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Finally have an answer - now what?

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    Finally have an answer - now what?

    After years of on and off NQR, orthopedic vet found chronic mild hind suspensory problems. He prescribed 8 weeks walking under saddle 4-5 days/week for 20 minutes and then re-check.

    I think this has been going on for at least 4 years on and off because lameness was always in the same leg. Lameness was so mild and not identifiable by previous 2 vets.

    If she doesn't come sound with time vet suggested neurectomy surgery but that seems too drastic for a 17 year old horse.

    We were doing 3rd level dressage until a month ago when she spooked and hurt herself. My heart is broken that my once in a lifetime horse may have to retire.

    Just looking for commiseration

    #2
    Big hugs! High hind Suspensory injuries suck. So hard to diagnose. Great big hugs to you!
    RIP Mydan Mydandy+
    RIP Barichello

    Comment


      #3
      Sadly, even the surgery is hit or miss. I did it on my then 10 year old FEI horse and he is now 14 and retired. I don't know that I would do it again.

      That said, I've known several horses with proximal hind suspensories that were less severe than his that came sound for lower level work with some combination of stem cells or IRAP and shockwave.

      Comment


        #4
        Jingles & AO ~ for a smooth and healing 8 weeks ~

        ((hugs)) laced with strength and patience ~
        Zu Zu Bailey " IT'S A WONDERFUL LIFE ! "

        Comment


          #5
          I totally empathize

          I would double the amount of time walking. At this point, there's nothing to lose and everything to gain. I mean sure, re-check at the 8 week mark, but start planning for 4 months of walking.

          I'm really curious why a neurectomy for this. That sounds like a terrible thing for a suspensory injury - what am I missing?
          ______________________________
          The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

          Comment


            #6
            100% what JB said

            Comment


              #7
              Hugs.

              How are the hind feet? Can you also increase TO time? Just my experience dealing with hind end suspensories, they tend to become worse with more stall time and poor angles behind. I'm actually of the opinion now that the way they are trimmed/shod plays just as much (if not more) a part of how they develop aggravation in that area in the first place.
              AETERNUM VALE, INVICTUS - 7/10/2012

              Comment


                #8
                Originally posted by JB View Post
                I totally empathize

                I would double the amount of time walking. At this point, there's nothing to lose and everything to gain. I mean sure, re-check at the 8 week mark, but start planning for 4 months of walking.

                I'm really curious why a neurectomy for this. That sounds like a terrible thing for a suspensory injury - what am I missing?
                The neurectomy and fasciotomy on a proximal hind suspensory creates space for the swelling/scar tissue. Because the origin of the suspensory is trapped between bones and fascia, it doesn't have room to swell/heal. There is also a small nerve in there. The surgery opens up the fascia to create space, and removes that nerve ending so that it isn't crushed/pinched/permanently causing pain from the enlarged suspensory post healing.

                That said, it didn't work in my case.

                Comment


                  #9
                  Thanks for more context. Fasciotomy I can understand, though that wasn't mentioned. The neurectomy also makes sense in the context of "post healing"

                  The OP makes it sound like the neuro would be done if things weren't healing, which is why I'm confused.
                  ______________________________
                  The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

                  Comment


                    #10
                    Originally posted by JB View Post
                    Thanks for more context. Fasciotomy I can understand, though that wasn't mentioned. The neurectomy also makes sense in the context of "post healing"

                    The OP makes it sound like the neuro would be done if things weren't healing, which is why I'm confused.
                    I think the OP meant if the ligament is given time to heal (and heals) but horse is still not sound.

                    Comment

                      Original Poster

                      #11
                      Thank you for the virtual hugs and well wishes! Its nice not to got through this on my own.

                      Comment

                        Original Poster

                        #12
                        Originally posted by joiedevie99 View Post

                        The neurectomy and fasciotomy on a proximal hind suspensory creates space for the swelling/scar tissue. Because the origin of the suspensory is trapped between bones and fascia, it doesn't have room to swell/heal. There is also a small nerve in there. The surgery opens up the fascia to create space, and removes that nerve ending so that it isn't crushed/pinched/permanently causing pain from the enlarged suspensory post healing.

                        That said, it didn't work in my case.
                        Yes this is exactly what the vet said. Sorry I didn't explain that properly. He said there would be a 90% chance of returning to same level of work after surgery but I'm super worried about putting my girl through general anesthesia and all the side effects/risks associated with that.

                        Comment

                          Original Poster

                          #13
                          Originally posted by beowulf View Post
                          Hugs.

                          How are the hind feet? Can you also increase TO time? Just my experience dealing with hind end suspensories, they tend to become worse with more stall time and poor angles behind. I'm actually of the opinion now that the way they are trimmed/shod plays just as much (if not more) a part of how they develop aggravation in that area in the first place.
                          Strangely enough she was doing GREAT when shod on all 4 feet. Farrier said she has wonderful feet and that we should try going barefoot. Looking back now I think taking off shoes did not help. It is not his fault of course but she starting showing problems shortly after taking shoes off and then got really sore after a bad spook.

                          She's now on a 5 week trim cycle or less if needed and gets out every day for either a hand walk or 20 minute ride. Large turnout is sadly not an option because she rips around and does more damage to herself.

