Collateral Ligament and Other Ongoing Issues

[AltersAreUs]

Looking for advice - young, BIG warmblood of dubious wisdom managed to sprain the collateral ligament in the LF, on top of other issues. Mare has a long history of hurting herself in new & creative ways and has literally been off of work or in rehab for most of her “riding” career.

This latest round started with on again/off again lameness in the fall, right after the ground froze solid. Normal vet x-rayed and ultrasounded and found nothing. We’d give her time off, then start her back on the lunge, and within a day or three, the slight lameness going to the left was back. This was on top of ongoing issues with constant cross-firing & kicking out at the canter and just a lot of WTF behavior - would be trotting along fine, then just whole body spasm, didn’t like to hold up her hind feet, sore back that came & went. We treated for lymes & ulcers, saddle fit, mare sees chiro religiously, but was not making progress on any front.

Finally hauled her out to Tuffs in late December, got a full work up (including a bone scan), found the sprain via ultrasound ( having an expert who does nothing but ultrasounds IS worth the money). Bone scan lit up a LOT of areas, the LF, SI, hocks, suspensory…this is obviously not a happy pony. Tufts injected the LF and sent us home with a rehab plan to start with the LF ligament and work on the rest once we knew that was good…

So months of small turnout (mare cannot be kept in while everyone else is out, even on drugs she tries to tear down the barn), hand walking, shockwave every 2 - 3 weeks, injections at Tufts … I took her back to Tufts in early April and sprain looks significantly improved on the imagining but on the lunge, she looks nearly the same. I was told to walk her under saddle on straight lines and every month or so, test lunge her to the left and see if she is sound.

Well, we just did the first “test lunge” and she looks exactly the same as she did out at tufts 4 weeks ago which was the same as she looked in December, which was the same as she looked in November. Just a mild, 1.5 - 2 head bob ever few steps on the circle to the left but it’s still there. Fine to the right & straight lines.

My trainer wants to pull the shoes (we put her in egg bars early on on Tuft’s recommendation) and throw her out in a field for a year or two, then see if she comes back and, if she doesn’t, just retire her.

I’m seriously considering it because even if we can get this LF fixed, we’re still looking at injecting multiple joints with no guarantee she ever comes fully sound and even if she does, well, how long will it last? Mare is only 8 and was doing intro/training level work and doesn’t stay sound for more than a few weeks at time.

I know ligaments can take a long time - are we throwing in the towel too soon? This mare has been absolutely heartbreaking and I feel like I’m just throwing more money & hope down into a bottomless hole.

[theresak]

Is it collateral ligament in the hoof or fetlock? My horse strained the LF fetlock collateral ligament that had become more chronic than acute. We did 6 months of stall rest (which I would never do again, I think small pen outside is better) and started hand walking, tack walking, and then trotting straight lines, working our way up to cantering 20 minutes with circles before he went back in full turnout. I think it was about 8 months total. We didn’t start trotting until he was sound jogging for the vet and we were trotting straight lines for 20 minutes before we added corners and circles.

I’d either keep with the pen rest and very slow rehab to see if anything gets better or throw her out for 8-12 months and try again.

[wsmoak]

So this is the collateral ligament in a front hoof? What’s her conformation like?

I had a QH type with this injury that had short upright pasterns. We rehabbed and even turned him out for a year. Unfortunately the mild lameness came back if he was in any kind of work beyond walking in good footing.

Sorry I don’t have a more encouraging story to share.

[AltersAreUs]

@theresak

Is it collateral ligament in the hoof or fetlock

Hoof & inside front. Her conformation is lovely - on paper she looks perfect and the vet Tufts had no complaints about her shoeing or angles.

[theresak]

My understanding is collateral ligament in the hoof is at least a year to heal and rehab from. I’d plan for 8+ months of rest before rehabbing, but if you think the rest of her body will continue failing in the meantime, dr. green for a year might be a good route.

[Peggy]

Assuming the neck is OK (Tufts did a full-body scan???) I would be tempted to pull shoes and turn her out for a minimum of six months, but probably a year. With good, consistent hoof care from someone who can work with a vet and their shoeing radiographs.

