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  1. #1
    Join Date
    Sep. 29, 2007
    Posts
    478

    Default Recovering from Collateral Ligament Injury

    Hi,

    Does anyone have any experieince with coming back from a severe colllateral ligament injury in the hoof. My horse was off almost a year - but has been back in full work for 6 months and is sound.

    My question is: what kinds of things should I be doing / avoiding to minimize the risk of re-injury? And do studs help or hurt the situation?

    thanks



  2. #2
    Join Date
    Aug. 22, 2000
    Location
    CT
    Posts
    2,645

    Default

    My horse likely had this in conjucntion with other injuries. Didnt do MRI, but vet felt there was a problem there. With the various problems he was laid up for about 18 months and then slowly brought back to work.
    For his feet, vet & farrier went with wide webbed shoes (eggbars, but that may be due to other issues) Excellent lateral balance was essential. No traction devices except the very minimum in the snow/ice season - didnt want any torque. He had solo turnout in a small paddock with the most level footing possible - and without playful over-the-fence buddies. When coming back to riding I was to avoid small circles and lateral work at first and reintroduce it slowly and carefully.
    With careful management my horse has been sound for two years



  3. #3
    Join Date
    Sep. 29, 2007
    Posts
    478

    Default thanks for replying -more ??s

    We had a very ugly MRI as proof - almost severed. Frankly, it's a surpise he's come back @ all. What kind of riding do you do? I am en ex-eventer. I've been doing dressage only with him since he's come back. While we've worked up to it slowly he's doing 10m circles etc. now... i'd like to start jumping him, but I'm afraid.

    Are you jumping at all?



  4. #4
    Join Date
    May. 11, 2002
    Location
    S Ctrl Kentucky
    Posts
    3,440

    Default

    Sorry to hear about your horse's injury, but happy to hear he's come back sound! Definitely getting the correct angles is very important to keeping him sound. My guy only sprained his, he did it tripping on something in the ring. So definitely make sure you have good footing with NO rocks in your arena.

    Good luck and here's hoping he stays sound for you.
    RIP Full Metal Jacket "Jack" 1998 -2/27/09
    RIP Salisbury Hill "Ted" 1979-4/2/10
    "God have mercy on the man who doubts what he's sure of" -Springsteen



  5. #5
    Join Date
    Feb. 9, 2004
    Location
    Sunny CA
    Posts
    4,594

    Default

    Bodie has a lateral Coll Lig tear. He stood around in a smallish area for almost a year! I am happy to report he is sound after a year of being ridden! He lives at an eventing barn and is out on the XC field 5 days a week, jumping about 2 days! I feel lucky that he recovered. I will add we do not let him out on his own and he lives in the barn in a small pen and 1/3 of the indoor arena at night. No running wild on the uneven ground for him!!

    I am lightly touching wood as I type! I have read that recovery rates have to do with wear the tear was located!

    Just keep up your good ground work and jump him I say!! Bodie is 17 so I figured what was I saving him for!!

    Good luck!!
    Steph

    http://community.webshots.com/user/stephanne014

    Rerider/Haydunker Clique

    RIP Barbaro, you were my hero!



  6. #6
    Join Date
    Apr. 13, 2007
    Location
    North San Diego County, CA
    Posts
    1,068

    Default

    How did any of you do follow-up to check on the ligament healing? Did you wait for clinical soundness to add more work (longer handwalk, mounted handwalk)?

    My mare tore her coffin bone ligament so it's way down in the hoof. The equine hospital said to haul back up for a 60-day ultrasound, but I am really debating the value of that, since only the top part of the ligament can be seen.

    jan



  7. #7
    Join Date
    Sep. 29, 2007
    Posts
    478

    Default

    I did an initial MRI to diagnose it. I put him on stall rest fpor 4 months - which was a disaster. He was miserable and we couldn't even handwalk him for all of the standing on 2 legs! I did another MRI, and they said retire him - it had actually getten worse.

    So I just turned him out for a few months. I didn't really expect him to get better, but at least he was happy. I actually brought him in to try to rehab him only because he'd gotten so fat, I was worried about laminitis and foundering. My plan was to go until he should pain, then turn him out again. He never did. we started with handwalking, then mounted walking, then 5 min of trot and so on. He'd been moving and even galloping in the field (until obesity set in).

    He's been in full flatwork for 6 months - no MRI. I knod of don't want to know. If he shows pain or unsoundness - I'll deal with it. By the way, I've friends get MRI's on their horses - the news is rarely good, so you have to mitigate it. It see's in such detail - all of the imperfections are clear - even those that may never pose an issue for you.

    good luck & thanks all for the good advice. I have good footing and have only walked him outside the ring. I will start him over cavaletti, then gymnastics soon.



