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Fracture aftercare thoughts? UPDATE: in surgery UPDATE: lost her

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  • Fracture aftercare thoughts? UPDATE: in surgery UPDATE: lost her

    My sure-footed 13 yo trail mare did a face plant in turnout on Saturday and came up 3-legged. Luckily my trainer saw it happen: a canter that she lost her footing and all four legs splayed out. She likely did the splits or fell forward with her legs behind her, bruising her stomach.

    Vet radiographs and sees greenstick fracture of LH cannon, confirmed by second vet. He said there might be pelvic issues too, but since he doesn't hear/see pain when palpating, and we opted not to a rectal.

    My mare was panicky and shocky. We gave her 10cc of banamine while awaiting the vet, and then EquiSpazz because she was acting colicky. (Equispazz is a miracle worker -- she calmed right down...)

    After a few hours, she would slightly weight-bear by slowly and gingerly straightening her leg from resting on her toe. It was clearly painful and her entire leg quivered and she jolted and spooked if she went too fast, but at least she did it.

    On Sunday we re-xrayed to ensure it wasn't a spiral fracture and then put a cast on. We also put up a zip line in her stall and she is tethered to it so she won't try to lay down.

    She isn't adjusting as well to the cast as the vet hoped. She kept no weight on it yesterday, propped in front resting on heel. The vet said that casting usually provided some relief, and even if they walked like a peg leg, they put some weight on it. She wasn't, so he considered taking the cast off, instead we opted to give it time.

    Today she is bearing some weight on it, has it more under her hip. Not a lot more weight, as I can easily move it, but at least she isn't propping it in front as often. She does not want to move. Good appetite and will pivot to get water, but if asked to move she lifts it up and hops, clearly flinching. She will not move to get a cookie.

    She is supposed to be on a zip line with no walking for two months. That is no laying down and no hand-walking for two months. Yikes.

    Although I understand the reason for minimal movement, I can't help but think it isn't good to not move some. I am worried about laminitis in the other leg, and I wonder if we should take the cast off to encourage more weight bearing.

    The vet says movement is good for soft tissue, but for a broken bone it is like a crack in a pane of glass -- any movement can make it worse.

    What have been COTHers collective experience on fractures? Did anyone make it two months in a stall, in a cast?

    I think the fracture has a good prognosis for healing if we can just get through the aftercare. And the idea of aftercare and no movement scares me.

    Last edited by 3Spots; Jun. 21, 2012, 09:39 PM.

  • #2
    The vet says movement is good for soft tissue, but for a broken bone it is like a crack in a pane of glass -- any movement can make it worse.
    Movement is good for virtually everything with the exception of a new fracture, sadly.

    I did have a horse in a stall for four months, no cast, no walking, no restrictions on lying down, but he had only a small slab fracture of one of the small hock bones. No danger of catastrophic breakdown like you'd be facing with one of the long bones of a limb. That's the problem . . . if a fracture gets worse in one of the big weight-bearing bones, that's disaster.

    Good luck!
    Click here before you buy.


    • Original Poster

      Thanks, DW --

      I am having so much trouble believing this has happened; she is such a strong mare. I believe I can keep her still, but laminitis scares the crap out of me. I really want her to put some weight on it - even if that's bad for a fracture.

      Am I crazy?


      • #4
        Is she on any analgesics? Maybe she needs more....

        If she's not comfortable in the cast there are two options, really - one is that there is more going on than you saw on the films you have (were they digital?), and two that the cast isn't comfortable for her. Sounds like an obvious statement, but she might just need another cast.

        You're right to worry about not bearing weight well - does she have a Soft Ride on the other foot? Did they show you how to palpate for increased digital pulses?


        • #5
          Would a sling be workable? Something to take some of the weight off the good leg, even for an hour or two here and there?
          Click here before you buy.


          • #6
            I had a mare in a stall with a cast for 9 months. We did have to put a different one on in the beginning, even though it seemed like a great fit when it was applied. Sometimes additional swelling can make the cast uncomfortable and there can be pressure spots. She may need a different cast or else maybe more is going on than first suspected. So sorry for you and your mare.


            • #7
              Years ago I did TTouch on a horse with a fractured forearm from being kicked. He was in a cast in a stall on a zip line arrangement. I was fairly new to learning TTouch but I taught his caretaker all I knew and his owners and vet were amazed at how well he did. He recovered completely and went back to hunting.

              TTouch is great at helping things heal. Or allowing the body to heal itself. It helps the horse relax and helps all the compensating muscles to relax as well. Overall it helps the horse feel much better. And you don't have to be an expert at it to really make a difference.

