I am hoping some people can provide their experiences on dealing with this kind of injury . . . my horse’s is not so bad that it needs surgery but he is currently barefoot and I am wondering if there are corrective shoes that can minimize stress on the flexor tendon? So far we have been doing lots of sweating and icing, stall rest and bute. This is so frustrating because my horse was never lame but my understanding is that this can become serious quite quickly??
The annular ligament is a support ligament. It holds the underlying structures in place. If it becomes scarred and thickened due to damage, it will constrict the underlying structures and without treatment can possibly do permanent damage to them.
On the other hand, if the underlying structures are damaged and inflamed they cause the annular ligament to constrict the underlying structures.
So, you must be sure that you aren’t dealing with a tendon injury that is causing annular ligament constriction. My understanding is that most annular ligament issues begin this way. Also, OLD injuries can cause chronic ALC (annular ligament constriction) and you may not necessarily be able to see the original injury anymore.
I had the annular ligament cut in a horse that I owned who had an old tendon injury. He had to be on stall rest for a month and then hand walked for another 4 weeks but he did just fine.
My vet, who is one of the great TB lameness vets, had recommended walking and trotting on hard surfaces to try to get the ligament to stretch out, as long as the horse was SOUND with bute. Since we were not able to keep my guy sound, even on bute, we did the surgery. We did try some other non surgical things as well but it was wasted time. His acute flare up occurred when an overzealous trainer took him out and trotted and cantered him on hills while he was still supposed to be in a walking with a few minutes of trotting phase of getting back into shape after 2 years hanging in a pasture. Once constricted, the bulge on the top of his fetlock would not go away. AT ALL. Until after the surgery.
In a way, it was a positive thing. I kept wondering if we would have had problems with being NQR due to a little constriction that wasn’t enough to diagnose ALC but was enough to keep him from being the athlete that he could have been.
Also, once the surgery was done, his legs matched. Before the surgery he was unable to flex the bad fetlock as far as the other.
My TB gelding had the same issue. But after the non-surgical route showed no improvement, he had his tendon spliced. He was perfectly sound 12 days later. Now he did have about 3 months of stall rest before the surgery with icing 2x day, a combo of DMSO/cortisone (my vet made) cream applied after each icing, 4g of bute/day, and living in standing wraps. He was hand walked as well.
After the surgery (which was done at the barn) he was on complete stall rest for 12 days until the stitches came out. He was drugged with a little Ace and turned out. Then I got on and was to walk him in a very forward for 20 mins a day. After about 2 weeks, the vet cleared him to start to trot. Within a month, he was back to work, just took things slowly to get him back into shape. Two months out, he was jumping again. We kept him in standing wraps when in his stall for a few months.
He has been sound ever since. He was 16 yrs old at the time and now he is almost 28. He still runs like a crazy TB in the field:-)
My vet was very firm with how he wanted his hoof angle to stay after the surgery. Never wanted him to get long. He is barefoot now but that is because he is retired. He never required a special shoe when shod.
My horse has an old annular ligament injury, happened in July 07. He also had a sesamoid fracture (which caused the annular ligament injury), so he was on stall rest for ~6-7months. We did 2 shockwave therapies and he has been sound ever since (knock on wood). My vet cleared us to jump “as the horse tolerates it.” This happened at age 13, horse will be 16 this year.
I did consult for surgery, but with only a 50/50 shot of any improvement, I opted to save my $2000…it’s not like this was an A circuit show horse anyways, just my pleasure riding buddy. He does have a lump on the back of his fetlock, but it doesn’t bother either of us 
When we had the surgery done, we got three estimates, $500, $1200 and $2000
$500 was a rocking older surgeon who has been working on race horses FOREVER with a low overhead practice
$1200 and $2000 were BNV (big name vets :lol:) with high overhead practices.
The first vet was my first choice anyway
Dr Allen in Middleburg didn’t think shock wave was going to do anything for it. Said he’s be willing to do it if we wanted to spend the money. He did try some injections to reduce inflammation.