  8. #8
    Join Date
    Sep. 29, 2007
    Posts
    478

    Default ps

    my experieince has been that ultrasounds for hoof injuries is only directional anyway. I'm not sure you'd get value for doing it. You really need an MRI to be clear - and I'm not sure that's worth it if you have a good clinician. Most of the injuries it could be are treated the same way, I don't know if it helps to know the details as far as treating goes.

    Had to do over, I would have just turned my horse out when he injured and forgone the rest.



  9. #9
    Join Date
    Apr. 13, 2007
    Location
    North San Diego County, CA
    Posts
    1,068

    Default

    Thanks for the feedback, it is echoing my thoughts. I did have the initial MRI and know it's a 25% tear of the coffin bone ligament; I'm just failing to see the benefit of a follow-up ultrasound if it can only see the top part of the ligament and the tear is at the bottom part.

    The two questions that plague me about progressing are: should one progress by adding more time, more weight, or more diversity (to the footing,)? And, should one progress from handwalking at all if she is still off at the trot?

    She has always been, and continues to be, perfectly sound at the walk. I haven't trotted her to see if she has improved because my vet advised me not too. (I believe the thought was not to trot until the ultrasound says it's okay -- though I am not sure how the ultrasound will show that - and I certainly don't want to break anything.)

    But if I elect to skip the ultrasound -- do I add progressively add more weight and stay on the paved roads, or do I progressively add more time in the arena where the footing is sand?

    I agree about preserving medial-lateral balance, so my instincts are to add more weight first; but I tell ya, we have limited paved roads and though she has been a saint, another two months on the same "track" will make us both looney!

    jan



  10. #10
    Join Date
    Aug. 22, 2000
    Location
    CT
    Posts
    2,645

    Default

    We do dressage. Didnt do more than trot over crossrails before, and do even less of that now.
    My vet's advice was to add either time or difficulty slowly, going at least a week before another step, but never add both together. Excessive high spirits are healing's enemy, but so is fatigue, so it is a fine line. To this day, I am careful of not riding until he is really tired as that is when he is more prone to injury. I gained a few (okay a LOT of) gray hairs early in rehab when he would leap about or spook. I stopped breathing every time he did a stupid move, but we did both survive. I was told to stay on good footing in our arena - not too hard and especially not too deep. I was to avoid any footing that was uneven or slippery. I dont think we attempted a 10 meter circle for two years!
    Again, my horse's program may be different because he also damaged his cannon bone, suspensory, and check ligament as well! Just talented that way...



  11. #11
    Join Date
    Jul. 18, 2006
    Posts
    410

    Default You guys have given me hope.

    I too am dealing with the same injury, diagnosed through MRI. I was given two choices. OK, well three.

    Stem cell surgery, shock wave therapy - both with anywhere from 8 to 16 months complete stall rest OR nothing. The treatment options only gave about a 30% chance of full recovery and to be effective I was told that unless he was on full stall rest, the treatment would be futile.

    He was miserable on stall rest and actually was in danger of hurting himself being couped up,so that didn't last long.

    I've accepted he'd never be fully sound and just happy he'd be pasture sound and have just turned him out. It's been four months. I'm just letting him be a pasture puff for a while and see what happens.

    He's comfortable and happy just hanging around. BUT I would be so happy if he was sound to do a little bit of flat work and maybe an easy trail ride. I know he'll never be a jumper again which is OK with me.

    But hearing you guys and your happy stories has given me hope.



  12. #12
    Join Date
    Feb. 11, 2007
    Location
    Ontario, Canada
    Posts
    45

    Default

    Blue&Blond,
    I had similar problem with my mare's ligament. The stall confinement did not help: what was cured with the rest, that was ruined with the uncontrollable jumping around on the hand(walk). It was time and nerve consuming. Then I decided to move my mare to a cheap place with lots of pasture and very quiet pasture mates. The best move! After one year we started walking under saddle on the pasture - just getting used to the added weight of the rider. I waited till the mare is 99.9% in the hand trot. I think after a month of wandering around pastures and trails (with approximately even footing) we will start trotting 5 minutes. In my opinion as long as the lameness lasted, that long the rehab should last. So I plan a year of careful preparation to give time for those ligament fibers to coordinate themselves.



  13. #13
    Join Date
    Apr. 13, 2007
    Location
    North San Diego County, CA
    Posts
    1,068

    Default

    Blue&Blond,

    My vet said the options were:

    1) do nothing but rest (35% prognosis to return to work)
    2) stem cell (70% prognosis to return to work)

    No option for shockwave since there was a tear to heal. His plan was you do stemcell when you have something to fill in and shockwave when you want to stimulate repair. Who knows?

