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Low Suspensory lig. Front leg (susp branch in fetlock area) stories

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  • Low Suspensory lig. Front leg (susp branch in fetlock area) stories

    In searching for peoples experience in rehabbing a low suspensory tear I can't seem to wade through all of the susp stories.

    So if you have posted before on a Low Suspensory ligament (Front leg) tear (the suspensory branch in located in the fetlock area) please just post on this thread. It's helpful if you can give location and degree as well as tour successful or unsuccessful rehab schedule.

    But if you've already told the story on COTH before just give your screen name and perhaps the title of the thread you posted on. I can go dig it up and you don't have to rewrite everything.

    I had a horse who tore inside and outside branches of the RF susp, inside was bad enough to take a piece of bone off of the sesamoid..... who re-injured 1 year in and is just a pasture pet now.

    Second horse has injured his RF susp at insertion in fetlock and also collateral ligament (same area) and a couple sesmoideian ligaments.

    So in my experience the Low susp was not rehabable.... am hoping to hear success from others

  • #2
    Sorry to hear of your horses injuries! I work at good sized equine hospital and what I have heard and seen is that suspensory branches have better prognosis than main body suspensory injuries. Branches in particular respond really well to shockwave. PRP would also be highly recommended.

    I am personally a fan of Smarttendon and back on track pillow wraps for recovery.

    The multiple injuries seem more concerning that just a branch injury. Was this diagnosed by MRI (sesmoidean ligaments) and what is the severity of the ligament injuries?


    • #3
      My old horse injured one of his suspensory branches. It was only a strain not a tear though. We shockwaved 3 times and he needed about 3 months off. We brought him back in time to do the end of the year shows at 3ft, at the beginning of the next year shows we were back up to doing 3'6. Unfortunately at the first show, he came up lame. It took a long time to diagnose as after the initial lameness (which vets thought was a stone bruise/abcess) he was so mildly lame that no one else could see it or feel it and I thought (having had so many injuries in my ridign career) that I was just being paranoid at the tiny little thing I felt. Eventually it was diagnosed as another suspensory. Same leg, however this time it was higher up, so he didn't re-injure the lower suspensory. 3 shockwave treatments and 4 months rest and we brought him back to be a 3'3 horse. Maybe he could have jumped bigger again and been ok, we will never know, however I already had my new horse and needed to sell this horse so we rather wanted to play it safe and keep him sound than risk another injury.
      Generally though, lower and in front is (from what I have heard) the best diagnosis, rather than high or in back.


      • Original Poster

        I thought that the branch was worse than the main suspensory ligament. I'd read that in a COTH article and other places (that I can't recall now). And I just figured that the branch is in an area of high range of motion (fetlock area) and was prone to reinjury. So I had it in my head that it was the worse of the 2 injuries....

        diagnosis on the 2nd (and current concern) horse was by high field MRI (anesthetised) and then follow up exam with vet doing blocks and Ultrasound in locations the MRI dr's pointed out.

        The MRI results read; injury to the lateral collateral ligament of RF. Mild desmitis of the lateral suspensory branch in RF. Mild desmitis of the medial oblique distal sesamoidean ligament bilateral (u/s find a tear in the LF one) and desmitis of the distal straight sesamoidean ligaments.... (and u/s found tear on the RF one).

        according to the vet (is local top lameness vet) the sesamoidean ligaments can be helped by more heel (horse has underrun heels long toe) or wedging the shoe. He is not as concerned about them. And feels that they will mend during the layup and rehab time (8months) for the collateral and suspensory. HE adn the MRI docs think that the collateral ligament is the main concern, followed by the suspensory.

        We are doing shockwave (3 sets 2 weeks apart), stall rest, Surpass under wraps at night, handgrazing and 15 min handwalking per day. will re u/s in 6 weeks from 1st shockwave and see ho he's doing.

        Horse came to us 7 months ago slightly off. just ever slightly off on the longe, vet called a grade 2. so we did adaquan, shoeing changes and he went sound. in work entire time (and before we got him) then 2 months ago he was off a grade 3, we thought abccess, treated, and he got better by a degree or 2 but still that little bit off., had vet out few more times... then did the MRI. So it was 2 months from a grade 3 to his first shockwave. But of course in hindsight, he obviously had damage to the ligaments for at least 7 months if not a lot longer.


