Bringing Back The Horse After the Third Major Injury - What Would You Do?

[scrbear11]

Shortened version of the story - Little Mare tore her DDFT, after an extensive rehab she came back to her purpose (Jumpers). She stayed injury free for a little over a year until she tore her Collateral Ligament in the other leg, with a subchondral bone injury and avulsion fracture at the ligaments attachment to the fetlock (diagnosed by MRI). After another extensive rehab she returned to full work. She remained injury free for less than a year, when she strained her collateral ligament again. After this strain I decided I would not do another expensive rehab - she spent three weeks on stall rest then went back to her normal turnout schedule for three months with no under saddle work.

All soft tissue injuries occurred in the field. She does not have much sense turned out.

She’s not inexpensive to keep sound not factoring in the injuries. She has navicular. She requires pads and to be shod all around. She’s on isoxsupriine and she requires maintenance in the form of injections and Adequan.

Recently I put just front shoes back on her to have her do some forced exercise, as she’s very fat. She had radiographs and an ultrasound recently that confirmed there is no reason she should be unsound and no reason she could not return to work.

With front shoes alone, she is foot sore. She doesn’t appear outright lame, just foot sore.

Here’s my internal debate. Do I spend the money to do everything necessary to get her comfortable to go back to work? But with her track record, it’s uncertain she could hold up to returning to the Jumper ring, and it seems the odds are not in my favor that she will remain injury free.

She’s a young horse. If she was aged, I would have no problem just letting her be. My trainer thinks I am crazy for even considering dumping more money into Little Mare.

Thoughts? Suggestions? Words of Wisdom?

[beowulf]

I am really sorry you’re going through all of that, I remember you talking about this mare when she first got hurt. :no:

All of those injuries in a short time, involving lower structures of the limb, has me immediately suspecting her farriery work - especially the collateral ligament tear. Care to post pictures of her feet?

How do you know these are pasture-related injuries? I’m going to get on my soapbox for a second, apologies as I am sure you are just repeating what was told to you (re: “pasture injury”).

I know “pasture injury” is commonly thrown around as a reason for horses getting hurt, but it’s a misrepresentation of the real factors that cause soft tissue injuries, which is management. There are really no such thing[s] as freak accidents when it comes to soft tissue injuries - most were brewing chronically for a while before total structural failure.

Horses should not get soft tissue injuries from running around in a paddock. They are very well designed for running. Wild horses traverse ~30-40 miles a day, on uneven terrain, at walk trot canter and gallop; their bodies are made for moving actively in turnout.

In my experience, absent sudden/blunt trauma, most soft tissue injuries are a result of chronic (long standing) duress of the ligament/tendon. Soft tissue injuries are most commonly caused by chronic inflammation in the area; from shoeing, from standing in a stall, from work… It can be difficult to isolate the reason why it happened, but it’s imperative to the future health and soundness of the horse to look critically at all aspects of management, and improve where things need improvement. Otherwise, you are faced with a rinse/repeat cycle of heal, get hurt, heal again, get hurt again.

How did the rads of her feet look? A horse should not be foot sore with just front shoes. Makes me wonder if the navicular is not fully addressed. As owners, we tend to place implicit trust in our farriers to be shoeing them well, but the longer I spend in the horse industry the more I am realizing there are some chronically unhealthy feet (and horses), and many owners and farriers can’t point them out and the owners & horses are paying the price.

In your position, no I would not do everything $$$$ wise to get her back to work. I would look into modalities to get her comfortable, and would seriously go over her hoof health with a fine-tooth comb. I might consider Dr Green (24/7 though) too, while getting everything sorted. These are not insignificant soft tissue injuries, and it may be she needs a long time to recover from all three of them.

[NaturallyHappy]

The above post is very good. I second a good look at her feet. A good farrier who sees balance well is worth their weight in plutonium. If she’s fat, can you put a muzzle on her for more turnout? I know you said she’s young, but I wonder about having her insulin checked because she is fat. Best of luck to you!

