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 » Overview of Fetlock (Ankle) Lameness »
  Discussion on Rehab for medial collateral ligament injury
Author Message
New Member:
Next1

Posted on Wednesday, Feb 22, 2006 - 1:49 pm:

My young horse has been diagnosed with a slight tear in his medial collateral ligament in his hind fetlock. It is slight but visible on the ultrasound. He has been on and off lame for 2 months (at most a grade 1 out of 5) and was not lame enough for a block until recently--(at his worst he might be considered barely a grade 2--but gets sound quickly with rest). My vet is optimistic on his full recovery but I'm looking for any advice on how to rehab him. We plan on giving him stall rest for 8 weeks with handwalking if he stays quiet (then re-scan) and I will probably have him treated with shockwave too (covered by insurance). Should I expect that he may need to be on stall rest longer? How slowly should he be brought back---I have experience with re-habing other ligament injuries, just not this one. Am I kidding myself that he will recover from this?--this is an event horse.
Moderator:
DrO

Posted on Friday, Feb 24, 2006 - 10:18 am:

Hello Melissa,
No you are not kidding yourself but let's start with the diagnosis, since slight ultrasound changes are often insignificant, what other findings lead you to this diagnosis? If we assume the diagnosis is correct, the prognosis and therapy will depend on the details of the ultrasound findings.
DrO
New Member:
Next1

Posted on Friday, Feb 24, 2006 - 11:12 am:

My vet could see the tear from both views on the ultrasound and it fit with everything else we were seeing.

He's been on and off lame for at least 2 months. With a few days rest he'd be almost sound, but as I slowly increased his work, he'd get worse again. Always right hind. The more he worked, the worse he would get. Occasionally there would be slight swelling like wind puffs--I treated with Surpass for a few days and it would clear up. Looked fine at the walk, worse at the trot and NQR at the canter--didn't want to pick up the right lead, kept his hind feet closer together going right. He got worse quicker if he jumped. Easiest to see/feel on a circle to the right. It didn't act like foot--same lameness in soft footing and hard, no pulse, no reaction to hoof testers--my farrier found nothing. It flexed as the ankle. I was finally able to make him sore enough and time it with my vet so we could block him--typically he was not lame enough to block. It also blocked out as the ankle. A few days later, we x-rayed him using a digital x-ray machine and according to my vet his x-rays looked beautiful--(he doesn't often see them that clean--but this is a young horse--4 year old). We x-rayed from the ankle down including a few views of his foot. We'd previously x-rayed his stifle (which was also clean). Since there was nothing on the x-ray, my vet went to the ultrasound. He checked every where and it all looked good. The medial collateral ligament in the fetlock was the last thing he checked (of course) and the spot was pretty consistent when he changed the view (I think that what you call it)--I could see it too. He thought that it seemed to fit with everything else we were seeing and experiencing.

Any time a vet says "hole" or "tear" on a ligament or tendon--I get nervous! My vet stressed that it was very slight so he was optimistic as to his recovery. He didn't think the success rate for horses just turned out in a field was very good and suggested we lock him up on stall rest for 6-8 weeks and then rescan. I'm accustom to walking horses with suspensory type injuries but it seems like this is different and while my vet said I could walk him after 2 weeks --since this horse is not going to be much fun (his a bit difficult when in work) my vet also said that we may need to skip the walking until I'm starting him back under saddle (with chemical assistance--i.e. drugs).

Is this an unusual injury--or just one that isn't often diagnosed? It was suggested by others that I do shockwave therapy (particularly since this has been going on for some time)--and that would be covered by my insurance. My vet wasn't against the idea but also not convinced that it would matter (but he didn't think it would hurt either). Do you think this would be helpful (or a wast of my time). Is there anything else that I could be doing to help this heal strong. Should I bit the bullet and hand walk him--given that he will need to be drugged daily to do so and keep his feet on the ground? or is it better to try and keep him quiet in the stall and let it heal?
Moderator:
DrO

Posted on Saturday, Feb 25, 2006 - 8:59 am:

Collateral ligament tears are not unusual and I like the diagnostic work up. I am not much of a fan of shockwave over the joint maybe in time I will shown to wrong here but it works by microdamage and inducing inflammation and joints do not do well with inflammation, like other tissues do.

The main think is appropriate rest, you have not allowed healing to occur so keep reinjuring it. Stick carefully to his rehab schedule and always error on the conservative side when considering increasing work. We have a schedule that could be adapted to your injury at Equine Diseases » Lameness » Treatment Methods » Rehabilitating Injuries to the Tendons and Ligaments.
DrO
New Member:
Next1

Posted on Monday, Feb 27, 2006 - 12:28 pm:

Thanks Dr. O. Yeah..I'm not to sure on the Shockwave. The people suggesting it most and saying how useful it is are also the the people with the machine.... The one friend suggesting it said that my guy might need it since he kept re-injuring that ligament while we were trying to figure out what was wrong with him. I guess I'm leaning toward just doing the stall rest and slow re-hab and see where that gets us. The only draw back is insurance would cover me now if I did the shockwave...not sure it will if I wait too long. I'm just worried because it obviously was getting re-injured but since he was so slight in his lameness it wasn't easy to diagonse...especially in a green horse. Anyway, thanks for your advice and the the rehab article is helpful. His re-hab should be..interesting...I have a strong feeling drugs will be my best friend with him!

Is 6-8 weeks of stall rest probably realistic with this type of injury?--I was thinking that we were being conservative. Obviously, we will scan him before starting the next step of re-hab but just trying to prepare my self...
Moderator:
DrO

Posted on Monday, Feb 27, 2006 - 6:46 pm:

Even seeing the injury Melissa, it is very hard to predict the course. Identical appearing injuries on ultrasound in some horses heal very quickly and others cause chronic problems. That is why the rehab is set up based on specific conditions of improvement.
DrO
New Member:
Next1

Posted on Monday, Feb 27, 2006 - 7:09 pm:

Ok--thanks. I'll just suck it up and wait until his next scan. Well at least he's saving me entry fees.....
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