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High Suspensory Injury LH - any experts, thoughts?

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  • High Suspensory Injury LH - any experts, thoughts?

    Is anyone familiar with this lameness. My vet is quite certain that this is what it is and he says the prognosis is poor, regardless of treatment.
    Last edited by Cruiser12; Mar. 1, 2013, 09:34 PM. Reason: can't spell

  • #2
    I do know that high suspensory damage can mean that a dressage horse won't be able to do upper level work, at least that's what I was told. As for jumping, I don't know. I do have a horse that recovered, fully, from double hind tears, and is still sound, 7 years later. I didn't continue into upper level work with him. I think it depends on what you want to be able to do, how bad it is, and how patient you are at rehab. I took a year to rehab mine. My advice would be to go to a top hospital and have him evaluted by them, then follow the rehab, religiously.


    • Original Poster

      Hmmm Well the trouble is, he's been out of work for four months and still visually short, almost with a little "hop" on the LH. My vet, who is not a TOP vet, but considered quite a good vet, thinks that I would be wasting my money. That makes it sound pretty bad. I don't know, it just makes me ill to think of dropping a bunch of money on him if he never really heals. I love my horse, but I don't want to go broke over him... ugh


      • #4
        What did the ultrasound show? Without an ultrasound it's just guessing.

        My horse had a high (and low at the same time) suspensory injury on his right hind. He had four shockwave treatments, 60 days of stall rest, a month of tiny day turnout, another month of single paddock day turnout, and two months of single 24 hr turnout before returning to his 24 hr group turnout. Careful rehab and he was back to doing most of what he'd been doing on the flat seven months later - though I was still very careful about the footing he worked on. We took a while longer to really get jumping again, but it's been four years and he's not had any issues with either injury (high or low). His recheck ultrasound done at almost four months post injury showed excellent healing (the vet actually said his ligament looked like it belonged to a horse half his age).

        Yes, it took time. Yes, it took some money. But given the horse's age and how many years we likely had ahead of us it was worth it.

        If you haven't had an ultrasound done that would be the second thing I would do. The first would be to find another vet.


        • #5
          I agree with getting the ultrasound.

          All these years later, I still have his hind shoes set back a bit, to prevent accidental injury, and I'm very careful not to let him in deep arenas or sand. The shoeing is so important.

          Other than the initial studies, I did the rehab, myself. I think he had injections, but no shock treatments (I don't think they were around, back then). The main thing was controlled excercise, as my guy loves to take off, like a bat out of joyful hell, and I couldn't risk him accidentally reinjuring himself, during the healing process.


          • #6
            You have to have an ultrasound. I had one OTTB going training level. Last event was fall 2010. His ultra sounds were not bad but showed that they had been chronic. We did careful rehab over many months (shockwave etc) but no dice. I ended up doing the surgery...more rehab over many more months but the surgery doesn't seem to have been successful with him. I've turned him out for the winter and hopefully with more time can at least get him sound enough for low level work but I'm not very hopeful.

            I know others who horses fully recovered. I did drop a ton of money in mine but he was really really REALLY nice.....not sure I would do it again though. Whether this boy comes fully sound or not, he is comfortable in a pasture and has a home for life with me.
            Last edited by bornfreenowexpensive; Mar. 2, 2013, 06:24 PM. Reason: typo
            ** Tact is the ability to tell someone to go to hell in such a way that they look forward to the trip. ~Winston Churchill? **


            • Original Poster

              Thank you all, perhaps another vet is the way to go.


              • #8
                Getting an ultrasound is really important. Also make sure they have experience doing hind suspensory ultrasound. Its not the easiest area to image.

                Prognosis will depend on if there is bone involvement at the origin which ultrasound can give you a clue of or bone scans or rads. After that you can do stem cells, shockwave, rest, swimming therapy, etc.


                • #9
                  I would not ever do it again. They say 80 percent recover with surgery, rest and careful rehab, I guess I'm the 20 percent. I could have bought a really nice horse with all the money I spent the last year on him.


                  • #10
                    I had a TB with evidence of chronic strain, and a clear tear. I did 10 months of controlled rest. The first few were in a stall, followed by making him a small paddock with electric tape inside his paddock with his friends, as he was going insane in the barn.

