Am considering going the route of a Cunean Tenectomy for my gelding. He is 11 and has a spur on the lower portion of the left hock since birth. The sides of the hock have some fusing but the center is wide open still. Read the discussion on Cunean Tenectomy and was very interesting but would love to hear from people who have had this done. Hock injections last only 4-6 weeks on him.
Does injecting the cunean bursa give him any relief? If it does, then releasing the tendon may help ,otherwise the pain is coming from the joint and the tenectomy would probably not be all that effective.
Over the years, I have had the jack cords cut (cunean tenotomy - the tendon is just cut, nothing is removed) on several horses. In most horses, soundness returns within a few days, if not the next day, and performance improves greatly over a short period. The reason for the speedy return to soundness is that the cunean tendon is severed over the rough portion of the bone, and by the time the tendon reconnects (several months) the offending hock(s) fusing is complete, and the scraping of the tendon over the partially fused bones is no longer an issue. If I remember right, the first couple of days after the cords are cut, the horse is handwalked, and then returned to light jogging within a few days.Return to full work is generally a month to six weeks; some horses return sooner, others take longer.
A small and fairly gross aside here: if you are present for the procedure, you can tell the extent of tendon damage by the sound the scalpel makes as the tendon is cut; the louder the crunch, the more inflamed and scarred it is.
Hope this makes sense, as I am quite decaffeinated at this point in time, so forgive any rambling.
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I would love to take this discussion one step further. There are two vets in my area that will perform this surgery. One cuts the tendon the other cuts the tendon and clears out the bursa. can any that have had this surgery say if the vet they dealt with did one or the other procedure? and if so your feelings on the success of the surgery?
Well I was able to send my disc with the digital xrays of his hocks to a surgeon a few hours away, very highly recommended. He will get this on Monday but in speaking with him on the phone he highly agreed that this procedure will help him and once he sees the xrays he may take it the extra step if he sees what he feels is enough arthritis in it and do arthrodesis by drilling 3 holes into the cartilage. He said this is the new procedure for this and he has done a few and has had great success with it. It is very much less painful than the old way and he will be turned out for 2 months, then brought back to work slowly. He said 90% of them come back and fuse without a problem. When they do the arthrodesis they cut the cunean tendon anyway. He may be able to do this within the next week. http://chronicleforums.com/groupee_c...on_biggrin.gif
My gelding is scheduled for the Cunean Tenectomy on Tuesday. Surgeon viewed his xrays and said he has very little arthritis in them but lots of spurs along the front of the lower hock joint. He does not want to do any drilling because the arthritis is not advanced enough, however he feels the tenectomy will help him tremendously. Will keep you posted.
Cuneon tenectomy was performed this morning. Surgeon said that the tendons were so tight that yes, they made a huge snapping noise. Had about 1/2" of scar tissue that he was able to remove. The tendon retracted quickly after he took out the section. Bursa was fine. He feels that he should be a whole lot more comfortable now. 14 days of handwalking, then stitches out and turned out with back to light work, gradually building up to full work after a few weeks. I am very glad that I decided to go this route. It was an easy surgery and he is in minimal pain from it. Will follow up in a few weeks so others can determine if this may be a surgery that can help them.
Warmblood mom, really sorry I missed this thread. How is your horse doing post CT?? Per the original thread, I have had 4 personal horses done and all have totally or greatly improved.
If you have found a vet surgeon who is not in Colorado to do CTs, this is exciting.
Would you be kind enough to PM me and tell me where you live and what vet did your surgery? Not many vets across the country advocate this very useful surgery, or do the modern version of removing a piece of tendon and cleaning out the scar tissue.
My vet feels that a lot of the post surgery improvement comes from the elimination of inflamation in the joint due to cessation of hock joint twisting from being torqued by a tight or scarred down tendon. I am discussing with her finding some grant money to re-radiograph horses several years post surgery to see if arthritic changes and/or bone spurs have reduced in size.
I missed this thread as well. I had CT done on my horse in March. Plumcreek, I've been meaning to PT you for ages to tell you. I'm definitely pleased I had it done. She had never been lame, but xrayed with some hock arthritis.
Hi, I am very glad I did the CT. I live in Illinois near the Wisconsin border. Dr. Langer at Wisconsin Equine Clinic in Oconomowac was kind enough to do this. I called all around (even the big teaching hospitals!) and nobody would do it, said they haven't done that procedure in 20+ years! Dr. Langer looked at my boys xrays and thought it would be worth doing, being that he has a bone spur on the lower joint right where the tendon laid. Both hocks have arthritis, but the left with the bone spur has extreme narrowing of joint space. He said he would consider drilling that one being it has so little space left but he felt the CT would give him some relief, enough to where he would be able to continue riding so fusion would begin. He said that the tendons were so scarred up and tight, he took all that he could of the scarring off of them. The left he took about 1 inch, the right about 1/2 inch. He was on hand walking only for 14 days, bandages came off after 7 days and I did standing wraps for the 14 days of rest. Stitches removed at 14 days and then full turnout. Never any swelling, no pain, stood totally square about a day after surgery. It has been 3 weeks now and I have ridden him for the past 4 days. He is not yet totally sound, just starts out stiff but does warm out of it, something he has never done in the past. I would love to know of horses that have had this procedure done and how they are doing now, and if fusion has occured. I have read that it usually takes about 8 weeks or so before a noticeable improvement is seen. He still has a decent size "bump" where the tendon is laying and I would think that once the tendon shrinks the bump will shrink. Either way, it is not a big noticeable thing. Thanks for asking!
