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Proximal Suspensory Surgery Advice - Updates at end

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  • #21
    I know they help some horses with hock or stifle issues, but we were told very specifically NOT to use eggbars on the hinds for proximal suspensory issues. Just shoes with good heel support. And make sure the fronts have really good heel support as well, as that will also effect the hind end.


    • #22
      I was also told no wedges behind as that is the wrong change for suspensory support, if that helps any.
      The big man -- my lost prince

      The little brother, now my main man


      • #23
        Eggbars seems odd to me.

        My mare is barefoot. She had front shoes before the surgery, but she was barefoot and competed barefoot her entire life until I bought her, and discovered the New England rocks do a number on her fronts. She has typical Morgan feet: strong, well-formed, easy to care for. Just before her issue was diagnosed, when it was still a mystery lameness, I tried shoeing her hinds, too, but that made it worse, and she cut up one of her legs thanks to the borium studs on the shoes (it was still winter, and icy.)

        Have talked to the vets involved, and her regular vet suggested shoes in front once we are not always working in arenas with good footing, but he thought that hind shoes should be avoided unless there is some other issue that requires them. Keep in mind that she's not going back to jumping or eventing; she's on her way to being a nice LL dressage horse, trail horse, pleasure pony etc. We shall enjoy our middle age decrepitude together.

        BTW -- she is feeling gooooood and playing a bit too much on the longe line, but she seems quite sound. Wish I had video to share. If I give her enough Ace to keep her from ever playing, she is too doped to trot. I feel like I am back in chemistry lab trying to do a titration of the *exact* correct dose of Ace.
        You have to have experiences to gain experience.

        1998 Morgan mare Mythic Feronia "More Valley Girl Than Girl Scout!"


        • Original Poster

          Glad your mare is feeling well, quietannne! Venture is doing as well as to be expected on stall rest. Two more weeks, then tiny turnout starting at 1hour per day with a cocktail on board!

          Chatted with farrier today. He thinks that eggbar or extended heel was recommended in Venture's case for two reasons. Support suspensory, and to move his base of support back some due to long sloping pastern and underslung heels--he really has TB feet and angles. Especially as I live on sand at th coast, he thought more support. My farrier would rather extend the heels than go with eggbar as he feels eggbars are not as stable base of support. We are also going to try New Balance shoes on the front (he has always been shod on front, but again sloping pasterns). But...while he is on stall rest and very little turnout he will still be barefoot. So, still have some time to mull things over...


          • #25
            dbamford -- how is Venture doing? Still being a good boy?

            As for maresy -- she got cleared by the vet for riding on Thursday! She gets 10-15 minutes of walk per day, and we started on Friday... wow, we have a long road ahead. She is quite unbalanced and spent the first 15 seconds trying to figure out where to put her feet, poor thing. but we have video (awkward looking!): http://www.youtube.com/watch?v=rTFOu3HgcJk. She accepted loose contact with the bit and didn't do anything silly.

            The vet wants her worked on hard ground as much as possible -- which is better for supportive tissue healing because it increases blood flow. Friday was cold and windy, so we stayed in. I rode outside yesterday, and she was very sore and stiff, and I was wondering whether I should be riding her at all. Today she was much better, and made me laugh by actually trying to trot a few steps, goofy girl. She decided very quickly that this was NOT a good idea. She prefers being ridden outside.

            I still hand walk her about 15 minutes, and then longe her in a very big circle at the trot for about 10-15 minutes. By the time I get on her, she's fairly tired.

            Her prognosis is still guarded; because of how long she had the suspensory issue (vet thinks years, and probably before I bought her), she may end up with a non-painful "mechanical lameness," in which case her show days would be over, but we could still trail ride, she might be used for a few lessons, etc.
            You have to have experiences to gain experience.

