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collateral & sesamoid ligament desmitis - treatments?

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  • collateral & sesamoid ligament desmitis - treatments?

    I have been doing a lot of thinking. Horse has "seemingly" been sound for the past 10 years with deep digital flexor tendonopathy and p3 fracture from the track. both have healed with scar tissue (on DDFT). LF hoof is clubbed from this. This horse has been doing 3'-3'3'' hunters competitively for 6 years with minimal/no soundness issues.

    The other major issues on the MRI were collateral and sesamoid ligament desmitis. What are the treatment options for these? Has anyone ever had these issues with their horse? How did you overcome them? Was it a retirement sentence?

    The vet told us that our best chance was to nerve this horse - so the horse was nerved and is a .5-1/5 depending on the day on concrete. He looks pretty darn good in his round pen jumping around like a nut.

    I think they were looking at the big picture instead of focusing on the "new" trauma. I got MRI copies from the clinic and am planning on sending them to other veterinarians. I was just looking for any experience with any of these issues.

    note: we have had issues talking to the surgeon who did his sx and treatment options since we left. at the time, we were so devastated that he had so many things wrong with him, we didn't focus on the ligament damage.

  • #2
    Short version. Had a horse diagnosed with collateral ligament damage. Treated with shockwave and IRAP. Got a couple of good years after long, meticulous rehab and return to work. Slightly re-injured a bit more than four years after original injury. In the process of diagnosing that we found neck arthritis which may have been thee driving force for the front end issues.

    My understanding is that you didn't want to nerve a horse with collateral ligament damage alone.
    The Evil Chem Prof


    • Original Poster

      Thank you. The clinic nerved him because of the DDFT tear, navicular damage (although not horrible), p3 fracture, collateral lig and ses lig damage all together in one hoof.

      We were told that the DDFT issue and fracture were old and healed...so not sure why that would be bothering him now.

      I guess I'll send off his MRIs to a couple more lameness vets and see if they see anything else that we could do that is not super invasive.


      • #4
        Norm Rantannen (sp?) is the person my vet consults with on weird image interpretation. He's in Southern California. Not sure if you have to go thru a vet or what it costs.
        The Evil Chem Prof


        • Original Poster

          Thank you! Do you know the name of his practice or a way I could potentially contact him?


          • #6
            The Evil Chem Prof


            • Original Poster

              thank you!


              • #8
                My horse had a p3 stress fracture and collateral ligament damage about 16 months ago. Search for "coffin bone stress fracture and collateral ligament damage" on this forum, because I kept the thread updated and chronicled the whole treatment/rehab process. Horse is fine now. Good luck with yours!
                It's 2017. Do you know where your old horse is?

                www.streamhorsetv.com -- website with horse show livestream listings and links.


                • #9
                  So you did an MRI and subsequently nerved one front foot? How long ago was he nerved and is he sound?

                  If so, I wouldn't treat either issue. Desmitis (like tendinitis) can be very painful but there is no actual lesion or tear. It can resolve on its own with controlled exercise.

                  If he is not sound, 1) you need to confirm the nerving was successful by blocking the foot 2) do an abaxial block to confirm the pain is between the fetlock and pastern ( making the sesmoidean ligament desmitis a likely culprit of the pain).

                  Which sesmoidean ligament is affected (straight, medial, or oblique)?


                  • Original Poster

                    -previous articular fracture p3
                    -lateral collateral ligament desmitis
                    -lateral oblique distal sesamoidean ligament desmitis
                    -navicular apparatus degenerative changes

                    He did not fully block out, even up to the knee before the sx. Given his MRI results, the surgeon thought nerving him in the one foot was the kind thing to do, and if he was sound enough, he could be a low level dressage horse.

                    We did not trot him until probably 6 weeks after sx, near xmas time, and he was still lame. he became more and more lame until he was reshod (think visible lameness at walk). once reshod he has been much less lame (.5-1.5/5)

                    I do feel like his heel has contracted even more since sx, and he has a large stress ring from when sx occurred I suppose. He shipped 7 hrs to and from sx.

                    **this horse was sound 95% of the time since 2006 until April 2012**

                    It's just hard for me to think that one day he would be sound with the DDFT and p3 damage and then the next not be...which is why I was thinking it was his ligaments that he may have strained this spring.


                    • Original Poster

                      Shoeing in October (had just been done) vs January (probably due to be done)


                      I should also state that once lame in April/May, he has been in a 1.5-2 acre pasture at least 8 hrs a day until he went to get sx. Now he is getting walked at least 30 min a day in the aisle and is being turned out in a oval round pen (ironic I know) 2-5 hours a day.


                      • #12
                        [The other major issues on the MRI were collateral and sesamoid ligament desmitis. What are the treatment options for these? Has anyone ever had these issues with their horse? How did you overcome them? Was it a retirement sentence?

                        For Collateral ligament damage IRAP and a controled rest and rehab program. For the sesmoid ligament desmititis ligament splitting and controlled rehabilitation program. Maybe ask if previcoxx would be helpful.

                        I am a bit surprised nerving was advised considering the soft tissue damage in the foot, you would want to be really cautious ridding that horse.

                        Good luck!
                        Last edited by Fharoah; Jan. 15, 2013, 06:41 PM.