[AltersAreUs]

@Peggy

Assuming the neck is OK (Tufts did a full-body scan???) I would be tempted to pull shoes and turn her out for a minimum of six months, but probably a year. With good, consistent hoof care from someone who can work with a vet and their shoeing radiographs.

Yes, Tufts can do a full body bone scan. On one hand, it cost a fortune. On the other, I know a lot more than I did going in and, frankly, a full body bone scan is just cool. And since we were dealing with multiple symptoms that came & went, I decided to light her up entirely and get a full picture of what was going on.

[Peggy]

Agree. Having made the mistake once of scanning only the parts that we thought were problematic. And the radioisotope cost is the same no matter how many body parts are scanned.

[SLW]

My donkey was diagnosed with a tear of her sesamoidean ligament (distal) on her RF last October. The tear happened in August. She was confined beginning in August because of another condition we were treating and, like your big WB girl, my 12.2 donkey did not like confinement to a stall and 30’ run. I was raised Episcopalian but have seen enough Pentecostal’s in movies to know that sometimes snakes and Jesus are needed to make a point with a donkey. I tip my hat to you folks with great big horses being confined!

Anyway, last week was the most recent US that shows excellent scar tissue filling in. Since February she has been driven, weather permitting, with increasing intensity- we added trotting in March at two minutes each drive, adding 2 minutes weekly. I was not doing circles, just stayed along the edge of my grass paddock, until late April. Even now, the circles aren’t tight.

I’m wondering if your mare might benefit from being under saddle longer to build up strength since the US looked good. One month under saddle at a walk isn’t a very long time post December diagnosis. If no better in 6 weeks then consider long term turnout.

[AltersAreUs]

Vet (both Tufts & normal) seem to think trotting under saddle would be a mistake if she’s not sound on the circles

[Libby2563]

With horses like yours I tend to wonder if there is something underlying/systemic going on, like a cervical issue or DSLD/ESPA.

I had to euth my 5-year-old Hanoverian after a year of intransigent lameness and numerous diagnostics and treatments (including surgery and shockwave). His acute injury was to a collateral ligament in his front hoof, which like yours failed to respond to rest and shockwave and controlled exercise. He was barefoot with great feet and had only been in light work when he went lame at the ripe old age of 4. He also had bilateral hind suspensory branch issues (originally diagnosed as proximal suspensory, hence the surgery). I have a long thread about him on here if you want more info.

I’m not saying yours necessarily has DSLD, but it might be worth looking into. It affects all of the connective tissues, not just the suspensories. Most vets aren’t very familiar with it in young horses and wouldn’t think of it unless the horse already has dropped fetlocks.

Having been through all that once, I think I would give up sooner and retire or euth, as indicated by the horse’s comfort. Unless there is something correctable like hoof balance, I tend to think that horses who can’t stay sound have something driving the lameness that we just haven’t managed to find yet. Being chronically unsound and in pain can’t result in good quality of life for them, even if they are stoic. I made the hard decision to euth mine when he started struggling to stand for the farrier and to get up from naps.

[SLW]

Very good, they know best!!

[IPEsq]

Those structures can take a long time to heal. Yes, you just have a sprain but the horse also does not sound like a good patient. I think the trainer’s proposed plan is not a bad idea if the horse won’t tolerate potentially several more months of stall rest and not be trying to do a lot of stupid things that will impede progress.

[Jealoushe]

I highly recommend turning out for a year. I’ve had a few horses with bad lameness that after a year off came back stronger than before. Rest does wonders.

I also highly recommend listening to this podcast. It might open up to other possibilities causing all these issues.

[sara78]

Hi, i Know what that means, having a horse with multiple issues…had many horses in my life but had a couple of them that no matter what i did they just would never Come sound. And those were actually préserved horses in really super light training. Do you have thé possibility to have or ride another horse? I Hope that your horse will come right. I just share my expérience on thèse kind of horses. I fought to have them right, spending thousands and giving them Time, sitting on a chair and looking other people enjoying there sound horses. It IS frustrating, because anything you do they just do not Come right. I Saw that when you start having multiples issues it IS quite difficult to have them back to a full Athletic carreler. Hope your horse will Côme right but AT one point you will have to start to think at yourself and AT what you would liké to do. Good Luck with your horse. It IS really Heartbreaking sometimes.