[IPEsq]

I disagree beowulf. These are not wild horses for one. And being designed for running does not mean the average show horse is conditioned to run. And any time you get speed happening, it doesn’t take much of another factor (uneven footing, mud, height added with some interesting aerials, catching a shoe on something). Not all soft tissue injuries are acute failure of a chronic issue. Acute soft tissue injuries do actually happen. As for the horse that is more prone to them, I think there’s something either biomechanically (including proprioceptively) or conformationally less than ideal that might have other factors that we can address like hoof balance but maybe not.

[JB]

If she’s fat and footsore, consider her insulin resistant until proven otherwise. It’s a terrible time of year for laminitis for EMS horses.

It doesn’t sound like she is suited for Jumpers or any significant jumping. Her history of navicular issues could be the underlying reason she’s been plagued with leg injuries.

I agree that a deeper dive into her feet would be where I’d start. Backs, as well as fronts.

[beowulf]

@IPEsq

I disagree beowulf. These are not wild horses for one. And being designed for running does not mean the average show horse is conditioned to run. And any time you get speed happening, it doesn’t take much of another factor (uneven footing, mud, height added with some interesting aerials, catching a shoe on something). Not all soft tissue injuries are acute failure of a chronic issue. Acute soft tissue injuries do actually happen. As for the horse that is more prone to them, I think there’s something either biomechanically (including proprioceptively) or conformationally less than ideal that might have other factors that we can address like hoof balance but maybe not.

Right, which is why I said most in my post, not to be confused with “it never happens”, which I did not say. :yes:

No such thing as a freak accident when it comes to structural failure of soft tissue or limb. Every injury has a root cause. For the most part, the root cause is consistently the management of the horse (poor farriery, standing in a stall, inappropriate or hard work, riding a subtly lame horse, pre-existing issues, etc).

Yes, there are horses who slip in mud and pull a muscle, there are horses who might have acute soft tissue injuries from a sudden twist in the mud or change in footing… However, it has been thoroughly investigated by JC + studies, that limb failures are commonly associated with pre-existing inflammation/stress already present in the leg. Microfractures, micro-injuries, etc.

The modern (sound) horse is not so fragile that it can’t handle running in a paddock… especially when that same horse goes and runs over terrain at big events, jumps in a ring, etc… If a horse is constantly injuring soft-tissue in turnout, something else is at play.

Another factor often overlooked is how good the horse’s connections are at seeing lameness. Most owners/trainers aren’t able to see subtle lameness. Many trainers won’t address it either, as it’s a loss of income. So the horse is worked with a subtle lameness, until a big blow-out appears. Disclaimer: I am not saying this is the case for the OP.

That’s not to blame OP for her horse’s injuries - she’s facing an uphill climb, especially with navicular which I suspect has played a huge role in her horse’s injuries… But… navicular is another disease that is in my experience commonly contributed to chronically unhealthy hooves.

[JB]

@beowulf

Another factor often overlooked is how good the horse’s connections are at seeing lameness. Most owners/trainers aren’t able to see subtle lameness.

This. IMHO there are far more horses out there who aren’t truly sound, than most people think. Just the sheer amount of poor trimming makes horses unsound, even if they never head or hip bot. Add to that poor saddle fit and poor riding, and lots and lots of horses are just surviving, not thriving.

[IPEsq]

@beowulf

Right, which is why I said most in my post, not to be confused with “it never happens”, which I did not say. :yes:

No such thing as a freak accident when it comes to structural failure of soft tissue or limb. Every injury has a root cause. For the most part, the root cause is consistently the management of the horse (poor farriery, standing in a stall, inappropriate or hard work, riding a subtly lame horse, pre-existing issues, etc).

Yes, there are horses who slip in mud and pull a muscle, there are horses who might have acute soft tissue injuries from a sudden twist in the mud or change in footing… However, it has been thoroughly investigated by JC + studies, that limb failures are commonly associated with pre-existing inflammation/stress already present in the leg. Microfractures, micro-injuries, etc.

