Suspensory Injuries and turn out

[WishIWereRiding]

So my horse had a bad left hind high suspensory injury in the end of August, had surgery (fasciotomy, bone marrow injection, neurectomy) mid November, and just this week we have started tack walking.
What I want to know is for those that have rehabbed a horse with a suspensory injury, when were you allowed to turn out your horse? He's been on stall rest with hand walking.
I asked my vet a while ago when he could be turned out and the response was, "when he's sound." When the vet came 2 weeks ago to check him, he called him sound, but no turnout yet. I figure I'll ask my vet again when I see him in a month or 2 (I just don't want to bother him with another phone call).
Were you allowed to do 1 or 2 hours a day initially? Did you wait until you were cantering? If your horse had surgery, was the vet more conservative? My horse is an 8 y/o TB, and I think he's getting sick of being in his stall! As it is he gets oral ace twice a day in his grain, and IV dorm for tack walking.

[asterix]

I had bilateral version of what you had, although it sounds less severe (no bone marrow, but did the fasciotomy). We had the procedure done in June 09, and he was sound by I think his August checkup. Our turnout schedule did not depend on being sound (although had he not come sound, I'm sure it would have been delayed), but on the vet's long experience with these injuries (he's a specialist).

We did 30 days stall after the surgery, 30 days handwalking, 30 days walking under tack. When we started walking under tack, he started on turnout -- just an hour at a time, at first, small paddock.
He was going out all day in a medium sized paddock with a quiet buddy by October, so I think we spent 2 months working up to that. At the end of December, 7 months out, he went back to 24/7 turnout with a big herd in a hilly field.

It is a slow process, but it is worth it!!!

[WishIWereRiding]

I had bilateral version of what you had, although it sounds less severe (no bone marrow, but did the fasciotomy). We had the procedure done in June 09, and he was sound by I think his August checkup. Our turnout schedule did not depend on being sound (although had he not come sound, I'm sure it would have been delayed), but on the vet's long experience with these injuries (he's a specialist).

We did 30 days stall after the surgery, 30 days handwalking, 30 days walking under tack. When we started walking under tack, he started on turnout -- just an hour at a time, at first, small paddock.
He was going out all day in a medium sized paddock with a quiet buddy by October, so I think we spent 2 months working up to that. At the end of December, 7 months out, he went back to 24/7 turnout with a big herd in a hilly field.

It is a slow process, but it is worth it!!!

My vet is also a specialist--probably the best you can get around here, and has treated many grand prix show jumpers with the same injury with great success. I think he is more on the conservative side. We did 3 months of stall rest with hand walking before progressing to tack walking, which we just started this week. Honestly, I'm not too interested in turning out right now because we are getting a foot of snow today, and my horse doesn't have snow shoes (obviously no need). But if the footing is dry and decent in a month or two, it would be nice to turn him out for an hour or so at least. I don't think he would do anything too stupid since he is getting ace with his grain.

[retrofit]

My horse had bilateral fasciotomy surgery for hind suspensories in Oct. '08. He didn't heal well from the surgery until he had PRP therapy in Feb. '09. One month after the PRP therapy, even though the vets were still not totally pleased with his progress, I was told to start walking & trotting under saddle.

Problem is, he had been on stall rest with hand-walking only for 5 months. He was INSANE. There was literally no way to start him trotting under saddle without turnout - not even ace or resperine was helping at that point. I couldn't do daily IV shots - long story but has to do with the way my horse reacts to needles.

Thankfully he is very quiet and predictable on turnout so at that point, I put him back on daytime turnout. I was at a big boarding place at the time - with no control over the other horses' schedules - so I just put him back on all day turnout, like the other horses. I could have done 1 or 2 hours but knowing my horse, he still would have been very upset at the long hours in the barn alone. And besides, he is better off grazing quietly in the paddock than spinning around his stall. It was one of those things where his mental health (and my safety) had to factor in somewhere. If he was less predictable on turnout, I would have had to wait on both turnout and his rehab.

Good luck!

[simc24]

My horse had a pretty severe hind suspensory and tendon injury last spring. He didn't require surgery, so I'm sure his rehab wasn't as extensive as yours may be, but I'll throw my two cents in. I read everything I could get my hands on about tendons and ligaments, and I'd love to share it!

He was on 5 weeks stall rest- he only came out to hand graze. At ultrasound #2, he was cleared by my vet to go into 30 days small pasture. We set up a temp fence about 20'x40' right outside his stall, so he had free access to both.

