View Full Version : Hind suspensories and losing elasticity?

Jun. 8, 2011, 09:24 PM
This may be better placed in the horse care forum, but I usually stick to the eventing forum, so I'll pop it here and let the mods decide.

My one-eyed wonder-pony has been having some issues for awhile. He has always been stiff to the left, but we placed the blame on losing his eye and having (known) decreasing joint space in that left hock.

He ran at Chatt Hills in April and was brilliant. I knew he was due for his hocks in May and he was a little sticky in dressage, sometimes almost missing a beat in his left hind. We did not have footing in any arenas at home and I only noticed this happening in footing.

I gave him some time off and injected his hocks, and he has been in light riding since then because he was just not feeling right- I also switched farriers in that time and we got our arena finished, so there were a lot of factors going on. He was feeling better and then last week he was blatantly OFF. I had the vet out and was hoping we just needed some chiro work, but my gut feeling was not aligning with that.

So, his acupressure points gave a reading for his left ankle, and my vet blocked the foot and bam- sound. He suggested injecting the coffin. He said 80% of horses he injects show drastic improvement.

His secondary concern, though, after that, was that he drags his toes. He felt he was losing some elasticity in his hind suspensory- although he wasn't sure if this was because of the discomfort in his foot or just a condition we're worried about in general.

His recommendation was a week of rest, icing 2x day and surpass on the suspensory, then back to light riding and see what we've got. I've gone to icing and surpassing both hind suspensories because with the improvement I've seen with the soundness, I'm see him moving pretty evenly in the back, (still dragging toes, but he has always moved like that, so I figure if this IS the suspensory/ies, it can't hurt to work on both. I don't know, I'm crazy.)

So, now that I've had two days to process and think and figure and cry and worry, etc, I've have a boat load of questions for the vet, which I'll try to address tomorrow when I call him. But in the meantime, I'm just curious for everyone on COTH's views, stories, input, questions, things I should be looking for, asking etc. I'm just not really sure what I'm dealing with and where I'm going.

My vet implied that this could be career ending- he asked the level we were going and when I told him Novice, he just shrugged and said "maybe..." so I'm trying to wrap my brain around a lot of things. The fact of it is, he's my BABY, but he's going to be a novice horse, maybe training... he's not exactly going to Rolex, so if working him at the N/T level is going to be hard for him and ultimately decrease his soundness longterm, I'd rather drop him down and find him a job (he's mine for life) where he can be happy and comfortable on a longer term. He's only 12, so I hate to think of him turned out as a lawn ornament, but if that is it... then, well, that is it.

Thanks for anything you have to offer!

Jun. 9, 2011, 09:12 AM
There is another thread on the Eventing forum about proximal suspensory surgery... check it out there is lots of advice there!

I am far from an expert but my horse was diagnosed with bilateral hind suspensory injuries (desmitis) and underwent surgery a couple of months ago. If I were you I would probably get the suspensory ultrasounded and discuss more treatment options at that point. From what I understand, the surgery is the very best option for returning to work. I combined the surgery with PRP and my horse is doing extremely well. I would assume that if the damage is fairly minor that your horse may improve with rest and anti inflammatories. However, keep in mind that if you do 60 days of stall rest and then come to find out he needs the surgery anyways you will be 60 days behind the ball...

The problem with suspensories and ligaments in general is the loss of elasticity. It makes hind suspensories so difficult to deal with and my vet said he calls hind suspensories "dumb" ligaments because the lack of regrowth without intervention. That is why he strongly recommended doing the PRP.

I'm not necessarily saying the surgery will be required but I think doing an ultrasound will be the best place to start, and maybe send the ultrasound to another vet for review as well.

Jun. 9, 2011, 09:32 AM
Yes, do check out the thread on proximal suspensory surgery... my mare had it (LH only, hers was an atypical case) and is back to nearly full work (but no jumping) 15 months later. If she drags her toes now, it's a sign I've pushed her a bit.

Jun. 9, 2011, 10:45 AM
Don't get all worked up until you know what's going on. Hind suspensories - if it's that (and you don't really know - it could be a lot of things from general hind end weakness to the other hock etc), can be very treatable. Heck, I had a horse who did both hind suspensories, and he went back to being a solid Prelim horse. But you really can't diagnose through "acupressure points" - this is get-an-ultrasound territory. Figure out what you have, and then you can put together an action plan. In general though, while of course totally disappointing and frustrating, even if it's a mild hind suspensory strain, I wouldn't necessarily call it "career-ending", particularly for a novice horse.