    He also said that healing is very slow with no results the first 4 months, and then they start to get better rapidly. He said people see this rapid improvement and add work too quickly and they reinjure themselves.

    Back to Work by Lucinda Dyer has been an excellent reference and reassurance.

    Thanks, MsM, for sharing your vet said to add time or diversity but not both. I was planning on adding 5 min increments per week or weight or time, still at handwalk (I'll add the weight by tacking up and using a western saddle). I don't even want to consider trotting until well after month 4 (two months from now)

    jan



  14. #14
    Join Date
    Oct. 4, 2007
    Posts
    87

    Default

    Hi, I have been reading this chat line for ages but just signed in so I could comment on this thread. I just helped a horse that had a collateral ligament injury come back to soundness. I want to share it with you. My friend had bought the horse a few years earlier and he had passed the prepurchase with flying colors (at 14). He is a QH type but isn't very downhill and doesn't have tiny feet. He injured himself by putting his front foot through a grate door and ripping it back out. She dealt with the initial injury and thought that was it. But he was on and off lame for the next year. They kept changing his shoeing angles, etc. Finally the vet told her that he had such bad navicular disease that she should nerve him or put him down. She refused to nerve a horse so had another vet out for a second opinion before she made her final decision. The second vet is new to the area and has a new diagnostic clinic with an MRI. He didn't think the horse looked like a navicular candidate and pushed the MRI to see if they could find out what specifically was wrong. She had the horse at a nice stable but it was expensive. She had gotten the horse with a half leaser lined up who was backing out of the deal. So she was facing the cost of the MRI, full board and still not knowing if he could be fixed. So I offered her my empty stall for a rehab period. He was too nice a horse to not try to give a chance to. He was on complete stall rest for 6 weeks, actually 8 because it was so icy that we extended it. Then I made a stall size enclosure outside the stall. He could move about a little more, see the sights, but not get to running. He was in that for about another 4 weeks and we started hand walking him. Then the vet declared him @80% recovered and said go ahead and start riding him. I made a little bigger turn out, and then after another month we let him out of "jail" and he had the whole sand ring. He was like a kid out of school, ran around like crazy, but luckily held up. We (me at first) would get on and slowly built up his time working. First it was 10 mins of walking. Then 15, then more, then trot the long side a couple of times, then all the way around the whole ring once, twice, etc. etc. The old vet - who I use too -came for shots and said he looked 90%. He did bauble slightly on one wide corner. I helped her balance him a little better and it disappeared. After a few months of this she started up with the canter the same way. By the time 8 months passed he was doing a 45 min workout every day with large circles and all three gaits. We worked on getting him to carry himself a little better to not be on the forehand and he looked better and better. She didn't get either vets opinion again but to me he looked and felt 100%. She is an older woman and had gotten to 1st level dressage before this happened. She says she will be happy if she can just keep riding him. She has no interest in jumping or riding wildly cross country, so for her purposes he is fine. The horse is a saint and the perfect mount for her, so it is wonderful that he is better. They both moved down to So. Carolina this month and seem to be doing fine. The environment sounds perfect - lots of sandy trails in moderate terrain, big fields to be put out in, nice footing in a large size ring. Plus it is alot cheaper to keep a horse there! He is 17 now and I am confident that they will have many more happy years together, maybe even compete again! The "new" vet did want her to keep coming back for shock wave treatments at $500 a whack. He also talked about stem cell therapy. But she said she'd do the MRI and the rest period and that was it. Luckily for him it was enough. My opinion was "you've got to know". If there was a way for her to find out, I had to help her. Without the MRI they were just fooling around with different shoeing angles making things worse! Once the injury got a chance to rest and heal then he was shod with normal angles and nice wide web shoes. I know many of the people posting have much more technical advice, but I thought our little success story was worth mentioning.



  15. #15
    Join Date
    Aug. 17, 2007
    Location
    Mount Airy, MD
    Posts
    494

    Default

    Oh my gosh! I am so happy this thread has started. You all have given me hope!

    My very very special upper level event horse ruptured his medial collateral ligament at a big FEI 3 day event this spring. Luckily I have this horse well insured and was able to afford Radiographs, Ultrasound, Full Body Bone Scan and 2 MRI's. We applied a foot cast to try to allieviate the arthritis in the coffin joint, it will have to be injected. He had a skin slough on his heel bulb when the cast was pulled, he went for 6 treatments in the hyperbaric chamber which circulates 99% pure oxygen, to prevent necrosis of the coronet band. He has been in a stall for 5 months. Luckily he is a fatty warmblood and as long as he has food & a friend he is just fine.