Once he went on the small pasture, we started handwalking. Started with 5 min/day and added 5-10 min each week until we got to 45/min day. (Handwalking a cranky horse in 100 degrees is not very fun, btw) Be very careful to walk him on very flat, very solid ground only! I actually dodged around potholes when handwalking! And my vet was very particular about his walks consisting of "marching" and not "strolling" around:winkgrin:

After that 30 days, ultrasound #3 was encouraging, so out in regular pasture he went. We started turning him out in the arena for 1-2 hours/day. We did that about a week to accustom him to being out, then out he went in the regular pasture. I actually went about introducing him to full pasture pretty stupidly and he ran around like a lunatic scaring me half to death. Thankfully he didn't reinjure himself.

The secret to rehabbing from this kind of injury is controlled exercise. You can't do too much for obivous reasons; you also can't do too little because his ligament has the potential to heal very tightly, in which case he'll never have full extension. It is imperative to do exactly as your vet says.

I am not a vet and I know all situations are different, but I feel pretty strongly that some horses don't come back from these sorts of problems because they are not rehabbed correctly to begin with. It really is a lot of work, and it's not something you can bail out on. My horse came back 100% and is progressing well in his jumping training. It's an on-going thing though. Every single ride I spend easily 20-30 minutes walking and light trotting to warm up his soft tissue before I really put him to work. You have to avoid bad footing at all costs. I also avoid very uneven footing (like potholes) like the plague. Running my eyes and hands over that tendon and ligament to check for abnormalities has become second nature to me.

Sorry if I got a little too long-winded:winkgrin:. Good luck with your guy!

[WishIWereRiding]

Thanks for the info so far! My horse is keeping it together so far with the ace. Although when we are hand walking he loves to jump if he gets startled with a loud noise or something. Mentally I think it would be great for him if he could get out for an hour or 2. The stall windows are all shut to keep the barn warm, and we can't leave his door open with the stall guard up because he chews on and moves the tack trunk that is adjacent. Plus he's right in the middle of the barn, so his head would get in the way when horses are being moved in and out. (I'm not moving him because his stall is a little bigger than others.) Fortunately he does walk around his stall a bit (which is about 11 x 12' or so). Nothing neurotic, just moves around. And this past weekend the poor guy was whinnying all day--I think he just wanted to go out!
Right now the footing is either snowy, ice, or mud, so I'd want to wait to turn him out anyway.

simc24--thanks for your input! While my horse had a bad injury according to the ultrasound, we opted for surgery because the horse is insured, and it would give him the best chance at recovery. If we waited to see how he did without surgery, it wouldn't be covered the next policy year. The vet doesn't even want to ultrasound him until like April, which will be 4-5 months after the surgery.

[Beethoven]

While my horses was not a serious as your sound. We never did stall rest. We kept him on his regular schedule so he would never get all the pent up energy and feel the need to be crazy. He went out alone for a few months in a smaller area but got bored of that so went back with a buddy. We are back to w/t/c under saddle. He injured himself in June. It was just a strain.

We shockwaved as treatment but that was it.

[simc24]

I'm sure you've already got this covered, but I actually kept a little armory of toys to rotate in his stall so he'd never get bored. I had different salt licks (they all seem to love those pink himalayan ones) and hangings toys, etc, that I'd change out ever 3 or 4 days. Makes you feel like you're at least doing something to help occupy the poor thing.

[FineAlready]

Ah, suspensories. My horse is in month 7 of rehabbing a right front suspensory strain. We started tack walking maybe a month and a half ago. Before that, we were walking twice a day on a progressive schedule, ending with twice daily 30 minute hand walks. We are up to 2 and 1/2 minutes of trotting now in addition to a half hour of under saddle walking. No mention of turnout yet, but it has been hinted to me that he won't be cleared for turnout until he is in full w/t/c work under saddle. I'm 100% fine with this (though he can be a nut for our rides!). That said, my horse is four and an OTTB. He plays VERY hard outside, and I think that is how he got hurt originally. The ground here is covered in ice/snow right now. I feel like putting him out right now would be like taking a knife to the ligament intentionally. So, we will wait. I'm hopeful that he will be cleared for turnout by perhaps May or June. Hopefully the ground will be in better shape by then as well. That will be about a year after his injury.

If I had a horse that I was SURE would be able to keep it together in a small paddock, I would probably be more willing to try it. With my little maniac, I'm just too afraid to try!

[WishIWereRiding]

Yeah, he has a jolly ball that he has no interest in. He has a lick-it that he doesn't lick/chew at all unless I take off the top piece. And when I do that it's gone in 2 days. I think I'll get him another Uncle Jimmy's hanging ball because the one I got him for Christmas lasted almost a month!

