This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Lower Limb » Suspensory Desmitis, Strain, & Sprain »
  Discussion on Prognosis for long standing proximal hind suspensory ligament desmitis
Author Message
New Member:
chrisl

Posted on Friday, Jan 24, 2014 - 7:03 pm:

My relatively new 13 year old paint gelding has not been right since I bought him - irritable, stumbles, no overt lameness, but clearly uncomfortable even lunging. I recently discovered more of his history - he had been bucking under saddle and was returned to the person I (foolishly) bought him from. I have had several evaluations of him by chiropractors, accupuncturists, cranio-sacral therapists, my own vet. I recently had a lameness specialist evaluate him - she was very thorough and logical, and she was quite confident - after evaluating flexions, blocks, and ultrasound, that the primary problem was a proximal right hind suspensory ligament problem. I have started him on Previcox, and a very conservative rehab program (hand walking 15 minutes 5 days a week, etc. - much like the one in your article). My question is - with no acute injury, with no sign of acute inflammation (heat, swelling, effusion) and the fact that he has already been rested for over 2 years with only pasture turn out (and he's very sedate in the pasture) - is there much of a chance that he will be able to return to even light work (trail riding, trail classes) comfortably? She talked about surgical release if the slow return to work wasn't effective. Can't find anything more specific about prognosis...
Moderator:
DrO

Posted on Saturday, Jan 25, 2014 - 7:19 pm:

Hello Christine,
It is very difficult to offer more than the most general of prognosis (see the article for more) with the amount of information you provide. The person who did the exam and ultrasound will have the best information. When you say surgical release do you mean check ligament desmotomy?

Here is a fairly recent review looking at Shockwave Therapy:
Schweiz Arch Tierheilkd. 2006 Oct;148(10):561-8.

Treatment of chronic proximal suspensory desmitis in horses using focused electrohydraulic shockwave therapy.

Lischer CJ, Ringer SK, Schnewlin M, Imboden I, Fürst A, Stöckli M, Auer J.

Abstract
The objective of the present clinical report was to investigate the short- and long-term outcomes of chronic proximal suspensory desmitis (PSD) treated with Extracorporeal Shockwave Treatment (ESWT). Fifty-two horses with chronic PSD in the forelimb (34 cases) or hindlimb (22 cases) were included in the study. Three horses had lesions in both hindlimbs and one in both forelimbs. The origin of the suspensory ligament was treated every three weeks for a total of three treatments using 2000 impulses applied by a focused ESWT device (Equitron) at an energy flux density of 0.15 mJ/ mm2. This treatment regime was followed by box rest and a controlled exercise program of 12 weeks duration. The horses were assessed 3, 6, 12, 24 weeks and one year after the first treatment. Of the 34 cases with forelimb PSD, 21 (61.8%) had returned to full work by six months after diagnosis and 19 cases (55.9%) were still in full work one year after ESWT. Of the 22 horses with hindlimb PSD, 9 (40.9%) had returned to full work by six months and 4 (18.2%) were still in full work one year after diagnosis. There was no association (chi-square test) between the outcome and the severity of the initial ultrasonographic and/or radiographic findings. Compared with the results of other clinical studies, these findings suggest that in horses with PSD of fore- and hindlimb, the prognosis for returning to full work six months after diagnosis can be improved when ESWT and a controlled exercise program are used. However, a high rate of recurrence occurred in the hindlimb despite treatment.
DrO
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC