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Suspensory Ligament Injury

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  • Suspensory Ligament Injury

    I am new to the forum, and wanted to share the recovery progress of my horse's right front suspensory ligament tear. I have really enjoyed the other entries on suspensory/tendon injuries, and have read received excellent advise on care and rehab. I have an 11 year old NSH who injured his fetlock bone and suspensory in mushy, deep ground after a Florida tropical storm last August. He was slightly lame on and off every 6 weeks or so, but always recovered after a 3 day layoff. From what I have read, this is typical of a suspensory injury. Finally we had it diagnosed over the Christmas holidays. We are currently in the rehab phase of walking under saddle for 30 minutes a day, still no turn out, and hand-grazing at will. I typically hand-graze him at least an hour a day to keep him feeling like a horse. My vet performed a Platelet Rich Plasma procedure 2 weeks ago. I wondered if any of you have created outdoor stalls so your horse can at least get out in the sun and move around an hour or so every day? My horse has been wonderful about stall rest, but is very lonely. We watch him closely and if he gets frisky we bring him in. Hopefully as he begins to get further along in his recovery, we can add to the size of the 12x18 outdoor paddock. He was grateful just to roll in the dirt! I also wondered if anyone noticed that the horse seems to physically recover faster than the monthly ultrasounds indicate? He seems perfectly fine after 9 weeks of stall rest and 6 months from the initial injury, but I understand that I am only half-way to the finish line. Thank you for your comments and support.

  • #2
    Originally posted by DianneEJ View Post
    I also wondered if anyone noticed that the horse seems to physically recover faster than the monthly ultrasounds indicate?
    Definitely something that was true of my currently-rehabbing front-suspensory horse.
    He seemed completely sound within a month of the diagnosis, but his ultrasound a few months after the diagnosis showed almost no progress. However, the next ultrasound (2 months of walking later) showed significant progress. It was kind of tough spending months walking with a horse who was sound and feeling ready to trot, but I'm definately glad we waited. Now we're up to 10 minutes of trotting (~7 months after the injury), and so far so good...

    Originally posted by DianneEJ View Post
    I wondered if any of you have created outdoor stalls so your horse can at least get out in the sun and move around an hour or so every day?.
    My horse is in a covered pipe pen outdoors, so he can socialize with his neighbors and be out in the sun. That said, I also turn him out occasionally in a small paddock with an old mare who he loves so he can have some time to just be a horse. If out alone, he wants to play, etc., but with her there, they just walk around hanging out for an hour or so (and he gets a chance to roll). My horse is older and fairly mellow in general, though, so it works out very well.

    Good luck with the rehab!!
    Last edited by Aquila; Jan. 31, 2011, 01:32 AM.

    Comment


    • #3
      Go slow with suspensory injuries --- and then go even slower!

      Originally posted by DianneEJ View Post
      I wondered if any of you have created outdoor stalls so your horse can at least get out in the sun and move around an hour or so every day? My horse has been wonderful about stall rest, but is very lonely. We watch him closely and if he gets frisky we bring him in. Hopefully as he begins to get further along in his recovery, we can add to the size of the 12x18 outdoor paddock. He was grateful just to roll in the dirt! I also wondered if anyone noticed that the horse seems to physically recover faster than the monthly ultrasounds indicate? He seems perfectly fine after 9 weeks of stall rest and 6 months from the initial injury, but I understand that I am only half-way to the finish line. Thank you for your comments and support.
      Hi,
      I've rehabbed a few with suspensory injuries. Go slow and be ultra conservative. They can backslide easily.
      As for your stall idea, it's a great one. When I have a layup horse, I have a "day stall" and a "night stall" so they get "turned out" into a different stall for all or part of the day. Recently I've had a horse here who has a healing fractured pelvis. He's getting pretty low being on stall rest. I made him a 12x12 paddock outside, next to the barn, with pipe panels. I move them around as needed so he can graze.
      Watch the footing in your teensy layup paddock --- make sure it's not slick or slippery. You can throw down some pea gravel or sand to help provide better traction.
      Other thing I do is I have a dutch door on the back of the stall. Behind the stall is a paddock. While I am cleaning or working, I put a horse friend in the paddock and let the rehab horse visit and play quietly over the door. Just 30 minutes of this does wonders for their mental health.
      Good luck!