              You can find a TTouch practitioner at: www.ttouch.com

              I really hope your horse heals up fast!


              • #8
                HHHHHUUUUUGGGGGSSSSS and prayers for your girl and you.
                HAS provides hospital care to 340,000 people in Haiti's Artibonite Valley 24/7/365/earthquake/cholera/whatever.
                www.hashaiti.org blog:http://hashaiti.org/blog


                • Original Poster

                  Thank you, thank you for these ideas! Animaldoc, you are right, maybe painkiller is too low. 5cc bans mine: does that seem too low? She's a stout 15'3"' prob 1100lbs

                  I just read about Softride -- sounds like I should order some.

                  If she isn't more confirmed weight-bearing tomorrow, we can take the cast off. If she is no better sans cast, we can clamshell the cast back on. If she is better, we can try for new cast. Does that sound reasonable, or should I wait a couple more days to see if she adjusts?

                  It did seem like a perfect cast, put on while she was sedated and fully weight bearing..


                  • #10
                    Jan - I just wanted to send you hugs from Ojai. So sorry to hear about your mare. I wish I had some helpful advice to offer but this one is out of my league. I'm just glad the fracture is such that she CAN heal. Hope all is well otherwise and that life is good.
                    R.I.P. Ollie (2007-2010) You were small in stature but huge in spirit. You will never be forgotten.

                    Godspeed, Benjamin (1998-2014). A life well-lived. A horse well-loved.


                    • #11
                      Originally posted by 3Spots View Post
                      Thank you, thank you for these ideas! Animaldoc, you are right, maybe painkiller is too low. 5cc bans mine: does that seem too low? She's a stout 15'3"' prob 1100lbs
                      Definitely too low - that's a "half-dose" of banamine - I would probably have her on at *least* 1g bute PO BID - for the first 5-7 days, then you could back off. The most painful time of a fracture is when the periosteom is movable. After fixation/stabilization it gets more comfortable.

                      Originally posted by 3Spots View Post
                      If she isn't more confirmed weight-bearing tomorrow, we can take the cast off. If she is no better sans cast, we can clamshell the cast back on. If she is better, we can try for new cast. Does that sound reasonable, or should I wait a couple more days to see if she adjusts?
                      I obviously haven't seen the films, but if your vets feel she needs a cast, then I would remove and replace it if she's not comfortable in it (too early for a bivalved splint if she actually needs a cast). I would also perform a rectal and try and determine if she has any pelvic fractures - if she doesn't feel unstable she can probably come off that tie line.

                      Originally posted by 3Spots View Post
                      It did seem like a perfect cast, put on while she was sedated and fully weight bearing..
                      But its like having a little spot on a new boot that rubs you - feels fine on Mile 1 of the hike, on Mile 10, not so much. Your vet might have SoftRides you can have.


                      • Original Poster

                        I really, really appreciate you guys and your ideas and hopeful thoughts.

                        Last night she willingly followed me into the in/out of her pen. She took two weight-bearing steps, otherwise it was hop/drag the casted leg. I was encouraged that she wanted to move - she hasn't been depressed, but would only pivot, not step, with cast on.

                        This morning I found her right after she slipped/fell and broke her attachment to the tie line. She seemed okay, not holding her leg any differently, but did not want to move or eat. I am glad I didn't see the struggle to get up.

                        Vet came. I asked if she definitely had a fracture and he said "not definitely," but the line they see in the cannon is not normal. We talked about Softride (we will get some) and more banamine (yes!). He was agreeable to experimenting with cast off, especially after seeing her move with it. She hop-dragged for him and although it was better than last night, he said it should be better yet and he was worried about pelvis.

                        We discussed bone scan and decided that would be next best bet. So, I hauled her to equine hospital. We removed her cast so we could load her. She moved much better without cast, weight-bearing a few more times, loading easily with a few hops. Unloaded more tentatively. I left her there.

                        ***They just called my trainer -- cannon lit up like christmas tree, nothing in pelvis. The two docs thought that given her reaction to cast, and how she is more sure-footed without the cast, they would keep her in a soft bandage, zip line, rest, xray each week and see how it goes. They think that given it is a straight line fracture, that it has a good prognosis.

                        I will talk to doc in 30 min or so.. I think this is good news...


                        • #13
                          Yay for good news!


                          • #14
                            Hold still, mare!!! Jingling for fast healing.
                            Click here before you buy.


                            • #15
                              Jan, I'm sorry you're dealing with this! How horrible for your poor girl! You've already gotten tons of good advice, but I just wanted to send some healing vibes your way.


