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Horse with ruptured peroneous tertius-- anyone deal with this before?

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  • Horse with ruptured peroneous tertius-- anyone deal with this before?

    So, my old man Trooper came in last night really really lame. I called the vet, they told me to bute him and they'd come out this morning. I wasn't sure what was up last night, thought it may be an abscess but thought I felt a little swelling in the hock area. This morning I could tell it was def. in the hock area. Vet comes out, says it is a textbook rupture in the peroneous tertius. He took Xrays just to make sure there is no bone damage, wrapped his whole leg, gave him some dex and told me he needs 2-3 months stall rest.

    This is not a horse that is good on stall rest. I've had him for 10 years and only had to do stall rest a couple times for a couple days for an eye injury. Nothing ever like this. He's at home with my pony and other old guy. My plan is to rotate the pony and other old guy so one is always in with him (pony out at night, old guy out during the day.) Luckily his stall faces my big pasture so the one outside can always see the ones inside thru the dutch doors.

    I plan on getting some sedative (respirine I think he said) from the vet-- he didn't have any on the truck. I think I need to have some on hand in case of a big meltdown/freakout. He did tell me the first few days would probably be the worst.

    I've never dealt with extended stall rest, so any tips would be greatly appreciated. I do plan to move him to the empty stall to muck, and to try to keep a horse in the stall beside him (he can see thru the wall) to keep him happier.

    If stall rest proves impossible, he will have to go back out. He is 20ish, retired and lame anyway due to severe ringbone/sidebone in his front foot (on the same side). Vet said this is not ideal but it would heal, would just take longer and wouldn't heal as well. But heck, he's a pasture ornament anyway, so if it comes to him losing his mind on stall rest, I guess he'll go back out on 12 hour turnout.

    This is so going to suck. I'm extremely thankful he didn't have to be put down but the diagnosis hit me pretty hard.

    I'd appreciate your experiences, thoughts and jingles for my poor old Trooper man.

  • #2
    Do a search, there have beens lots of discussions of that injury on here. I had a really good outcome with mine.
    Can you build him a small paddock, and reserpine is your friend.
    "You can't really debate with someone who has a prescient invisible friend"
    carolprudm

    Comment


    • #3
      Dex? What for?

      Wait for JB to show up, she's been thru this and can tell you all about it!
      "Kindness is free" ~ Eurofoal
      ---
      The CoTH CYA - please consult w/your veterinarian under any and all circumstances.

      Comment

      • Original Poster

        #4
        mroades, maybe you are more gifted than me with the search function, but all I got were two threads, neither of which was actually about a PT rupture.

        http://www.chronicleforums.com/Forum...oneous+tertius

        http://www.chronicleforums.com/Forum...oneous+tertius


        Could you link the other previous posts for me if you can find them? Thanks!

        Comment

        • Original Poster

          #5
          EqT, I didn't see your post until just now. Dex for swelling, I think he said. I'm pretty sure it was dex, I was pretty upset and may have heard wrong. It was packets of white powder. When I get home, I'll check and make sure it is indeed dex. I have zero experience with tendon injuries, sorry for sounding stupid.

          Comment


          • #6
            Dex *can* be used that way but that's not really ideal IMO or IME considering the potential side effects.

            I would think Surpass used topically and a short course of bute would be more helpful unless the horse is prone to ulcers.

            I will be curious to see what JB's vet put her horse on. He used to do things like this routinely!
            "Kindness is free" ~ Eurofoal
            ---
            The CoTH CYA - please consult w/your veterinarian under any and all circumstances.

            Comment

            • Original Poster

              #7
              He is also on a gram of bute twice a day for the next three days, he had 2g this AM and last night... I thought that he'd need bute for longer than that, but the vet didn't think so. Personally I think vets have gotten a little paranoid lately over the long(er) term use of bute.

              I'm relatively new to this vet but he has 20 yrs experience and a good rep in the area. Honestly if this horse wasn't retired, I'd probably get a second opinion but since the goal is for him to be pasture sound, I'm not going to spend the $$ on another vet.

              I'd love to hear from JB.

              Comment


              • #8
                Here I am!

                Sorry you're going through this!

                Where, exactly, is the rupture? It is GREAT there is no bony fracture involved - that is a big concern with this injury, as that tendon is big and strong and can easily take a chunk of bone with it if it ruptures too close to the hock.

                So, here's the short summary
                - NSCU vet school said 2 months stall rest, recheck, and go from there.
                - 2 weeks after total stall rest, I started putting Rio out while I cleaned his stall
                - 2.5 weeks PI (post injury) he was going out in a small pasture by himself for a few hours a day
                - 4-5 weeks PI he was out while I was at work
                - 6 weeks PI he was out all day
                - 10 weeks PI he had his checkup - 100% sound, tendon was VERY nicely healing, roughly 80% healed by that point
                - 4 more weeks of all day turnout, but this time with his buddies

                That's *roughly* the timeline, give or take a week here or there.