      Comment


      • #4
        agree

        I agree with Watermark, and had success using 2 or more stalls for suspensory layup. I had one gelding which would not heal....ultrasound after ultrasound after bone marrow. I did feel that the shock wave was very helpful.

        Comment

        • Original Poster

          #5
          Thank you all. He is very happy in his mini-turnout we made him with the pipe panels, and we are watching the ground and moving it around so he can get some grass to nibble on and a bit of dirt to roll in. I am being very careful with him. After each 30 minute walk under saddle I cold hose the leg and so far, no heat or swelling. He hasn't exhibited lameness now for over 5 weeks. We are hanging in there. There doesn't appear to be a quick fix, but the outdoor stall is the trick!

          Comment


          • #6
            you can make turnout work

            My horse has a high L. front suspensory injury, and we are going into our 8th month of the recovery process, we just started trotting 1 month ago, currently at about 5 min.

            I had PRP done also. I have taken it really slow, but I elected to put my guy out in a small turnout. Some people disagree with me, but it was either that or my sanity. So we are going really slow.

            He has been wrapped for the most part in turnout, but recently we stopped wrapping and the leg is staying cold and tight. I think getting some scurf from the wrap was causing a bit of irritation that I mistook for the leg filling a little bit.

            I have iced him every day. I know he excercises himself more than 30 min in the paddock, but that's the way it is. He is much happier and so am I, and he is doing wonderfully. Thanks goodness I am at a barn with excellent management, I wouldn't have made it without that.

            His turnout is within a larger paddock, and is about 30' x 30'. He has gotten rambunctious a couple of times, but nothing like he has when he has been in for 3 days and I am trying to handwalk him.

            We put a pony on the outside of the smaller paddock who is calm, cool and more mature than him. The pony doesn't feed his emotions, but gives him the companionship he needs to make him feel like a horse, and has been a godsend, I love that pony. We now put the hay under the fence between their two areas and they share it, it is so cute. When the pony lays down, he lays down.

            He gets 3 pills of reserpine each morning, and a pile of alfalfa in the turnout field which he doesn't get inside, which peaks his interest and distracts him from getting too excited, and he has done really well.

            Next U-sound on Friday, I am quite optimistic.

            Comment

            • Original Poster

              #7
              Originally posted by kwilhide View Post
              My horse has a high L. front suspensory injury, and we are going into our 8th month of the recovery process, we just started trotting 1 month ago, currently at about 5 min.

              I had PRP done also. I have taken it really slow, but I elected to put my guy out in a small turnout. Some people disagree with me, but it was either that or my sanity. So we are going really slow.

              He has been wrapped for the most part in turnout, but recently we stopped wrapping and the leg is staying cold and tight. I think getting some scurf from the wrap was causing a bit of irritation that I mistook for the leg filling a little bit.

              I have iced him every day. I know he excercises himself more than 30 min in the paddock, but that's the way it is. He is much happier and so am I, and he is doing wonderfully. Thanks goodness I am at a barn with excellent management, I wouldn't have made it without that.

              His turnout is within a larger paddock, and is about 30' x 30'. He has gotten rambunctious a couple of times, but nothing like he has when he has been in for 3 days and I am trying to handwalk him.

              We put a pony on the outside of the smaller paddock who is calm, cool and more mature than him. The pony doesn't feed his emotions, but gives him the companionship he needs to make him feel like a horse, and has been a godsend, I love that pony. We now put the hay under the fence between their two areas and they share it, it is so cute. When the pony lays down, he lays down.

              He gets 3 pills of reserpine each morning, and a pile of alfalfa in the turnout field which he doesn't get inside, which peaks his interest and distracts him from getting too excited, and he has done really well.

