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  1. #1
    Join Date
    Nov. 25, 2009
    Location
    Alabama
    Posts
    216

    Unhappy Potential Tendon Injury: Help?

    Hey all,

    Yesterday I noticed that my 12 year old Thoroughbred gelding had a small swelling/lump just under the back of his knee, at the back of his cannon bone. Though there is SLIGHT swelling at the very back, most of it appears to be to the left of the superficial flexor tendon. The area of swelling is about the size of a quarter or so, at most. Unfortunately I'm not certain how long it had been there - my boy isn't showing any lameness or discomfort. The swelling isn't tender, nor is there any heat.

    I asked one trainer at our barn what he thought it was, and he suggested the possibility of a splint, and thought it unlikely that it was a bowed tendon. The farrier happened to be coming out tonight so I had him take a look, and while he admitted the possibility that it was a tendon or ligament injury, he said that normally there would be obvious lameness associated with such injuries, along with much much more swelling. He said that often times the ankle would be swollen as well as the excess fluid drained down the leg. My horse has no ankle swelling and is (as I said before) not lame. Instead, the farrier believes that he may have knocked himself and is just suffering a little resulting trauma.

    Currently, at the suggestions of the farrier, I am using Ball Solution on his leg where the swelling is and wrapping it. If the swelling becomes worse and/or he develops a limp, I will move on to more comprehensive diagnostics (beyond one trainer and the farrier, no matter how knowledgeable). However, I am curious to know what others have experienced with bowed tendons/splints/swelling with respect to lameness, swelling size, and such.

    Thank you so much for your help, and for taking the time to read this lengthy post.

    Side note: I DO realize that the farrier is NOT the vet, but he is very experienced and I value his opinion. Should the problem persist or grow worse I will, as I stated, call in the higher powers to assist.



  2. #2
    Join Date
    Aug. 21, 2000
    Location
    USA
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    2,601

    Default

    If you actually think it might be a tendon injury, waiting for it to persist or grow worse would be the not-so-smart option.

    You know that expression, "a stitch in time saves nine"? By "stich" the author actually meant "vet call."

    Talk to your vet.
    I evented just for the Halibut.



  3. #3
    Join Date
    Feb. 1, 2008
    Location
    Nowhere, Maryland
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    3,064

    Default

    Last year my horse developed a lump on his tendon. He was never lame and there was no heat, but when it didn't go away after a couple of days, I chose to have it ultrasounded. It turned out to be a bruised deep flexor tendon. I had a choice between shockwave and three weeks of jogging, or a month off, and I opted to do the shockwave--when I unwrapped it afterward, the lump was gone. No further problems.

    Realistically, without ultrasounding, you won't know for sure. Chances are he whacked himself, and will be fine--chances are my horse would have been, too, even if I'd ignored it and kept him in work. But Ihave seen both tendon and suspensory injuries that presented with just a lump and then got worse, and soft tissue stuff scares me. I have seen a number of severe injuries(both tendon and ligament tears) with no ankle swelling, so I'm not sure what your farrier meant.



  4. #4
    Join Date
    Apr. 9, 2006
    Posts
    275

    Default

    I have seen check ligament injuries present with a swelling right under the knee, right behind and on the sides of the leg. This doesn't sound like what you are describing, but keep it in mind. Lameness was not always obvious with the two horses I've seen with this injury. It might be a good idea to keep him confined and quiet for a little while if a soft tissue injury could be a possibility.

    Good luck. I hope it turns out to be nothing!



  5. #5
    Join Date
    Sep. 27, 2000
    Location
    Southern California - on a freeway someplace
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    9,644

    Default

    Definitely a good idea to have a vet look at it. Or at least call the vet. I've seen check ligament strains and other soft tissue injuries present without lameness.
    Last edited by Peggy; Feb. 2, 2010 at 11:29 PM.
    The Evil Chem Prof



  6. #6
    Join Date
    Nov. 25, 2009
    Location
    Alabama
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    216

    Default

    Thanks for the advice so far!

    I'm out of town this weekend so I don't know that I'll be able to have the vet out before next week, but the more I read online (especially not always having lameness evident...) the more I believe I would feel way more confident with a vet checking out the problem. I have a feeling that simply calling the vet would end up in a visit. This kind of thing is hard to describe over the phone, I'd imagine.

    Hopefully it turns out to be nothing.



  7. #7
    Join Date
    Sep. 5, 1999
    Location
    Central FL
    Posts
    4,379

    Default

    VET.

    You can have a ligament tear without any lameness. Trust me, I know.

    Call the vet. If it is indeed, "nothing", then all you've paid for is a vet call and examination.

    On the other hand, if it IS "something", you can start treating NOW and avoid futher injury.

    I am of course assuming that you are NOT working him during this time, and monitoring turnout.

    Off my soapbox, and off to ride the FatPaintMare who is reaching the end of rehab for a check ligament injury last July.



  8. #8
    Join Date
    Sep. 13, 2002
    Location
    Azle, Teh-has
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    Go have it looked at.

    nothing like a quick ultrasound to put your mind at ease.

