Any input on surgeries on Deep Digital Flexor Tendon?

[Equus_girl]

We are on 9th month after being diagnosed with significant lesion on DDFT in his front, with most of the injury being inside the hoof. We have done IRAP and shockwave and I will schedule another MRI to see what is going on in spring, but visually there is no improvement :(
I remember seeing on the thread last year that some people have done the endoscopic surgery (the only kind that would work for us since its inside of the hoof) on the tendon to clean out scar tissue and give tendon a chance to heal all over, but cannot find posts now.
This would pretty much be the last resort as far as I see it, since our vet is convinced its a chronic injury and there is a small chance of him ever being sound again. I would hate to retire him at 9 and besides all the sentimental issues, he will just not be a trail/once a month ride horse, as due to his naughty character he needs to work in order to stay sane. Nine months of rehab have already turned him into a monster :(
So, I am looking for any input as well as vets and clinics recommendations (they do not perform anything of this kind in NorCal) and I am willing to travel as far as it takes.

[BornToRide]

Hmmm, what is the prognosis of the surgery and what is the reason for it being done? The only way for a body to repair a tear in a tendon or ligament is with scar tissue. Tempering with it could potentially make things worse and create even more scar tissue.

What symptoms is he currently showing? How did he injure himself?

[Fharoah]

Ask your vet about platelet rich plasma: http://www.equinesite.com/articles/modules.php?name=News&file=article&sid=1178 Here is a good article

[Equus_girl]

BornToRide, we do not know how he injured himself, he lived in a paddock and just came up NQR one morning, so probably was just playing around and put his foot in some funny way. Lameness was going on and off for a couple of weeks while vet was trying to pinpoint the issue. X-Rays did not show anything since it was a soft tissue, and ultrasound did not show because it was a DDFT vs SDFT :(
UCDavis did an MRI and it showed lesion of about 10sm long starting at coffin bone and going up the tendon, dividing it in two parts. They gave a very poor prognosis for his recovery and they were 90% sure it was not a first time he injured the tendon (I had the horse for a year, he was imported and the history is unclear and his prepurchase was clean since neither ultrasound nor X-rays could pick it up.)
If this is was in fact not the first time it happened, than the combination of old scar tissue and new growth would not let the tendon to be flexible, and hence if teh surgery is performed they can clean it up (or at least its my understanding.) My vet is not a surgeon and does not have an opinion on this, and UCDavis does not perform this level of surgeries either.
We put him on stall/paddock rest while doing treatments and once we were done, we pulled the shoes off and moved him to different barn which has flat ground and pastures (something hard to find where I am at :() All 3 vets agreed that the extent of the injury is so bad that it would not make a sense to keep him stalled for the duration of healing, and it was not feasible to keep him stalled anyways. So he is in the stall for the night and out in either paddock or a pasture for 10 hours daily.
He seemed to be getting a bit better, but I visited him on Saturday and he is displaying same symptoms as before, he has good and bad days, sometimes he looks lame, but its usually not more than 2/5 lameness, sometimes he is just NQR, and sometimes he looks good. He does not appear to be in pain and will definitely be pasture sound, as much as I would hate to retire him, but I am just trying to research all the options available.

[Equus_girl]

Thank you, Fharoah!
I will forward it to my vet, maybe its something he will be able to do.

[BornToRide]

If he he indeed kept re-injuring that tendon, it makes me suspicious about what his hooves look like. Does that affected hoof have a tendency to have a long toe and underrun heels?

If so, I think the best bet of recovery and remaining sound is to make sure he gets trimmed correctly to support healthy and correct hoof biomechanics. Anything less than that will only increase the risk of further assault the an area that is already weak.

Have you noticed a correlation with him being better after trims by any chance? Do you have photos of his fronts to share?

[Equus_girl]

I have some pictures, he is due for a trim here. You are right, his affected fore, left one always seems to be a bit longer than the right one. I thought it was maybe just he way he naturally is and the result of barefeet transfer (we pulled the shoes off in August) :O

Here are some pictures, although he is not standing perfectly square :( The injury is in front left.

http://public.fotki.com/equusanya/jaxon-in-lodi/img1785.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1788.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1787.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1786.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1790.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1792.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1795.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1799.html

Thank you for the input!

