Collateral Ligament Injury Recoveries?

[Zeidant2]

I have been reading a ton of mixed experiences, and I am sure I will likely get more mixed experiences. My horse has a “suspected” collateral ligament injury of coffin joint but will be having an MRI tomorrow to confirm. My vet has based his tentative diagnosis based off of injecting the coffin joint and horse is still lame after injection. When he did a nerve block (I am not sure which was specifically blocked) but he did the first nerve block in the heel and still lame, and then went one up and that’s where he was sound, so it was the second nerve block if that helps. So vet came to this diagnosis solely based of nerve block and then injections–absolutely no imaging yet–he has zero swelling, no heat, no tenderness noted anywhere. just lame to the RF.

I know it isn’t official until an MRI confirms (and still very well could be anything else at this point), but I am wondering if anyone has had any experience with a collateral ligament injury and had any success stories with returning to work eventually? My vet said it was essentially career ending. He is a TB that has never raced, only 6 years old and is a hunter but hasn’t jumped more than 3’3 and doesn’t show a ton–maybe 3 times a year. He has never had any medical problems or soundness issues so this is all new to us. Thanks in advance.

[joiedevie99]

It’s hard to say anything without knowing what exactly is going on, and whether there are multiple soft tissue injuries in the hoof, or just one. There is always the possibility of a curve ball too - a friend’s horse ended up with a bone cyst that no one anticipated. That said, horses can and do recover from collateral ligament tears in the hoof, although it’s a long rehab with no guarantees.

IMHO, I’d be talking to the vet today about what the plan is if the MRI is conclusive. My vet likes MRI or CT guided injection of stem cells or PRP, followed (or preceded) by a series of shockwave treatments. If you plan ahead, you may be able to have the stem cells or PRP put in tomorrow, rather than sending the horse back in two months - or soaking the hoof and using ultrasound to do the best you can to visualize the injection location (which is still a viable option).

Going forward, correct hoof angles and good shoeing will also be important.

[Zeidant2]

@joiedevie99

It’s hard to say anything without knowing what exactly is going on, and whether there are multiple soft tissue injuries in the hoof, or just one. There is always the possibility of a curve ball too - a friend’s horse ended up with a bone cyst that no one anticipated. That said, horses can and do recover from collateral ligament tears in the hoof, although it’s a long rehab with no guarantees.

IMHO, I’d be talking to the vet today about what the plan is if the MRI is conclusive. My vet likes MRI or CT guided injection of stem cells or PRP, followed (or preceded) by a series of shockwave treatments. If you plan ahead, you may be able to have the stem cells or PRP put in tomorrow, rather than sending the horse back in two months - or soaking the hoof and using ultrasound to do the best you can to visualize the injection location (which is still a viable option).

Going forward, correct hoof angles and good shoeing will also be important.

interesting! I had no idea that was a possibility to inject same day. I would have to call and see. Thanks for your input! I was hoping to gain hope and hear those injuries aren’t career ending.

[scrbear11]

My Little Mare tore her collateral ligament at the fetlock attachment, while also sustaining and avulsion fracture and subchondral bone injury to the fetlock.

She was diagnosed via MRI. Her prognosis was guarded and I was told she would need to retire as a riding horse all together by three vets. I did shock wave early on in her injury, then PRP. She was on and off of stall rest for about eight months as she is not easy on herself at turnout. She re-injured herself twice during that eight month period that required another thirty days of strict rest.

She healed well and returned to soundness, enough to start in hand and some light under saddle rehab. She remained sound through under saddle rehab. My vet recommended Prostride injections in both fetlocks prior to any more intense work. She felt like a completely new horse after the Prostride.

She returned to jumping after about 16 months of injury. She competed in the 1 meter Adult Jumpers this winter. Unfortunately, she re-tore her collateral ligament in the same location on turnout. She’s now been retired.

