UPDATE after u/s - Peppy has a suspensory injury

[LDavis104]

Update - Peppy had the ultrasound this morning which showed mild tearing. Could be worse! Vet wants to do another u/s in 6 weeks.

So after two weeks of on and off again lameness, had the vet out this morning and Peppy has been diagnosed with a right front high suspensory injury :cry: I will make an appt for him to have an ultrasound next week so that we'll know whether it's a strain, tear, etc. He's now begun his stall rest, leg wrapping, vet said handwalk ~30 mins a day, and is on 6 days of bute.

So looks like I'll be doing a lot of COTH research on suspensory injuries! I'm so bummed. I guess I should be thankful he's only four and I have a wonderful barn owner and barn-mates who will help should I not be able to make it to the barn some days.

:cry::cry::no::no::cry::cry:

[Peggy]

You have my sympathy, esp as I went down that path last spring. It will end.

[CatchaBreeze]

Hang in their! I rehabbed a horse for sever tendon tear last winter and she is sound and back to normal.

Sounds like you have a good vet. UC Davis has some good material published on suspensory injuries.

You might want to take look at Back on Track legs wraps.

Keep the rehab up and maybe ice down after therapy. I made ice cubes in dixie cups and ice massed the area immediately after therapy for about 20 minutes. Then wrapped it for support. County supply was good source for vet wrap. I went through a case of it.

You will get your horse back with patience and stay on the therapy.

[SFLAhorse]

Hi LDavis,

Sorry to hear about this. I would check out some PRP treatments for this injury. A company named VetCell has a PRP system that has done very well with suspensory injuries.
Here is a link:
http://www.vetcell.com/vetcell/technology/acelere_fprp_system.aspx

I have some friends that have used this product and the results were great.

[horsepoor]

Can you really diagnose such an injury without an ultrasound? Did they do any blocks or anything on the leg to whittle it down to that?
I've dealt with a front high suspensory injury in the past, and it certainly isn't the end of the world and there is a very good chance of full recovery. We did shockwave and that really helped, from what I understand. But in the course of diagnosing this, my vet did a full lameness work-up, including blocking to rule out everything else it might be (and there is some reason that when you do the blocks, and move up the leg, the lameness gets worse and that can indicate even more so it is the suspensory, but that was awhile ago that we did this so I can't remember the details). After all that, we ultrasounded both suspensories (good and bad legs to compare) and it was only then that my vet was willing to give a definite diagnosis and treatment plan.
In my case, the horse made a full recovery and was back jumping about 2 years later -- all with regular exams and the full blessing of my vet. I actually went much slower with him than the vet was suggesting, and was extremely careful about what footing I would work on and which I wouldn't. But he reinjured it -- in his case, he has a conformational flaw that contributes to uneven loading of the suspensory, and that coupled with what will always be a weak spot in the suspensory proved to be his downfall. So we treated with PRP this time, he's rehabbing again and going well and likely will be a flat horse only (my decision - vet still thinks he could jump but I won't take the risk). But again, he had more than just the injury going on, but also a slightly club foot and crooked leg.
Will be interesting to hear what you find when the horse is ultrasounded.

[LDavis104]

Can you really diagnose such an injury without an ultrasound? Did they do any blocks or anything on the leg to whittle it down to that?


My vet did the lameness exam w/ flexion test, jogging, lunging, etc. to narrow it down to a particular leg. Then he did the blocks on that leg working his way up. Blocking the foot made no difference, blocking the high volar made a slight improvement, and the suspensory block/infusion made him completely sound.

[Bayou Roux]

Hang in there...it's a long road, but there is a finish line.

You'll find lots of good info here on CoTH, as elsewhere on the internet. Trust your instincts as you digest it all in coordination wtih your vet's advice.

It'll feel like forever, and there will be setbacks. But with good care, time will be your friend.

Good luck!

[horsepoor]

My vet did the lameness exam w/ flexion test, jogging, lunging, etc. to narrow it down to a particular leg. Then he did the blocks on that leg working his way up. Blocking the foot made no difference, blocking the high volar made a slight improvement, and the suspensory block/infusion made him completely sound.

Having gone through this twice now, both times we had the horse get progressively worse as we blocked the foot then the next one up (abaxial? I can't remember what it is). I remember this because the first time, my vet told me that might happen and it was something odd he had found with suspensories, so when it happened the second time, I knew without my vet telling me what the verdict was. We did not do the suspensory block because I think that means you can't u/s that day, unless I'm remembering wrong.

But anyway, you'll know much more once you have the ultrasound. Can your vet provide treatment options such as shockwave, PRP, etc? If not, you might explore options for such treatment as they really can be helpful. I had insurance the first time out so that helped with the cost.