            1998 Morgan mare Mythic Feronia "More Valley Girl Than Girl Scout!"


            • Original Poster

              Quietanne, I think she looks great in the video! Keep up the good work, glad you are in the saddle again. How does her trot look on the lunge? Venture was never truly, head bobbing 'off' throughout all this, but he had an strange cadence and was not using that left hind in circles when it was on the outside. He was also much less balanced at a canter to the right. Under saddle he always looked fine, so people thought I was crazy when I took him to NC for surgery. My own barn manager keeps saying to me that my surgery was 'not necessary', sigh. Luckily Dr. Schramme thought it was for him to be sound, plus that tendon sheath had REALLY blown up the weekend before I took him. We had been back and forth for a year at that point with home vet.

              Venture is up to 1 hour turnout per evening in tiny double-wide paddock now that we are in month 3 post surgery. He gets his hand walking first, which he pouts during, and shoves me freqently to show his frustration. Never enough to hurt me, but a nudge every few steps to say I AM BORED!! We are at 30 minutes in hand. He had two incidents in small turnout of fractious behavior. I actually got to see him trot, and while it made me a nervous wreck, he looked sound then--so somewhat comforting. He will have his first post surgery ultrasound the week of Thanksgiving, jingles please!!! I am nervous about it...


              • Original Poster

                So we are almost 3 months post-surgery, Venture is starting small pen turnout for 1 hr/day. We have been TRYING to increase it but he goes balistic as soon as the hay is gone! Tried small mesh net, he threw a royal fit that he could not eat easily and paced and bucked, while squeaking in his throat (love when they do that-monsters!). So 15 - 30 minutes into turnout session, once he HOOVERS his hay he starts trotting/running in the pen. Sharp turns on that left hind (it has not blown up-can't imagine why NOT) and me stomping out almost in tears to bring him in YET AGAIN and cold hose and wrap. He is on fluphen, which has been great for daily handwalking (up to 40 min) and keeping the stall walking to a minimum and wears boots for turnout. Have not tried ace but worried he will have the penile paralysis issue since reserpine made him drop and hang for a day both times I have tried it. He is supposed to be up to 1/2 day in small pen by now, but I am not getting anywhere. Plus we live on the coast, so SAND everywhere, so worried if he plays too much will restrain...HELP-any advice for the transition?? Follow up US is next tues. will be asking MAJOR advice from vet, so may start riding at a walk, might help chill him out? Such a delicate balance trying to heal...
                Last edited by dbamford; Nov. 16, 2010, 09:25 AM.


                • #28
                  I'd at least try ace. Of course, talk to your vet, but the side effects are pretty uncommon and it's used a lot to take the edge off in exactly this kind of initial turnout situation. Plus, I'd also up the amount of hay he gets - if he's calm when he's eating, keep him eating. Make sure it's timothy or grass, not high octane alfalfa, and then put enough out there that he's not running through it and ramping himself up. Seriously - this isn't the time for a flake or two - put a couple of flakes out, then put a couple more out, etc. so he's got something to work on. He'll get through it, but it takes time for the excitement to wear off.


                  • #29

                    Since you asked. Here's the thing. The rehab protocols we follow are not identical. They are not set in stone. They are based on certain principles but then developed based on the vet's experience.

                    Case in point. My horse had bilateral fasciotomies for hind suspensories; a friend's horse had the same surgery. Same recommending lameness vet, same surgeon. She followed the surgeon's protocol, I followed the recommending vet's protocol.

                    I don't remember any more exactly how they were different but they were (for one thing I think I started shockwave a month earlier); one had more walking under tack before turnout, the other started turnout earlier, that sort of thing.

                    Both horses ended up sound and back doing their jobs at the end of it.

                    So...I'd talk to your vet ASAP about revisiting the protocol. Perhaps given your horse and your situation (some horses hate being alone in a little space; mine did better when turned out in a bigger paddock [not RIGHT away, but sooner actually than the vet wanted] with a very quiet buddy), you need to swap out the turnout for more walking, or walking under saddle.

                    I know in my case I was walking under saddle before I was turning out.

                    Turning and running in a small space like that repeatedly IS a cause for concern.
                    The big man -- my lost prince

                    The little brother, now my main man


                    • Original Poster

                      So on the Ace, how much to test? My BO might have some, that can tide over until vet gets here on Tues to reassess plan...


