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  Discussion on Best Prognosis For Severed Deep Digital Flexor Tendon
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Posted on Thursday, Dec 7, 2000 - 9:13 am:

Dr. O; I am hoping to get any response in a very short amount of time to minimize the impact on my horse to the best possible prognosis for a horse with a severed deep digital flexor tendon on his left hind leg. Barb wire went through the tissue laterally and cut the surface and went through that tendon. As I understand from my vet - the tendon beneath that one is intact and is why my horse could walk the distance (carefully & painfully) back to the barn. Pain killer was only used after the horse had had several hours of distress the evening of the injury and he has been on bute and penicillin until my recent vet call yesterday. My vet indicated that alot of people put a horse down with this type of injury; but that the 2 instances he knew of involving recovery left 1 of the horses alive and well, but not rideable, and the other rideable at a walk on gentle surfaces. It is imperative that I have ANY input from ANYONE with experience that presents a possibility of a better recovery prognosis (granted that is with all immediate and ongoing care being the best possible). I am willing to try with him as his personality and stick-with-it-ness certainly would justify the effort. But I do not want to "bark up a tree" either. I am also feeling that the personality type of this horse is such that a lazy life would not be easily tolerated. I didn't feel that much of his current care or medications was a necessary run-down for you (or any other seeing fit to provide input) until I can make the all-important decision to try or not. I thank you ahead of time for any assistance or input!!!! Dawn Friesen.

Posted on Thursday, Dec 7, 2000 - 9:58 am:

Sorry, brain is in a twist and I think before most would give any idea of a prognosis they would want to know what they were starting with: my horse is 5 years old, saddlebred/quaterhorse mix, 16.5 H, in good health and good physical condition. Also, the injury occurred Saturday afternoon, he was initially pressure-wrapped due to a severed artery; and has had the wound thoroughly cleaned by: his own arterial bleeding, a BP & water solution and NFZ dressing. Both legs are wrapped now for support and he is bright eyed and bushly tailed (as can be for what has happened). Thanks!

Posted on Friday, Dec 8, 2000 - 7:02 am:

Hello Dawn,
I don't really see a question in the above post. You do seem to want a prognosis but without seeing your horse we cannot do that and it would also depend on your goals.

At what level is the DDF severed and is it conpletely cut: does the toe elevate off the ground? Without seeing the wound and the specific injuries it is difficult to generalize beyond those principles that are layed out in the first aid article on wound care.
DrO

Posted on Friday, Dec 8, 2000 - 9:14 am:

I guess what I am looking for is your best "recovery" story regarding any horse with a completely cut through, deep digital flexor tendon. My horse has received a wound from barb wire that he backed up against (hidden in soft soil) that made a 4 inch gash below his fetlock and above his coronet band on his left rear leg. The gash was deep enough to severe the deep digital, but only nick the next suspensory ligament behind that. As I said, he is 5 years old, 16.5 H, saddlebred/quarterhorse mix; and an extremely positive and easy keeper. He is starting off this injury with good health and a good diet, and received all his booster shots about 1 month ago. He has a stable mate who is loving and supportive. So really, along with excellent care; he definitely has an edge on things. However, due to all the information I have heard from those with "hands on" experience with such an injury - both laypeople and 2 vetrinarians; my current outlook on his prognosis is not good; and doesn't sound like a challenge I will be up to if I don't hear of anyone with a better "story" to tell. That is really what I am looking at.....not so much a vet judgement call; as your "hands on" vetrinarian experience(s), if any. Thank you for your reply; I will review any posts to help make my decision. Thanks! Dawn. :)

Posted on Friday, Dec 8, 2000 - 5:42 pm:

One more additional info - NO, the toe is not pointing up, it was the deep tendon, but not the tendon directly behind that one which is why he could "walk home". He limps on it, will stand with light pressure on it, and is laying down off and on due to it. Hope that helps some too. The reason I am seeking "stories" is I am trying to find finished products that leave my horse with a reasonable to good existance after all the intermediate care is finished. Thanks ahead of time for even reading these posts; answers or suggestions, or stories are appreciated!!!