              Next U-sound on Friday, I am quite optimistic.
              That sounds awesome and good luck on the upcoming ultrasound. I too put my mini-paddock/outdoor stall inside another paddock. We are hoping once we start adding trot work we can increase the size to 24x24 and so on. My horse is already a quiet horse, but too much inside is too much. Sometimes you have to go with your gut on your horse. We also have excellent management and he is only outside if I am there, or the 2 managers. Right now he gets from 1-3 hours a day depending on how quiet he remains. If its windy and brisk, we don't even try and just hand-graze. The pony sounds like a great idea. May I ask how you ice the leg and for how long?

              Comment


              • #8
                Originally posted by DianneEJ View Post
                That sounds awesome and good luck on the upcoming ultrasound. I too put my mini-paddock/outdoor stall inside another paddock. We are hoping once we start adding trot work we can increase the size to 24x24 and so on. My horse is already a quiet horse, but too much inside is too much. Sometimes you have to go with your gut on your horse. We also have excellent management and he is only outside if I am there, or the 2 managers. Right now he gets from 1-3 hours a day depending on how quiet he remains. If its windy and brisk, we don't even try and just hand-graze. The pony sounds like a great idea. May I ask how you ice the leg and for how long?
                Thanks!

                Mine is out all day. Because it is his routine, he is much less reactive to things like wind, but the drugs do help to just take the edge off. We did go through a time where it was about 3/4 hours which seemed to be his 'limit'. He too does get brought in if he starts acting wacky.

                I use the icehorse boot. It is sometimes hard to get it exactly on the right spot, but I can usually get it cold. I find if I coldhose for 5 min. then put on the iceboot I get the best result. Or just coldhose, but I ask the BM to use the iceboot when I can't be there. He gets iced when he comes in from turnout and also after a workout. I have tried a number of different ice boots/packs etc. but I think the softer ice gel conforms to the leg better and gets it where I want it.

                I usually leave it on about 20 minutes, longer than that sometimes can get warm. After I take it off I massage(for circulation) with a liniment that has arnica in it. Or LPC Tendonil, but I can't seem to get that right now.

                I also use the Back on Track quick wrap at night. It supposedly promotes circulation, which is key to healing these injuries, especially if they are standing in the stall alot, anything you can do to promote circulation will help the healing.

                Comment

                • Original Poster

                  #9
                  Great advise on ice therapy! Thank you so much. I have read about the Back on Track.

                  Comment


                  • #10
                    Good luck!

                    My guy just got the all clear about nine months after his diagnosis of a hind high suspensory lesion. But we caught a minor strain just days after it happened and he responded well to shock wave and rehab. (I can't comment on the surgery since we didn't do it.)

                    This horse would have torn down the entire barn if he was shut inside, so my barn owner built him a stall sized paddock. This made a huge difference! He is just the kind of horse who needs to get out of his stall for a few hours every day. If he got wound up, he'd just come in early. But most days he was content to munch hay and enjoy the view.

                    We took it very slow and followed the rehab plan. There were many months of walking under saddle, which I think were key. We iced after rides for the first few months (those Icehorse boots are great) and now I only ice on days when he jumps. We never wrapped his leg.

                    We were very lucky that this horse was such a champ about participating in the program. He was quiet to turn out, hand walk and ride with no drugs throughout his recovery. But I really do believe that many horses reinjure these ligaments because of silly things they do that are not part of the plan. I would definitely have used drugs if he needed them.

                    In terms of his soundness--that seems pretty consistent with our guy. He felt better very quickly, but the ultrasound told another story. His 9 month U/S last week showed that he was close enough to end his regimented rehab, but still not 100% healed.

                    Comment


                    • #11
                      Ok, the duration of the recoveries that you are all discussing are freaking me out. Are all of the really looooong recoveries for hind suspensory injuries, as opposed to front?