The modern (sound) horse is not so fragile that it can’t handle running in a paddock… especially when that same horse goes and runs over terrain at big events, jumps in a ring, etc… If a horse is constantly injuring soft-tissue in turnout, something else is at play.

Another factor often overlooked is how good the horse’s connections are at seeing lameness. Most owners/trainers aren’t able to see subtle lameness. Many trainers won’t address it either, as it’s a loss of income. So the horse is worked with a subtle lameness, until a big blow-out appears. Disclaimer: I am not saying this is the case for the OP.

That’s not to blame OP for her horse’s injuries - she’s facing an uphill climb, especially with navicular which I suspect has played a huge role in her horse’s injuries… But… navicular is another disease that is in my experience commonly contributed to chronically unhealthy hooves.

Those JC studies are for horses undergoing racing stress. And racing stress causes much of the micro damage itself. This doesn’t apply to the average show horse who gets some pasture turnout. Horses are exceptionally talented at hurting themselves. I wouldn’t make such broad generalizations. A jumper is not going flat out in the show ring. Any time you increase speed there is increased risk for acute injury. That is moreso on a horse that is not conditioned for it. Not many jumpers show on grass anymore. Think about what it takes to properly condition an eventer. Do we do this with most other show horses? No. We are not just conditioning the muscles or cardiovascular system but the delicate tendons and ligaments of the lower limb which have zero muscular support and protection. Some horses just make poorer choices when it comes to their yahoos. For this horse, when you add sore feet and navicular issues, sure that could make her move in a way that is even less adept at handling stupid moves and may have underlying issues from the navicular that may make the soft tissue connections abnormal. I think its condescending towards the OP to blame their management solely on this. Some horses are just problems and they don’t necessarily make decisions that help themselves.

[IPEsq]

OP, your mare sounds like my friend’s horse (except she isn’t little). One soft tissue injury after another. Hinds. Fronts. Bone bruises. Abscesses. Thin soles. No expense spared, many rounds of rehab tried, and another soft tissue injury would happen. At some point you may have to throw in the towel. With the navicular and foot soreness, I think despite her age you may have gotten to your limit here. I unfortunately do not feel confident that you could bring her back without something else happening.

[beowulf]

@IPEsq

Those JC studies are for horses undergoing racing stress. And racing stress causes much of the micro damage itself. This doesn’t apply to the average show horse who gets some pasture turnout. Horses are exceptionally talented at hurting themselves. I wouldn’t make such broad generalizations. A jumper is not going flat out in the show ring. Any time you increase speed there is increased risk for acute injury. That is moreso on a horse that is not conditioned for it. Not many jumpers show on grass anymore. Think about what it takes to properly condition an eventer. Do we do this with most other show horses? No. We are not just conditioning the muscles or cardiovascular system but the delicate tendons and ligaments of the lower limb which have zero muscular support and protection. Some horses just make poorer choices when it comes to their yahoos. For this horse, when you add sore feet and navicular issues, sure that could make her move in a way that is even less adept at handling stupid moves and may have underlying issues from the navicular that may make the soft tissue connections abnormal. I think its condescending towards the OP to blame their management solely on this. Some horses are just problems and they don’t necessarily make decisions that help themselves.

We’re going to have to agree we’re disagreeing :yes:

People are afraid of turnout enough, and it’s detrimental to the horse. Throwing in incorrect things like “pastures can cause soft tissue injury” for soft tissue only further cements the opinion of the average (sport-geared) amateur owner that turnout = bad and confirms the impression “my horse can’t go out on turnout because he’ll get hurt.”

The majority of these injuries are because of factors outside of a horse kicking up his heels in a paddock:

• owners can’t spot a subtly lame horse
• owners/farriers can’t spot a chronically unhealthy hoof
• inappropriate work / repetitive work like circles or too much lunging

A horse out on turnout reliably and worked reliably, is fit enough for a little romp in a paddock. Even galloping around for a few minutes. That should not cause total system failure, even at speed.

