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Proximal Suspensory Surgery Advice - Updates at end

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  • #41
    We got to the 1cc Ace slowly, a course I would recommend to anyone trying it.

    Since it is essentially a "cocktail" with the reserpine as the other part of the mix, it works.

    Sorting out the reserpine was another story entirely.
    Taking it day by day!

    Comment


    • #42
      brief note: all of a sudden, maresy is WAY more sound. She is on a small dose of Bute (1/2 gram twice per day, and will probably go down to once per day soon), which seems to have "unlocked" a lot of her stiff joints. She's walking sound and would really, really like to canter, and her attitude is 100% better. Obviously she can't stay on Bute forever, but given that I was thinking she'd be retiring just 2 weeks ago....

      There is hope, everyone!
      You have to have experiences to gain experience.

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

      Comment


      • #43
        Quietann,

        Thanks for your update. We are, by my calculations 7 mos behind you and about 7 weeks behind "dbamford". I follow both your reports.

        You both give me hope.
        Taking it day by day!

        Comment

        • Original Poster

          #44
          Hi guys, got caught up with holiday and rehab.

          Quiteanne, so good to hear you turned a corner, was seriously thinking about you guys often, and worrying.

          Vicarious, hang in there, so far even for my complex case we have made slow, steady progress.

          I really will not breathe a sigh of relief until we are a year out from this nightmare.

          Venture is on fluphenazine, and 1.5cc Ace as needed to walk and for turnout. This has been a prefect combo, especially with cold windy weather. The suspensory incision site has gone down in swell quite a bit as I stopped wrapping. Was using Back on Track wrap for the lower tendon sheath, but the incision was getting rubbed. I am off Surpass now, and no swell. He is walking well, even for 15 min undersaddle, his hock arthritis is not flaring too bad with this added regular work. His tendon sheath was a little warm last night -- so a little worried about that. The vets are actually much more concerned about the tendon sheath's healing than the suspensory. It seems that it is a delicate balance between making him use the fetlock to keep adhesions from forming and pushing too hard. I am being VERY cautious. Refuse to accept that my 7 year old could be done for riding. Wish us luck, shoes on next month, based on NC State recommend getting square toe, heel extended shoes behind. Will be the first time he has had hind shoes in his life.

          Comment

          • Original Poster

            #45
            Quietanne, and others

            I was told that hock arthritis and Proximal suspensory seem to go hand in hand. In fact, last year I had Venture's hocks injected for the first time with minor start of DJD (just with Hylartin) and for months after that he seemed 100%. Only to have mild lameness return, which finally prompted me to take to NC State *(that and a big fat tendon sheath). So...have most of you also gotten the prognosis of the start of arthritis? My vets all said that the injections last year may also have helped the suspensory, hence the soundness, since the fluid also ends up in the area of high suspensory. Once we get a few more months of walk under our belts we are going to get injections again, this time with cortizone. He does also get Adequan monthly.

            Other experiences, comparisons for arthritis?

            Comment


            • #46
              I chickened out on the Surpass. The swelling stabilized. It is firm, runs slightly above to a couple inches below the incision. We had backed off on the walking for a week, but after observing that there is no apparent lameness at the walk, and that he does move more freely in the stall after walking , we will gradually increase it again. Here in the North hand grazing is no longer a possibility. So walking will have to be it.

              My local vet is more concerned with recurring adhesions, so that is why we are moving forward with the walking.

              My initial instructions were to bandage til the sutures came out, and for a few more days, then to start handwalking progressing 5 min a week. No turn out until 3mo after surgery and an U/S to determine progress.

              I think what threw me is that the swelling didn't appear as soon as the wraps were off but waited a bit.

              Day by day. One foot in front of the other.
              Last edited by vicarious; Dec. 16, 2010, 02:22 PM. Reason: typo
              Taking it day by day!

              Comment

              • Original Poster

                #47
                Happy Holidays everyone!! A quick update, Venture has been out in a very smallpaddock (3 stall size) for 8 hours during the day for over 1 week. I stopped the under saddle walking (we had only gotten to 15 min anyway). He has been quiet, and much more content, still hand walking in evenings for 30 min. Will add undersaddle walking back next week, wanted to see if all day turnout made leg blow up. Clean and cool, so far! It will be 4 months since surgery on New Year's day.

                Comment


                • #48
                  Thanks for all the stories guys. My TB Mare was diagnosed with a hind proximal suspensory mid December. We just completed 3 rounds of PRP, and probably will do some shockwave next. She has been on stall rest this whole time(and been a very good girl ) and gotten wedge shoes in back (She has the TB feet).

