Another suspensory issue

[MsM]

My horse is not and has not been lame. As we began schooling third level work, I decided to have the vet look at him, thinking maybe we need to look at the hocks. Horse is 12.

He was slightly reactive to palpation on the RH proximal suspensory. Flexed a 1 on that side. Hocks looked fine on xray. Ultrasound showed disruption in proximal suspensory, with some on the LH as well.

Vet indicated that the clinical significance was unclear since there was no lameness. It could be old injuries that healed that way or it may be active. Would need MRI etc to tell. I chose to pursue treatment as if it is active.

Did 3 rounds of shockwave and added a Chinese herbal remedy. He had small paddock turnout and his work was limited to handwalks and 10 minutes of ridden walk and trot. (both for mind and body)

We are two weeks out from last shockwave, and just did another ultrasound evaluation. Vet will tell me more when she can compare images on the computer in the office, but her first impression was that there was some healing, rather minimal. He flexed about the same.

I am waiting for her report. We discussed slowly adding time to his ridden work. He is getting Adequan as I was giving it to him every 6 months just because he was working hard. We discussed what further treatment. She said she didnt like injecting into the proximal with biologics due to the limited space and the thicker nature of those. Discussed injecting lower hock with something that would also diffuse and help knock down inflammation in the suspensory. We could try steroids or something like alpha2EQ.

I know it is early days and it will take time no matter the treatment. What have been your experiences with the various treatments available?

[hut-ho78]

I just did old school, stall rest with hand walking for some time, riding at the walk for 10 minutes and upping it by 5 minute intervals weekly. I can’t remember now if I could lunge before I trotted. I think so. Then I think turnout was allowed after trotting but I’m not sure anymore. One horse had a lower suspensory. Another had an upper suspensory and had to go through the process twice. The horse with the lower suspensory was lame and also had sesamoiditis and a bone chip that did not need removal, all from an acute injury. The one with the upper suspensory came off the track with it. She was only lame in tight circles. It took two rounds of old school rehab. Get help with the riding at the walk prior to lunging or turnout. I would handwalk for about an hour trying to get the horse calm enough that I could muster up the courage to get on. The second rehab of the upper suspensory, I got help with someone to lead her and we still had to use a chain over her nose. These were horses that were and/or became rideable bareback with a halter so they had pretty chill temperaments, just lots and lots of energy.

The horse with the upper suspensory had an injection prior to the first rehab but I read later steroids could inhibit healing in soft tissue. There appeared to be differing veterinary opinions.

Other friends have had good luck with shock wave and/or injecting stem cells. Some use a regional rehab facility that offers swimming, etc.

Good luck!

[sammy14]

If both hind suspensories are involved you can’t accurately assess lameness without blocking. My experience was a horse non weight bearing lame lame on RH after a fall, he had 3 months off and was a lot better but not quite right.
He was then lame on the LH as well when the RH was blocked.
Blocking the suspensories completely resolved any lameness.(however this was without a rider and he does look perfectly sound in the paddock, but some horses only have issues when ridden so I don’t know why they don’t check that)
Ultrasound showed only disruption, no tears or holes.
N/F surgery was recommended with a good prognosis which was done.16 months later we’ve just started cantering again.
IME vets under play the recovery time line massively.
Rehab is tedious, sometimes scary, and an emotional roller coaster. The N/F surgery is the best bet for recovery statistically but it’s a huge commitment to rehab and i’m pretty sure id retire the horse if I knew then what I know now. My horse is hot and tricky so that made it harder.
I hope your horse gets better soon and is only mildly affected fingers crossed! Good luck.