    It could be something, it could be nothing.
    http://kaboomeventing.com/
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    Horses are amazing athletes and make no mistake -- they are the stars of the show!



  9. #9
    Join Date
    Jun. 3, 2008
    Location
    Caifornia
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    182

    Default

    I worked for an ultrasound specialist whose been around
    the block quite a bit. She will be the first to say that many tendon injury horses are not normally lame or significantly lame especially on hard ground, and having a horse who had a tear that had no swelling or lameness I would get it checked out rather then turning a 3-6 month rehab into a 9-12 month rehab



  10. #10
    Join Date
    Nov. 25, 2009
    Location
    Alabama
    Posts
    216

    Default :)

    Thanks all!

    A friend and I are actually splitting a vet call this coming thursday. Hopefully the vet will make fun of me for calling her out over nothing...

    @FlightCheck - Nope, not working him. Just doing handwalks twice a day. Last thing I want to do is risk making things worse! Glad your mare is doing better!

    @Sightunseen - That's what's scaring me - the not lame part. I know he didn't have this small bump before, so I'm just not sure what's going on. Praying it's nothing, but I'm soooo afraid the vet is gonna tell me I'm out of the game for the next 6 months.



  11. #11
    Join Date
    Dec. 7, 2007
    Posts
    151

    Default

    Any update on what the vet said?

    The reason I ask is because 2 days ago I also found a small (quarter or less), soft bump, on the outside (not the back) of his SFDT up high (about an inch below the knee). And he was not all lame.

    Since I'm just receiving the big vet bill of a nasty laceration injury, I'm dreading the idea of having to go again for an ultrasound.

    I wonder if it makes a difference if the lump disappears? Now it is the size of a lima bean.



  12. #12
    Join Date
    Nov. 25, 2009
    Location
    Alabama
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    On Thursday our vet looked at my boy and she said it was definitely his check ligament that was irritated. However, she really couldn't manage to make it bother him much - he wasn't lame, and he never flexed lame at all. It was not very sensitive to her squeezing it, really no more sensitive than her squeezing the other leg (which was not at all...).

    The lump on his leg (which sounds like it's exactly where your horse's lump is) is not soft now, it's hardened up. From what I've read it seems its common for the ligament to thicken after damage? Therefore, the vet asked if it was an old injury that had been re-inflamed, but since I'd never noticed a bump there before and told her so, she said the only way to really know what was going on was an ultrasound, which I scheduled for the following Monday.

    On Monday the vet performed the ultrasound and found that his LF check ligament was slightly inflamed as compared to his RF check ligament, though there weren't any tears. Vet said it was an extremely minor strain to his ligament, and thankfully everything else seemed to be in good form.

    Thank god it wasn't something like a tear to his suspensory or tendon!

    Prognosis is good since I caught it so early. He's already had two weeks off, so we're doing another month off. Vet said that the first two weeks are only walking, then if things look good we might be able to add in a little trotting in weeks 3 and 4. I'm a little concerned that this isn't enough time off, but we'll see how his leg looks in two weeks and decide then. Certainly if nothing seems better I won't push things, I'd rather give him more rest than he needs than risk another injury. I'm currently using alcogel and wrapping his legs every day, along with handwalking him.

    Come March, we're doing another ultrasound to evaluate and then we'll go from there.

    I hope your horse is okay, Martina! While his injury isn't nearly as bad as it could have been, it's still frustrating to have to work with something like this, especially when my guy was going so well before this happened.

    The ultrasound itself didn't cost too much, all in all considered, and it was more than it had to be with me because my boy is silly and was scared to death of the machine, so we had to help him calm down.



  13. #13
    Join Date
    Jun. 7, 2006
    Posts
    8,535

    Default

    Basically, if the horse HAD injury a suspensory, the protocol would be

    -stall rest
    -cold hose/ice boots 2 or 3 times a day for 20 minutes
    -furacin sweat in the meantime
    -1 gram bute to reduce inflammation.


    Thus, when I suspect there is a possibility of soft tissue damage, I follow the full protocol until a vet can come out and do an ultrasound and give the all clear.

    My personal experiences with this are as follows:

    1. was a horse that was simply getting routine joint injections behind, showing no signs of any problems in his routine work, from a vet who did a very thorough palpation/checking/etc before injecting.
    Vet thought she detected some soreness, put him on the full protocol until she could come back with the ultrasound, and a few days later the ultrasound revealed the smallest beginnings of a suspensory strain.
    Horse got two weeks stall rest and then brought gradually back to work in slowly increasing increments of walk/trot, and so on.
    Her very careful check may well have saved us a six month ordeal.

    2. was a horse that came back from the paddock with a notably fat leg. Vet could not come out for five days because obviously this happened over Christmas/New Years.
    Horse got same protocol as "worst case scenario," by the time vet came out swelling was gone and upon thorough palpation and jogging vet ruled out tendon issue without use of ultrasound.