Jun. 9, 2011, 11:10 AM
Yep, get an ultrasound. It will keep you from fretting over some of these what-ifs.

Jun. 9, 2011, 11:42 AM
When I think dragging toes, the first thing that jumps to my mind is weak stifles, not suspensory (and I've had both!).

If he's sound with the coffin joint injection, and is now moving "normally," then I'd take a deep breath and not panic about the suspensories. Ultrasound them for a full diagnosis.

I've had a hind suspensory strain that healed up in two months, never had a problem with it again 6 years down the line.

Jun. 9, 2011, 04:49 PM
Wow, this is exactly what Im going thru rightnow, too. Except its a horse that is just starting out..

Jun. 9, 2011, 05:01 PM
Get an ultrasound to get an actual diagnosis for the suspensory.

I agree with Sancudo that the dragging toes is more indicative of something in the stifle than a suspensory issue, but that's just my experience.

If you're still worried about elasticity in the suspensory, you could look into special shoeing for suspensory issues. They have more support at the toe and thinner branches behind, encouraging the heel to drop a little lower in an attempt to keep the suspensory from tightening up too much.

Jun. 9, 2011, 06:06 PM
I think the vet didn't recommend ultrasound at the time of the appt because he wasn't thinking it was a a tear etc (this is my speculation, because I did ask about ultrasounding and he said not yet). His thought process is that he may be compensating for the pain in his foot, so hopefully with the foot pain cleared up, we may see an improvement in the suspensory-like behavior. I meant to get a little video of him walking around today but forgot.

His main focus was on the left suspensory, he actually never mentioned the right, I'm just treating it because... well... why not? He does drag both toes and always has, although I'm not sure if he's gotten worse as time has gone on? It's hard to tell since I see him daily, but I think I will go back and look at some of his old dressage videos.

As an aside, the accupressure points were not used to diagnose the lameness, it led us to the general direction of the main lameness, and blocking was used to diagnose that it was in his foot. The suspensory was only brought up when he trotted out sound after blocking his foot.

So, if we're not dealing with tears/lesions in the suspensory, will an ultrasound show me anything- aside from the obvious we will KNOW that there is no damage? I'm totally clueless re: ultrasounding and suspensory issues.

Jun. 10, 2011, 08:44 AM
Yes an ultrasound will show you if there is any disruption of the fibers in the ligament as well. Some horses can be really stoic and have significant damage and not show extreme lameness. My horse's injuries were probably from his racing days and just had been exacerbated- we couldn't believe how bad the damage actually was when we saw it on ultrasound. Another thing to note is that my horse didn't have any pain on palpation of the suspensories. However the ultrasound revealed the problem and he blocked out to the suspensories, so we knew that is what it was.

If nothing else, an ultrasound will give you peace of mind!

MTA: Plus, suspensory injuries tend to show up as the weird, vague lameness, not "my leg is broken" lameness like hoof abscesses. That's just in my experience, though...

Jun. 10, 2011, 09:34 AM
I'm going to agree with everyone else. Get the ultrasound, just in case. My horse was occasionally NQR behind, and he has arthritic hocks, so I sort of chalked it up to that, until one day he was really NOT right at all. He had run Prelim a few weeks earlier and although he was his usual excellent self on XC, his dressage was pretty meh and he had an uncharacteristic couple of rails in SJ.
Then a few weeks go by basically fine, and then he suddenly felt off.

We got him in right away for a checkup and they found bilateral high hind lesions.

I did a fasciotomy immediately followed by shockwave. The surgeon told me that this is very typical in his experience -- minor damage on one side, often that you can't see or feel (without u/s), then horse compensates and starts damaging the other side, and can go along without obvious lameness until one day he decompensates.

I had a wonderful outcome -- horse became sound within a short period of time and has been sound ever since. We have not been back to his prior level due to totally unconnected circumstance but he has run Training with zero issues, and the vets tell me there is no reason he can't go prelim again.


I didn't wait around.

I have heard many suspensory outcomes where the issue was either not pinpointed or not aggressively treated early on, and the outcomes seem much more marginal.

Jun. 10, 2011, 10:40 AM
I did the same thing as Asterix- faciotomy/desmopathy with partial neurectomy and PRP as SOON as we found the problem- like he was in surgery 2 days later. Obviously, I wasn't able to find the problem when it onset as we suspect it is an old racing injury. I agree that especially with hind suspensory injuries aggressive tx is the best option. BUT I'm not a vet or expert by any means... just my opinion/experience.

My horse has bad hocks and we chalked it up to that initially as well.