Posted on Friday, Dec 8, 2000 - 9:01 pm:

Hi Dawn, I wouldn't like to give you false hope but I had a mare with the exact same damage, plus was down to her bone. The vet said if she didn't die of a bone infection we had a slight chance. Well to make a very long story short, after 1.5 yrs she was trail sound. So it is possible the vet said he had one other recover from such an injury. It is a long journey and just the proud flesh battle is exhausting. Good Luck whatever your decision.

Posted on Saturday, Dec 9, 2000 - 2:07 am:

Wow, thanks Diane....hands on experience counts a bundle in this. My dilemma has been whether to put him down before alot of stress accumulates on him or me if the ultimate end was not going to be good. Your experience coupled with further information I got from my own vet and a consultant vet is heartening enough for me to try. I've battled the proud flesh for a horse before on an extensor tendon injury and can deal with that. I was really concerned about any sort of use of the horse after all the treatment and rehab I know he'll go through. His personality is definitely a "keeper". Just got through re-bandaging tonight, he handled it much better, got the wound area squeaky clean and dry - in fact he seemed to enjoy the dry rubbing so long as it wasn't directly on the wound. Swelling has remained minimal, and not getting any nasty smells coming up when I am removing the bandaging....I guess he gets to have a shot at recovery, so I will call off the "wagon" I set up. Thank you so much, granted there are no guarantees, but horse ownership is always like that, it's just nice to hear from someone on the other side of the tunnel with something good to say to help the heart motivation. Dr. O - still would love to hear if you have any experiences and where the toughest areas in recovery might be. I.E., adhesions, shoeing, etc. Thanks....Dawn :)

Posted on Saturday, Dec 9, 2000 - 6:37 am:

There does seem to be some confusion about the extent of the problem: when the deep digital flexor tendon becomes severed the toe will elevate off the ground. It is the DDf that keeps the toe on the ground. If it is severed or damaged significantly an extended heel shoe will remarkably support the structure while it heals.

Diane misspeaks when she says her injury was exactly the same: no two injuries are exactly the same and they certainly can't be compared with the scant amount of information here. Even two cuts that look similar may have small punctures or blunt trauma that signicantly affect treatment and outcome.

I know I seem a bit of a prude on this but it is critical you understand the limitations here. It really takes a thorough exam by a knowledgable person to prognosicate wounds in this area. I have to admit my reluctance to comment is also related to the fact that the clincial signs do not agree with the diagnosis: completely severed DDF tendon.
DrO

Posted on Saturday, Dec 9, 2000 - 7:09 pm:

Thank you Dr. O - I do understand your reluctance to comment but appreciate beyond belief your participation in this discussion. It has helped me to formulate better questions for my vet. I have to say also, the sections on deep wound care and tendons, along with diagrams have been a fantastic resource for me. When my own vet finally made it out 5 days after the incident; I was mentally armed with much of what would be the care, control, medication and healing process. I discovered your article addressing adhesions which helped me to pose that to my vet right off the cuff. I am now extremely curious as to the "completely severed" DDF too....my horse walked over a mile home, and has been stepping toe down (granted very ouchily) on that leg ever since the occurrence. The shoes are what my vet posed as part of the rehabilitation process also. We are going to get the professional opinion of a vet surgeon who has dealt with several of these types of injuries. That should pretty much solidify the direction I am now committed to - trying to restore the horse to the best possible condition. Also, Diane's story, though maybe not the "same", definitely gave me the emotional boost I needed when I had already scheduled for my horse to be put down Sunday. At the very least I needed someone with a positive story concerning a tendon injury in that area of the leg. My vet concurs with your opinion 100% - NO TWO INJURIES ARE THE SAME. Any further input or advice would be welcome, as this is going to be a "long haul" item for me and the horse - and I guess my greater concern than healing the wound and the infections (none have reared their ugly heads - no pun intended) will be the adhesion issues during the mending process. Thanks again! Dawn :)

Posted on Saturday, Dec 9, 2000 - 9:39 pm:

Good luck Dawn and I hope you are sucsessful. It is a long haul and many times I questioned myself but it was worth it, as Dr O. said I'm sure they are not exactly the same, however the same tendons were involved. It's been many years ago but if I remeber right I had to completely stall her for months it seemed, with some hand walking. Believe me she didn't walk well. Had to keep the wound exteremly clean. When she was finally somewhat mobile I put her out in pasture and kept the wound rapped so it wouldn't get dirty and also put a shipping boot over that to protect from knocking it on something. Good Luck