                              • Original Poster

                                I brought her home today. She gave out a big nicker when she heard my truck at the clinic. I couldn't see her, but I could hear her!

                                She was standing on the injured leg, walking better, loaded just fine. Same when we got home. Some very ouchy/jolt steps, but some good ones. I hooked her up to tie line because I was afraid she might want to roll in new shavings. She finally settled down a couple hours later.

                                She looks happy, is putting some weight on the leg. The other leg is stocked up, but not hard like it was a couple days ago. I wonder if she laid down last night for sleep and rested that leg? They didn't tie her, but I didn't see any shavings in her mane either. My vet wants me to tie her for as long as she tolerates it.

                                I have a Softride boot that I will put on the un-injured leg tomorrow. For today, i just want her to get used to being back, no cast, no shoes. I won't be surprised if she is sorer tomorrow since she used her leg so much today.

                                She is her bright-eyed, fiesty self. It makes recovery look entirely possible. I read that bone heals as good or better as before, whereas tendons/ligaments, not so much.

                                The first couple xrays will be our guide; I am hoping the Osteon and PP, will have an effect. I added PP's gastric support too -- thinking she might need it. All is the best it can be for right now.

                                Liz, Mel, thanks for piping in and caring -- it really does make me feel like I have a support network. My trainer and vet has been wonderful with all the "what do you think of this/that approach questions."

                                Thanks for the Softride boot tip - those are way cool, even if she is not stocked up tomorrow and we don't need them, I am glad I have them. Very well made and definitely useful for the lost shoe syndrome.

                                I expect I will be a pro at a Robert Jones bandage pretty soon, and looking for a discount source of cotton and vet wrap...



                                • #17
                                  Originally posted by 3Spots View Post
                                  Thanks for the Softride boot tip - those are way cool, even if she is not stocked up tomorrow and we don't need them, I am glad I have them. Very well made and definitely useful for the lost shoe syndrome.
                                  Just to clarify - the purpose of the Softride is to try and protect the other foot from laminitis while she is not bearing full weight on the affected limb. Nothing to do with being stocked up or not. I would put the Softride on and leave it on until she is 100% back to bearing even weight on both limbs.

                                  Glad to hear she's home and doing OK...
                                  Last edited by animaldoc; Jun. 1, 2012, 12:27 PM. Reason: Typo


                                  • Original Poster

                                    Yes, thank you, Animal Doc. I will probably put the boot on tomorrow. I wanted her to settle first, without adding another thing on her leg.

                                    And perhaps a good thing - last night she managed to ding her right eye -- completely swollen shut (her left eye has stitches above it from the fall)! Vet came today to confirm no eyeball damage.

                                    She's had a vet visit or hospital stay every day since Saturday; I am hoping tomorrow starts a run of vet-free days!


                                    • #19
                                      I wonder if you could build her a ledge, so she can rest her butt and take some weight off. I had an old mare who wouldn't/couldn't lie down who loved to sit on things like mangers and water buckets.. might help.


                                      • #20
                                        My little arab mare fractured her left front canon a few years ago. Vet's instructions were stall rest with a stack wrap on the injured leg to restrict movement, standing wraps on the other legs for support. We set her up in a stall at the back of the barn so that all the activity would be in front of her, hung a hay net on one side of the door and put her water on the other, and rotated a couple of "babysitter" horses in the next stall. The idea was to give her as little reason to move around the stall as possible without actually restraining her. She was on 2g of bute for the first couple of days, tapering down to 1g then .5g then nothing. I don't know if or how much it helped but the vet put her on a chinese herb compound (can't remember the name) that was supposed to encourage bone growth, and I applied comfrey extract to the area of the fracture daily when I changed the wrap.

                                        She appeared sound moving around the stall by about the second day. I didn't see her take a lame step at any point during her recovery after that. After 8 weeks she got a larger stall and some hand walking, and after 4 more weeks a stall and small paddock. I believe it was about 4 months after the injury she was allowed to go back to normal turnout. She has been 100% sound ever since. Her vet says since it healed cleanly there were really no concerns about her future soundness relating to the fracture. If anything, that particular area of bone should be stronger from the remodeling.

                                        Initial fracture

                                        8 weeks later

                                        This was her stall set up for the first 8 weeks.
                                        We used a stall guard so there was no chance of her pawing against a solid door with the injured leg. The pole across the bottom was to keep the shavings in since the stall was deeply bedded. We chose something round so her foot would slide easily if she stuck it on the other side.

                                        I hope you end up with as good of an outcome as I did! Fractures are hardly fun, but with a little luck they certainly can heal and go back to a normal life.