Beside myself - suspensory in older horse

[shadesofbay3]

advice needed!

my mare (25… cushings… otherwise in great shape, people often think she is in her teens) came in from turnout with a swollen back leg over the weekend

long story short, vet was out today and she has a suspensory…… i’ll be the first to admit i don’t know much but i know that isn’t a good thing… a lot of what he said next kind of went in one ear and out the next due to shock (i haven’t got the visit summary yet), but i’m pretty positive it isn’t ruptured (fetlock isn’t dropped), and he didn’t say anything about surgery

he mentioned possibly 3-6 months stall rest but that seems so cruel … mentioned possibility of giving her low dose of tranquilizer if she isn’t able to remain calm in her stall and to recheck in a month, at that time maybe she can be hand walked and/or hand grazed

my mind is buzzing with questions… is it cruel to keep her stalled for all that time? some morning she won’t even finish her breakfast because all the other horses are going out and she’s ready to go too… i know this could end any performance career, which is fine as she’s mostly retired, but i’m so worried about the prognosis, especially with the cushings affecting her rate of healing

am i overreacting to this diagnosis because of this “dirty” word and what i’m associating it with? or am i right to be so concerned? am i looking at the end here or just a long , not fun recovery?

[Renn_aissance]

You’re probably looking at a long recovery that will be complicated by her Cushings, and it may be the end of her performance career, but it doesn’t have to be the end of the story.

A lot will depend on what exactly is going on in that leg. Hind suspensories can be more complicated than front, and the degree of the lesion or tear certainly has bearing. So do have that conversation with your vet, and either take notes or bring a friend to help you recall the details. Take some time to get clear in your mind about the goal of her recovery and how you are able to manage her care. If the goal of rehab is pasture soundness and you’re able to keep her from being an utter loon in turnout, then you can have a quality of life conversation with your vet about turning her out at the cost of possible extended recovery time and higher risk of reinjury. The surrounding tissues need to be strong enough to compensate for the suspensory for this to work- though the flip side is that if she stands around in a stall for three months they won’t be! I think you’re right that it’s a quality of life issue so it’s worth a discussion about the trade offs.

The Cushings will complicate things a bit. Ask your vet about dietary support. Mine wanted my fellow on a higher protein diet while he was on layup to make sure he had the resources for tissue repair.

[atr]

Suspensory injury isn’t exactly happy news, but not necessarily something life-threatening.

My old man was supposed to be stall rested for months and just wasn’t having any of it, which wasn’t helping the healing process as he thrashed around in there. So once the initial injury had settled down, we made him a small paddock in his regular turnout so he could mosey around but not get to running, and see his neighbors and keep his normal routine. It worked out fine.

[shadesofbay3]

how would i trailer if needed? pretty sure barn is going to ask me to move

[atr]

Wrap the heck out of it from hoof to hock with cotton batting, a padded liner and a stable bandage on top to keep it as supported as possible.

[carman_liz]

Why would they ask you to move? Do they not want to have to provide the care for rehabbing that type of injury?

[shadesofbay3]

pm me… don’t want to get into it on the boards

[Fat_Dinah]

I had a 25 yr old gelding do the same, left hind. There was no stall, he just had a pasture with another horse. I wrapped him and used a sport boot and let him stay on pasture, trusting he would be calm. Took the whole summer but he emerged ok, just a minor hitch as that hind didn’t extend quite as far as before (an inch or so). He was pasture sound and fine to ride around at the walk until he passed at 29.

[carman_liz]

I’m really sorry you are in any kind of situation like that. Big hugs n jingles!

[shadesofbay3]

you all have me in tears i feel so much better !!!

[StormyDay]

Some vets no longer advocate for stall rest unless it’s a very dire injury. If I was in your position, I’d find a very calm pasture mate and ask the vet for a long term sedative for her to be on for a month or so, so she doesn’t take off buck-farting around the field.