[Ruby G. Weber]

If he were my horse I would ease him into 24/7 turn out and forget about him for another nine months.

Horses do not recuperate well when left in a stall for months at a time.

[Equus_girl]

Ruby, he is turned out from dusk till dawn alternating pasture and paddock. I cannot let him into 24/7 turnout now because there is too much grass (I am in NoCali) and he is prone to colics and grass is too slippery and he is on a clumsy side, do not want another injury to happen :( Also, pastures are 10 acres and he will be sharing with other equines and he has never been in a herd situation before, so we are trying to get them all used to each other from behind the fence first.

[Pippin]

Equus Girl.. i feel your pain.. don' t have any pearls of wisdom for you.. only that tendons can take years to heal.. i know i am rehabbing a mare from a completely severed DDF right above the heel bulb.. we are in month 27 now.. I went very slow and stayed the course.. she is 100 % sound now ... but i worry every day ...

She lives outside 24/7 becus bringing her in and out would only add excitment for her.. living out in a 24X40 paddock works for us...

Good luck , there are no for sure answers with these kind of injurys.. just time and luck..

P~

[BornToRide]

I have some pictures, he is due for a trim here. You are right, his affected fore, left one always seems to be a bit longer than the right one. I thought it was maybe just he way he naturally is and the result of barefeet transfer (we pulled the shoes off in August) :O

Here are some pictures, although he is not standing perfectly square :( The injury is in front left.

http://public.fotki.com/equusanya/jaxon-in-lodi/img1785.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1788.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1787.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1786.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1790.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1792.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1795.html
http://public.fotki.com/equusanya/jaxon-in-lodi/img1799.html

Thank you for the input!Not good hoof form at all - very unbalanced and unnatural hooves. I see toes and quarters that are too long and the right front has heels that are too high.

I would find a good, trimmer, farrier or barefoot, who really knows how to trim hooves correctly and turn him out for a while as Ruby suggested, before I would seriously consider surgery.

I would also do any kind of supportive therapy I could find that has a low risk and shows promise to help.

Often giving the horse time to heal with movement and then later with specifc strengthening exercise will lead to better recovery than surgery in such cases.


I thought it was maybe just he way he naturally is and the result of barefeet transfer (we pulled the shoes off in August) :O
It is - your horse is left sided. The left front gets used and loaded more and therefore is flatter and wider than the RF. It also means it makes it more prone to strain, especially if the hoof form is not correct.

[Ruby G. Weber]

Grazing muzzle=great invention.

[BornToRide]

Ruby, he is turned out from dusk till dawn alternating pasture and paddock. I cannot let him into 24/7 turnout now because there is too much grass (I am in NoCali) and he is prone to colics and grass is too slippery and he is on a clumsy side, do not want another injury to happen :( Also, pastures are 10 acres and he will be sharing with other equines and he has never been in a herd situation before, so we are trying to get them all used to each other from behind the fence first. Are you worried he'd colic from grass? What do you mean about being clumsy?. How does that present? Could he have some neurological issues? Is he not sensible when turned out because he may be getting too much energy from grain?

He loves you very much btw :)

[VirginiaBred]

I have had the surgery done on both of the twins my TB mare had.

See thread:

http://www.chronicleforums.com/Forum/showthread.php?t=38203&highlight=HOLY+CRAP!+TWINS (http://www.chronicleforums.com/Forum/showthread.php?t=38203&highlight=HOLY+CRAP%21+TWINS)!!!

What questions could I answer for you? :)

They were done here: http://keswickequineclinic.com/

I had check ligament surgery done on them first and that didn't fix the clubbing look I saw in each one (opposite front feet of course since they should have been one pony), so Dr. Schmidt talked to me about the Deep Digital Flexor Tendon surgery.

Best advice I ever got. Completely fixed one 100%. The younger twin is 98% perfect. He wears a toe extension and may for another year. Both are sound. I had the younger twin done 10/31/07 and one month later the older one was done. Dr. Schmidt told me to hold off any breaking, riding, etc a full year. I'm waiting longer as I had them done at one year old. There is hardly a noticeable place on their legs either. I did NOT keep them in a stall 24/7. Not at all. They have always stayed out 1/2 day and in 1/2 day.

[Equus_girl]

Thank you for info, VirginiaBred!
Its too early to say if the surgery would be the last resort, but I wanted to do research on the subject early to know what options are available.