    I have recently started shockwave treatment. I feel that it has helped incredibly. My vets are going to put him in a corrective shoe once he is sound enough. I can send you a picture of the type of shoe he will be put in if you want.

    I hope he comes back and retains at least some of his incredible athletic ability. He is really a world class athlete. It is so comoforting to hear other success stories.



  16. #16
    Join Date
    Apr. 13, 2007
    Location
    North San Diego County, CA
    Posts
    1,068

    Default

    Yellow Rose, ClassicGal,

    Thanks for posting! It is helpful to hear people's stories along with their success and setback.

    ClassicGal, how long were you hand-walking before the vet said he was 80% and could be ridden? And was that 80% referring to lameness at the walk or trot? My mare is 100% sound at the walk, and I want to move to a mounted walk, but I wonder if I should wait until she is also 100% at a hand-trot before I begin progressive mounted walk.

    YellowRose, if you could post the corrective shoeing picture, it would be great. I've heard of using half-rounds, but my vet recommended eggbars and pads for two shoeing cycles, then back to normal shoeing.

    jan



  17. #17
    Join Date
    Oct. 4, 2007
    Posts
    87

    Default

    I'm going to have to look at my barn calender for a time table for that. But as I recall it was at least a month that we still kept him fairly confined and did the hand walking twice a day. Then the vet came back and she wouldn't let him be lunged for fear of his tearing it so we just hand trotted. We started the slow work up under saddle with another month of just walking and she was religious about the timing - adding a few minutes a day, ready to back track if we felt or saw anything. After that the same with the trotting - first just a long side (no corners), then more times, then once around, etc. etc. By the time we got to trotting all the way around the ring he was being let loose in the big ring and really cavorting on his own, I'd look out there and say - that horse is fine. But she did the work bringing him back under saddle very slowly and I believe that was key.



  18. #18
    Join Date
    Feb. 9, 2004
    Location
    Sunny CA
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    Default

    I wanted to add that I did 3 shock wave treatments at the beginning. Bodie was ultimately sound on the line but he got away from me one day. He ran like a banchi (sp?) and was lame again. After a few more months they reultrasounded and found the tear healed. But he still was unsound in one direction. After that I did not take him back to the clinic for months. I waited until it had been at least 10 months and took him back for a soundness check. He was sound that day and slowly went back to work. First walking under saddle and then small trot sets addting aobut 3 mintues a week until he was at 20 minutes. After that he cantered and jumped!!

    There is hope but you have to give it some serious time in the end!!

    Good luck to you all!
    Steph

    http://community.webshots.com/user/stephanne014

    Rerider/Haydunker Clique

    RIP Barbaro, you were my hero!



  19. #19
    Join Date
    Sep. 15, 2001
    Location
    Queen Creek, Arizona, USA
    Posts
    1,446

    Default

    I did shockwave and stem cell with a every 4 day adequan series, I bought a game ready and did it twice a day for 8 weeks. I was told 50% chance of being rideable when diagnosed. Now 6 months later, I have a 90% chance of return to function. We have gone super slow. Stall rest was only for 60 days then agressive handwalking on flat hard ground. We have progressed to riding with a person for 60 minutes a day and nest week, we start out JOGGING! YIPEE! It has been 7 months since the injury and I have been told I could bring her along faster but she wouldn't hold up. So we go the slow and easy route and hope for the best in the long term. It will be a year plus until she jumps again. I have ultrasounded along the way and everything is reviewed by both my regular vet, boarded surgeon and outside radiologist. They do not always agree. So far, the radiologist has been spot on but I think he sees more of this type of injury.

    The biggest thing that helps here is rest and being brought back slowly. Too many people are in a hurry. This was my only riding horse, so I actually went out and bought another one to ride in the meantime to avoid the temptation of rushing her recovery.

    One more thing obesity is a huge problem. My mare looks preggers and is getting NOTHING to eat. I am not sure how to address this.



  20. #20
    Join Date
    Apr. 13, 2007
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    North San Diego County, CA
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    Default

    Hey Rubs! Glad to see you are about to trot!

    Can you share the points on which your vet, surgeon and radiologist disagreed? I mean, were they diametrically opposed on some things? How'd you decide which to believe or what to do?

    Thanks for the calendar timing ClassicGal. I am sort of making a list and it's pretty uniform that folks are hand-walking or mounted-walking for at least the first four months, and all being careful about footing and only doing straight lines.

    jan



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