                          Comment


                            #14
                            Chestnut Mare, My horse sounds a lot like your horse. After five years of NQR, he was finally diagnosed with chronic suspensory issues, proximal and branch. He did have two rounds of shockwave and a treatment of OSPHOS this last spring. He looks better than ever, but I have only tack walked him, and then got off of him in July.

                            I am told that what joiedevie99 has described is right on track. I have not trotted the horse under saddle yet (had some significant shoeing issues to resolve), but I threw him on the lunge line for a few minutes after have the summer off, and he looks sound. Let us know what you decide. The procedure you described is always in the back of my mind, although I agree with again with joiedevie99 that the outcome is unknown until it is already done.

                            On the farrier work, all I can say is I think we are where we are today in large part because the farrier work is excellent. The horse is in eggbar shoes with a slight trailer, and the angles are meticulously observed and improved by proper trimming. I hope this helps. (Five week trim cycle also.)

                            Comment

                              Original Poster

                              #15
                              Not knowing the outcome of the 8 week walk period, I have already decided not to go the surgery route. Knowing this horse very well, stall rest and possible ulcer/colic episodes would not be fair to her. She's also getting older and after surgery and rehab I may only get a year of higher level riding before retirement anyway. If she does get better I will put shoes back on and see if we can maintain at lower level work, may first level dressage just for fun but will probably never show again

                              Comment


                                #16
                                Originally posted by Chestnut_Mare View Post
                                Not knowing the outcome of the 8 week walk period, I have already decided not to go the surgery route. Knowing this horse very well, stall rest and possible ulcer/colic episodes would not be fair to her. She's also getting older and after surgery and rehab I may only get a year of higher level riding before retirement anyway. If she does get better I will put shoes back on and see if we can maintain at lower level work, may first level dressage just for fun but will probably never show again
                                Take it one day at a time. See where you are in 8 weeks. There are lots of treatment options short of surgery - including shockwave - that might give healing a boost.

                                Comment


                                  #17
                                  Agree, just take it one day at a time. I'd still double the walking time before deciding which way things are really leaning. 8 weeks might be ok if this was a new issue, but the fact that this is (likely) years old means it will take a lot longer to come through it, if that's going to happen at all
                                  ______________________________
                                  The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

                                  Comment

                                    Original Poster

                                    #18
                                    Not much to update but we are almost at the 8 week mark. I don't feel much progress because all we can do is walk under saddle but she definitely wants to go to work. Poor mare can't understand why we only do warmup and not real work. She's getting more spooky in hand and under saddle now too. The spooks are huge sideways jumps or cantering on the spot. I'm worried she's going to hurt herself more.

                                    How can a 17 year old still be so silly!? So full of life and LOVES her job.

                                    It is difficult not to be sad and depressed, I had so much hope for our future. It's almost like grieving a loss. Anyone else feel like that while rehabbing and not knowing the outcome?

                                    Comment


                                      #19
                                      I really hesitate to ask this, what would you lose if you completely 'unplugged' her for a bit? I don't know your situation at all; but I'm sort of wondering what 6+ months of 24/7 Flat (if possible, hills take work! even little ones) would do. Sedated at first if she is a nut. It might not be an easy option or the best option. But I sometimes think that these suspensory issues in particular get stuck as chronic because the horse gets so very bored with hand-walking or they seem sound...and they blow up, so they get put back on stall rest, and then they blow up, and....
                                      My experience is odd. I have two personal horses at the moment. Both out 24/7. The first injured himself, tore a right hind suspensory almost entirely just after I got him. The only thing I could safely do with this horse (because of his behavior) was simply turn him out and pray. It took almost two years, he looked sound after a year but actually wasn't. Emphasis on that 2 Years. We never give enough time I think. He is sound. I will always watch that leg and worry. But it is a solid recovery.
                                      The second is the companion pony. I got her cheap. Because almost three years before I got her, she had torn the the left hind suspensory. The owners did everything under the sun for her. But it was always stall rest and handwalking. Put her back into work and it tore again. She is also out 24/7 now. It is routine for her to spook or play too hard and come up lame again, with a swollen fetlock. It is a truly chronic injury. She is happier out 24/7, happier as a companion. She will never be sound.
                                      I'm not sure what I am saying here, except....I think a radical shift in lifestyle might be in order for her, and hopefully in the spring she would be sound. If she is not, I think the answer is retirement too early. And that hurts, I am sorry.
                                      (I would also put shoes back on, I know that makes 24/7 big turnout even harder to find...)

                                      Comment


                                        #20
                                        Originally posted by Chestnut_Mare View Post
                                        Not much to update but we are almost at the 8 week mark. I don't feel much progress because all we can do is walk under saddle but she definitely wants to go to work. Poor mare can't understand why we only do warmup and not real work. She's getting more spooky in hand and under saddle now too. The spooks are huge sideways jumps or cantering on the spot. I'm worried she's going to hurt herself more.

                                        How can a 17 year old still be so silly!? So full of life and LOVES her job.

                                        It is difficult not to be sad and depressed, I had so much hope for our future. It's almost like grieving a loss. Anyone else feel like that while rehabbing and not knowing the outcome?
                                        Drugs. I've only had one horse that made it through rehab with zero drugs, i.e. he never once acted spicy, spooked, jumped in the air, etc. They truly are your friend at this stage.

                                        Comment

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