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Discussion on Any body rehabbing for suspensory? Set backs? PRP?
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Member:
babyzeke
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Posted on Sunday, Oct 3, 2010 - 10:19 am:
Hi, just wondering if anyone has done the PRP. Also curious if you've tried to move forward (begin trot, etc.) and had a set back and what you did. Would love Dr. O's opinion on this as well:
Vets wanted me to start riding at the trot as hocks were getting sore and needed work. Am rehabbing the RF for Proximal Desmitis. I did not feel real comfortable doing this as I had not been even walking under saddle, but was supposed to start. I was asked to do 5 mins at trot and add 5 each week. I started at walk and only got up to about 2 mins trot and on the fourth day, he started limping again on RF.
My question is: (seems to be many varied opinions) Was I truly back to square one? or are setbacks normal and you need to just back off for a few weeks? I have heard/read you need to stress the ligaments a bit to encourage healing. This was 5 weeks ago. I just 4 days ago started trotting him in hand for a couple min's a day (after at least 20 mins of hand walk) and he looks great. It is hard to do in hand, (especially more than 5 mins a day! but I am to do so and add 5 mins a week, till I get to 15 mins, then get on him and do walk and trot work. I"d like to just ride at walk for like 1/2 hour before I start trotting, to get him used to carrying weight again and to avoid reinjury. (He has been off 6 months now, started with the hinds, got the fasciotomy/neurectomy surgery- (see previous posts for entire history) went lame on RF from compensation. So it is 15 weeks since PRP treatment to RF (only thing we did besides stall rest and hand walk), and 5 weeks since he re-injured. Upon reinjury, there was heat and swelling and I did poultice/cold hose and wraps for 10 days and it looks fine) BTW I also am doing electromagnetic therapy.
PLEASE, all opinions and experiences are so appreciated!!
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Moderator:
DrO
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Posted on Monday, Oct 4, 2010 - 7:47 am:
Hello Lori,
I have had horses with Proximal Suspensory Desmitis that after rest and rehab started limping again that did not have to redo the initial period but a shorter period to become sound but I have no idea how this might apply to your horse. A complete exam and ultrasound comparing the lesions you have now with those in the original disease is the best way to get close to answering your questions.
DrO
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Member:
babyzeke
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Posted on Monday, Oct 4, 2010 - 9:52 am:
Hi Dr. O
I have been doing regular US.
So glad to hear that a set back like mine might
not mean we are back at square one. I know each case is individual and this is a broad statement, but I just think he is ready to do a bit more - but the exercise regimen below leaves me with some questions. (listed at end)
(we are at week 5 per the schedule below)
Here is the last report: (am trying to load it, it will not load - Ok - I had to put the whole report and this message in a pdf. Sorry - could not copy from a pdf and paste.
I have a couple more questions (my original vet that did surgeries unfortunately went back to England)
* If you were me, would you do some ridden work at the walk for a while before doing the trot work (week 8)?
* Do you wrap legs for excersize or turnout, if so - any suggestions as to with what? I have read alot about wraps and boots not really offering any real support, but I want to give him every advantage.
* Have you noticed body soreness with this much time off? He is especially sore in lower back and glute muscles. I chalked it up to sore hocks, as he did flex sore on left hind and we injected it on the day this report was made. But it has been persistent for last few months and is very slowly getting better with electromagnetic therapy, Back on Track blanket and lots of massage with Sore no More.
I also started applying Surpass to hocks and RF pastern, as I read the joints below the affected ligament will be "less stable" - Any suggestions on how to deal with that?
* He does a strange curving of his body in an attempt to reach and itch his hindquarters and does it when I approach him to groom or clean his feet. It is really aggressive on his part in an attempt to get me to rub just the right spot. I wondered that he has something in the "whorlbone" - (Trochanteric Bursitis?) area, but it is not sore exactly on palpation - seems more like all the surounding muscles are affected, or I have not found the right one. Hope this is not too much for this post, but this condition and his curving around and pointing his hip at me has been going on the whole time.
Any comments on what type of soreness is typical? He has been off work 6 months and was very fit when diagnosed.
Thanks so much! Lori
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Moderator:
DrO
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Posted on Monday, Oct 4, 2010 - 8:03 pm:
Taking one point at a time:
1) Yes, you always walk before you run (or trot).
2) No, for the reasons you give.
3) No, how does rest cause soreness?
4) Something itches back there but I is unlikely to do with the trochanteric bursae. Pruritis is usually a skin thing.
DrO
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Member:
babyzeke
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Posted on Monday, Oct 4, 2010 - 9:16 pm:
Ok, thanks alot Dr. O.
On the last point, I forgot to mention that he hikes his leg up and loves it stretched out to the side. He is a sensitive skinned TB, and is on all precautions and treatments for puritis, as the knats, etc, etc were awful this year. But--- He is muscle sore, for certain.
His xrays are clean in hocks, no sign of fusing - but he was diagnosed as having Osteo. for the Lhind, and injected when he flexed positive on last exam. Both sides of low back and Glutes are sore - equally. Electro magnetic relaxes, but I cannot get rid of it. Would like to do so before I put the saddle on his back. Any suggestions for how to diagnose what this may be? Am tempted to have other local vet do accupuncure (he will get chiro at end of this month) Am wondering what to try - I feel I've done about everything. I read another post where a gal said her horse was "sore, sore, sore" but it did not explain where. Similar rehab situation if I recall correctly.
