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Soft Tissue Injury in Hoof - Updated Post #23 12/11/17

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  • Original Poster

    #21
    Originally posted by omgtb View Post
    I've been poking around these soft tissue threads mostly to see what people have done for rehab. I have an original thread on my guy's situation elsewhere on coth, but just find this thread interesting because the OP did opt for the MRI which showed the extent of the damage but did not change the healing protocol versus, say, what we are doing without an MRI.
    I should note that the initial diagnosing vet did not think that he would need such extended rest and was initially thinking that he could remain in very light work due to how minor the lameness was most of the time, and that he had not worsened with work for the entire month between the first lameness and the second. The reason for the plan of turnout for the winter was because I do not have the time to rehab him, between getting a second horse and school.

    And again, if I had had time for rehab this winter, we would have gone ahead with shockwave and he would likely already be back to walking under saddle based on his last ultrasound. And without the MRI, there would have been no PRP injection etc because he did not present as severely as most horses would have for his injury. What I'm trying to say is that while his R&R is vet approved, it was not their recommendation at all post MRI.

    So instead of him still being on restricted rest and doing a careful rehab under saddle I am (at this moment) watching him look for more food under the snow up in VT at his winter home with his new pasture mate (who he gets along great with). Sans shoes, his feet look good, the RF is a tiny bit misshapen but not in a way I was expecting (flared on the outside, more upright on the inside, which is how his feet tend to grow when not addressed properly, rather than flaring on the inside from trying to relieve pressure on the outside of his foot). His VT farrier (who I prefer) will be able to fix it up easily when Pizz is due next. But he is fat and happy and very very dirty.
    "I'm too sexy for my blanket, too sexy for my blanket, these mares-they should take it..." (J-Lu) - Featuring The Skypizzle Pony aka Classic Skyline

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    • #22
      My mare had a collateral medial ligament tear several years ago. She was on stall rest with handwalking for a YEAR, then turnout for another six months, before she started back lightly to work. My rule has always been "soft tissue injury, rehab at 50% to 100% MORE then recommended". It has been about 2.5 years since she started back to work, and we've had a few other minor setbacks, but she's schooling 2nd and parts of 3rd level. It is possible to survive these injuries and go back to a performance career.

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      • #23
        Originally posted by Hawks Nest View Post
        I should note that the initial diagnosing vet did not think that he would need such extended rest and was initially thinking that he could remain in very light work due to how minor the lameness was most of the time, and that he had not worsened with work for the entire month between the first lameness and the second. The reason for the plan of turnout for the winter was because I do not have the time to rehab him, between getting a second horse and school.

        And again, if I had had time for rehab this winter, we would have gone ahead with shockwave and he would likely already be back to walking under saddle based on his last ultrasound. And without the MRI, there would have been no PRP injection etc because he did not present as severely as most horses would have for his injury. What I'm trying to say is that while his R&R is vet approved, it was not their recommendation at all post MRI.

        So instead of him still being on restricted rest and doing a careful rehab under saddle I am (at this moment) watching him look for more food under the snow up in VT at his winter home with his new pasture mate (who he gets along great with). Sans shoes, his feet look good, the RF is a tiny bit misshapen but not in a way I was expecting (flared on the outside, more upright on the inside, which is how his feet tend to grow when not addressed properly, rather than flaring on the inside from trying to relieve pressure on the outside of his foot). His VT farrier (who I prefer) will be able to fix it up easily when Pizz is due next. But he is fat and happy and very very dirty.
        We are in a similar boat--of course after I posted my reply, he went ahead and jogged a bit off the next time I jogged him, and so, we are humbled and reminded that time is the only thing that will truly help at this point. Understood about the mild lameness--my horse presented similarly mild at first, and was probably attributed to residual SDFT soreness, and he is also quite stoic, so he was worked (however lightly) through a time when he should have been rested, because none of the evaluating vets seemed to think anything was wrong enough to prohibit work. I didn't actually ride him all that much because my gut feeling was that he should just have some time off, and he incidentally ended up getting quite a bit of stall rest thanks to a combination of unrelated factors, but then was turned out improperly and went wild and so on. IF he had been lame enough, with a savvy-enough group of people trying to figure out what was really going on with him, an MRI at that time might have given us an answer (keeping in mind that we wouldn't have actually known *where* to MRI because his lameness was so variable and transient) and made him a candidate for PRP or other therapies that are beneficial in the early stages of a soft tissue injury. As it ended up, by the time we figured out what was actually going on, he was beyond the point where an elaborate therapy would have helped him, and magnetic therapy, cold laser and rest/turnout were his best options. He also lost a bit of weight (he was much too fat) thanks to moving somewhere where he was properly managed and I really do think 24/7 turnout has made the biggest difference for his various limb complaints/stiffness.

        He is still a complete idiot at times but there's nothing I can do to protect him from himself. He's at the point in his healing where time, patience, and supportive therapies are all he has. He has been improving consistently, and even the tiny bit of 'off' that he was at the last jog was much less than the 'off' that he was after his last antics that made him lame at the walk, so, we are theoretically getting somewhere.

        Even after having done your MRI/PRP and such, your horse is still basically doing what mine is doing, and whatever the reasons, I do take comfort in that. I think doing more diagnostics would only be to make me feel better, as we are doing all that we can already to make him feel better.

        Interestingly, I had minor tears in two tendons in my shoulder, and it is taking *forever* to return to truly normal function, despite proper rest and rehab, and I remember a similar long-term sensation of abnormality healing a seriously sprained ankle. No matter what we do, these things, just by their nature, take a very long time to *truly* heal, and pushing the horse before they are ready is always the downfall of the healing process.