                He did this Feb 15 of that year ('07). June 22 (my birthday!) I got on his back for a ride I did do 2 weeks prior to that of 20 minutes of hand walking - marching right along, no putzing.

                IMVHO, movement is very very helpful for good healing of these. Rio also severed an extensor tendon (same leg!) when he was just turned 5, and I did the same thing - got him out moving free choice in small areas, working larger, asap.

                Rio was on NOT painkillers, no bute. He really did not swell much at all, so if there is some significant swelling in your guy, that Rx may be different. I could see a dex/dmso mix used to get the initial swelling down. Rio had that mix painted on (not ingested!) when he tore the flexor tendon sheath when he was 3 (yes, same leg!).

                I don't think the bute protocol you're using is anything to worry about either way - IMHO better to get after the inflammation early.

                Rio was VERY rarely lame on this leg, as in, rarely did it seem to hurt him, once the initial shock of the injury wore off. It was REALLY creepy to see him canter on 3 legs (yes, he did that early on!). He did end up running a bit, and that stung some, but only briefly.

                Hang in there. When I posted about Rio's injury, someone here PMd me with her experience and it was so much help - she had turned her horse right back out with the herd, as she had nowhere to put him in a stall. Something like 6 months later she was back foxhunting him

                I'm MORE than happy to share anything else I can about this. EqTrainer can attest to his soundness on that leg, scar tissue and all
                ______________________________
                The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

                Comment


                • #9
                  I wish I could say I haven't been down this road, but......

                  Stall rest is the best but if he was a pasture puff to begin with try to stick it out as long as you can. Your vet was right, the first few days will be the hardest until you can get him into his new program. We were allowed to go out of the barn only as far as the nearest blade of grass and back, but this time of year it might be easier to just leave him in.

                  Also, be careful of your bute use. Our guy colicked after a couple of weeks and was found to have ulcers from one end to another - spent 2 weeks at VT. They said he may have had them to some degree before but that the stress of the injury + stall rest + bute put him over the edge. As mentioned before, you might want to try Surpass or Banamine to help his pain.

                  Good Luck, I hope it is an uneventful rehab!

                  Comment

                  • Original Poster

                    #10
                    I *think* the rupture is right in front of the hock. The vet showed me but honestly, I'm not positive of the exact location, was trying to hold my spazzy horse while he worked on him-- he didn't have an assistant with him today. Plus I was so upset about all this, my brain wasn't working right. Thank God for written care instructions!

                    Xrays are back, no bone damage at all.

                    Leg is wrapped from hoof to well, belly... wrap needs to be redone on Friday... that should be fun. He was bad about today after no stall rest. I may end up paying the vet to come back Friday and re-wrap, depending on how bad his behavior is by then.

                    JB, if he (and I ) can last for 2 weeks of stall rest, I'll be thrilled. I'm going to try my best but like you said, sometimes all that stall rest just is not practical. My vet seemed to agree to try it as long as possible and if he has to go out, put him out, it will just take longer to heal and may not heal as well.

                    I guess I'm lucky... 10 years with this gelding and this is the worst he's injured himself. But it still majorly stinks and will be a big ol' PIA... the joy of owning horses, right?

                    Comment


                    • #11
                      Originally posted by KPF View Post
                      I *think* the rupture is right in front of the hock. The vet showed me but honestly, I'm not positive of the exact location, was trying to hold my spazzy horse while he worked on him-- he didn't have an assistant with him today. Plus I was so upset about all this, my brain wasn't working right. Thank God for written care instructions!
                      That's where Rio's was as well - that is apparently the most common location.

                      Leg is wrapped from hoof to well, belly... wrap needs to be redone on Friday... that should be fun. He was bad about today after no stall rest. I may end up paying the vet to come back Friday and re-wrap, depending on how bad his behavior is by then.
                      Did the vet say why the wrap? I never once wrapped Rio. My vet didn't say to, NCSU vet school didn't say to. Other than keeping swelling down I'm not sure what good wrapping for this injury does?

                      JB, if he (and I ) can last for 2 weeks of stall rest, I'll be thrilled. I'm going to try my best but like you said, sometimes all that stall rest just is not practical. My vet seemed to agree to try it as long as possible and if he has to go out, put him out, it will just take longer to heal and may not heal as well.
                      The first couple of days for my guy was a bit difficult. He's laid back, but suddenly being all alone in the barn, the 2 others just disappearing, was a bit tough on him. I did some creative rotating of company and that made things a lot better, a lot more quickly. After just a couple of days of that he decided life with a buffet of hay was alright

                      Honestly, twirling around a 12x12 stall is far worse than the movement he's likely to do with a fairly non-functioning hind leg in the field. Like I said, Rio's healed extremely well. More and more vets, I think, are starting to realize that once the acute phase is over, free choice quiet movement is really, really beneficial to stronger healing. Faster healing even, with the increased circulation.

