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HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Lower Limb » Annular Ligament Constriction » |
Discussion on Treatment Options - annular ligament constriction | |
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Posted on Friday, Dec 29, 2000 - 12:09 am: We have a 13hh, 11 yr old part welsh pony. He has been with us for 6 years doing dressage, hacking and light jumping with the children. He has never had a day off or injured himself. Three months ago he started stepping short and showing front leg lameness. Vet advice, including nerve blocks and ultrasound was extensive thickening of the prox annular ligament in both front fetlocks - the lame one more so than the other. A course of bute relieved the lameness but it returned once medication stopped. Paddock rest and egg bar shoes with raised heels have improved the condition, but there is still lameness after three months. Vet advice is to first look at cortisone injections with stable rest or as a last resort, surgery to cut the ligament. Your research seems to indicate surgery can be an early option. I have heard it can cause side effects such as large wind galls. Can you advise on side effects and pronosis for light use after surgery or alternate treatments please. |
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Posted on Friday, Dec 29, 2000 - 7:51 am: Hello Ms Sturgess,Concerning adverse outcomes, this surgery can be done several ways and though uncomplicated on paper, is not a simple one. So the best source of side effects and prognosis will have to come from the surgeon himself. As indicated in the article under the right circumtances the prognosis can be good. DrO |
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Posted on Wednesday, Jan 3, 2001 - 11:27 am: Dear DrOA bilateral annular ligament desmotomy was performed on my 9 year old horses hind fetlocks at the end of November 2000. Following the operation my horse was on box rest for two weeks during which time he appeared to move freely around his stable with no signs of lameness or swelling beneath his bandages. Within 3-4 hours of the staples and bandages being removed however, my horse was severely lame on his left hind and there was obvious heat and swelling. My vet thought this may be due to the breaking down of an adhesion that may have formed following surgery. Three weeks later, my horse is still slightly lame on his left hind when trotted up in hand, and there is still some residual heat and swelling. He is still on box rest but is being walked out in hand for 30 minutes twice a day. He is on a course of Hyonate injections (into the neck) and is on one sachet of Bute a day. My vet says not to panic just yet, as the leg may eventually settle down on its own. As yet we have had no such problems with the right fetlock. What do you think? Am I expecting to much too soon? Is there anything else we can do at this stage? Thanking you in advance for any help you may be able to give. Heather Parsons |
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Posted on Thursday, Jan 4, 2001 - 7:12 am: While the adhesion theory has some merit, it is a little early for significant adhesion formation. Sounds more likely to me that the horse kicked something or hurt the leg in some other fashion and the trauma may in some way be related to the recent surgery. Either way as long as all the other likely possiblities that turned up on the physical exam have been checked and ruled out the treatment regimen seems reasonable.DrO PS: Keep us appraised of what happens. |
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Posted on Tuesday, Jan 16, 2001 - 9:01 am: Dear Dr OJust after I wrote to you I asked my vet to reassess my horses left fetlock. He suspected that there may be some sort of infection around the internal stitches and suggested that I put him on a relatively high dose of antibiotics for six days to see if this made any difference, and said that he would reassess the limb in 12 days. Thankfully the antibiotics seem to have worked and the left fetlock now appears little different from the right fetlock. My vet has just been out again and confirmed that my horse now appears sound and suggested that I begin to slowly increase his exercise over the next 4wks until he is doing an hours walking, twice day - either in hand or ridden. You were right - the problem certainly appears to have been connected to the actual surgery. Until my vets next visit in one month, my horse is to remain on one sachet of bute a day, but I did wonder whether or not you think administering Cosequin (or similar) would also have been of benefit. As this is not a joint problem my vet is doubtful, and feels that the Hyonate injections should have proved sufficient. Again thank you for your help and the promptness of your replies. Heather Parsons |
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Posted on Tuesday, Jan 16, 2001 - 11:39 am: Hello Heather,It may have been coincidence and just time to heal: the fact that it had come up so quickly and then he had been improving for three weeks sort of ruled out infection for me, but then again I have seen stranger things than that. Maybe it flared than smoldered for 3 weeks. Delighted that he is doing better. DrO |
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Posted on Monday, Jun 4, 2001 - 4:28 am: Dear Dr OFollowing the bilateral annular ligament desmotomy performed on my horse November 2000 (see previous E-mails), and some concurrent chiropractic work, my 9 year old horse appears to be going really well and his dressage work has much improved. However on a 10m circle on hard ground he still seems slightly unlevel on the right hind. Vet opinion as to the next course of action seems to differ. One vet suggests corticosteriod injections and maybe even a repeat desmotomy, whilst another vet suggests simply avoiding 10m circles on hard ground - as the horse otherwise appears to be performing well. What is your opinion? Are there any pros and cons to further treatment? Is the unlevelness we are noticing really significant? Is it indicitative that my horse will eventually become chronically lame - or would he already be classified as such despite the fact that the lameness does not show up when the horse is trotted in straight lines (he does however show lameness following flexion tests on both hind legs)?. Sorry to ask such a lot of questions, but I feel I need to consider the matter very carefully before I proceed with further treatment. Hope you can help. Regards. Heather Parsons. |
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Posted on Monday, Jun 4, 2001 - 9:02 am: Hello Heather,Without an exam I cannot determine the significance and it really depends on the cause of the uneveness as to what the proper treatment would be. I think that they need to concentrate on the cause of the lameness then decide the treatment. DrO |
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