PDA

View Full Version : Recurring hind end suspensory injury



Shadbelly
Nov. 22, 2011, 04:50 PM
Below is a link to a previous thread from 2009. I was wondering if anyone else has done a neurectomy & fascitomy (or knows someone who has done this procedure) since then. This is what my vet is recommending for my gelding with a hind leg high suspensory injury. He tore his suspensory many years ago and somehow he has done it again despite all efforts to wrap him in bubble wrap. I've googled it and seen some really positive personal experiences and satisfactory clinical results.

Any info would be helpful! thanks!

http://www.chronofhorse.com/forum/showthread.php?t=225589

Herbie19
Nov. 22, 2011, 04:59 PM
We currently have two horses at my trainer's barn that have had bilateral faciotomies/neurectomies. Both are sound and returned to their original level of work. I will say that these were "original" injuries and was told by my vet that the prognosis is not as good if the suspensory doesn't heal well the first time. Best of luck.

ElisLove
Nov. 22, 2011, 07:16 PM
My older horse strained his front suspensory, did shockwave therapy. It healed and we slowly brought him back into work. A year later he strained it again, more shockwave therapy, healed and brought back to work. We never went back to what we were doing before (used to do 3'6, after he strained his suspensory a second time we did 3'3) but he stayed completely sound from then on. 2.5 years later and I just sold him. The vet who did the prepurchase (who knows my horse) could not feel ANYTHING on that suspensory and when he flexed him he took one step lame then was fully sound (and my horse is 13 years old so that was quite a good flex for a horse that age)
Have you tried shockwave?

Shadbelly
Nov. 23, 2011, 08:09 AM
thanks for the responses!

I have not tried shockwave. My vet recommended this over shockwave since its the second go-around. I have heard that the prognosis is lower if its a re-injury.

quietann
Nov. 23, 2011, 10:30 AM
Lots of experiences, mostly positive, including my own, described on this thread in the Eventing forum:
http://www.chronofhorse.com/forum/showthread.php?t=271451

Also feel free to join the thread if you go ahead with the surgery.

ljo
Nov. 23, 2011, 10:38 AM
My vet always had me do the labor intensive 3 days of sweat wraps followed by 3 days of alcohol wraps and keep alternating until your horse shows improvement. I think I've done it for as long as 2 weeks, maybe longer.
It's an old fashioned cure, but it works!

cmcrill
Nov. 23, 2011, 01:12 PM
I have an 13 year old warmblood gelding that had these procedures last year by Dr. White at Leesburg. They did the fasciotomy first (that is what Dr. White believes in), horse went sound and a few months later was lame again (it was bilateral high hinds). He then needed the neurectomy, so that was done and after a few months of rehab horse is now sound. I do give him previcox every day for his overall comfort. Have not shown him again but probably could (he was a 3' hunter). Whether to do the procedures or not depends on the extent of the suspensory injury. Interestingly I had a mare around the same time that also had a high hind suspensory that healed with multiple shockwave treatments and gentle rehab under saddle, but her injury was more mild - just swelling of the suspensory, no core lesions like the gelding had. In a recurrent injury, the recommendation for surgery is probably a good one. If you decide on surgery, I would do both the fasciotomy and neurectomy at the same time, I wish they had recommended that for me and it would have saved me another surgery. Apparently the nerve that goes to the hind suspensory is in a very narrow channel in the leg and it tends to get inflamed and causes the soreness, so many vets do it at the same time as the fasciotomy. I am happy I had the surgery done for him because otherwise you can spend months up to a year trying more conservative approaches and end up back to square one, horse still lame. They gave me a success rate of 80%. I feel pretty good that both my horses came back. I've been very happy with Kent Allen's evaluations too, they've always been spot on for me so you could get an opinion there if you haven't already.

Herbie19
Nov. 23, 2011, 03:41 PM
I have an 13 year old warmblood gelding that had these procedures last year by Dr. White at Leesburg. They did the fasciotomy first (that is what Dr. White believes in), horse went sound and a few months later was lame again (it was bilateral high hinds). He then needed the neurectomy, so that was done and after a few months of rehab horse is now sound. I do give him previcox every day for his overall comfort. Have not shown him again but probably could (he was a 3' hunter). Whether to do the procedures or not depends on the extent of the suspensory injury. Interestingly I had a mare around the same time that also had a high hind suspensory that healed with multiple shockwave treatments and gentle rehab under saddle, but her injury was more mild - just swelling of the suspensory, no core lesions like the gelding had. In a recurrent injury, the recommendation for surgery is probably a good one. If you decide on surgery, I would do both the fasciotomy and neurectomy at the same time, I wish they had recommended that for me and it would have saved me another surgery. Apparently the nerve that goes to the hind suspensory is in a very narrow channel in the leg and it tends to get inflamed and causes the soreness, so many vets do it at the same time as the fasciotomy. I am happy I had the surgery done for him because otherwise you can spend months up to a year trying more conservative approaches and end up back to square one, horse still lame. They gave me a success rate of 80%. I feel pretty good that both my horses came back. I've been very happy with Kent Allen's evaluations too, they've always been spot on for me so you could get an opinion there if you haven't already.

We are actually going through this same situation with a horse at my farm. He had a faciotomy only (per the recommendation of his old vet) last September and came to me for rehab. Unfortunately he did not stay sound very long despite doing every bit of the rehab by the books. The vets feel that even though the lesion has healed that scar tissue near the nerve is causing the lameness--we will be repeating the surgery with a neurectomy this winter.

cmcrill did Dr. White do your horse's neurectomy? I was under the impression that he did not like to do them. But my vets have always told me that the nerves are so close to where they make the "cuts" for the faciotomy that you might hit some of them in the process--so you might as well take care to them all while your horse is on the table. Apparently it's a controvertial procedure. Glad to hear your outcome was positive.

cmcrill
Nov. 24, 2011, 09:48 AM
Herbie19, Dr. Norrie Adams did the neurectomy at Leesburg. You're right, apparently Dr. White does not believe in doing them - I think Dr. White is a great vet, but I wish he had told me about this potentially being an issue down the road. If I had not done the neurectomy, I would not have a useful horse at this point. I can only assume it is controversial because if there is no sensation in that area (after the neurectomy), the horse may not feel pain if there is a recurrent suspensory injury. But obviously if the horse is lame and the suspensory is healed after the first procedure, you have no choice.

Herbie19
Nov. 24, 2011, 11:26 AM
Herbie19, Dr. Norrie Adams did the neurectomy at Leesburg. You're right, apparently Dr. White does not believe in doing them - I think Dr. White is a great vet, but I wish he had told me about this potentially being an issue down the road. If I had not done the neurectomy, I would not have a useful horse at this point. I can only assume it is controversial because if there is no sensation in that area (after the neurectomy), the horse may not feel pain if there is a recurrent suspensory injury. But obviously if the horse is lame and the suspensory is healed after the first procedure, you have no choice.

Our horse is definitely healed and is still lame--blocks to proximal suspensory :(

Dr. Adams will be doing the neurectomy on the horse we have too--I only wish I had been involved pre-op on this horse because I would have made the owners aware of this and then let them make the decision. I just hope that's it's not too late for this horse :( Glad to hear that you had a successful second go round!

Dr. White is an amazing surgeon--I waited two months for him to remove a chip from my horse's ankle when he broke in Florida one winter--he only deserved the best :)