                      My horse has a mild high suspensory lesion on her left front, and we are currently on 6 weeks of stall rest, doing ESWT, and hand-grazing and walking in the indoor in hand. We will re-ultrasound her at the end of her stall rest period.
                      I tolerate all kinds of animal idiosyncrasies.
                      I've found that I don't tolerate people idiosyncrasies as well. - Casey09

                      Comment


                      • #12
                        Originally posted by Lori B View Post
                        Ok, the duration of the recoveries that you are all discussing are freaking me out. Are all of the really looooong recoveries for hind suspensory injuries, as opposed to front?

                        My horse has a mild high suspensory lesion on her left front, and we are currently on 6 weeks of stall rest, doing ESWT, and hand-grazing and walking in the indoor in hand. We will re-ultrasound her at the end of her stall rest period.
                        Nope-- with my horse, at the point of recheck in just over a month from now, it will be four months. Front suspensory. At this point he is still on stall rest with two sessions of 20-30 minutes walking. We are at the stage where it could have been undersaddle walking, but he is nut-so, so it has been hand walking. Waiting on the reserpine to arrive (had to order in the oral) and hoping that makes a good enough difference to be able to climb on again. In a week I get to start short trot sets-- two minutes a "ride." Working up to 10 minutes after a month when he will then be re-ultrasounded. Provided he feels sound enough when I start with the trotting, otherwise he will be walking for the next month as well before the recheck.

                        Provided all goes well at the recheck, I can't see us jumping right back into a training routine and I am sure it will take another 2 months or so to work up to canter. So 6 months at that point.

                        My horse's injury was not even severe-- very minor strain, no legion or tear. Vet said the worst thing you can do with injuries like this is to bring them back too quickly. Nine times out of ten you will find yourself with a lame horse again within a year if they are brought back too quickly. It sucks. Big time.

                        Comment


                        • #13
                          Lori, when we thought that all we were dealing with was a high front suspensory on Star, the vet said she had originally hoped to start us tack walking at the end of the first month. The ultrasound showed decent healing at that point, but he still wasn't sound (tho not from the suspensory as it turned out) so we kept hand walking. And hand waking some more. When I had the scintigraphy done about three months after the injury, the high suspensory showed no active remodeling.
                          The Evil Chem Prof

                          Comment


                          • #14
                            Originally posted by Lori B View Post
                            Ok, the duration of the recoveries that you are all discussing are freaking me out. Are all of the really looooong recoveries for hind suspensory injuries, as opposed to front?

                            My horse has a mild high suspensory lesion on her left front, and we are currently on 6 weeks of stall rest, doing ESWT, and hand-grazing and walking in the indoor in hand. We will re-ultrasound her at the end of her stall rest period.

                            Can't comment on front vs. hind, though I know the prognosis with hind injuries is much worse, so the recommendations may be more conservative.

                            FWIW: With our horse, the "stall rest" portion of his rehab was very brief. Within a few weeks of the injury, he was walking under saddle. There was just a long time where he was just walking under saddle before we were oked to move on to trotting and cantering. We started jumping small fences after about 7 months.

                            Comment


                            • #15
                              I think I want to go throw up now. This is so depressing. I don't know what I was thinking, just that we were going to be back to work in another 6 weeks or so. From these posts, sure doesn't sound like that's realistic.

                              I really hope that the stall rest portion ends on schedule, because stall rest costs me an extra $180 a month. The boarding place Katy lives is really lovely, but there is no facility for building her an outdoor stall or similar. There are small paddocks next to the actual turnout area that I will be investigating for her once she is farther down the road of recovery, both for her sanity and my solvency, but this is utterly demoralizing.
                              I tolerate all kinds of animal idiosyncrasies.
                              I've found that I don't tolerate people idiosyncrasies as well. - Casey09

                              Comment


                              • #16
                                Lori, don't be too depressed -- it won't get you anywhere. Trust me, I've been there SO often -- I had a horse I did 5, count them, 5 soft tissue rehabs on in 5 years (yes, he was a disaster).
                                Instead look towards incremental progress.