                    With each u/s we graduated him to a larger turnout space. He did, however, end up having to have the surgery to release the band around the suspensory at about month 9. He recovered well from the surgery, but I was told that if he ever evented again, I would have to be very, very careful with him and that he could go back to doing endurance (well, limited distance) but again, I'd have to be really careful with the footing.

                    I have scaled back what I was doing, and his "recovery" was officially over in 2008, but he is pretty much retired anyway. He is 20 this year, and while he'd love to go back to work, I'm not sure it is a good idea.

                    I do keep him in special shoes, even for turnout, where he has a lot of support behind.

                    I'm very fortunate, because I have the room and the ability to retire him here, and that he was insured when he got injured, and most of his shockwave (all but $200, I think) was covered and his ultrasounds and surgery were all covered.

                    Rear high suspensory is a tough thing to return them to work from, but my vets all agreed that it could be done, providing you rehabbed them carefully, and then were always mindful of footing and careful with them later. FWIW, he was treated by the lameness experts at UofF and was also seen by a performance horse vet that works with a lot of distance horses.

                    A second opinion, with an ultrasound will be crucial in determining what you should do.

                    Best of luck with it, whatever you do -- it is a tough road to do the rehab, but it can be worth it.

                    Libby & Taz (yeah, I am not sure I want to go back to those cold, cold, Winter nights of doing controlled handwalking through downtown, cause goofball was too spooky to handwalk around the field. He does love Christmas lights in people's yards, though. The tackier, the better! )
                    I have Higher Standards ...do you? Find us on FB!
                    Higher Standards Custom Leather Care -- Handcrafted Saddle Soap


                    • #11
                      My first horse had that exact injury in June 2009 - he was almost three legged lame with a hole in his suspensory. He had 3 months of stall rest with PRP and shockwave treatments, then 6 months of turnout, then walk/trotted for 4 months then returned to cantering and small jumps by Oct 2010. By Jan 2011, he was back to coursing around 3' (where he was before) and competing at Novice events, schooling Training level.

                      I really think the PRP helped immensely - by Sept 2009 (3 months after the tear), there was no visible tear on the ultrasound and he was trotting sound.

                      Best of luck to you and your horse. It's never easy


                      • Original Poster

                        Thank you all for your thoughts, advise and stories. I'm really so upset, I only have a four acre pasture for this boy (OTTB) and my hubby's companion/older trail horse. I know I will keep him regardless of his level of soundness, but I really don't feel as though I have enough room for a third horse. We just bought a 5 acre mini farm, we are building the house and living in an RV while doing so. This was my dream, to have a small farm of my own, and Sable was going to be my low level eventing buddy. I am just so sad and torn, I really don't want to spend a bunch of money on him without an excellent prognosis. Ugh, I'll just stop


                        • #13
                          (((((hugs))))) and jingles
                          Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.

                          You call it boxed wine. I call it carboardeaux.


                          • #14
                            I'm almost at a year on my guy's LH high suspensory injury. I got on the internet and did my research and totally freaked out reading other people's experiences and the statistics. Then I decided to STOP reading about other people's experiences on the internet and trust my vet. He said he'd heard the 20% statistics but that hadn't been his experience at all. At a friend's recommendation (whose horse had a high hind suspensory injury and came back to compete at Training level eventing), I bought the book Back to Work. It discusses these sorts of injuries, treatments, and the rehab process. The best part of the book for me was that it has a ton of really positive case studies. No doomsdayers. I needed that.

                            Yes, do the ultrasound. Take him to a sports med vet if you can. I had two vets look at my horse and they gave me the complete wrong advice, unintentionally. Don't skimp on making sure you get a correct diagnosis.

                            I can tell you that it took 6 months before my horse's suspensory looked normal again on an ultrasound. We had monthly u/s and at least 6 shockwave treatments. I was totally anal about the rehab, and I still haven't brought him back to full work yet (I'm terrified to jump him as we were jumping when he sustained the injury). But he's been doing well, knock on wood, and I'm hoping that we'll get back into the show ring this year.

                            Please, feel free to PM me if you need encouragement at any time. Don't give up on your guy yet.


                            • #15
                              I do also think that a whole lot depends on the injury. I think in the chronic cases like my horse....while he he had a decent prognosis with the surgery, there is a reason they are chronic and the likelihood of a full recovery are just not as good. My guy does look pretty good in the field and he may be able to come back to do novice or training level....it just sucks for me because he was looking like a much higher level horse.