        Along the lines of what MysticOakRanch said, basically. Thankfully, we are quite a ways into his year off, and since he is somewhere where there's no indoor, the temptation to ride him over the winter is basically zero. Other horses are fine and all, but I'd rather ride my own, and I'm okay waiting to do that.

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        • Original Poster

          #24
          Wow so it's been over a year since I posted an update and boy is there lots of good news.

          Pizz reportedly spent most of his 8 months of turnout running laps around his 7 acer hillside pasture like an idiot. He refused to come in during the blizzards and went without meals more often than not, instead digging for grass under the snow. Somehow come may of this year he was still fat, very very fuzzy, and 100% sound. He had gotten so wild by the end that he wasn't safe to handle for the woman he was staying with.

          At the beginning of May 2017, he returned to the farm, spent 24hrs in a stall (horrible mud at the time) and then was brought out for the vet to evaluate before we started him back into work. Much to our surprise he was a perfect gentleman to jog and lunge (he had been sedated to be evaluated last summer). Vet was hugely impressed at his soundness and his overall fitness after 10 months off and gave the all clear to put him back to work. No special rehab protocol, just bring him back slowly for his own fitness and strength.

          Pizz stayed barefoot for the first month or two and then got front shoes, followed by hind shoes the next cycle as he was starting to get a little foot sore. He was back to jumping less than a month after going back into work (small stuff and mostly trotting). A month after that he schooled XC for the first time in over a year just for the fun of it. Days after the XC school he filled in for my other horse at a schooling dressage show and performed his best test ever to win with his best prelim score ever.

          At the beginning of november we had our first serious dressage lesson in ages, impressing the clinician and really stepping up our game. He is consistently schooling 2nd/3rd level work now and has gotten so strong that he outgrew his martingale neck strap (his neck is so thick now!).

          Yesterday, icing on the cake, he just loped over a 4ft oxer in a gymnastic line. He has gotten so strong that he now doesn't need to pound the ground to spring up (which he is very good at), instead he can just lift up easily! 4ft.

          What is so amazing is that a year ago the plan was to wait to jump him for quite a while after starting him back, to take it really slow. That plan changed when he came out of the pasture so sound and happy to work. The only lame steps he has taken were when he was getting foot sore before getting his shoes back on. He is stronger now than he ever has been and I have so many plans for the coming years with him, from getting at least my bronze medal to trying our hand at jumpers (more than just the indoor schooling shows he has already dominated at in previous winters). I never worry about if his injury will come back to haunt us and that is the best feeling ever.
          "I'm too sexy for my blanket, too sexy for my blanket, these mares-they should take it..." (J-Lu) - Featuring The Skypizzle Pony aka Classic Skyline

          Comment


          • #25
            Great news! Glad he came back better than ever. Amazing what a year of turnout does for their mind and body.
            "Anyone who tries to make brownies without butter should be arrested." Ina Garten

            Comment


            • #26
              Thank you for giving us an update. It will help others.
              I am so glad that you had good results. You were very patient.

              Comment


              • #27
                I had been told to wait and see on a front foot lameness since July. My guy was not getting better. Vet just comfirmed with Ultra sound and blocking he has a ruptured lateral collateral ligament of coffin joint. Lateral DIP.
                Plan is apply a lateralized central support shoe.

                The question is confined rest help or leave him in turn out in 20 acre field with 3 other horses.
                The injury is 5 months old

                Comment

                • Original Poster

                  #28
                  Originally posted by ALBIE View Post
                  I had been told to wait and see on a front foot lameness since July. My guy was not getting better. Vet just comfirmed with Ultra sound and blocking he has a ruptured lateral collateral ligament of coffin joint. Lateral DIP.
                  Plan is apply a lateralized central support shoe.

                  The question is confined rest help or leave him in turn out in 20 acre field with 3 other horses.
                  The injury is 5 months old
                  For our guy he was on limited space for the first few months, a few weeks of stall rest mostly so he could be where he could be iced daily, then 2 months in a flat paddock to reduce stress on the ligament before he was turned out for another 6 months in a bigger hilly pasture. In my case, however, there was not a tear, just lots of disrupted fibers.

                  I did find, however, that my boy as more comfortable the more he could move. I would try to find a middle ground between stall rest and the 20 acre pasture, under guidance from your vet of course.
                  "I'm too sexy for my blanket, too sexy for my blanket, these mares-they should take it..." (J-Lu) - Featuring The Skypizzle Pony aka Classic Skyline

                  Comment


                  • #29
                    Originally posted by ALBIE View Post
                    I had been told to wait and see on a front foot lameness since July. My guy was not getting better. Vet just comfirmed with Ultra sound and blocking he has a ruptured lateral collateral ligament of coffin joint. Lateral DIP.
                    Plan is apply a lateralized central support shoe.

                    The question is confined rest help or leave him in turn out in 20 acre field with 3 other horses.
                    The injury is 5 months old
                    My mare has the same injury. After diagnosis via ultrasound she spent 6 weeks in a stall with small run attached (maybe 12' by 24'). After 2nd ultrasound showed significant healing (yay!) she now goes out in a roundpen for turnout with handwalking daily, being careful to minimize sharp turns to the right.

                    I personally would not leave mine out in a field that large with others. The footing has to be good to minimize further damage and you are taking a risk of further damage running around with the others. If he's been doing that since July already and hasn't improved, it isn't helping him.
                    My vet prefers a small outside area for them so they don't go crazy and can move around a bit.

                    Also you might have better luck starting a new thread, this one is pretty old.

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