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Bad ultrasound: suspensory lesion that wasn't there

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  • Bad ultrasound: suspensory lesion that wasn't there

    My horse is lame in his right hind. Blocked to his upper suspensory (60% improvement). So the ultrasound expert from my vet clinic came out, and found 50% enlargement of the suspensory ligament, and a core lesion. Sent him to New Bolton for ultrasound guided PrP injection, and the vet called me and said the ultrasound showed a perfectly normal suspensory. They reblocked him and he showed NO improvement up to his stifle. I took him back the next day and they blocked him again from the hock down (didn't do the hock on the previous day) and again he showed no improvement.

    I'm just curious if anyone has ever experienced anything similar. To me ultrasounds look pretty much like gobbledygook, but I would think that an experienced vet would know what they were looking at.

  • #2
    Yep, this happened to me. Local vet did blocks and said that rear suspensory blocked. Her ultrasound showed a large lesion in the upper suspensory on a rear. I did the 3 month hand walking rehab program and she came and redid the ultrasound. Said that the lesion was worse and I should consider retiring my horse. Took horse to the clinic to see the lameness experts. New ultrasound showed no lesion. Horse had bad hocks and first vet had probably messed up the blocks. Why she misread the ultrasound? I have my thoughts and none of them are fit for a public forum.


    • Original Poster

      Well, PM me! I'm so glad I took my guy to New Bolton!


      • #4
        Sometimes that is why I just go straight to New Bolton. The cost is the same and they have experts in every single field that spend a lot of time looking at one particular thing. I was up there with a tricky lameness that did block out and was ultrasounded. Got my answer and came home with a plan.


        • Original Poster

          Good point, JLee, and I am only 10 min away! We have a plan (bone scan) but no diagnosis, unfortunately.


          • #6
            If the ultrasound wand is not held properly, it can create a false shadow/hole. I think it has to do with uneven pressure on the ultrasound wand.

            I think I would want my money back on the incorrectly performed ultrasound.


            • #7
              Ultrasounds can be hard to interpret. Years ago, we had a horse who was acting like something was bothering him and stopping at fences cross country. The first ultrasound, done by a good vet, was normal. The second ultrasound by a good vet was normal. The surgeon did a third ultrasound and found bilateral, high suspensory, core lesions. The lesions resolved after paddock rest and a rehab plan. The horse went back to jumping without ever stopping.

              A few years later, we sold the horse. The vet who did the prepurchase saw the old ultrasounds and told me they were a normal variant. I told her that we had gone to an expert who felt they were abnormal. I was amazed at the different interpretations of the ultrasounds on this horse. I am sure he had the suspensory problems, but they must have been awfully easy to miss.


              • Original Poster

                Thanks! That was exactly the information I was looking for. I don't think the first vet was being dishonest; I think he just made a mistake.

                I'm not sure what to do about asking for reimbursement. I'm still considering the best way to handle the situation.


                • #9
                  this is the reason why they tell you to make sure your vet is very experienced in reading ultrasounds. and this is the reason why i don't rely on my regular vet but take my mare to a specialist for the lameness issues (which in her case are related to bilateral hind suspensory desmitis). besides her obvious specialized training the specialist looks at u/s daily which i think further hones their skills.

                  hope you get your real diagnosis and hope it's easier to deal with than hind suspensory issues...
                  TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique


                  • Original Poster

                    Thanks Marta. That's what I'm hoping too!


                    • #11
                      We’re in the same area. The majority of our horses start out as flat then steeplechase horses. We also do re-hab and leg up. So we deal will soft tissues injuries. Our go to ultrasound expert who is also used extensively but many top outfits is Dr. Mariah Lewis 717 529-3122. Ultrasound is all she does and is highly respected and travels extensively. We also use Dr. Kevin Keane, 610 869 4000 one of his partners who’s name escapes me I am embarrassed to say is also and ultrasound expert. We also do a lot of business with New Bolton both at our farm and the majority of surgical needs. Dr. David Levine is great. I know that diagnosing lameness issues is not an exact science I just wish vets didn’t charge as if it is. I pretty much always pay the cost for a second opinion. I also rely on my experience and “gut” as much as I do with any vet’s opinion.

                      “To me ultrasounds look pretty much like gobbledygook”

                      Great way of putting. It takes a while to “wrap your brain around it” to really understand what you are looking at. Kind of like trying to read Chinese.

                      “ but I would think that an experienced vet would know what they were looking at”.

                      This comes down to ones definition of experience. IMO just because a vet has access to an ultrasound machine, has been “schooled” in its use and has examined horses from time to time in their general practice does not make them experienced enough for me. IMO it takes years and many, many, many horses to develop the “eye” to be able to give sound diagnostic, treatment and likely outcome advise. Any expert worthy of the name will tell you they don’t always get it right. But I have found they are more right then wrong.