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Bone Resorption & Suspensory

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  • Bone Resorption & Suspensory

    Hi all, I'm new to the forum. I have an 9 yr old mare (Percheron/TB) that was diagnosed 8 months ago with "significant bone resorption at the attachment site" of the left Front Prox. Suspensory Ligament. She has done shock wave (4 times), PRP (1 time), Growth hormone injection, Osphos, and 30 days of Previcox as per Vet's recommendation. After 6 months of treatments and controlled exercise she is really not much better than she was at the beginning. Maybe slight improvement. Vet is saying it's going to take more time and more treatments. I'm wondering if it is realistic to expect much improvement at this point and whether I should consider finding her a pasture board situation or a home where she could be used as a casual trail horse instead of a jumper (vet says she is perfectly sound in a straight line at w,t and c - only lame when going to the right). She's a big girl (1300 lbs) just the way she is built. What are the chances this gl is going to return to a jumping career at this point? AND if she does, what is the likelihood that she will re-injure herself given her size and previous history? Any thoughts or helpful info is appreciated.

  • #2
    Definately need to get a second opinion from a different vet. Horse is lame. Period. Or just turn her out for a year and skip all the treatments that may or may not help this condition which I’m not familiar with, can you put in layman’s terms? Bone loss at the attachment site? Detachment? Was this found by ultra sound or x ray?
    When opportunity knocks it's wearing overalls and looks like work.

    The horse world. Two people. Three opinions.

    Comment

    • Original Poster

      #3
      Hi findlight, Yes there is bone loss at the attachment site. The ligament is only mildly enlarged. The main issue seems to be that there is nothing for it to attach to until the bone remodels.

      Comment


      • #4
        i've had good luck with stem cell on a stubborn to heal suspensory with no bone involvement. I had luck with one year turnout on one with bone involvement. no therapy. was purchased as a broodmare with hope to ride.

        I also did well with the Artemis laser treatment on a suspensory that was minor, but got reinjured even while doing all the right things. got us over the hump. Furlong has it. not sure who else.

        Comment


        • #5
          My horse Sonny partially detatched his hind suspensory ligament.
          First vet never mentioned the detatched ligament only the suspensory lesion. So his recommendation was 60 days of individual small paddock turn-out.
          After no improvement I switched to a differnt vet. She did PRP and used a heavy guage needle to score the bone to try to get the bone to recognize it as a "new" injury and hopefully start to fill in again. Stall rest for a few months with hand walking. No improvement so did 3 rounds of shock wave therapy. We were never able to get him sound enough to be ridden again. He showed a period of improvement so we started back on tack walking but he regressed. I retired him. He was a fairly bulky halter lines QH.
          Oh, well, clearly you're not thoroughly indoctrinated to COTH yet, because finger pointing and drawing conclusions are the cornerstones of this great online community. (Tidy Rabbit)

          Comment


          • #6
            I agree with findeight. I would get a second opinion from my regional vet school. Consider their options and go with them or consider simply turning out for a year and re-evaluate then.

            I would not plan on jumping this horse again, but if she could do dressage or just be a pleasure horse that would be grand.

            If you do not want to use her yourself for that, if sound you could find her a good home that does with a clearer mind of her soundness. More hope for a true home.

            If she is an unsound pasture puff, I would either keep her myself or put her down. I would not rehome an unsound horse with no true knowledge of what her future would be
            _\\]
            -- * > hoopoe
            Procrastinate NOW
            Introverted Since 1957

            Comment

            • Original Poster

              #7
              Thanks everyone. She is now on 30 days stall rest with walking on concrete daily only. We asked the Vet practice owner for a second opinion and he said she needs stall rest first. This is the opposite of what the first vet said. His thinking was she needs exercise to make the bone remodel. I'm so confused I don't know whether I'm coming or going.

              If she never comes sound to jump again she will retire and become my husband's pet. He loves her and says we can keep her!

              Comment


              • #8
                Listen to the second vet. You have two problems here, one with soft tissue and one with bone with the soft tissue needing the immediate attention, the bone may remodel at the same rate with just the handwalking on concrete as it would with more exercise. The soft tissue often needs less movement to heal and risks reinjury if not carefully supervised.

                Often there’s quite a bit of inflammation and some swelling around the injury site. You can’t see it from outside but it’s enough to cloud ultrasound and sometimes rads making exact dx difficult. Stall rest with hand walking is often the choice for 30 days then the vet will take another look. I’d be comfortable with that. Was not comfortable with the light work since soft tissue is also involved.

                Sucks it’s summer but if treated properly, recovery has a much better chance of returning to work instead of reinjury. Time is the biggest factor in that recovery but 6 months with no improvement under first vets supervision means it’s time to switch gears and try the more experienced vets program.
                When opportunity knocks it's wearing overalls and looks like work.

                The horse world. Two people. Three opinions.

                Comment


                • #9
                  How was she diagnosed? MRI?