    From these experiences, my basic rule is to treat AS IF it is the big problem, until I know for sure that it is ok to continue a more normal care program.
    Also, in the days immediately following an injury, the amount of swelling can make it difficult to make an accurate diagnosis, even with expensive technology. If the vet had come out right away for horse #2, I would have certainly incurred an ultrasound bill and an xray bill. The fact that the vet could assess him much better without all the swelling saved us the equivalent of one or two local shows, and the horse got the same level of care he would have if the vet had come out on day one.

    It certainly won't hurt a horse without a suspensory to have a few days of stall rest, icing, and wrapping, and it doesn't help the horse WITH a suspensory any MORE to have the vet come out to tell you the protocol and that you will have to wait and see. The protocol is the same either way.



  14. #14
    Join Date
    Jul. 6, 2007
    Posts
    441

    Default

    Quote Originally Posted by Hevonen View Post
    I am curious to know what others have experienced with bowed tendons/splints/swelling with respect to lameness, swelling size, and such.
    I know one horse with a bad (new) bow thats completely sound on it, and was right after he did it as well. Poor bugger can't figure out why he's stuck in a stall at the farm and can't go out to play with his friends. "But I'm not on the track, and I'm not lame. LET.. ME.. OUT!"



  15. #15
    Join Date
    Sep. 5, 1999
    Location
    Central FL
    Posts
    4,379

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    Hevonen,
    Welcome to the Check Ligament Club!

    Glad to hear that it is inflamed, not a tear.



  16. #16
    Join Date
    Dec. 7, 2007
    Posts
    151

    Default

    On Thursday our vet looked at my boy and she said it was definitely his check ligament that was irritated. However, she really couldn't manage to make it bother him much - he wasn't lame, and he never flexed lame at all. It was not very sensitive to her squeezing it, really no more sensitive than her squeezing the other leg (which was not at all...).

    The lump on his leg (which sounds like it's exactly where your horse's lump is) is not soft now, it's hardened up. From what I've read it seems its common for the ligament to thicken after damage? Therefore, the vet asked if it was an old injury that had been re-inflamed, but since I'd never noticed a bump there before and told her so, she said the only way to really know what was going on was an ultrasound, which I scheduled for the following Monday.

    On Monday the vet performed the ultrasound and found that his LF check ligament was slightly inflamed as compared to his RF check ligament, though there weren't any tears. Vet said it was an extremely minor strain to his ligament, and thankfully everything else seemed to be in good form.

    Thank god it wasn't something like a tear to his suspensory or tendon!

    Prognosis is good since I caught it so early. He's already had two weeks off, so we're doing another month off. Vet said that the first two weeks are only walking, then if things look good we might be able to add in a little trotting in weeks 3 and 4. I'm a little concerned that this isn't enough time off, but we'll see how his leg looks in two weeks and decide then. Certainly if nothing seems better I won't push things, I'd rather give him more rest than he needs than risk another injury. I'm currently using alcogel and wrapping his legs every day, along with handwalking him.

    Come March, we're doing another ultrasound to evaluate and then we'll go from there.

    I hope your horse is okay, Martina! While his injury isn't nearly as bad as it could have been, it's still frustrating to have to work with something like this, especially when my guy was going so well before this happened.

    The ultrasound itself didn't cost too much, all in all considered, and it was more than it had to be with me because my boy is silly and was scared to death of the machine, so we had to help him calm down.
    Hevonen - thank you for the update. I am glad there is no tear, but sorry that you still have the injury. I swear we are in the same boat!

    I set up the appt to have this lima bean sized swelling ultra sounded. I lost my entire summer last year because I ignored a slight swelling-without-lameness on his knee. I don't want to risk it, esp if this is something pretty minor right now.

    Good luck with your rehab!!



  17. #17
    Join Date
    Nov. 25, 2009
    Location
    Alabama
    Posts
    216

    Default

    @meupatdoes - Thanks for the advice! That procedure is similar to what I was doing previous to him being diagnosed. I really didn't want to risk a 6-12 month recovery period because some people thought it could be nothing.

    I'd rather be safe than sorry when it comes to stuff like this.

    @spaceagevalkyrie - Oh wow, that can't be common! It's so hard when you have a big issue but the horse isn't lame. Easy to miss, but at least with a tendon there is swelling. My last mare developed back pain, but anyone who saw her commented on how "she doesn't look lame, how come you aren't riding her?" It's not like an arthritic back causes a limp!

    My boy is the same way, when we were walking tonight he was looking for any excuse to play! He doesn't understand why he's suddenly confined to his stall when he used to get out to play all the time. XD

    @FlightCheck - Hurray! (sorta...) Do we get hats? Or just vet bills?

    @Martina - Sounds like a good plan! I hope that your swelling turns out to be nothing!



  18. #18
    Join Date
    Dec. 7, 2007
    Posts
    151

    Default 'tsall good

    The vet came out today and tendons and ligaments are in good shape. There is inflammation in the layers between tendon and skin. A few more days of stall rest and we should be good to go.

    I agree, way too much at risk with soft tissue injuries. The vet thought it was good to have it checked out. She said it looked like it could be the check ligament, although the swelling was pretty small from what she usuallly sees.

    Thanks for letting me steel a little from your post! Good luck with your boy!



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