                      • #31
                        Drugs. Drugs are you friend on horses freshly on turnout. I would give 2.5cc's IV to start. See how he reacts to that. You can always give more.

                        If you can't do IV shots, do like 4cc's IM. Actually, how big is he? I am dosing based on a 1500lb horse.

                        Give it at least 30 minutes before turning him out.
                        Last edited by sar2008; Nov. 16, 2010, 10:06 AM.


                        • #32
                          To test his reaction to Ace...I'd go 2-2.5 cc's IM (but call your vet and ask...they can just talk to you over the phone for this). Give it a full 45 minutes before you turn him out (at least 30 but I find 45 minutes better).

                          Also agree...give him more hay. Just spread out when it is given to him. A few small piles.

                          He may also just be one that you need to turn out back on grass (if you have it)...or do more undersaddle and less in T/O.

                          You have to adjust the re-hab protocol to fit your horse. I've personally never had one stay quiet in a small turnout....so when I turned them out...it usually is just turn them out in their normal field (with drugs) and slowly up the time.

                          Can I tell you that I'm not looking forward to getting out my current stall bound horse in a couple of weeks. This boy jumps fences when he is bored or unhappy...or just feels like it. I'm pretty sure the vets would not approve of his 5' jumps as part of his re-hab!
                          ** Tact is the ability to tell someone to go to hell in such a way that they look forward to the trip. ~Winston Churchill? **


                          • #33
                            My vet didn't want the horse turned out until he was w/t/c under saddle. Why should he be doing stuff in turnout yet that he's not doing under saddle? If you insist on turning out, try ace, or give a hefty dose of IV dorm which should last for about an hour.


                            • Original Poster

                              Thanks for all the feedback so far, keep it coming.

                              I really feel like I am between a rock and hard place on the Ride First / No Turnout Saga...

                              Surgeon and local vet said after 2 months stall rest with handwalking-start small enclosure turnout for full day (yeah right, if we can't get 1 hour??). After 4th month start walk undersaddle -- following the 2 months in small pen. BUT -- Totally getting what others are saying, if he is running, of course we are getting nowhere but pushing our chances at reinjury . Think I want to try Ace for sure. Really wondering about undersaddle being better for him than turnout though??? I am relatively small (125lbs) but he is not big either (16 hands, 1250). Wonder if I can compromise, 1hr turnout AM with LOTS hay and Ace (have a local feeder stop by and bring in as I and BO are at work). Then hand walk / start gradual under saddle walk in PM when he has MUCH less patience with turnout due to GRAIN FEEDING TIME (seriously why is it such a big deal he gets a HANDFUL)??? Will run by vet (obviously not going to ride til US), but what do you guys think??
                              Last edited by dbamford; Nov. 16, 2010, 12:56 PM.


                              • #35
                                Well, I am no vet, but my vet DEFINITELY wanted me to do under saddle exercise before turnout.
                                We had 1 month post surgery in a stall, 1 month hand walking, then begin walking under saddle, one month.
                                I think turnout was after that 3rd month.

                                They want them to start moving around but my vet told me they really want to "control" the movement as much as possible -- so they favored more controlled exercise and less "let's hope he doesn't blow through his ace and run around" exercise until we were later in the process.

                                And, I don't want to get your hopes up -- my horse (a VERY quiet soul -- I used to do his walk work in the field once I could, bareback, because his saddle didn't fit) blew right through his ace once or twice when a stimulus was applied (like, he saw another horse in a distant paddock getting turned out an cantering away).

                                It is not a total solution but it does help.

                                Best is to figure out what is likely to make him most happy in that regard and tip the odds in your favor.
                                The big man -- my lost prince

                                The little brother, now my main man


                                • Original Poster

                                  Thanks for all the advice! It was a rough two weeks. The good news, the US looked great. Upper suspensory looks good, slight scar tissue at site of surgery up top, but visually looks great. No idea if slight scar tissue at incision site is to be expected. Tendon sheath very minimal effusion (he is expected to have some from now on from the stretching, hopefully will stay like windpuff). Overall you would never know he had surgery unless I told you. Still very minor short striding/toe drag on the left hind at trot if on turn--but vet feels minor hock arthritis is acting up due to so much stalling or weakened stifle. Sound on straight away at walk and trot.

