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Hind leg soft tissue injuries

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  • Hind leg soft tissue injuries

    One of my horses was diagnosed with a soft tissue problem in RH yesterday. The general area is mid/upper cannon down. We don't know the exact area yet as the vet wants to do more blocks to locate specifics. I was told to keep him in a small paddock for 30 days then see what he looks like.

    He flexed sound on everything and had super clean xrays on RH (only leg xrayed). The vet could not find heat or swelling.

    I didn't have his paddock set up last night so I kept him in the stall (he is usually out 24/7). This morning his leg is stocked up from mid cannon down and has heat.

    I've called the vet, but seems like controlled TO is a better option then stalled. Also wonder why he showed stocking up now after he has not in the past.

    Fortunately, until now I have not had to deal with this. Let me hear your hind leg soft tissue stories

  • #2
    I'd want to know a lot more about what it is you're dealing with, honestly. Bit of a difference between something like a low bow or a suspensory lesion and one who is working on another form of low-level inflammation in the joint. Why does the vet think he has an issue if he's not lame, doesn't have heat, and isn't swollen? That he stocked up a bit overnight in the stall could be anything from a tendon to a skin munge causing a reaction to starting a case of cellulitis, so I'd really want to know what it is you're dealing with. Ultrasound can be really useful in diagnosing what's going on with soft tissue, but it strikes me that without knowing what the injury or issue is, it's pretty hard to talk about treatment/timing.

    That being said, with most serious soft tissue issues, you want to control exercise and footing. Stall rest plus controlled walking (hand or under tack depending on the injury), on hard surfaces in straight lines, plus wrapping and cold-hosing is the usual Rx, but all depends on what it is you've got going on.

    Comment

    • Original Poster

      #3
      The block lasted 4 hours so we couldn't do more yesterday. The xrays were clean. They didn't ultrasound b/c they wanted to do more blocks to see where to ultrasound. So the Rx was to rest for 30 days and come back for more diagnostics.

      I don't get the stocking up overnight though unless it is cellulitis from the block or something else. I just gave him SMZ's b/c I have seen cellulitis and this is what it looks like.

      Comment


      • #4
        My horse had a long ordeal a few years back with suspensory lesions in both hind legs. He was misdiagnosed numerous times before we got the issues properly diagnosed--I would be getting the leg checked via ultrasound today to know what I was dealing with--as figuring out my guy's issues sooner would've made things much easier.

        My horse was on stalls rest for several months with controlled hand walking. He was getting daily injections of sedatives to keep him controlled for the hand walking (longer-term oral sedatives made things worse for him). We sweated his hind legs for at least a month with a DMSO/furacin mixture made by the vet, etc.

        ETA: I'm confused as to how he flexed sound. If there has been no heat/swelling he must be "off" for you to have gotten the vet to check him in the first place? And in order to do blocks he would've had to have been off. Are you saying he remained the same upon flexing his fetlocks/hocks/stifles? Did the vet palpate, for example, his suspensory ligament? Did he trot off worse at all then?

        And If they started blocking at the hoof and worked their way up until he came sound they'd know an approximate area for where to look via ultrasound. You're not going to know the exact area of the lesion/inflammation/problem just from doing blocks. You're not going to know for sure until you ultrasound.
        Originally posted by RugBug
        Don't throw away opportunities because they aren't coming in exactly the form you want them to.

        Comment


        • #5
          My horse has a hind right suspensory injury that we are dealing with right now. If I were you id get an ultrasound asap. I know after you block you have to wait a few days to ultra sound, but if i were u that would be my next step. I know with my horse as soon as they blocked the suspensory he was sound, so we knew right away what it was and where to ultra sound
          Good luck to you hope you figure everything out soon!
          He knows when you're happy, He knows when you're comfortable, He knows when you're confident, And he ALWAYS knows when you have carrots

          Comment

          • Original Poster

            #6
            I called the vet out b/c my horse was short strided and would not pick up the RL canter, very sore back. He did flex sound but looked a little off on a circle. Very subtle but enough for the vet to work with.

            I got a better explanation from my vet regarding the u/s. Either way it seems like rest in the Rx.

            Comment


            • #7
              hunterrider33--I've never heard that before--needing to wait a few days after blocking to ultrasound? What's the reasoning for that?