But first, find out for sure what you are dealing with -- good luck with that!

[Eventer13]

My vet did the lameness exam w/ flexion test, jogging, lunging, etc. to narrow it down to a particular leg. Then he did the blocks on that leg working his way up. Blocking the foot made no difference, blocking the high volar made a slight improvement, and the suspensory block/infusion made him completely sound.

There is a chance that it blocked more than just the suspensory (it happened to my horse). Its rare for this to happen, but not impossible. Def. do the ultrasound to confirm. You may have less of a problem on your hands then you think.

[Rescue Pony]

Yeah hang in there! There is a end in sight!

I recently had to send my 5 year old paint Lucy to my mother's for a year (insidentaly her first name before we got her was Peppy)......she has presuspensery issues......just grew to fast after being "rescued" and properly fed...so had to take a year off before we can think about any work to allow her to heal. Vet said a year before jumping again and a year of trails would be a perfect thing to help her before the issue.

Do you know if this was brought on by work or was Peppy just prone to it like Lucy growing to fast?

[LDavis104]

Do you know if this was brought on by work or was Peppy just prone to it like Lucy growing to fast?

Thanks for all the words of wisdom everyone... I'm def looking forward to seeing what the ultrasound shows - I would be so happy if somehow it was a mistake and it wasn't the suspensory after all.

Rescue Pony - I have no idea how Peppy would've pulled the suspensory, he doesn't move any faster than you make him, and we were jumping 2 ft once a week. Not sure if it was out in his snowy paddock or just landed wrong from a jump or how it happened...

I feel so bad for him...

[SonnysMom]

I am dealing with a high hind suspensory on my horse. He had PRP done in late Sept. It seems to be slowly working. But he is 17 years old, we are trying to rehab a tear that happened about 6 months before the PRP treatment that wasn't healing with the original vet's protocol. Sonny also tore the suspensory away from the bone a bit at the top origin point and damaged the bone.
Lots of stall rest and hand walking. He is also getting turned out into a small indoor that is a about the size of a round pen. He is reasonable quiet in there.
Based on my experience with the first vet's protocol and the lack of healing that I had with that protocol I would suggest doing shock wave or PRP to help the healing.
As an FYI the PRP, ultrasound, initial lameness exam, xrays and lots of drugs for sedation cost about $1,200. In addition to the PRP he had micropicking done to the bone to encourage it to heal so he had to have additional sedation for that. I had it done at Mid Atlantic Equine.

[Lori B]

Good luck, SM, on again off again lameness will eat your brain, don't I know it.

[LDavis104]

Update in original post.

[marta]

shockwave? anything?
take it easy. front suspensories have much better prognosis. and if the tear is mild, i'm sure you'll see great progress in 6 weeks.
my mare is still rehabbing from a bad hind suspensory tear. her first follow up u/s (6 weeks or so) didn't show any improvement. at that time she already underwent 2 shockwave sessions. she had the 3rd shockwave session that same day. we also started walking her. 6 weeks later u/s looked much better and clinical improvement was dramatic. she keeps improving. it's been 10 months so far.

[horsepoor]

Darn! But at least, like you said, it could be worse. Everytime I mentioned my horse with the suspensory injury, people would ask "front or back?" and then be so relieved when it was the front.
The prognosis for a front high suspensory is very good. My vet said something at the time about 90% of the horses with this type of injury return to full athletic performance (or was it 95%?). Anyway, he was very optimistic and my horse did come thru the first injury great -- it is just his bad luck that he has a very crooked leg athat likely contributed to his reinjuring it. I'm hoping your luck is better!
Was shockwave mentioned as a treatment option? If you have that available to you, it can really help things along.

[LDavis104]

The vet did mention shockwave as an option if Peppy didn't improve as he should with just rest. He also mentioned the other treatments where they inject something into that area, but said it was also expensive.

So the plan is to just let rest heal it, and if i need to, shockwave. But hopefully just the rest/handwalking/time/patience will do the trick.

That does make me feel better what everyone is saying about front high suspensories having a good prognosis for a full recovery!

[Peggy]

Star's high suspensory injury (area 2B in ultrasound) healed so well that not only did the ultrasound look great after two months, but just over three months later when we got a nuclear scintigraphy done to diagnose the lingering lameness in the feet, the now-apparently-healed suspensory didn't light up at all.

<small break while cable guy installs new modem>

The protocol my vet gave me for Star what pretty much what the OP describes. Hand walking. Cold hosing for the first 2-3 (?) weeks, bute for about 10 days, wrapping. We weaned him off the wraps after the first month by having him wear them at night but not during the day for about a week.