to lay down several times per day. She has free choice hay and alfalfa.

I don't have any photos that show the aweful rotation. The first vet went with me to the specialist's, and she was taking photos while they were working on the filly and I was holding her. I'll see if she can forward any to me. I have an ultrasound of the "mush" of muscle on the bad leg, and one showing the right side (what it should look like).

Dr. O, any additional information that you feel would help in her rehabilitation would be greatly appreciated.

Thanks for any info!
Member:
gr8care

Posted on Monday, Sep 21, 2009 - 10:14 pm:

Forgot to thank you, Robin, for your input. Thank you SO much for sharing. It is an uncommon injury, so there is just very limited info and experience.

Thank you!!!
Moderator:
DrO

Posted on Tuesday, Sep 22, 2009 - 5:09 am:

Grace I don't have any special words, long term splinting and stall rest is the best advice I have and you seem to be there already. You mention 4 weeks but I think that 8 weeks might be more realistic in forming a union.

It is good the weanling can get up and down with the splint but does make decubital sores a likely complication. Be sure the bedding stays fresh, soft, and dry. Early attention to any abraded areas with protective wraps will help.

If you can get images of the appearance of the injury this will help others diagnose the problem for themselves and not much else looks like this.
DrO
Member:
gr8care

Posted on Tuesday, Sep 22, 2009 - 9:18 am:

My first vet is coming to us today to change the bandage, so I will try to get photos, if there's enough hands to help. Also, I was wondering about putting a support wrap on the good leg??? The bedding issue is a double edged sword, too... I want it deep enough to be comfortable and minimize sores, yet any depth at all makes her mobility more difficult (perhaps that is a good thing??). I pick her stall at least 4 times a day to make certain it stays clean.

Please give me your best recommendation for a topical ointment for the scuffs/rub sores.

The specialist advised that we would re-evaluate the filly's condition at 4 weeks and determine if she could get by with a lighter bandage or not. He did say 8 weeks of stall rest and he was not happy with me about the large stall size. Although, he said the filly's calm disposition is to her benefit.

I'll see if we can get any photos today.
Member:
crobin

Posted on Tuesday, Sep 22, 2009 - 10:40 am:

Grace,

I'll be saying a prayer for your filly. Miracles do happen, and these little ones seem to have an amazing ability to heal. At 3 years old, my girl is big, beautiful, and healthy, and other than a slight difference in the shape of her foot, you'd never know she'd been injured. The vet said her hoof will probably grow more normally as her body growth slows down and her tendons stretch out in that leg. I hope yours does as well, or even better!

Robin
Moderator:
DrO

Posted on Wednesday, Sep 23, 2009 - 8:02 am:

Grace I would not put ointments on the areas before a sore develops. They will have a tendency to soften the skin. Instead if you begin to get an abrasion, try to rig some sort of thick padded bandage that protects the area, if that fails creating a bandage that somewhat resembles a donut provides the ultimate protection. Once a wound forms I would look to our Long Term Wound Care article for suggestions on treatment.
DrO
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