My mare has is conformationally HORRIFIC. Her feet are terrible, her front angles are terrible. My farrier worked with my vet on her shoeing. They did the best they could, but I believe her terrible conformation has been her downfall. So I think, if your horse is conformationally sound, you can rehab correctly, and you can return to work slowly, you’ll have a long time left with your horse.

[Zeidant2]

@scrbear11

My Little Mare tore her collateral ligament at the fetlock attachment, while also sustaining and avulsion fracture and subchondral bone injury to the fetlock.

She was diagnosed via MRI. Her prognosis was guarded and I was told she would need to retire as a riding horse all together by three vets. I did shock wave early on in her injury, then PRP. She was on and off of stall rest for about eight months as she is not easy on herself at turnout. She re-injured herself twice during that eight month period that required another thirty days of strict rest.

She healed well and returned to soundness, enough to start in hand and some light under saddle rehab. She remained sound through under saddle rehab. My vet recommended Prostride injections in both fetlocks prior to any more intense work. She felt like a completely new horse after the Prostride.

She returned to jumping after about 16 months of injury. She competed in the 1 meter Adult Jumpers this winter. Unfortunately, she re-tore her collateral ligament in the same location on turnout. She’s now been retired.

My mare has is conformationally HORRIFIC. Her feet are terrible, her front angles are terrible. My farrier worked with my vet on her shoeing. They did the best they could, but I believe her terrible conformation has been her downfall. So I think, if your horse is conformationally sound, you can rehab correctly, and you can return to work slowly, you’ll have a long time left with your horse.

This makes me feel so hopeful!
I am so sorry she has suffered multiple injuries. You sound like such an amazing horse mom though! 16 months doesn’t sound awful of a length of time either considering another injury while rehabbing.

[scrbear11]

@Zeidant2

This makes me feel so hopeful!
I am so sorry she has suffered multiple injuries. You sound like such an amazing horse mom though! 16 months doesn’t sound awful of a length of time either considering another injury while rehabbing.

This is the chance we all take when we buy these suicidal creatures.

In all fairness, Little Mare also had two other major soft tissue injuries prior to the collateral ligament. She tore her DDFT and ruptured the tendon sheath in her right front. And she tore (very small tear) her suspensory in her right hind. Those injuries were considered by the vets in the guarded prognosis. The choice to retire her on the re-injury of the collateral ligament was actually my choice. I thought it best to stop the bleeding before she sustains a life ending injury.

[IPEsq]

Friend’s horse healed well with stem cells for a medial collateral that looked like it had completely separated from the bone on MRI. It actually reattached itself in a slightly different location–very strange case and he was on stall rest for over a year, plus the stem cell treatment. Stem cells take weeks to grow after you harvest the tissue (e.g., bone marrow), so you won’t be doing all of that in one day. PRP can be done stall-side. He didn’t go back to jumping because he had a frequent flyer card with the equine hospital for a multitude of unrelated things, but the collateral hasn’t been an issue.

[joiedevie99]

@IPEsq

Stem cells take weeks to grow after you harvest the tissue (e.g., bone marrow), so you won’t be doing all of that in one day. PRP can be done stall-side.

I’ve only used autologous stem cells once. Harvesting seemed really painful, and as you mention, there is a delay while they grow. My vets have been leaning heavily on allogenic stem cells (shipped from KY I believe) for a while now. They are available same day (or overnight if your vet doesn’t have them), and are a bit less costly too.

[pony4me]

Yes, get an MRI to confirm. My TB had mystery lameness which turned out to be a coffin bone stress fracture and collateral ligament injury. Long recovery, but he recovered well enough to go back to regular riding and 2’6” competition. I posted a thread on the Horse Care forum, maybe eight years ago, detailing the whole process. You may be able to find it if it hasn’t been deleted. Good luck!

[TuxWink]

I’m afraid to even type this as I may jinx myself, but I wanted to give you some hope. Mine was diagnosed back at the end of 2017 via MRI. Presented suddenly and was very lame, even at the walk. It was a large tear, 75% I believe. I did PRP and then shock wave.