                  Comment

                  • Original Poster

                    #10
                    She was diagnosed by ultrasound. Never had any X-rays. Second vet has requested X-Rays so we will get those at end of 30 days. Unfortunately she was allowed turnout for the past 7 months and may have done more damage than the original ultrasound shows.. We'll see. I'm curious about the Bone Resorption component... is that similar to avulsion or are hey two different things? It sounds like Avulsion fractures heal quite well?

                    Comment


                    • #11
                      No idea. Never heard of resorption causing detachment before this thread..
                      When opportunity knocks it's wearing overalls and looks like work.

                      The horse world. Two people. Three opinions.

                      Comment


                      • #12
                        I may in the minority here... but no turnout for suspensory injuries. Stall rest and controlled hand walking. No circles. The soft tissue needs to reform and band together. Build up the walking, and then walk under saddle to increase resistance. When you can get up to 45 minutes of under saddle walking, building by a minute or two a week, get the vet's opinion on adding some long sides of trot work. Start with 2 long sides and slowly build up from there. No corners for a long time. Walk through the corners. No circles or abrupt changes of direction.

                        It can take a LONG time to properly rehab a suspensory.... This is a months and years sort of problem. Following this program is how I have a sound 18 year old that had a bad suspensory tear.

                        Comment

                        • Original Poster

                          #13
                          Thank you Mocha0303! I have heard the No Turn Out thing from everyone. I don't know why the initial vet said turn out was OK. He also had us walking and trotting in the arena on soft footing which I now hear is really bad too. I feel like I've been doing everything wrong for the past 7 months and she could have been half way to better by now if we had followed a different protocol. SIGH.
                          I suspect the first vet is overly focused on Bone Resorption and not on the Suspensory Ligament itself. Not sure which is the more critical injury at this point.
                          Did your 18yr old return to jumping after it healed?

                          Comment


                          • #14
                            Welcome to the "suspensory with bone issues" clique. I am 2 years into "rehab" and I was also not told to keep him in a stall;; after the first month he was on light turnout and nothing was getting better.

                            From my experience, there is not much you can do if the horse has not begun to respond to treatment, after the first 6 months, except "benign neglect". My horse has been turned out in a field with his BFF for about a year now. He is not on drugs, nor is he having any therapy. We do ultrasound ever 3 months to see what is going on. Finally, 2 weeks ago the ultrasound show a lot of improvement!! The huge hole is about 80% filled in (although any 'repair' is made with scar tissue, which is much weaker than the striated ligament he started with, If he were to go back to work, it is a matter of 'when', not 'if' he breaks down.

                            I think you should adjust your thinking and hopes to the belief that 'trail horse' isthe best he will ever be. And that beats the hell out of 'cripple'. That leg will never be strong enough for high-pressure sports, Sound and pain free is the best you are hoping for.

                            Today I took my boy for a long hand walk around the area. He and I were both dancing up and down with excitement because he was sound, and out of his field and doing something.

                            I am so sorry to be a nay-sayer, but this is what others who have been through this told me, and now I am passing it along.

                            PS: If he goes lame in the opposite leg, you might be in the realm of DSLD. But, chances are, it that has not yet happened, then it probably won't.

                            I know how devastating this is. You have all my sympathy
                            "He lives in a cocoon of solipsism" https://www.chronofhorse.com/forum/c...lies/smile.gif

                            Comment

                            • Original Poster

                              #15
                              Thank you LordHelpUs. I feel like you have said what the vet doesn't want to say. They keep saying she will heal and "go back to work" but when I ask about long term prognosis they say there's a 50% chance of re injury. So, from my viewpoint that doesn't sound like a horse that is going back to her "work" as a jumper EVER. I'm only 7 months in but I'm starting to lose hope that she is coming back as a sport horse. Trail horse may be her next career if I can find someplace less expensive to board her for retirement. 2 years is a long time.... is this typical timeline for Suspensory with Bone complications? Do you know of others?

                              Comment


                              • #16
                                Oh wow, I sure don't like reading this. I have a 4 y.o. Quarter horse mare who was recently diagnosed by x-ray with bone demineralization at the suspensory attachment in her right hind, no ultrasound. Unfortunately, she also has sesamoiditis in both fronts. Everything points to suspensory strain in all four legs (she has only been ridden occasionally over the past 8 months and was completely off for 3 months to heal a splint). The vet was suggesting I rehome/give away to one of her clients as she will never be an athlete; the hope is that she will become serviceably sound for light flat and trail after 1-2 years of turnout on flat ground. I was optimistic but after reading your experience...I'm not even a month in. Does your vet have any idea what caused your mare's injury? Shoeing? Work load? Conformation?

                                Comment

                                • Original Poster

                                  #17
                                  Hi MGLpony, in my mare's case it is probably a combination of many issues: big heavy conformation with front loading; poor soft and deep footing in arena; over use; probable over-training before she was fit enough. My vet thinks she probably came to me already injured as there is so much bone involvement.(Silly me I didn't X-Ray all 4 legs!).
                                  What makes you think your mare has Suspensory issues in all 4 of her legs?

                                  Comment

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