Maybe it’s because my early years with horses was largely spent outside of highly groomed disciplines like H/J or jumpers, but it really blows my mind how afraid the average owner is of letting their horse stretch out their legs a little. A sound horse should not get a soft tissue injury after cantering / galloping around in his paddock for a couple minutes.

Makes me think some would be horrified to see the gelding herd (which includes two competition horses), who run around like absolute loons at 5AM and 7 PM like clockwork for a half an hour, every day. Including galloping, spinning, sliding, bucking… and it’s NE so half of the year it’s totally mud in the congested parts of the paddock.

That totally took OP’s very legitimate question off on a total tangent, but we can agree on one thing – that the mare doesn’t appear to be a great candidate for expensive treatments with the ambition to return to the prior level of work.

I still think that looking at the feet might help. That’s an awful lot of soft tissue damage in a short time, which makes me believe it is caused by external factors outside of turnout. The other thing to consider, some horses are not structurally sound for the job they’ve been intended to do. It may be looking at her critically gives us answers… or, it could be something systemic - sometimes chronic soft tissue injuries is an early sign of things like ESPA/DSLD.

[IPEsq]

A sound horse is also not one that is subtly lame, subjected to bad farrier work or being worn down by poor conditioning choices. All it takes for the fragile lower limb of a horse is the right combination of factors is all I’m saying, and that can certainly happen out in the field. Turnout has a lot of benefits of course, and so the benefit outweighs the risk in many cases. And some horses are actually more careful in bad footing. But even the sound horse many not be properly conditioned for being a nutcase in the field on occasion, and that lack of varied terrain and varied speed conditioning itself could lead to an injury even if he’s got good feet and isn’t lunged to death and whatever.

In OP’s case, mare has chronic issues. She’s not a “sound horse” even when she’s not limping. Mare only gets back to a certain level of rehab/conditioning before something else breaks. Mare makes poor life choices. She is the type of horse to certainly make an owner nervous about turnout. But mare is young and can’t live 24/7 in a stall for the rest of her life because that’s not healthy either. So, what is reasonable for the OP to do? The management side is a lot more complicated and a lot more expensive than for the average sound and less suicidal horse.

JB brings up a good point about her weight. Too much weight isn’t good for a horse with her foot issues. And maybe she’s got something metabolic going on making it worse. Something like Thyro-L might help you get weight off without exercising a sore horse too much.

[scrbear11]

I believe her conformation - and feet - are 100% of the problem. The inside of her feet are EXTREMELY contracted. Her foot radiographs are balanced, less having minimal hoofwall on medial aspect of her foot. Her foot grows UP, not out. After her strain my farrier recommended pulling her shoes and letting her feet grow in hopes the growth would balance her foot better. No luck… at all. My farrier does what he can with what he’s given to work with. My vet approves of her shoeing.

In work, she was ridden for fitness at home. She only jumped when at the trainer’s farm or at horse shows (with the trainer with us).

Little mare has quieted down as she’s aged, but even when she was much younger and lived out, she was VERY hard on herself in the field. She ran through the fence on more than one occasion.

It’s been a hard pill to swallow. I’m glad I asked for the advice here, while difficult to hear, it just reiterates what I was already feeling.

At least she’s pretty! And she still tolerates a bit of forced exercise so I can enjoy sitting on my horse.

[JB]

@beowulf

A horse out on turnout reliably and worked reliably, is fit enough for a little romp in a paddock. Even galloping around for a few minutes. That should not cause total system failure, even at speed.

:yes: and this is why more modern rehab thinking is get on the horse, ride him, work him correctly, get him more fit, BEFORE turning him back out full force. Of course that’s not always necessary, or possible, sometimes you can truly turn a recovering horse back out and he’s inherently quiet enough to continue healing. But this IS the reason this is sometimes the best way go go

Maybe it’s because my early years with horses was largely spent outside of highly groomed disciplines like H/J or jumpers, but it really blows my mind how afraid the average owner is of letting their horse stretch out their legs a little. A sound horse should not get a soft tissue injury after cantering / galloping around in his paddock for a couple minutes.