Posted on Tuesday, Dec 12, 2000 - 4:39 pm:

Dr. O, had my followup visit from my vet today; interviewed him on the injury and had a medical diagram book with a beautiful back of the fetlock/pastern/hoof area and all tendons/ligaments numbered and labeled on it. Basically, his diagnosis: traverse laceration plantar mid-pastern, severed DDF tendon, can bear some weight - suspensory apparatus intact. His followup visit was: wound is starting to cover with granulation tissue, "he looks great!". It seems we have a good handle on how to keep the wound clean and uninfected, he is getting bute (1 1/2 - 1 gram) and septra at 15 tablets - both twice a day currently and he is set for another 10 days or so; The wound is cleaned with a Betadine solution, dried, then Nitrofurozone directly on & in the wound, held in place, and quilt wrapped for padding and protection along with the other leg for uniform support. My questions are: how anxious should I be about the amount of antibiotics he is taking now that granulation tissue is forming (I don't want a sore tummy or worse, colic); and what about his useage of that leg, will that promote adhesions if he is "feeling good" from too much painkiller bute? He is probably about 1,000 pounds, maybe a little heavier, and 16.5 H tall. All his eating, drinking, pooping, peeing and personality have held up to this point; but I know that complications can mean setbacks so I'm hoping to avoid them since everything to this point has been so much on the up and up. I hope you can review this and give me a post, let me know if I've left you lacking some info. again, it won't be intentionally! :)
New Member:
Mtca

Posted on Friday, Oct 11, 2002 - 12:56 am:

We have a mare with a severely contracted flexor tendon in her front leg. The knee above has arthritus and has swelled over the years to the size of a cantelope which may have affected the tendon. She is knuckled over and has trouble bearing any weight on it. We have been wrapping it for support and have tried splinting the back of the leg, then the front with little positive results.

We are now to the point where our vet says to cut the flexor tendon. The question is do we cut the superficial flexor, the deep ,or both? And if we cut both won't she just break backwards and walk on her heels ? Help!
Moderator:
DrO

Posted on Friday, Oct 11, 2002 - 8:30 am:

Hello Linda,
What are your goals with this horse?

The short answer to your question is you cut those that are contracted and interfering with proper extension, it could be one or both. The way to tell which are contracted is explained at » Equine Diseases » Foal Diseases » Tendon Laxity and Contracture. We will worry about complications once we know what surgery is required.
DrO
PS, when you post a new question you should start your own discussion and not post it at the bottom of someone else's thread. When you create your own discussion, it keeps discussions easy to read and you will get more responses quicker. The buttons for starting new threads are at the bottom of most pages with a list of subtopic titles on it. For more on this see the "Before you post" topic besides the "Add your Message" label on the form below. Go ahead and post follow up here and I will move this into its own discussion on my next post.
Member:
Dartanyn

Posted on Thursday, Dec 5, 2002 - 2:18 pm:

Well, closing this saga out thankfully. My horse was seen for this for the (hopefully) final time. I have been allowed to let him go barefoot for the winter. The vet feels that whatever healing and mending can be done/has been done at this point in time; and it seems that Dartanyan will be left with a form of mechanical lameness only really evident at the trot or on any tight circles - neither of which is of great concern due to his pleasure trail useage only. He did not become a pasture ornament, and his demeanor is as chipper as it was at 3 years old. If anything, his thoughtfulness at any new encounter is one of the most pronounced changes from this whole affair. Anyway, wanted to close the post out: there is life after a severed tendon, even a support tendon at that; but I'd emphasize that the horses disposition and constitution have an immense impact on that, in addition to speedy vetrinarian care. Thanks so much for the site, it continues to be an enormous resource for reassurance, information, education, locating helps, and just plain fun and interesting! Keep up all the posts all! Dawn, Dartanyan, Wildfire, and new to us: Tony Pony!!! :-)
Moderator:
DrO

Posted on Thursday, Dec 5, 2002 - 4:29 pm:

Good Luck Dawn, Let us how it goes.
DrO
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