                  Thanks for all the stories though and ideas. One thing is, has anyone trailered there horse during recovery? I'm moving mine soon to a better rehab facility, but am worried the trailering may shift us back in our progress(even if it is only a ten minute ride), although the vet says it should be fine. Any ideas?

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                  • #49
                    Can't help with that!

                    I would hope and pray that she trailers well, and will continue to do so. I wouldn't use Aceprimazine in this case, as I'd worry about stability.

                    Good luck!

                    Keep us posted.
                    Taking it day by day!

                    Comment

                    • Original Poster

                      #50
                      Each case is unique. But I had to trailer Venture five days after his surgery-five hours back to Charleston, and the vets at NC were not worried about it at all. Believe me I asked, and am a complete worry wart. He was always sound on that leg. It did not blow up after this experience, though he was in stacked wraps for another 3 weeks following.

                      On Venture update, we are at 20 min hand walk/15 min undersaddle walk, hind shoes with extended heel-no wedge, 8 hour turnout very small pen. Going to build up to 45 min at a walk before trot (adding 5min per week)--playing extra safe. We are 5 months post surgery now. You can't even tell he had it. Will see what the future holds.

                      Jingles and Good Luck EventerForever!!! I hope you never have to go the surgery route...

                      Comment


                      • #51
                        dbamford, very good news!!!

                        The folks at EMC in Leesburg told me I could take my guy home (1 hour trailer ride) the day of surgery -- I didn't because it was absolutely sweltering and I thought I sure wouldn't want to ride in a trailer after anesthesia on a day like that .

                        He trailered 2 hours each way for checkups at the fancy lameness vet 30, 60, 90 days out. Not only did no one ever suggest this was a bad idea, but his recovery was textbook all the way through.

                        I was told to take his wedges OFF his hind shoes (we had had them on for his creaky hocks) -- that wedges put MORE strain on the suspensory.

                        best of luck everyone! I'm several years out of this now, and although we have yet to get back to our previous level of work, that's mostly about time and other issues getting in the way (it was the highest either of us has ever been, so...). He competed happily this fall at Training and I do have my eye on Preliminary this spring again...
                        The big man -- my lost prince

                        The little brother, now my main man

                        Comment


                        • #52
                          So I trailered my mare to her new home today. Did not go very well My normally pretty good loader, decided to be horrible this time. Took almost an hour to get her on the trailer. So much up and down the trailer, all worried me sick, but we kept it slow and at a walk. But when we got there and wraps came off her leg was on fire. Humpf. We hadn't had any set backs so far, but it seems this is our first. Put surpass all over it and wrapped. We will have to see how to looks tomorrow.

                          Comment

                          • Original Poster

                            #53
                            EventerForever, sorry about the bad day! She is at a rehab farm now, correct? Hopefully this means that she is in the best possible hands, and that your setback will be minor. Heck, if Venture can travel 5 hours, then spend days in a stall with stacked wrap when its 90 degrees without any 'known' longer term damage--pretty sure we tested all the bounds--I think your snafu will pass. When we switched from stacked to standing wraps we had a few days of swelling on the leg, 2 weeks of surpass cleared it right up. Chin up!! I am very jealous that your girl is at a rehab farm, best of luck for a complete recovery!

                            Comment


                            • #54
                              Someone asked, so...

                              There have been a lot of ups and downs with Feronia. She had SI injections in late December, because the reactivity she'd had when she first went lame came back full force once she was being ridden again. That did help, but she's clearly uncomfortable. Vet does not want her maintained on Bute, which is what helps her feel more comfortable (we tried prevacox, and it did nothing for her.) She is on robaxin (a muscle relaxant) which does help some.

                              We've trotted up to 2 1/2 times around the indoor; she struggles a bit in the corners and won't bend unless I really help her, and she tends to get speedy on the long sides, and at other times she gets balky and I just have to keep her moving.

                              The cold, snowy winter in New England does not help, in rehabbing a hot, fresh horse! Our last outdoor ride was in December and we're trapped in the indoor (quite literally, tonight, because just as I got on her, the snow removal guys showed up with some huge noisy machine, and she barely coped, and there was no way I could take her back to the barn until they were gone.) She's forgotten that other horses jumping or moving fast near her won't cause her any harm, and has had a few big spooks over that, and I can't say, "OK, we're going outside, it's too crowded in here!"

                              Our next ultrasound and vet visit is next week, and I'll admit to being at the point of thinking about just retiring her, because she's not happy in her work and she's clearly still quite off. OTOH... she has come such a long way since the end of October when I first got on her, and she could barely walk and was exhausted after toting me around for 5-7 minutes. Part of the problem is that I am no expert -- I am more or less a permanent advanced beginner rider -- so I can't really tell if she's acting up because she's in pain, or just giving me a lot of ponytude.