                                My horse had BILATERAL HIND suspensory lesions -- the kind everyone here is saying "at least it was in front." We did the surgery right away and had 1 mo. total stall rest, 1 mo. handwalking, 2 1/2 months small pen quiet turnout/walking under saddle, 2 1/2 months medium flat pasture turnout, trotting, eventually cantering. He was sound on exam by 3 months out. They did not ultrasound very often as progress is so slow to see on the pics.
                                I did shockwave as well.

                                They have told me this is pretty normal for this injury and, frankly, I am lucky to have a sound horse who was back to 24/7 turnout, hacking out, wtc under saddle 6+ months after the injury. We have not started jumping yet, but I think we will -- just spent a month having an unrelated setback.

                                It is really slow. It is what it is. You just have to grow a patient gene. It is REALLY hard, trust me, we all know!!! But freaking yourself out about it only makes it harder.
                                The big man -- my lost prince

                                The little brother, now my main man

                                Comment


                                • #17
                                  I just didn't fully understand the time frame I was dealing with, that's all.

                                  My riding time is pretty much taken up with coming out to groom and hand walk her 5+ times a week. I haven't been on in more than a month, and I'm afraid I'll be a worthless unfit chicken of a rider when I finally get back on. Fortunately, a nice fellow boarder has offered me some rides on her horse, which I hope to take her up on soon.

                                  Since the injury hasn't had any heat or swelling at all that I or the vet could detect, he said there was no point to cold hosing or ice. And I borrowed Trickonometry from a barnmate, so we can learn some fun stuff to fill up our time and brains. I am trying to be constructive, trust me. But it is hard.
                                  I tolerate all kinds of animal idiosyncrasies.
                                  I've found that I don't tolerate people idiosyncrasies as well. - Casey09

                                  Comment


                                  • #18
                                    I once heard that the old saying about how long it took tendons and ligaments to heal was that months = number of letters in the word. Ligaments are SLOW!
                                    But with early diagnosis, shockwave, etc etc, it is definitely better.

                                    You will be (or be convinced you are) a pathetic blob when you get back on, but that, too, returns. If you can catch ride that will help.

                                    I found the only reasonable way to move on was to set really small goals; thus I was genuinely excited when my horse could walk hack on uneven ground, instead of just being in the ring. Or super excited when we could trot.

                                    ALso, after a long time off, they feel pretty wacky when you get back on. my poor guy felt wobbly at the walk at first!!!

                                    Baby steps, baby steps.

                                    And, this is brutal, but true, if you are easing into horse ownership, this will give you a better feeling about it than anything else. yes, it's fun, yes, it's rewarding, but, yes, a lot of it can be spent rehabbing, wrapping, driving 2 hours to check on a wound, etc etc.

                                    I just spent yesterday driving horse 2 hours to lameness clinic, 4 hours figuring out (we hope) and treating problem, 2 hours home. Did I work? nope. Did I ride the other one? Nope. Did I come home thrilled that horse is not on stall rest and can be ridden next week. Yep. Small victories.

                                    Chances are, this is part of your experience at SOME point if you are in it for the long haul. There is a tiny upside in terms of bonding, and learning for you. But it's small.
                                    The big man -- my lost prince

                                    The little brother, now my main man

                                    Comment


                                    • #19
                                      Originally posted by asterix View Post
                                      You will be (or be convinced you are) a pathetic blob when you get back on, but that, too, returns. If you can catch ride that will help.
                                      HA HA HA - OMG that is me !!! It's been almost 6 months since I've ridden (my horse has bilateral hind suspensory issues). I've been too depressed/unmotivated to catch ride. Now probably no one would let me on a decent horse anyway! Hopefully I can start his rehab around the end of the month.
                                      "You become responsible, forever, for what you have tamed." - The Little Prince

                                      Comment


                                      • #20
                                        don't worry, he is a pathetic blob too right now.
                                        You will work back in together.
                                        The big man -- my lost prince

                                        The little brother, now my main man

                                        Comment

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