But, the reason I'm feeling more and more pleased for having done CT is that she's stopping better and better as time goes on. And as we know, with joint injections say, the biggest effect is noticed right after and then starts to fade. Doesn't continue getting better months later. Which the literature said happens with CT. It cost me $700 and if it means she can go longer, or even without, joint injections, it will be more than worth it.
Warmbloodmom, please keep us up to date on your guy. When my mare was xrayed she wasn't anywhere close to fusion. I'll be xraying her again next year.
As posted in the original thread, most of the horses in my H-J trainer's barn have had a CT, since both vet clinics near here advocate the surgery. All these horses are majorly improved, both in hocks and back pain. All I have heard of are sound for the rest of their careers, retiring for other reasons. All my CT'd horses with arthritic changes have stayed sound in their hocks, without any supplements, injections, nothing.
Keep riding your horse regularly. Dr. Page, my vet, thinks they should have LIGHT walk-trot-canter exercise from the beginning to insure that new scar tissue does not cause adhesions at the surgery site. She cites 80% improvement at 8 weeks, due to greatly reduced inflamation, and the balance of the average 95% improvement in 6 months. Never gets to re-radiograph these horses (they are sound), so does not know about hock fusion (I have asked her).
I found it staggering that the major vet schools are so dismissive of this surgery.
Thanks for all of the input! Even if he doesn't improve much more than he has, I know he is in much less pain just from the expression on his face and the way he stands now. With every ride he seems to be getting better and stronger. He suffered a major suspensory tear that we found last August (first one) and a second tear that was higher up that we missed last December. Both tears have healed well and this was the same leg as the bone spur. I am being very careful not to do circles for at least another 4-6 months. Before the CT we were just starting on straight line canter work and he just kept deteriorating. Thought it was the suspensory again but it was the hock. Actually, the vet thinks the suspensory really didn't bother him much but the hock was the major problem. Now he is loading that leg properly instead of twisting it to the side when he lands so hopefully the suspensory will be o.k. now. When I bought him 6 years ago he had the bone spur then. Wish I would have known about CT's back then, would have done it in a second! Amazing how many vets are against doing it also. They would rather inject, which to me has a lot more risk than a Ct.
He is doing well! http://chronicleforums.com/groupee_c...icon_smile.gifWith the colder weather setting in he was a little stiffer in the hocks being that he has very little joint space left in the lower joint of the left hock. He is able to work through the soreness regularly now. Before the CT he never worked through it. I am hoping that fusion will happen by next
Spring. I started him on some Hyalun and that is really making a difference. He is also on Adaquan, which helps keep him comfy enough to work, too. I have been told it takes about a year for fusion to happen. One thing I have noticed is he now stands straight on the left leg instead of having it being twisted to the outside all of the time. And his hoof was always growing a little angled when you look from the front, but it appears that it is growing down and straighter now. He is very willing to stand on his hind legs for the farrier and the suspensory that was so badly torn in the left hind is doing wonderful now (knock on much wood). I have him doing more circle work now and a little leg yielding, but being careful. I am very glad to have done the CT, it is amazing how much more comfortable he is! Will post an update this winter when we are a little further along with this!
Glad to hear things are going well. So nice to keep a good horse from becoming an expensive, painful pasture ornament. The thing that gets me is, injecting the hocks will help very litle if the problem is a too tight or scarred down cunean tendon. One significant clue, in the horses I know about, to whether the cunean tendon is the problem, seems to be narrowing of the joint space. My large gelding had clean joint X-rays, but progressively narrowing joint space, and back pain. His cunean tendons were so tight they made a zinging sound when cut, says the vet.
Wanted to give an update on my gelding. It has been 3 months now since the cuneon tenectomy and he is doing the best he ever has! He still has stiffness in hocks when beginning to work but very quickly warms out of it. His left hock has extreme narrowing in lower joint space with a spur so it is a given he will still have soreness till fusion happens but before the surgery he NEVER warmed out of it. He is as happy as can be and sometimes a little too happy under saddle now! Will update again at the 6 month mark. Will do xrays at the 1 year mark to see if fusion has happened or not.
Wanted to update on my gelding with cunean tenectomy. He has been a little short in the left hind leg trotting in circles lately, fine on straight line, so wanted to check it out. While trying to block the lower joint (which he is terrible with doing, hates needles, kicks!) he never flinched (no sedation) and the vet could not get a needle into the back of the joint without them bending in half. Appears that the back of the joint is almost fused, she finally found a very small spot after 4 bent needles and (still a very unflinched horse) to get the needle into. He went sound after blocking so fusion is progressing quickly. I think the cunean tenectomy helped him to use himself better and has helped with fusion. Injected with a small amount of steriod to calm down the inflamation so he can continue to work on it and fuse. Will xray in a few months to see where he is at.