                              But I carry on nonetheless... Knowing from this thread that recovery *is* possible helps.
                              Last edited by quietann; Feb. 5, 2011, 08:02 AM.
                              You have to have experiences to gain experience.

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

                              Comment


                              • #55
                                Originally posted by vicarious View Post

                                I think what threw me is that the swelling didn't appear as soon as the wraps were off but waited a bit.
                                The same thing happened with Feronia, for what it's worth.
                                You have to have experiences to gain experience.

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

                                Comment


                                • #56
                                  Brief update: two days of pretty awesome work from Feronia. She's still struggling a bit, and I know she's NQR but she has shown me what she *could* be if she is sound again. (Today she had an audience, which always helps; she is a show-off!)
                                  You have to have experiences to gain experience.

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

                                  Comment


                                  • #57
                                    Originally posted by dbamford View Post
                                    Quietanne, and others

                                    I was told that hock arthritis and Proximal suspensory seem to go hand in hand. In fact, last year I had Venture's hocks injected for the first time with minor start of DJD (just with Hylartin) and for months after that he seemed 100%. Only to have mild lameness return, which finally prompted me to take to NC State *(that and a big fat tendon sheath). So...have most of you also gotten the prognosis of the start of arthritis? My vets all said that the injections last year may also have helped the suspensory, hence the soundness, since the fluid also ends up in the area of high suspensory. Once we get a few more months of walk under our belts we are going to get injections again, this time with cortizone. He does also get Adequan monthly.

                                    Other experiences, comparisons for arthritis?
                                    I work as a technician at a large university vet hospital in the lameness dept, so for the last 2 years all I do, 5 days a week is work up lamenesses.

                                    I would not say that to two injuries are related to eachother. I would say that many many horses have low degrees of arthritis in their lower hock joints. The presentation, response to flexion and even the result of blocks can overlap significantly between DJD of the hocks and minor proximal suspensory damage. We often see horses who have been low grade lame, had hocks injected, improved for a short period of time and then become lame again, often worse. I believe this is because the steroids have a local effect, and are placed quite near the origin of the suspensory ligament. Perhaps the hock DJD is not clinically significant in these horses, (not causing any lameness) and initially there was just a slight strain the suspensory, which, without rest, and with the masking of effect of steroids, worsens.

                                    It can be very difficult to diagnose early suspensory damage. It is difficult to image sonographically and in the proximal suspensory the fascia over it can make small amounts of swelling difficult or impossible to see or feel.

                                    The fasciotomy and neurectomy (plus or minus stem cells) is the "Gold Standard" approach to these right now. And allows many horses to return to soundness.

                                    I hope all your horses have a full recovery!!

                                    Comment


                                    • #58
                                      Quietanne: thanks for your input.

                                      I am sorry though that things are not progressing well for you. I hope your next U/S goes well. I would be careful that when she's showing you a good day that you resist the temptation to take advantage of it. Like us, they have established a muscle memory, and as I know to my cost, if I go back to even simple work after a month out of the saddle, I pay dearly for the next week

                                      Please keep us posted.
                                      Taking it day by day!

                                      Comment


                                      • #59
                                        Denali:

                                        Thanks for the post. Your observation on hock injections makes sense. I know my post op horse had wonderful spotless clean hocks radiographically when we were tearing our hair for a Dx.

                                        In retrospect (Hindsight always being 20/20) I suspect the problem was there subclinically for more years than I like to think. It demonstrated with occasional bouts of difficulty with one canter lead or one direction of lateral work. I put it down to rider error, and the problem would resolve itself...until.

                                        Coming up on the threemonth U/S. Hope the "gold standard" proves solid gold here. I'd even settle for less than 24 karat.
                                        Taking it day by day!

                                        Comment


                                        • #60
                                          Originally posted by vicarious View Post
                                          Quietanne: thanks for your input.

                                          I am sorry though that things are not progressing well for you. I hope your next U/S goes well. I would be careful that when she's showing you a good day that you resist the temptation to take advantage of it. Like us, they have established a muscle memory, and as I know to my cost, if I go back to even simple work after a month out of the saddle, I pay dearly for the next week

                                          Please keep us posted.
                                          I'm going pretty easy on her... two to three circuits of the arena and then a long walk break, repeat about 5 or 6 times, and she gets a long warm-up walk. In fact, the vets have had to push me to work her "hard enough" because I get so worried about her. They say they have other clients where they'd be saying "NO trotting around corners, no!" and they know the clients are trotting their horses around corners for 10-15 minutes at a time. That's not me
                                          You have to have experiences to gain experience.

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

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