Another question on suspensory surgery

[MGLpony]

Any further updates?

I have a young mare who was diagnosed at the end of May with “mild sesamoiditis” in both fronts and “bone demineralization” at the proximal suspensory attachment on the RH. I purchased her as a 3y.o. last March and as soon as I got her home, I noticed that she rested the RH a lot. She also was shorter on the RH and took more encouragement to track up. The PPE just noted a hind splint and high-low.

Since maresy was young and petite I rode very little and kept it short. Lots of handwalking on the trails until I sent her for training in May. She was supposed to get some trail training but that didn’t happen ; rather, for the entire 3 months, the trainer just rode her (Western Pleasure) in her small arena. I lessoned about 6 times and twice, she had odd stumbles with her hind.

Once I got her home in August, we headed out on the trails and I noticed that she tended to stall out going up hills. It felt like she was pulling with her front end rather than pushing with her hind. I found it quite odd but I just thought, “young, flatlander horse”.

At the end of September, I started with college classes (again) full-time, work full-time, and really rainy weather so I can’t say that I even rode once a week. But I noticed that after I did ride and was untacking, she would point her right front and COCK the fetlock forward as if to relieve discomfort. I also noticed that she tended to shift weight to the left front, regardless of work. At the beginning of February, I said, “no more work of any sort”; the discomfort was too obvious despite how little I rode.

A massive splint on her left forced paddock rest for 3 months and confounded a lameness exam; during that time she scooted, torqued, kicked, and performed airs-above-ground. End of April I started handwalking and just a short 10 minutes might leave her cocking the fetlock. We persevered for another month until I got in with the vet and here we are.

The vet said that maresy has chronic suspensory strain in all four legs based on nerve blocks and radiographs. We didn’t ultrasound at this point because we have an obvious mess. Turnout on flat ground for a year or two and shoes behind were the only instruction. However, good 'old Dr. Google is telling me this is very unlikely to remedy what appears to be very long-standing inflammation. Her history of lameness maintaining or increasing without work makes me quite worried. Surgery seems to be the best bet but the bone demineralization and apparent chronic nature make me worry about adhesions that will render the surgery useless.

For those who have gone through this, any words of wisdom?

[tipzythegreat]

I don’t know that surgery is your best venue.

Your mare is young, in little work, and has problems with all four suspensories – is that correct? I would be inclined to think she has DLSD or something else going on.

That being said, I’ve been working with Dr. Carol Gillis on my horse’s bilateral hind suspensory issue (chronic). I asked her point blank about the surgery and my horse’s prognosis. She said he can absolutely heal, and that she sees it all the time. In her opinion, the surgery was a means to hurry the horse back into work and often results in more long term complications.

So far, my horse’s chronic proximal hind suspensory has showed moderate healing after shockwave treatments and walking. It’s been difficult and expensive, but I think that’s his best way forward.

For me, it’s been 6 months of mostly just walking. For you, I think you need to get ultrasounds and perhaps temporarily retire her. She would do best with hand walking and confined turnout, but I know that’s hard to manage.

Sorry to hear about your poor girl

[MGLpony]

Thank you for the additional info. I’m glad your boy is making progress. I will put a call into the vet about ultrasounding the right hind. Right now she is strictly on solo turnout, about 2-3acres of flat land. She wasn’t able to tolerate handwalking due to sesamoiditis in the fronts.

Unfortunately, yes, the vet did speculate that the mare may have mild DSLD in the hinds. The recent COTH threads on DSLD are rather sobering.

Hope your gelding continues to improve.

[tipzythegreat]

I know it’s not the news you want @MGLpony and I am so sorry to hear she isn’t even comfortable to walk.

I am thinking you’ll need to treat for sesamoiditis first. And it looks like that’s a lot of rest. There’s a good chance both of these things are connected. I wouldn’t say there’s NO hope, but I think you’re going to have to do a lot of rehab for your poor girl. I just did a bit of googling on sesamoiditis and it looks like she will probably need about 8 months of rest.

Has your vet recommended any treatment for you?

If I were you, I would do something like this:
Get her on stall rest for 30 days
Get her on bute for a solid week
Cold hose/ice her legs, especially the fetlocks as much as possible
Poultice her legs often

After the 30 days, I would then try and introduce hand walking. If she’s still lame, I would give her another 30 days of confinement and cold therapy.

I’d then try to introduce hand walking again. Just 15 minutes a day for maybe a month. I would then do 2 15 minute hand walks a day for another month. And then make one hand walk longer, etc. Continue to slowly build as she strengthens. And definitely keep on the cold therapy. Eventually you can tack walk but that’ll be months out.

If you do nothing else, get her on a NSAID and on confinement for 30 days. I know it’s tough with a lovely pasture to roam, but she needs to get that inflammation under control.

I would think you can get her sound to walk and maybe trot a little bit with proper rehab and a GOOD farrier.

I hope you aren’t too demoralized! I am so sad for you! You could also consult with Dr. Carol Gillis once you get ultrasounds and x-rays if you want another opinion! I think it was $160 for her to review (2) sets of ultrasounds and 1 x-ray. Her recovery plan was a lot more in depth, conservative and slow vs what my vet had prescribed. And thank you for your well wishes for my boy. I wish you luck with your mare!

[Libby2563]

@MGLpony

Tnfortunately, yes, the vet did speculate that the mare may have mild DSLD in the hinds. The recent COTH threads on DSLD are rather sobering.

Just to clarify, DSLD (also called EPSA) is a condition that affects all of the soft tissues, so if your vet literally said “mild DSLD in the hinds,” you may want to get a second opinion from a lameness expert. I unfortunately had to euthanize my young horse with DSLD last fall (you probably read my thread) and found that most vets, even really well-reputed sporthorse vets, don’t know much about it.

I’m also skeptical of diagnosing chronic suspensory strain on all four legs without ultrasounds, so I think you’re right to look into getting that done. Good luck! I definitely would not proceed with surgery until you know more.

[joiedevie99]

@MGLpony Based on what you’re saying, I’d want to get a specialist to come take a look and do the ultrasounds. See what they recommend, but I’d be looking into shockwave and NSAIDS to get the inflammation under control ASAP. I wouldn’t jump towards surgery without a lot more information.