[Equus_girl]

Are you worried he'd colic from grass? What do you mean about being clumsy?. How does that present? Could he have some neurological issues? Is he not sensible when turned out because he may be getting too much energy from grain?

He loves you very much btw :)

Thank you :) I love him dearly, he is a very special horse and being my first horse he tought me many invaluable lessons in horsemanship.

I am afraid he might colic if introduced to pasture too soon, there is a lot of grass now :) He will move there eventually, but I thought its better to limit his pasture turnout, although I could be wrong?

About him being clumsy, he is just not attentive (like his dear owner) to surroundings :) If there is a chance to hit his head or butt or any other part of the body on something, he most definitely will. One day he came out of stall with bleeding wound across his forehead :O I have spent 3 hours looking for the cause of it, but wasnt successful. He is not clumsy movement wise, just bumping into things. Its gotten much better now that he spends that much time outside.I do not think its neurological, probably just a part of being Jaxon. We have checked his eyesight and there are no problems either.

Jax is not getting any grain, only hay, beet pulp and biotin supplements. So, thats not the reason. He is just one of those horses who need a work to stay sane and he hasnt had one since April. Without job, he gives himself an excuse to spook at the wagon he sees twice a day, not pay attention to me, and his surroundings. He was simply miserable at the rehab center where I could only walk him around and now being in the country, he forgot all the manners. I could only visit him twice a month, since the place is 120mi away, so only human contact he gets is when getting turned out/brought in/ fed and cleaned. I wish I could find simular place closer to me, but its simply impossible :(( He came down a lot since getting moved (October) and seems to be enjoying the place. I am probably just crazy worried and overprotective. After this injury which came out from nowhere I wish I could put him in a bubble wrap.

[Equus_girl]

Grazing muzzle=great invention.

Duh! Thanks, Ruby! :) I think my brain only registered little ponies in grazing muzzles, and it never came across that horses could wear them too :)

[3Hanns]

Equus Girl- My mare had this surgery about 6-8 months ago. It was performed by Dr. Marinelli in So Cal. Here is is contact info and website:

http://www.calequorth.com

He is awesome, and from what I understand the best at this type of surgery! I would suggest you give him a call especially since he is in CA. He is so honest, and will give you all the info you need to make the decision.

My Mare's injury was to ddft in RF, near coffin bone...she was EXTREMELY lame- head bobbing at walk, and would consistantly rest her RF when in her stall...I decided to do the surgery as a last resort - trying to make her more comfortable

Her surgery went well...she is now mostly sound at the walk, not yet at the trot, but MUCH better...I would say the surgery was successful...I am dealing w/ many other issues w/ her, so she is not ridable, but her ddft is def. better than it was. Feel free to pm me for more info on recovery, cost, etc.

[Equus_girl]

Not good hoof form at all - very unbalanced and unnatural hooves. I see toes and quarters that are too long and the right front has heels that are too high.

I would find a good, trimmer, farrier or barefoot, who really knows how to trim hooves correctly and turn him out for a while as Ruby suggested, before I would seriously consider surgery.

I would also do any kind of supportive therapy I could find that has a low risk and shows promise to help.

Often giving the horse time to heal with movement and then later with specifc strengthening exercise will lead to better recovery than surgery in such cases.
It is - your horse is left sided. The left front gets used and loaded more and therefore is flatter and wider than the RF. It also means it makes it more prone to strain, especially if the hoof form is not correct.

Thank you for taking time to reply, BornToRide! These picture were taken after we moved to a new place and before trimmer saw him. They changed a bit since. If you do not mind me asking you to look at the new set once I take them I would really appreciate it!

I did not want to jump to surgery and he can have all the time in the world to heal, but I would simply hate to hear "there is not a chance of him to recover" again and wanted to know that there are other options available, like a little light of hope :sadsmile:

I will follow your and Ruby's advice and work with BO to make his full move to pasture sooner, it was a goal from the beginning, but we could be taking it too slow.

[BornToRide]

Thank you for taking time to reply, BornToRide! These picture were taken after we moved to a new place and before trimmer saw him. They changed a bit since. If you do not mind me asking you to look at the new set once I take them I would really appreciate it
Not at all, go right ahead :)