              Originally posted by hunterrider33 View Post
              I know after you block you have to wait a few days to ultra sound, but if i were u that would be my next step.
              And good luck with your horse, Serigraph.
              Originally posted by RugBug
              Don't throw away opportunities because they aren't coming in exactly the form you want them to.

              Comment


              • #8
                Sometimes it is hard to diagnose via ultrasound when needles have penetrated the leg and create air in the leg (if that is where the injury ends up being). That is what I've been told. When my horse blocked out at his high suspensory, my vet was able to ultrasound immediately and his injury was 5-7 cm below the carbocaine injection.

                Comment


                • #9
                  They do sometimes stock up a bit after being blocked. Hopefully that is all it is.
                  You have to have experiences to gain experience.

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

                  Comment


                  • #10
                    I wouldn't wait 30 days to ultrasound. Knowing what you are dealing with can really change the treatment.
                    Case in point: my horse had high hind suspensory lesions. Treatment: immediate surgery, followed by strict stall rest, hand walking, etc.
                    5 years later, just brought him home from vet: low tear in suspensory. Treatment (same vet): shockwave, NO stall rest, restricted turnout (flat/quiet) and beginning to walk hack after one week.

                    Very different treatments. Also shoeing can be very different depending on what you are dealing with.

                    Waiting to u/s until a block or edema clears makes sense. 30 days? Not so much.
                    The big man -- my lost prince

                    The little brother, now my main man

                    Comment


                    • #11
                      SMZ's

                      Originally posted by Serigraph View Post
                      The block lasted 4 hours so we couldn't do more yesterday. The xrays were clean. They didn't ultrasound b/c they wanted to do more blocks to see where to ultrasound. So the Rx was to rest for 30 days and come back for more diagnostics.

                      I don't get the stocking up overnight though unless it is cellulitis from the block or something else. I just gave him SMZ's b/c I have seen cellulitis and this is what it looks like.
                      In my experience, if there is truly an infection, SMZ's don't cut it. I go for something a little stronger.

                      Comment


                      • #12
                        Were I in your situation, I would skip the blocks, and go straight to ultrasound if they believe it in the RH suspensory.

                        Blocking can mask accurate ultrasound results which is why some wait to do the ultrasound after blocks. Many people apply pressure wraps after extensive blocks to avoid swelling. I hope that is something as basic as that.

                        The sooner you get an accurate DX the quicker you can initiate treatment. Stall rest for a horse accustomed to 24/7 TO can be a bear when it comes to hand walking.
                        Taking it day by day!

                        Comment

                        • Original Poster

                          #13
                          Thanks for the replies. The swelling is considerably less today - almost normal. I did poultice and wrap plus cold hose. Vet thought the swelling may have been due to the alcohol in the scrub for the block. He said it sometimes can irritate white legs. I did see little bubble bumps on his leg while hosing.

                          Didn't have extensive blocks - just one from the distal cannon to hoof so that is where the problem lies generally.

                          I'm not sure what to do about the ultrasound. He would not have recommended 30 days in small paddock for nothing.

                          Comment


                          • #14
                            I would ultrasound the suspensory. My mare is currently rehabbing from a RH suspensory tear. The leg did not swell or have heat in it either so we were really clueless as to what the injury could be but ultrasound showed suspensory. Catching the injury right away probably saved her, she went in for a PRP injection and is now coming back nicely. I wouldn't wait the 30 days, best to figure out what's going on as soon as possible so treatment can begin.

                            Comment

                            • Original Poster

                              #15
                              Has anyone done an u/s and not find anything? What happened then if you didn't do an MRI?

                              Comment


                              • #16
                                Twice ultrasounded after blocking. Found nothing!

                                Finally went to a lameness specialist, no blocks, watched horse, went straight to ultrasound. found suspensory scarring , etc. MRI was frosting, expensive, but did it anyhow!

                                Had surgery, now rehabbing for second time
                                Taking it day by day!

                                Comment

                                • Original Poster

                                  #17
                                  From the u/s you found the suspensory scarring or was the from the MRI?

                                  Comment


                                  • #18
                                    Ultra sound will show scarring!, New, old, active, etc. Ultrasound, like anything else is only as good as the one interpreting it.
                                    Taking it day by day!

                                    Comment

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