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  Discussion on Treatment for suspensory lameness
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Posted on Thursday, Feb 21, 2002 - 10:11 pm:

Dear Dr. O,
My horse was diagnosed with a left front suspensory injury in November and had just recently gone through weeks of walking building to 20 minutes of trotting when he became lame again. The ultrasound shows the original lesion to be worse than it was in November, and he also now has a small lesion in his right front suspensory. Along with shockwave therapy, I am considering long-term turnout--as in, one year of no riding but out in full pasture for half the day. I've heard from two people that this is an option for healing, but haven't seen anything about this on the internet, only the weeks of rest with gradually increasing hand-walking and riding. What's your opinion on a year of "pasture and stall rest"? -- Barbara

Posted on Friday, Feb 22, 2002 - 9:18 am:

Hello Barbara,
Without seeing the lesion I really cannot comment on any particular therapy. However I can comment on someone who would comment without examination: they are clueless to the variety and severity of some suspensory lesions.

The first thing I would consider is that the many artifactual changes in EVERY ultrasound scan can make this type comparison very difficult. One of the biggest problems is that the average equine vet (and I stick myself in this group) do not receive enough specific training for this. We all pick it up on the fly so to speak and a common mistake we make is over-interpreting what we know.

Another part of this over-interpretation is the difficulty involved in getting a good scan with the average field unit in the standing awake horse. I am not saying that the procedure, it all boils down to how subtle this change is vs our knowledge and techniques ability. If you have someone who does this several times a day every day with a super-smart multihead, multifequency machine and you have a horse that stands rock still I apologize. A person like this would probably recognize subtle changes.

I quess what I would like at this time is a clear objective description of the original and second ultrasound lesion and then perhaps we can discuss whether letting him loose out in the pasture is sensible. No matter what I think you should probably follow the recommendations of your vet and if you think they are wrong get a second opinion from someone who can actually examine the horse.
DrO

Posted on Friday, Feb 22, 2002 - 10:10 am:

Dear Dr. O,

Thank you for your prompt response. I am thinking that even without a second opinion and more skilled interpretation of the ultrasound, the fact that my horse is lame again indicates he was moved along too quickly. The protocal for ligament injury in your article and in at least one other I've found are more conservative than that originally prescribed for my horse. I think we may re-begin a much more conservative protocal of rest and gradual exercise. One concern I have is long-term use of reserpine. My horse broke away several times when being hand-walked and once bucked me off and galloped off down a paved drive (the ace had worn off) prior to reserpine use. He's quite calm and contented on reserpine, which makes me want to use it while he goes through the continued confinement. He's getting the pills in his food. How long can a horse have this in his system without there being problems? I didn't see this in your info on reserpine. Thanks again, Barbara

Posted on Saturday, Feb 23, 2002 - 12:36 pm:

Hello Barbara,
A return to lameness is probably a more significant finding than some ultrasound changes.

Concerning the reserpine I do not know how long you can safely give it as some horses become ill with a single dose. Consider it a very long acting accumulative action drug so you might try every other day dosing and if you get a good effect that persists for a week or more, try every third day etc.. until you get to the minimum effective dosing. Generally diarrhea is considered the first signs of toxicity. I am interested in what your current dosage regimen is and the cost of the drug.
DrO
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