        • #5
          Strain of inside front suspensory branch- no tear/hole, just swelling, no lameness on initial exam but sore to palpation and 1/5 lameness on flexion. We did 3 shockwave treatments and 4 weeks walking only. Horse is back in work and 100%.


          • #6
            I have an off track horse that injured his suspensory branch during a race. In the 6 years I've owned him, he's never been unsound on it.
            "We're still right, they're still wrong" James Carville


            • #7
              My dressage/pleasure horse injured inside and outside of R hind susp. branches while running due to fireworks at a boarding facility. Four months later injured other hind inside and outside susp. branches due to separation anxiety while out at night. Vet said give a year or more off work but w/ pasture turnout. tried to bring him back into work 2 yrs. later but I decided w/ vet's suggestion, to retire him from regular dressage work and use strictly as a pleasure/trail horse. He is very sound now, but don't know if he'd hold up to regular work.
              "There is no fundamental difference between man and animals in their ability to feel pleasure and pain, happiness, and misery." - Charles Darwin


              • #8
                Originally posted by joiedevie99 View Post
                Strain of inside front suspensory branch- no tear/hole, just swelling, no lameness on initial exam but sore to palpation and 1/5 lameness on flexion. We did 3 shockwave treatments and 4 weeks walking only. Horse is back in work and 100%.
                My guy had a similar injury, although he did show a small hole in his ultrasound and plenty of fiber disruption. 2 months stall rest, 1 month small paddock and S-L-O-W careful rehab with lots of walking...he's sound in full work 1.5yrs later. We are jumping and I do not forsee it limiting him in any way for the future...I event him and plan to take him at least Training, maybe Prelim + but we will see. I'm a chicken!

                I did give him SmartTendon, which I think helped a lot. I also kept him wrapped up front for the stall rest portion. Did not do PRP or Shockwave, just careful, regimented daily hand walks and then u/s rehab.
                Founder & President, Dapplebay, Inc.
                Creative Director, Equestrian Culture Magazine
                Take us to print!


                • #9
                  Good news: desmitis is not a tear!! The collateral ligament will be your problem. Absolutely do prp (or better yet, stem cells) for the collateral. Good luck.


                  • Original Poster

                    thanks everyone; it helps give perspective. Of course I realize that the collateral lig is aslo of concern, but because I had bad luck with the previous suspensory injury that I was feeling very disheartened about this current situation.

                    I am not a believer in suppliments but this time I'm willing to throw everything and the kitchen sink at this horse in order to get him sound. So I had called Smartpak... but their phone lines were kaput yesterday.. will try again today.

                    Marla100 my first horse is about 3.5 yrs out from initial injury (was on Sept 11, 2009) and he's sound for hacking. After he reinjured on of the branches in Sept 2010 I turned him out for 8 months then started hacking him. He's been good for lite riding ever since (knock wood) but gets previcoxx for his arthritic hocks, he is 18yo and hock injections stopped helping him about 3 yrs ago. Point being that you may be able to do lite riding on yours.


                    • Original Poster

                      Originally posted by flyracing View Post
                      Good news: desmitis is not a tear!! The collateral ligament will be your problem. Absolutely do prp (or better yet, stem cells) for the collateral. Good luck.
                      WOOT. Have been playing phoen tag with the lameness vet. BUT his notes from the U/S after the MRI do say "tear" in re; to the suspens, the collateral and one of the sesmoidean (sp??) ligaments on the LF.

                      Vet said he had good success on collateral ligament injuries with SW, but if at 6 weeks he doesn't see the level of improvement that he expects then to go to stem cell or PRP....


                      • Original Poster

                        just as an update; finally caught vet on phone asked a few questions and now I have even more questions! argh. back to more phone tag. I totally forgot to ask him to define "tear" and desmitis and explain the extent of the injuries. doh!

                        He said layup is 4 months. 60 days install 60 days in "work" ie gradual return to work. starting with 30 days at walk under tack and etc. He did say that this is not a suspensory branch injury like my previous horse (mentioned in my 1st post) The inference that I got was that this injury was not as bad as that one. But then he went on to say the standard vet disclaimer; each horse responds to therapy differently, there is no way to predict how well he will heal, no guarantee that he'll be 100% sound in 4 months and etc. but he thinks chances are good that he will return to same level of work.....