                      I guess I'm lucky... 10 years with this gelding and this is the worst he's injured himself. But it still majorly stinks and will be a big ol' PIA... the joy of owning horses, right?
                      LOL, right! My guy is ONLY 10 and already has quite the rap sheet
                      ______________________________
                      The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

                      Comment

                      • Original Poster

                        #12
                        Whew, last night was not good. Really hoping the resperine that my vet called into the pharmacy is ready for me by the time I leave work at noon today. Homeboy needs some drugs.

                        I let the pony out last night, where he could see her, left his stall light on so she could see him thru the dutch door. Gave her plenty of hay so she was 30feet from him eating hay. Left my other gelding in, in the stall across the aisle so the 2 guys could see each other. I left the barn about 6:30 to go back to the house, came back to check on everyone around 9, and Trooper was freaking out. Spinning in circles and lathered under his blanket. Of course, I had to take his blanket off and bring the pony back in, even then he was still upset. This is one of those horses that once he gets to the point of being frantic, he stays there.

                        I think he calmed down some by this morning, but the poor guy was shivering from being sweaty last night. I threw a blanket on him for a little while this morning. He did manage to eat most of his breakfast, but dang, was he unhappy. I let the other gelding out in the pasture where he can see the ones in the barn and left the pony in again. Poor pony mare is having to suffer thru stall rest too, I guess, until I can get some drugs for her crazy boyfriend. At least she got out for about 4 hours last night. I gotta say, she is a really good pony... I haven't had her but about 8 months and she stayed level headed last night... I'm pretty impressed with her so far. She wasn't even bothered by being out there alone but of course, he was bothered by not being with her.

                        JB, the leg is wrapped to try to keep the swelling down... vet wants me to keep it wrapped until Sunday (five days).

                        I really hope the resperine works... spinning in circles cannot be good for that leg. Of course, like I told my husband, he's already ruptured the tendon, it's not like he can really hurt it anymore, he'll just keep it from healing. I swear if I can't get him calmed down by tonight, he'll just have to go back out... not the best course of action, but what do you do?

                        Sorry for my long winded-ness... but it's nice to "talk" to people that understand!

                        Comment


                        • #13
                          You need a more up to date vet......
                          Can you ace him until the reserpine comes in?
                          "You can't really debate with someone who has a prescient invisible friend"
                          carolprudm

                          Comment


                          • #14
                            If he's that keyed up the ace probably won't have much effect - the reserpine should help - hope it comes soon.

                            Is there any way to build a temp rehab paddock where he can be "out" with his friends but not enough room to do much more than walk around??

                            Comment

                            • Original Poster

                              #15
                              mroades, unfortunately, I had to come into work yesterday afternoon and also this morning, so I haven't had time to go to the vet's office and pick anything up (they are 30 min. away from my house, 1 hr away from my work). I'm leaving at noon today and if the resperine pills aren't ready at the pharmacy, will drive to the vets and get ace or resperine paste or both. The boy has absolutely GOT to have some sort of tranq asap.

                              Just curious, why do you think I need a more up to date vet? I haven't had a ton of experience with this particular vet, but he has a good rep and is at a major vet clinic/hospital in the area. So far I've been much happier with him than with my old vet who had a very small practice. If this was a performance horse, I'd be getting a second opinion (regardless of the first vet) for this type of serious injury, but this is a retired 20 y.o. horse.

                              knk-- Hubby and I were discussing a temp paddock last night-- we may get some round pen panels and make a small (maybe 20'x20') paddock outside of his dutch door. Then he could come and go as he pleased and also would be fence to fence with his little pony lover. That may be our weekend project... luckily Southern States has the panels and is only 10 minutes away.

                              If all else fails miserably, he will go back out with his pony in my small paddock which is about an acre... hope we don't have to go there!

                              Comment


                              • #16
                                Totally agree with JB - movement facilitates healing by creating a stronger scar tissue connection that is less likely to get re-injured and you want to keep bute to a min so he can feel the pain and not do to much.

                                Complete rupture or just a tear? Can this not be diagnosed with ultrasound? I doubt it is a complete rupture or else you'd have one seriously flacid muscle that is attached to that tendon.

