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  Discussion on Suspensory desmitis help and advice please
Author Message
New Member:
jessblue

Posted on Thursday, Nov 17, 2011 - 3:37 pm:

Hi all. My beautiful hanovarian event horse was diagnosed with hindlimb bilateral psd in march this year. As far as i could see he was never actually lame. I had ots of people look at him including 3 vets and 2 chiros and several v good instructors. His main problems were back soreness in lumbar sacral area. Slightly grumpy when working in the school, tail swishing, troube maintaining canter, bunny hops on canter trnasitions and sometimes becoming disunited. All symptoms were very vague and would come and go. My current vet nerve blocked him for suspensry injury and he nerve blocked well. Vet said he was short behind, but i have to say i struggled to see it! He was very slightly positive on suspensory flexion too. Treatment plan was neurectomy followed by box rest and slow return to work. Thae op wasdone in May and he is now trotting 20 mins a day and hacking out, turnout daily and lots of walking. Not started canter yet.

His scans showed no holes just fibre pattern disruption, right worse than left. ^ weeks post surgery right hind was still not great but better than before. Left was much improved. No scans since.

Does anyopne have any experience of this as I am very worried and confused as to the long term prognosis. My vet had offered surgery as he felt he was a good candidate and the idea was to return him to his previous level of work. However, having spent 5 months in a rehab facility, I was given verynegative feedback about neurectomy and PSD in general.

If his PSD is a longterm chronic issue, I am afraid it will continue to worsen even tho he cannot feel the pain as much due to the surgery. However, we have addresses his shoeing by using eggbars and getting a much better foot balance, raising the fetlocks as we go. Also back man has been working on his sacrumt ease the problems here, his back was also medicated and seems much more comfortable.

What is the liklihod of him coming right? He seems sound at walk and trot and seems to be moving quite well considering he is not as fit as he was.

Any experience or help would be great as I feel confused and worried I may be doing him harm all the time.
Member:
lrhughes

Posted on Friday, Nov 18, 2011 - 12:24 am:

Years ago I rode 2 horses that had were "nerved" the common term for neurectomies back then. These were ranch riding and stock working horses. I rode each for several years with no problems including doing hard work in the mountains. However, they both had navicular problems not complicated by other issues. I did keep them padded in the mountains. When they were 18-20 years of age I retired them to our ranch. They were occasionally used for guest to ride out on trails and were fine for that. Both lived into their mid 20's. When we used them after a rest period, I used a gram of Bute each time I rode just to cut inflammation potential. Your horse is larger and heavier, and you are asking much more exaggerated movement from him, so you are in a different situation. I'm mentioning the neurectomies because I often see that procedure discussed as bad in these blogs. It is sometimes, but other times it can save a horse that would otherwise be "gotten rid of." LRH
Moderator:
DrO

Posted on Saturday, Nov 19, 2011 - 7:26 pm:

Welcome Jessica,
When you say the horse blocked well, what did you mean exactly?
DrO
New Member:
jessblue

Posted on Sunday, Nov 20, 2011 - 12:19 pm:

Thank you for the replies. I mean when he was nerve blocked to the supensory he became sound. Now bearing in mind he wasnt really very lame. The vet said 2/10 but to be honest i think less than that. He also mentioned he was "short both hinds" so I assume when nerve blocked he became less short! I really struggled to see the lameness or even the shortness, in all honesty, so had to leave the judgement to my vet. He was happy with the nerve block result, which made him an excellent candidate for the neurectomy surgery as this nerve block gives the same effect as the neurectomy. I know he also had a positive flexion to the right hind, which appeared better after nerve block, but again, i could not see this as I was leading him at the time.
Moderator:
DrO

Posted on Tuesday, Nov 22, 2011 - 8:56 am:

Jessica, were both hind suspensories blocked to achieve soundness and if so was the neurectomy bilateral? Since the surgery has the horse looked sound to everyone?
DrO
New Member:
jessblue

Posted on Tuesday, Nov 22, 2011 - 11:29 am:

Hi Dr O. Yes both hinds were nerve blocked which showed him to be moving better behind. No longer short. His hocks were blocked on a separate occasion as were his fetlocks to ensure the suspensory was the route of the problem. Hocks were also x rayed and were clean. I believe my vet was very thorough and he put all this information before his senior partner who is a very well respected ortho surgeon, who did the surgery.

Both hinds were neurectomised and he appeared sound on all subsequent checks. He appears to be moving well, clearly overtracking as far as I can tell. He was slightly positive to right hind suspensory flexion when last reviewed by my vet, but that was in July and he was still on stall rest. He was completely sound on trot up but "maybe very slight positive response to flexion" Literally less than 2/10s was what he put in the report. Vet is due to review in december but i am nervous about findings now. I am worried that he may have deteriorated in the time since last reviewed and I feel that he is very fragile because of this injury.

I wondered how quickly a horse with these injuries could deteriorate and if so will he be at risk of having to be put to sleep? Could his ligaments snap altogether? I want to avoid this at all costs so if i feel he is at risk i will be happier retiring him off so as not to damage his suspensories any further.

Many thanks.
Moderator:
DrO

Posted on Sunday, Nov 27, 2011 - 9:26 am:

Jessica, further damage to the suspensory can occur either as a slow degeneration or rapid damage. While the prognosis for a bilateral hind limb PSD is guarded, I assume your veterinarians judged the suspensories to be in good enough shape to continue work. With this in mind, by monitoring the ligaments with daily inspection and regular ultrasound and slowly bringing the horse back to work I think it should be possible to work this horse and have a minimal chance of catastrophic injury. The level of work may be at a lower level of performance than before however. Perhaps the best way for you to address your concerns is speak with your veterinarian about your concerns.
DrO
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