                                  We have a game plan. 4 hours out in evening with 1.5 of Ace and his feed outside, before turnout continuing 40 minutes hand walk every day. Has been tolerating well, fingers crossed. Local vet checking with NC State surgeon to determine if ready for tack walking. If so, will start the walking before going to any extra turnout for at least another month.

                                  Wish us luck...thanks again for your support.
                                  Last edited by dbamford; Nov. 30, 2010, 09:00 AM.


                                  • #37

                                    it sounds like you have a plan! And better yet, a horse who's healing well.

                                    Maresy's been on Ace since she started turnout at 2 months post-surgery. She's usually pretty quiet, other than a little "talking" when it's time to be fed, but she did have a couple of bad spooks, and one full-blown tantrum over her hay being late. She gets brought in immediately if she does silly stuff, and not fed until she gets over herself and calms down.

                                    Have found that Ace (she's on tablets) doesn't last more than about 4-5 hours, which coincidentally is about how long she is turned out.

                                    Unfortunately her rehab is not going terribly well; she's much stronger since I started riding her 5 weeks ago, but nowhere near sound, even at a walk. (We have trotted a little, just straight lines, and only 3-5 per ride, for the past week and a half.) Her next US just got postponed by 2 weeks, which means 2 more weeks of fretting. I just want a yay or nay, so I know what plans I should make for next year.
                                    You have to have experiences to gain experience.

                                    1998 Morgan mare Mythic Feronia "More Valley Girl Than Girl Scout!"


                                    • #38
                                      My gelding is in middle of rehab. Bilateral fasciotomy - hind suspensory, plus PRP treatment. We're at 60 days post surgery, just had follow up u/s and he is walking under saddle 10 min a day now.

                                      My Vet sells a product called Relax Me. I can't find it anywhere in the US, he gets it from Ireland. Anyway, the stuff is amazing. I give him one scoop am and pm, and he is pretty chill about everything. He is going into a small turnout with my mare for company. He just stands around and soaks up the sun. If you can't find the Relax Me, send me a PM and I can give you contact info for where I buy it.


                                      • #39
                                        Thanks for all the great info.

                                        We are in the early stages of dealing with what "you all" have been coping with for months.

                                        Your experiences have been very helpful to follow.

                                        For those of you nervous about Ace, or injections, we have been giving the injectable Ace orally. The "patient" thanks to 2.5 mg of compounded reserpine powder, is reasonably patient.
                                        For added insurance though, we add 1cc of Ace under or as frequently happens, on top of the tongue,45-60 min before handwalking. This is for a critter in the 1500 pound range.
                                        Taking it day by day!


                                        • #40
                                          Just my .02--

                                          I have rehabbed my horse twice in the last 12 months from minor suspensory issues/fractures/surgery. Both times it was recommended that he get turned out BEFORE starting under-saddle work. This required lots of sedation--we used Ace.

                                          ALWAYS overestimate the amount of sedative you'll need--better to have too much and wait for it to wear off a bit, rather than put them out and find out you didn't use enough.

                                          With my gelding, we started with 4.5 cc's of Ace IM and stayed with that for 3-4 days. Then we started gradually weaning him off, decreasing by .5 cc's each day. For unusually cold or windy days, we bumped him back up a bit.

                                          The second time we had to start this routine, I underestimated what we'd need (he'd been so good with the handwalking!) and started him with 3 cc's. He was quiet for about 5 minutes and then BLEW UP. He was running, bucking, rearing, sliding etc. and I couldn't catch him. My heart was in my throat watching him going crazy, and I was a wreck for the next week, waiting for that leg to blow up.

                                          Rehab is so difficult--good luck to everyone out there in the middle of it!