Most people don’t know what a fit horse is. They’re maybe fit enough to do their job without dying, but no respectable coach would let their basketball or football player go on the field in a "fit enough’ state. They need to be more than fit enough for their job. That’s what helps prevent injuries. Cross train. Gallop. Jump the Dressage horse and learn more collected work with the Hunter.

Makes me think some would be horrified to see the gelding herd (which includes two competition horses), who run around like absolute loons at 5AM and 7 PM like clockwork for a half an hour, every day. Including galloping, spinning, sliding, bucking… and it’s NE so half of the year it’s totally mud in the congested parts of the paddock.

The horses turned out full time, or at least most-time, become savvy on how to navigate changing, or sloppy, or icy footing. Of course there are always exceptions, but deal with them, rather than treat everyone like an exception. Many Winters we too are wet enough that our red clay is just gross. The horses will run and gallop and buck in the main field, come galloping down to the “chute” to the barn, and slow down and be a lot more careful in that muddier area.

I still think that looking at the feet might help. That’s an awful lot of soft tissue damage in a short time, which makes me believe it is caused by external factors outside of turnout. The other thing to consider, some horses are not structurally sound for the job they’ve been intended to do. It may be looking at her critically gives us answers… or, it could be something systemic - sometimes chronic soft tissue injuries is an early sign of things like ESPA/DSLD.

:yes:

@scrbear11

I believe her conformation - and feet - are 100% of the problem. The inside of her feet are EXTREMELY contracted. Her foot radiographs are balanced, less having minimal hoofwall on medial aspect of her foot. Her foot grows UP, not out. After her strain my farrier recommended pulling her shoes and letting her feet grow in hopes the growth would balance her foot better. No luck… at all. My farrier does what he can with what he’s given to work with. My vet approves of her shoeing.

In work, she was ridden for fitness at home. She only jumped when at the trainer’s farm or at horse shows (with the trainer with us).

Little mare has quieted down as she’s aged, but even when she was much younger and lived out, she was VERY hard on herself in the field. She ran through the fence on more than one occasion.

It’s been a hard pill to swallow. I’m glad I asked for the advice here, while difficult to hear, it just reiterates what I was already feeling.

At least she’s pretty! And she still tolerates a bit of forced exercise so I can enjoy sitting on my horse.

We did go off tangent a bit, though I think it’s been a valuable discussion.

Your mare may also be one with out enough self-preservation going on. Running through fences is not cool! I do think it lends to those horses doing things a “normal” horse wouldn’t,.

[4horses]

I’m just going to throw this out there… My first horse eventually developed DSLD, at the age of 16. She sounds similar to this horse, in that for years prior she was never quite right- difficult to remain sound. She had one high front foot and one low front foot. Navicular syndrome… Eventually had an unidentified hind end lameness - moved crooked behind. We dealt with thin soles and abscesses on at least once or twice a year basis. Tried Adequan for hock arthritis…

It is not worth jumping a horse like this- they just break down faster.

I don’t think turnout is a factor - all horses should be able to handle turnout. If your horse is repeatedly getting injured, then I suspect you have something else going on. Either the horse is stressing from being separated from its buddies, or getting worked too hard, or maybe you just have a particularly fragile horse… If your horse injures their left front and starts to compensate for that injury, that will increase wear and tear elsewhere.

Ae your pastures all mud which makes slip/fall injuries more likely? Is the horse happy in turnout or is it being picked on? If there’s nothing in the environment contributing to these injuries, then i would look closely at the horse’s workload. The horse could just be unsuitable for jumping- too fragile, didn’t develop the bone density needed for jumping… Maybe the horse is compensating for some permanent damage elsewhere.