I feel like the annular ligament queen! In her lifetime my mare has had issues with all 4 legs. Her hind legs required surgery from which she recovered 100% and recently both of her front legs developed “issues”. She is 18 and I did not want to do surgery again and opted to try 3 sessions of shockwave therapy. Terrific results! Annular ligament problems are so treatable with usually excellent prognosis to return to complete soundness!
Thank you!
Thanks everyone for your stories–I feel MUCH better
Vet is coming today to re-ultrasound and keeping my fingers crossed as the swelling has gone down considerably. I wasn’t doing standing wraps as I was concerned about creating additional heat on the leg but it seems like they would be the best idea.
Just had surgery one week ago today on my paint gelding. He is recovering well; the swelling is down tremendously, I am told to expect a roundness in the back which will remain. I also wasted quite a bit of time doing non-surgical stuff. My instructions are one week of stall rest, followed by two weeks of stall rest with hand walking up to 40 min/day, followed by tack walking if he appears sound.
The prognosis is excellent, with the surgeon confident that DannyBoy will return to his career as a low level eventer/jumper.
Surgery was 1900.00 at a new state of the art clinic on Long Island, mostly covered by insurance.
All of the info on here about the annular ligament has been so helpful! I have a horse with a right hind annular ligament issue. I am curious how your vet specifically diagnosed that it was the annular ligament?
We x-rayed and nothing, flex tested and he flexed positive to his fetlock area. We nerve blocked and he went sound when we did his fetlock area. We ultra sounded and looked at his tendons, which didn’t show anything really. It wasn’t until we did all of that and shaved him some more to get a better look through the ultra sound that the vet said “you know he had quite a notch there” I bet that may be his annular ligament.
My horse has been diagnosed by process of elimination. Is there anything else I can ask my vet to do so I know for sure it is an annular ligament issue? I hate to think of doing surgery if I’m not 100% sure that is the issue.
Thanks,
[QUOTE=jillanddaniel;6868257]
All of the info on here about the annular ligament has been so helpful! I have a horse with a right hind annular ligament issue. I am curious how your vet specifically diagnosed that it was the annular ligament?
I hate to think of doing surgery if I’m not 100% sure that is the issue.
Thanks,[/QUOTE]
For my horse the injury was easy to detect because a “notch” or thickening was obvious on palpation and to the naked eye. I would always recommend the less invasive route first which is shockwave. My mare had a series of 3 treatments (some may need fewer or more depnding on the severity) and the results were as good as the legs she had surgery on. The added bonus for me was of course not having to change bandages and do the hand walking stall rest thing which my mare hated.
My horse injured the distal digital annular ligament, apparently there are more than one annular ligament. The one up high on the fetlock that everyone here is discussing. And another one lower down, sort of above the heel area.
http://www.australianwesternhorseshowcase.com.au/Features/medical/LEGS/anatomy2.gif
one image online also showed another annular ligament, below the fetlock.
edited to note that diagnosis was by high field MRI on Feb 5th 2013. But the main injury was a whole host of other things (RF lateral collateral ligament, RF lateral suspensory ligament, straight and distal sesmoidean ligaments in both front legs. And the distal digital annular ligament in RF.)
Thanks JLR1!! My horse definitely has a notch, but not that much more of a notch than the sound leg. The lame leg is his right hind and the "notch is only slightly more noticeable than his “good” hind leg.
You would really suggest shockwave first? Stall rest is going to go over like a lead balloon! I am planning on building him a outside 12X12 stall out in his pasture because I know “stall rest” will create a huge mess or he’ll need a buddy to stay indoors with him the entire time. He’ll be living on Ace and other sedatives at best 
I hate to put him through that! But will do it IF he is happier long term.
I’m just wondering if only THAT notch plus his lameness is enough to reasonably do surgery on?
MRI? lots of $$ and I wouldn’t do one w/o suggestion from a vet.
[QUOTE=jillanddaniel;6868257]
All of the info on here about the annular ligament has been so helpful! I have a horse with a right hind annular ligament issue. I am curious how your vet specifically diagnosed that it was the annular ligament?
We x-rayed and nothing, flex tested and he flexed positive to his fetlock area. We nerve blocked and he went sound when we did his fetlock area. We ultra sounded and looked at his tendons, which didn’t show anything really. It wasn’t until we did all of that and shaved him some more to get a better look through the ultra sound that the vet said “you know he had quite a notch there” I bet that may be his annular ligament.