[marta]

she had a suspensory tear with avulsion and a sesmoidean ligament tear in LH. given her stoic nature the vet allowed her to continue with turnout in a small paddock. she did not undergo surgery, however. we treated with shockwave. fasciotomy was the next step but it ended up healing well on its own. had she underwent surgery she would have been confined to the stall for 1 month.

she now has a much less serious tear in the RH. left her in the paddock turnout again.

there are two schools of thought on the turnout during the healing process. my vet is v. conservative and had i not asked she would not have even considered the turnout.

i would certainly think that by the time you're walking under tack you could turnout.

[touchstone-]

My vets' advice was a pen under 20'x20' is ok once they start walking, but hold off on anything bigger until they're cantering under tack. If your horse is not yet "allowed" to canter, but does in the paddock, then you risk reinjury. That said, I am a *big* believer in the small pen turnout. It does wonders for the horse's mental health.

[frisky]

My horse was diagnosed with a left high hind suspensory problem at the insertion point in August. It had been going on for some time though.

She went on stall rest for a month. No walking. After the first month, we started hand walking beginning with three minutes and working up to two 30-minute walks a day. My horse was grumpy at times, but still a star. She has a window that directly looks out on the indoor and outdoor arenas, so there is something to watch. The people were more difficult as they all told me how they thought that I should loosen up and turn my horse out. It was tiresome to hear.

Just after Christmas, my horse was revetted. The ultrasound and jogging showed improvement, however, my horse was most definitely lame. The vet okayed walking under saddle. We are now up to 12 minutes of walking. I also handwalk or pony for a half hour from another horse when I have time. The original idea was to begin turnout after my horse was doing serious walking. However, because of some setbacks (snow), I decided to turn my horse out in a small pole paddock. It's only slightly bigger than her stall and she's surrounded my other rehabs (two other suspensories!) and quiet types. I think my horse is reliable and the movement has helped.

My horse is twenty this year. Her injury is pretty poor and I'm not doing anything but giving her every opportunity for time. I am probably choosing a conservative path. I've listened to my vet and I'm also listening to my horse. I guess they're all different.

[buschkn]

I think mine was back on 24/7 t/o within a couple months. He had a significant tear LH but was never very lame, was found on a PPE actually. Did fasciotomy, desmoplasty, neurectomy and ACell. I turned him out in a 12x12 panel stall that I would rotate around so he could eat grass from the start. Gradually increased the size of that so he was turned out alongside the fenceline of the others, then to full turnout 24/7 after probably 2 months in the stall.

I am a FIRM believer in the benefits of turnout. He had an ultrasound before going to show in FL and it is totally normal. They said with his injury it never would be. The vet was amazed and she is an ultrasound guru.

Personally I think all the movement helps the fibers heal properly and in line and with less scarring. When they are on full turnout they are less likely to act stupid when you put them out. JMHO.

[Pascova]

We built my horse a portable paddock with electric tape and "step in" fence posts-- the paddock was about 3x the size of a stall and we put a pony in their to keep him company. We moved it every day or two so they would have grass. It kept him sane, as well as us. We also gave him injectable resurpin once a week for awhile...... he is a TB.... good luck....

[grayarabpony]

I would base turn-out on the ultrasound and your turn-out situation...

Smallish turnout, one other quiet horse, out all of the time or hand-walked/grazed a good 20-30 minutes before turn-out worked for my horse. If an injury isn't too bad I want the horse strolling around to help try to rebuild healthy tissue. Many horses just end up twirling around and around in a stall, even if it may be in slow motion.

[marta]

what nerve do you sever? what's the idea behind it?

[Gry2Yng]

I had a LH high suspensory. No turnout until he was cantering under tack. He came back 100%. Previous to the injury he was an intermediate level event horse. Previous to the injury I was an intermediate level event rider. He tore the suspensory a few weeks after my daughter was born. I am no longer an intermediate level event rider and the horse is now 18. He has done a novice ht and some second level dressage and 3' jumpers. 2 years later, I no longer worry about the suspensory. I suspect I could get him back to prelim, but I have a nice 5 yo and no reason to push the old guy. Good luck to you. It is a terrible catch 22 these horses put us in. My vote is to try and suck up the restricted turn out as best you can, unless you can get them on grass in a 12x12. Anything they can pick up a trot in is a risk in my book.

If you have the luxury of time, 24/7 turnout is probably the best once you get a decent ultrasound. Takes longer, but probably heals better and they just don't get as stupid.