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Non-surgical options for treating chronic suspensory inflammation?

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  • Non-surgical options for treating chronic suspensory inflammation?

    Short version of the story is my mare was diagnosed in the spring with a strained high suspensory in her right hind- clean on ultrasound, no pain on palpation, but short on that leg and mostly resolved by blocking the high suspensory. We went through two months of stall rest, another month mostly turned out due to her doing some other odd things (huge spider bite right at the girth, bruising the inside of her cannon bone), and then gradually put her back into work last fall. She was okay for the first two months or so, and then gradually became more reluctant to trot off and eventually uneven. Took her back to the vet and yep, she blocked to that high suspensory again .

    They are recommending surgery, which is a bit beyond my budget at this point, but she's just turning 6 this year and I hate for her to be nothing but a pasture ornament for the next 20 years, so I am looking at trying to save the money for the surgery but I wanted to get some feedback from others on what their experiences had been with this type of injury. Has anyone had luck treating this type of chronic inflammation in the high suspensory with anything other than surgery? What did you do? And for those of you who did do the surgery, are you happy with the results? How far out is your horse/how are they doing? Anything you wish you had known before doing the surgery?

    At this point she is happily turned out, barefoot, on about an acre pasture, which is as confined as I can get her at our current barn with their setup and her personality (she tolerates stall rest just fine as long as she has a buddy, but no one's volunteering their horse to stay in with her, so....), and has a round bale to eat to minimize the moving around she does, hopefully. It helps that she doesn't typically play hard- about the most she'll do is trot or canter once across the pasture. She is out during the day and in her stall overnight, and I have been putting Surpass on that leg for the past two weeks or so since bringing her back from the vet, always in the evenings after she comes in for the night.

  • #2
    If you head over to the Eventing Forum, there is a thread on Proximal Suspensory Surgery.

    From what I can read, the earlier the surgery is performed, the less scar tissue is there to start with, and the end result is better. There is a lot of info on rehab. IME yours was way too brief.
    Some riders change their horse, they change their saddle, they change their teacher; they never change themselves.

    Remember the horse does all the work, we just sit there and look pretty.


    • #3
      I'm no expert on all the "alphabet soup" products out there (IRAP, PRP) but could your vet give you a reasonable opinion on whether those have been shown to be helpful for YOUR HORSE'S particular condition?

      If that's not an option, sometimes a year of turnout can be the best medicine.
      Click here before you buy.


      • #4
        Shockwave (2-3 treatments) ~$150 each
        Accuscope (3+ treatments) ~$75 each
        Back on track wraps ~$75/pair
        PRP ~$600
        IRAP ~$1000
        Fasciotomy/neurectomy $1200-$2500 (varies regionally)


        • #5
          I use Back on Track wraps for a horse with a previously damaged suspensory and quite like them.


          • Original Poster

            I know a girl at my barn has been using back on track wraps for her horse who tore his suspensory, and I am curious about the shockwave option since from the research I've been able to do it looks like the point of that is to drive the inflammation out of the area, which would seem to be exactly what we want to do. I completely trust the vet I use- I've been using him for years and he's great at the diagnostic side, even with my horses who tend to be atypical presentations- but he's never suggested any kind of alternative therapy so I was just curious what other people's experiences had been with something like shockwave. My local vet briefly discussed IRAP, but that was when she thought the issue was in her hock, which we have shown with blocks to not be the case.


            • #7
              Did it all. Shockwave, surpass, injections and then the surgery with prp. I'm at 15 months post op and hoping I can start to leg him up in the spring. They are the worst injuries to deal with. Good luck.


              • #8
                I did PRP after my mare had a small lesion in her hind suspensory for the second time. Still had 2 months stall rest (with hand walking) then slowly brought her back to work. We're now 7 months after the PRP and are back to work. I'd recommend PRP for sure. My vet gave me a really good paper about suspensory injuries. They did a study where they took horses from all different disciplines with hind suspensory injuries and gave them different treatments. The biggest factor in the horses coming back to work successfully, regarless of discipline, was time! You MUST put in the stall rest, hand walking, walking under saddle, trotting long sides... Take your time! It will be worth it in the long run.


                • Original Poster

                  We did the first round of rehab exactly per vet's instructions- as much on straight lines as possible, beginning with walking three months post-diagnosis. We were trotting about 15min when she was NQR again, 6-7 months post-diagnosis. Unfortunately there's no viable way to do stall rest at our current barn (see first post), but the vet was okay with her being in her normal turnout area given her injury- strain only, no tears, holes, etc.- and personality. Obviously if I decide to go through with surgery I will have to find a different barn to use for the rehab process... Thinking I'll talk to the vet again next week to make sure we're not missing anything. Hate to put her through surgery if there's a better option.