                              But suspensory injuries in general just take a hell of a long time and a lot of anal rehab. I have one right now who had a very mild strain in a hind suspensory. No tear at all...just a bit more inflammed. She get's scanned (ultrasound) every month. She has been on stall rest for almost 6 months..with walking and now some trotting. We only walked for 3 months, then added trot to slowly build up to 5 minutes. We did 5 minutes of trot for 2 months...then were cleared to add another 5 minutes....slowly increase and then stay at walking 30-40 minutes and trotting 10 for another 4-6 weeks. She will then be scanned again before we increase again. It will be close to a year before she is back where she was at the diagnosis...and this is a horse who didn't even have a tear. Her prognosis is extremely good and unlike my other horse...I do expect her to fully come back.

                              Before you do anything, you really need a clear diagnosis. Good luck!
                              Last edited by bornfreenowexpensive; Mar. 3, 2013, 02:59 PM. Reason: Hind injury not front
                              ** Tact is the ability to tell someone to go to hell in such a way that they look forward to the trip. ~Winston Churchill? **


                              • #16
                                currently rehabbing

                                I am in month 8 of rehab on a high suspensory injury on a hind leg with a very bad tear. My horse is a JR/AM Jumper and is 14. I did surgery, stem cell, six months stall rest with hand walking 2x a day, shock wave therapy and smartpack rehab pellets. My horse is just finished his second month of six months pasture turnout after six months of stall rest. Knock on wood, the tear is healing much better than expected. I was originally given a 50/50 shot of him recovering by multiple top sports medicine vets and the surgeon. The last ultrasound shows it at about 75% healed and the vet now thinks he will recover.

                                I would say that my horse is irreplaceable as far as talent and heart. I do not have the money it would cost to even come close to replacing him so for me it was all or nothing. It has been a long hard road, but I am finally starting to feel optimistic. I would do the same thing all over again. I feel like if you really want the best chance of a good outcome, you need to at least start with an ultrasound so you know what you are dealing with. If my horse with a really bad tear, who is a terrible lay up patient, can recover, then I think anything is possible. The commitment to the daily bandage changing and handwalking is critical. Good luck.


                                • #17
                                  Without an ultrasound you don't even have a starting place. There are lots of treatment options, and lots of rehab protocols that can work quite well. Once you know whether you have a tear, whole, lesion, strain, etc. and the size and location, you can determine how much stall rest, when he can start walking, whether he needs shockwave, PRP, etc. Follow the rehab protocol religiously and it can work out. Best of luck


                                  • #18
                                    Do take a look at this thread:


                                    Now this concerns a particular type of suspensory injury and surgery, but there is a LOT of good general information about rehab there. A few positive endings, a few middling, a few, sadly, negative. (I am in the middling to positive group.)

                                    But do, please, start with an ultrasound so you know what you're dealing with!
                                    Last edited by quietann; Mar. 3, 2013, 07:01 PM.
                                    You have to have experiences to gain experience.

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


                                    • #19
                                      In a nutshell! High suspensory injury. A year on stall rest .

                                      Still unsound.

                                      Surgery, stall rest slow turn out, sound , slowly rehabbed. After a few set backs, almost back to full work a year and a half after surgery. Then a crash, terribly lame again. This time turn out, and walking u/s. Now 11 mo later, looking quite sound. Rider on lay/up for past 8 weeks.

                                      Stay tuned for next exciting episode!!!
                                      Taking it day by day!


                                      • #20
                                        I'm not a jumping person or dressage person but I have some knowledge of suspensory injuries from endurance riding. Those who suggest an ultrasound are 100% correct. While some vets are very good at palpating the suspensory and many of these injuries can be diagnosed with palpation, once the swelling is gone it is more difficult to tell what is going on and what the healing progress looks like by palpation. The horse may not respond negatively to an aggressive palpation at all and appear normal. That said, most rear suspensory injuries that I have seen in endurance don't come back. Front leg yes, great prognosis. Rear is very rare. That is just my observation. I've rehabbed a couple of front leg suspesnory injuries and one of those horses went on to do multi-day and 100 mile rides well after the injury. I've had friends with rear leg suspensories that never competed again after long, conscientious rehab attempts. If your looking at lower level competition I would think you may have a chance but if your looking to do some of the exercises I've watched where most of the pressure is on the rear legs with cantering in place etc., I would be less confident. Sorry for this opinion but it is what I have experienced and witnessed over more than a handful of injuries.