[shadesofbay3]

the plan is to do stall rest for a month and then re-eval from there, which i though was fair

[emeraldcity]

Stall rest typically means “small space”- I have seen many horses do just fine with an outdoor “stall” so that they get to go out with their buddies. My current barn has two tiny med paddocks, and in a past barn my horse and others who needed it at various times had round pen stalls outside- just a square made from one panel on each side. Not saying it equals normal turnout in a big field, my horse was still a bit nutty anyway, but WAY better than being left in alone for months on end.

[shadesofbay3]

the more i read and research online the more upset i get… my vet says she is a candidate for surgery and wants to see how she does for 2 weeks and then recheck and consider … but i’m reading that hind limb has a poor prognosis especially with rest alone… her official diagnosis is proximal suspensory desmitis of left hind

[quietann]

My mare also did well in a small medical turnout (the size of 6 round pen panels) after suspensory surgery and 6 weeks of stall rest (with ace on board) and handwalking. She did require a low dose of ace at first to remain quiet enough, and was brought in if she started getting silly. I’ve seen medical turnouts as small as 16 by 16 feet.

OP may not be able to get her BOs on board, it seems, or I’d recommend having a second horse in the barn while her horse is on stall rest. Mine had her stall right by the tack room, office, and main cross-ties so there was always something going on she could watch.

OP just saw your last post. A lot depends on what you think is a “good enough” outcome. Is pasture sound enough?

My mare had a long and complicated recovery, but reached “good enough” to be a trail horse and low level dressage horse, with a slightly short step on her LH. I took it, just because I like her. She was recently retired from riding at age 24, 12 years after her surgery, because of worsening arthritis and mild heaves.

[emeraldcity]

My mom’s horse is currently rehabbing a hind suspensory. It was a pretty mild injury, and she’s young, so this is obviously not the same circumstances, but just as a data point- she had 3 shockwave treatments, and has been on a pretty standard rehab program. She just had a recheck which she passed with flying colors, started cantering, no more rechecks required unless something changes, and the vet said she would consider her injury risk roughly the same as any other horse once she’s doing well with cantering ~15mins. My understanding is that hinds are easier because they bear less weight.

[shadesofbay3]

so we are going to a layup barn by a vet that surprisingly used to be the vet that i used when i first bought my mare, and she’s great. she’ll be in great care with her. still have lots of questions but know that a lot is wait and see, which me as a person just naturally hate

the cost of layup board tho omg lol

question for anyone that has rehabbed at a rehab facility - tho i know the healing process can take 3-12 month (or longer) - did your horse stay at the layup barn the whole time? obviously there are variables here

and yes, i will be fine if she is just a pasture pet and comfortable

[Natalie]

I didn’t read all of the details, but my old guy (22 at the time, recently diagnosed with Cushings) had a sizeable core lesion in the main suspensory (not branch) just above the fetlock in a hind. If I recall, we did 2 weeks of strict (no walking except out to the aisle to remove poultice and re-wrap) stall rest and then another 6 weeks of stall rest with hand walking added in very slowly. I kept him wrapped in a standing wrap and poulticed for at least the first month, and would ice twice a day in between wrap changes. Switched over to Back on Track quick wraps once the ligament “set” and wasn’t hot, mostly to keep him from stocking up. The first time he went out I put him in a sports medicine boot and held my breath. He’s usually pretty chill but he had himself a gallop and buck around the paddock. Hand walking had occasional adventures of airs above the ground as well. He wore that sports medicine boot for turnout for the first 6 months or so, just in case.

He still healed really well. There’s some drop in that fetlock now, but it stabilized and hasn’t worsened in 2 years. He’s retired due to some gnarly ringbone in the front end, but I don’t think this the suspensory injury alone would have kept him from being sound enough to trail ride or do some light ring work if the front feet were sound. He’s a happy guy living his life now.

I did supplement with Smartpak’s SmartTendon for about 6 months or so too. Not sure if it made a difference (I’m always skeptical about supplements, even when I use them), but it was fairly inexpensive so I figured it wouldn’t hurt. My vet was both pleased and surprised with how well he healed given scale of injury and age, so…maybe it helped?