                                Comment


                                • #17
                                  Originally posted by BornToRide View Post
                                  Totally agree with JB - movement facilitates healing by creating a stronger scar tissue connection that is less likely to get re-injured and you want to keep bute to a min so he can feel the pain and not do to much.
                                  I really do believe this, having healed to major tendon "separations" this way. I've seen the u/s of each healed area, and the new fibers/scar tissue is pretty damn well aligned. I've seen pictures of u/s of tendons that were healed while on stall rest, and the fibers looked like pixie sticks. The latter is not NEARLY as strong as the former.

                                  Complete rupture or just a tear? Can this not be diagnosed with ultrasound? I doubt it is a complete rupture or else you'd have one seriously flacid muscle that is attached to that tendon.
                                  Not necessarily. To look at my guy when he did it, if he was standing normally, you'd never know. it's when the leg was picked up that you could tell something was *really* wrong.

                                  If you can pull the leg back and the stifle AND hock extend, you know it's a complete rupture. VERY creepy.
                                  ______________________________
                                  The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

                                  Comment


                                  • #18
                                    Originally posted by KPF View Post
                                    Spinning in circles and lathered under his blanket. Of course, I had to take his blanket off and bring the pony back in, even then he was still upset. This is one of those horses that once he gets to the point of being frantic, he stays there.
                                    This is when you, and hopefully your vet(s) would be on board, have to make the decision of the lesser of 2 evils. There IS risk to the de-stabilized hock joint in all that twirling around. The risk there is MUCH greater than if he's moving in mostly straight lines, even if at some speed. I've had conversations with both Dr Nathaniel White at Marion DuPont, and Dr Mannsman in Ga, both well-respected lameness experts, about this issue.

                                    I swear if I can't get him calmed down by tonight, he'll just have to go back out... not the best course of action, but what do you do?
                                    Honestly, if he's quiet(er) out with buddies, it is by FAR the better option, than having him spend another 12 hours flinging around his stall. That hock joint, as well as the stifle, really is not all that stable without that tendon.
                                    ______________________________
                                    The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

                                    Comment


                                    • #19
                                      Originally posted by JB View Post
                                      If you can pull the leg back and the stifle AND hock extend, you know it's a complete rupture. VERY creepy.
                                      Yup, something I hope I NEVER see again!!!

                                      Comment


                                      • #20
                                        Originally posted by JB View Post
                                        Here I am!

                                        Sorry you're going through this!

                                        Where, exactly, is the rupture? It is GREAT there is no bony fracture involved - that is a big concern with this injury, as that tendon is big and strong and can easily take a chunk of bone with it if it ruptures too close to the hock.

                                        So, here's the short summary
                                        - NSCU vet school said 2 months stall rest, recheck, and go from there.
                                        - 2 weeks after total stall rest, I started putting Rio out while I cleaned his stall
                                        - 2.5 weeks PI (post injury) he was going out in a small pasture by himself for a few hours a day
                                        - 4-5 weeks PI he was out while I was at work
                                        - 6 weeks PI he was out all day
                                        - 10 weeks PI he had his checkup - 100% sound, tendon was VERY nicely healing, roughly 80% healed by that point
                                        - 4 more weeks of all day turnout, but this time with his buddies

                                        That's *roughly* the timeline, give or take a week here or there.

                                        He did this Feb 15 of that year ('07). June 22 (my birthday!) I got on his back for a ride I did do 2 weeks prior to that of 20 minutes of hand walking - marching right along, no putzing.

                                        IMVHO, movement is very very helpful for good healing of these. Rio also severed an extensor tendon (same leg!) when he was just turned 5, and I did the same thing - got him out moving free choice in small areas, working larger, asap.

                                        Rio was on NOT painkillers, no bute. He really did not swell much at all, so if there is some significant swelling in your guy, that Rx may be different. I could see a dex/dmso mix used to get the initial swelling down. Rio had that mix painted on (not ingested!) when he tore the flexor tendon sheath when he was 3 (yes, same leg!).

                                        I don't think the bute protocol you're using is anything to worry about either way - IMHO better to get after the inflammation early.

                                        Rio was VERY rarely lame on this leg, as in, rarely did it seem to hurt him, once the initial shock of the injury wore off. It was REALLY creepy to see him canter on 3 legs (yes, he did that early on!). He did end up running a bit, and that stung some, but only briefly.

                                        Hang in there. When I posted about Rio's injury, someone here PMd me with her experience and it was so much help - she had turned her horse right back out with the herd, as she had nowhere to put him in a stall. Something like 6 months later she was back foxhunting him

                                        I'm MORE than happy to share anything else I can about this. EqTrainer can attest to his soundness on that leg, scar tissue and all

                                        Wow JB.. I knew you and Rio had history... I didn't realize it was quite so... extensive. ;-) Sounds like he's be a good canidate for a bubble wrap suit if they ever make them in horse size. ;-)
                                        If i'm posting on Coth, it's either raining so I can't ride or it's night time and I can't sleep.

                                        Comment

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