A reduced intensity workload with no jumping, might be just what this horse needs.

[BAY_WITH_CHROME]

Does IPEsq have an axe to grind against Beowulf? This is the third thread I’ve seen them nitpick commentary in Beowulf’s post. Both of you are saying turnout injuries can happen. Beowulf is saying it’s rare that turnout is the only factor. Am I missing something? ”‹ ”‹

I’m another that’s not convinced that a brief spell of the sillies should cause a collateral ligament tear and subchrondal bone injury with avulsion fractures along the fetlock. That’s a BIG injury. I bet that lit up the MRI like Christmas Town.

Poor scrbear11, I bet your vet bills are crazy. In your shoes I wouldn’t pursue expensive treatment either.

[Lucassb]

@scrbear11

Shortened version of the story - Little Mare tore her DDFT, after an extensive rehab she came back to her purpose (Jumpers). She stayed injury free for a little over a year until she tore her Collateral Ligament in the other leg, with a subchondral bone injury and avulsion fracture at the ligaments attachment to the fetlock (diagnosed by MRI). After another extensive rehab she returned to full work. She remained injury free for less than a year, when she strained her collateral ligament again. After this strain I decided I would not do another expensive rehab - she spent three weeks on stall rest then went back to her normal turnout schedule for three months with no under saddle work.

All soft tissue injuries occurred in the field. She does not have much sense turned out.

She’s not inexpensive to keep sound not factoring in the injuries. She has navicular. She requires pads and to be shod all around. She’s on isoxsupriine and she requires maintenance in the form of injections and Adequan.

Recently I put just front shoes back on her to have her do some forced exercise, as she’s very fat. She had radiographs and an ultrasound recently that confirmed there is no reason she should be unsound and no reason she could not return to work.

With front shoes alone, she is foot sore. She doesn’t appear outright lame, just foot sore.

Here’s my internal debate. Do I spend the money to do everything necessary to get her comfortable to go back to work? But with her track record, it’s uncertain she could hold up to returning to the Jumper ring, and it seems the odds are not in my favor that she will remain injury free.

She’s a young horse. If she was aged, I would have no problem just letting her be. My trainer thinks I am crazy for even considering dumping more money into Little Mare.

Thoughts? Suggestions? Words of Wisdom?

I’m sorry to hear you’ve been through so much with your mare. These kinds of situations just really s*ck.

I think you’ve done a lot. And sadly I would agree that the odds of this horse returning to the jumper ring and staying sound are not on your side here.

What are your goals?

So many factors weigh in to these decisions. If your goal is to get back to the jumper ring, can you get another horse? Do you have options for this one that are acceptable to you, if she can’t return to her previous job? If it were me, I’d probably retire this one (or find her an easy job where she has a better chance of staying sound, if possible) and I would get something else… but that is easy for me to say bc I have my own place where retiring a horse is pretty easy/inexpensive, and retiring one doesn’t stop me from being able to get another horse to ride and show.

Best of luck to you.

[joiedevie99]

I have a friend with a dressage horse that has been through 4 soft tissue injuries now. Horse just has really terrible, small feet, with extremely contracted heels. They took him to a podiatrist at a big clinic, and are rehabbing the feet as much or more than the injury. Even though he’s fancy and well trained, they are planning to give up and retire him if this attempt fails.

[SporthorseFun]

Gosh, it could be genetic, and you are fighting an uphill battle. Someone mentioned ESPA/DSLD. It could also be that the little mare does not have the range of conditioning that includes managing their bodies for balance that can handle romps in the pasture. What is the prognosis with the avulsion fracture at the fetlock? What kind of a maintenance program will you be looking at? Or will it heal well with appropriate treatment and rehab?

[EmilyM]

Could you put her on trazadone and turn her out for a year then try again? Maybe an inexpensive retirement type place. Kind of an intermediate option. Lease another for the year?

[SuzieQNutter]

Just asking. When did it become normal to jump a horse with Navicular?