I did stall confinement and very controlled exercise for the first 6 months - hand walking for 15 minutes, twice as day, as well as using an Incrediwear wrap. After 6 months we slowly increased the hand walking to about an hour a day. At 8 months or so I was able to tack walk on hard ground. I also let her have access to her run at that point, which was hard packed dirt. Luckily I live close to fire roads and so was able to do trail rides. I alternated tack walking and hand walking daily for another 6 months, and built up to riding her at the walk for about an hour and 15 minutes on the trails.

13 months after her initial injury I began bringing her back with slow trot sets in a large arena. I didn’t do another MRI, just a lameness exam. We had a terribly rainy winter and no indoor, so it was a slow process. I took 6 months to bring her back to doing walk, trot, canter and basic lateral work. It took another 6 months to get her back into show condition. I mainly do dressage, but we have done a lot of lateral work, small circles, etc. and I’ve also jumped her over little jumps (2’6" and under) without issue and I was back to showing at the end of last year (2 years after the initial injury.)

[Nickelodian]

My horse was diagnosed with a LCL tear in September. We have a bone cyst and small avulsion fracture. I talked to at least 5 vets about his MRI, with a gambit of ultimate outcome ideas. The vets I trust the most think the horse will be just fine. They said 18-24 months before returning to jumping. Mine did it when he stepped on himself cantering, so incident related vs conformation.

I’m at month 9 now. We PRP and multiple shockwave treatments. 5 months strict stall rest, two months aquatread and walker. He’s been back under saddle for two months. The first month walk and trot only on straight lines. Second month started pushing on more flatwork. He’s currently at a cowboy trainer for some odd behavior he exhibited on return to work, but so far sound.

No one has a crystal ball, but I’m hopeful for my guy.

[Zeidant2]

Well update: he actually was diagnosed with navicular syndrome. Idk what’s worse at this point. A collateral ligament versus navicular syndrome. He’s only 7 with no prior soundness issues at all or health issues so this is all unexpected

thanks everyone who shared your stories!

[Peggy]

@Zeidant2 That seems oddly unsatisfying and vague for an MRI result but maybe easier to deal with than soft tissue?

[Zeidant2]

@Peggy

@Zeidant2 That seems oddly unsatisfying and vague for an MRI result but maybe easier to deal with than soft tissue?

When I took him to the university vet wanted to start out with x rays and ultrasound. X rays came back with degeneration to the navicular bone. Vet said it’s pretty degenerated for his age, ultrasounded that leg up to the abaxial block since that’s where he was sound (he was not sound with just the PD block strangely). Vet said with what he saw, and included the small view of what can be exposed of the collateral ligament joint above the hoof, ultrasound looked fine.
he injected the navicular bursa followed by coffin joint, and then bute for a few days with stall rest and slowly returning to work etc. I initially thought well maybe this is better than what I initially thought? But so many failure stories and success stories with navicular (as I know every horse is unique to their own diagnosis of navicular) so you just really don’t know which way it’ll go. Have to take it day by day and stay optimistic.

[Peggy]

@Zeidant2 Ah, that makes sense. Somehow I thought he’d gotten the MRI. At least you saved some money.

[Blinky]

As one who dickered around all last year assuming I was dealing with feet issues as that is what the blocks and x-rays suggested, I am going to suggest you still do the MRI. I did this recently on a horse that was off and on lame…and while there were no surprises with the feet there was a strain on the straight distal sesamoid. This was apparently injured last year and never fully healed hence the off and on lameness. He was getting enough time off for a feet issue like an abscess but not enough time for the soft tissue to recover. My horse always blocked to the feet. I would never had known he had that issue had we not done the MRI. Thanks Nick!

[pony4me]

Yes, do the MRI to be sure. Check your PMs because I sent you the link to my original thread from years ago which has everything I went through with my horse.