Was hoping for others experiences, I see alot of other posts get so much attention - hope this gets read by some others. Dr. O- I appreciate anything you can offer up as to how I may pinpoint the hind end issues. Anything else I can tell you that may help?
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Moderator:
DrO
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Posted on Tuesday, Oct 5, 2010 - 7:46 am:
What are this horse's serum muscle enzyme levels? If you feel you are dealing with a myositis you will find help at HorseAdvice.com » Diseases of Horses » Lameness » Muscle & Tendon Diseases » Rhabdomyolysis: Tying Up, Shivers, PSSM, EPSM. If deals with diagnosis of nontraumatic diseases of the muscle.
DrO
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Member:
babyzeke
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Posted on Tuesday, Oct 5, 2010 - 10:27 am:
Never had them analyzed. An interesting thought- My farrier was here this morning and I mentioned it to him again. My horse has eggbar shoes all around, and he said it is likely (as he has seen this before) that since he now has hind shoes, eggbars no less, that he is forced to walk a bit differently (correctly, and not put as much weight on the forehand) that it is causing some soreness behind. He feels he will eventually work through this as he starts to get fit.
Sound like it may be my issue with soreness? Seems to make sense, as it was only after we started putting shoes on behind, that he got the soreness.
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Moderator:
DrO
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Posted on Wednesday, Oct 6, 2010 - 1:41 pm:
Lori, not having seen the before or after I cannot really say what this has to do with anything Lori but horses are shod for the first time all the time without developing lameness.
If you think he is muscle sore, markedly elevated muscle enzymes would be proof.
DrO
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Member:
babyzeke
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Posted on Wednesday, Oct 6, 2010 - 2:30 pm:
Seems to be a general consensus between farrier and vet that the eggbar shoes on his hind feet may be causing the back and gluteal pain. Both have experience with this happening before, so we are going to a regular shoe - maybe with extra support/trailer? Will see if that helps.
Now that I've been asking the questions, seems eggbars are known to cause hind end soreness, as the horse cannot walk in his usual manner .Some use them just for the stall rest portion of thier recovery. I can update if you are interested in knowing if it helps. thanks!
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Moderator:
DrO
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Posted on Wednesday, Oct 6, 2010 - 7:01 pm:
Lori, I must say having seen hundreds of horses in eggbars I don't consider them a source of hind limb lameness if applied properly. Having read the lay and professional equine literature for 3 decades cannot remember a reliable report where this was a trend. And what is the biomechanical difference between a egg bar and shoes with trailers...not much that I can think of. And if your farrier feels egg bars are a source of lameness why did he put them on there in the first place?
Lori all of this is so much...hmmmm...fog (the nicest word I can think of) at least from the point of view of these postings. You present conjectures based on assumptions that are then treated with modalities that are poorly supported by scientific research, like magnets.
You need a good localization in order to get a good diagnosis so that you can get proper treatment. To take you back one more step from the diagnostic paradigm from muscle disease I would point out the article HorseAdvice.com » Diseases of Horses » Lameness » Localizing Lameness in the Horse.
DrO
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Member:
babyzeke
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Posted on Wednesday, Oct 6, 2010 - 7:56 pm:
Dr. O, I dont' recall saying he had hind leg lameness, not now at least, although I have not flexed him to see. He is just starting trot work in hand. He did get injected for flexing positive in the LH hock, but this is seperate from the muscle soreness issue - or so I think.
He moves quite well and evenly. Just sore in the gluteal muscles, and into lower back. My horse is sensitive and I am pretty in tune to what is normal, and this is not something that shouts out at you. I do regular massage, so noticed it begin and found it odd that it is taking so long to reside. I did not want to begin the ridden work until it was resolved.
If we use any trailer at all it will be slight - probably back to a regular shoe- I'll keep the eggbars on in front. Vet feels they do less disruption (assuming they are the cause of soreness behind) in front, plus the RF is most recent suspensory injury, hinds are pretty well along in the healing process.
Really I was hoping to get some feedback or comments from others experiencing compensatory issues as I am, due to having 3 legs with issues. It is too much to go into everything for you. Sorry if it seemed foggy - there is just too much to list it all.
I do have diagnosis. When lame, horses get sore, whether it is compensatory in nature, or just stiffness, muscle weakness, etc. It is all I can do to keep on top of where everything ends up, trying to manage soreness, but mostly find the original cause if it is a new compensation issue. I think I do alot more than most, but I find it interesting and challenging as well as beneficial to my horse to treat everything as it comes up, not just the original injury.
I will leave this as is, obviously there aren't any other current readers that are going thru this that have comments. If there were others with a horse with 3 legs affected with desmitis I am sure they'd have plenty of issues and comments and I just wanted to share, vent, and hopefully exchange ideas. I have alot of things that have worked so well, and would be happy to share. We are in a good place as far as healing - but far from done with rehabilitation.
I truly trust the vet and farrier who explained why and how the rear eggbars may affect hind end muscles, and they have also both experienced this in the past. Maybe I should get a post going in the shoeing area - eggbars are controversial in some ways and dont' work for every horse, from what I have heard and read. He had them for 6 months, so I feel we got the benefit of the support he needed early in the healing process. I am keeping them on the front feet for a while longer.
Thanks for your help.
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vet exercise schedule and notes from US comparison