My horse has been diagnosed by process of elimination. Is there anything else I can ask my vet to do so I know for sure it is an annular ligament issue? I hate to think of doing surgery if I’m not 100% sure that is the issue.
Thanks,[/QUOTE]
Ok that is what I was wondering! If a definitive diagnosis would be super costly and consequently not realistic.
I guess I am now just wondering if everyone else’s horse with annular ligament injuries are diagnosed by process of elimination? I was feeling as though I was the lone ranger and most people had a more solid diagnosis before embarking on surgery. Now I am wondering if this is the typical means of diagnosing these type of injuries?
Is there anyone out there with out lots of cash to spend on an MRI who can speak to how their horses were diagnosed? I’m just wondering if I’m alone on an island or if this is a common way to diagnose these type of problems??
thanks!!!
My understanding is that annular ligament injuries are secondary to some other injury. For my pony that was a stifle issue. We gave him lots of time off and rehab for stifles. Ligament issue resolved and he is sound at 24.
You need to find out what the u decrying issue is. I think that is why shockwave works so well.
Pkn
[QUOTE=Audrey79;4670635]
I am hoping some people can provide their experiences on dealing with this kind of injury . . .[/QUOTE]Which annular ligament? How did the injury happen? How was it diagnosed?
my horse’s is not so bad that it needs surgery but he is currently barefoot and I am wondering if there are corrective shoes that can minimize stress on the flexor tendon?
Have your vet and farrier discussed a treatment strategy?
So far we have been doing lots of sweating and icing, stall rest and bute. This is so frustrating because my horse was never lame but my understanding is that this can become serious quite quickly??
All the more reason your vet and farrier should be collaborating on treatment.
Thanks all!
[QUOTE=jillanddaniel;6868257]
All of the info on here about the annular ligament has been so helpful! I have a horse with a right hind annular ligament issue. I am curious how your vet specifically diagnosed that it was the annular ligament?
We x-rayed and nothing, flex tested and he flexed positive to his fetlock area. We nerve blocked and he went sound when we did his fetlock area. We ultra sounded and looked at his tendons, which didn’t show anything really. It wasn’t until we did all of that and shaved him some more to get a better look through the ultra sound that the vet said “you know he had quite a notch there” I bet that may be his annular ligament.
My horse has been diagnosed by process of elimination. Is there anything else I can ask my vet to do so I know for sure it is an annular ligament issue? I hate to think of doing surgery if I’m not 100% sure that is the issue.
Thanks,[/QUOTE]
My horses’sdiagnosis was very similar to this. Im excited to hear the surgery was performed in a barn in one case.
Did your vet do an ultrasound? I wouldn’t proceed with surgery without an ultrasound confirming a problem. That said, my horses first surgery was done without an ultrasound because a ruptured annular ligament was very obviously the problem. The second surgery was questionable and an ultrasound showed the problem. When she was older and I knew I did not want to put her through surgery it was based on palpation and lameness.
[QUOTE=jillanddaniel;6896753]
Ok that is what I was wondering! If a definitive diagnosis would be super costly and consequently not realistic.
I guess I am now just wondering if everyone else’s horse with annular ligament injuries are diagnosed by process of elimination? I was feeling as though I was the lone ranger and most people had a more solid diagnosis before embarking on surgery. Now I am wondering if this is the typical means of diagnosing these type of injuries?
Is there anyone out there with out lots of cash to spend on an MRI who can speak to how their horses were diagnosed? I’m just wondering if I’m alone on an island or if this is a common way to diagnose these type of problems??
thanks!!![/QUOTE]
Did your vet do an ultrasound? That is usually fairly definitive in pointing out an issue and not nearly as expensive as an MRI. I would really consider a series of shockwave treatments first before surgery.
I know this is old but I’m having a heck of a time finding info on distal digital annular ligament injuries! Any info/experience you had with this would be extremely helpful. Mine is in the right hind. Ultrasound confirmed along with some thickening of the sdft medial and lateral lobes. However these vets at a teaching hospital have never dealt with this injury and gave me a vet broard discharge. Meant this to be for NRB
