I think you need to consider that you started “treating” any injury, with stall rest collateral ligament or whatever, only from the time you began the stall rest after the turn out you tried. This type of injury takes forever to heal.
He could have aggravated the collateral injury with turn out, done damage or injury to other stuff inside his foot while on turn out…
Yes, you’re right. I just re-read the really long collateral ligament thread that started in 2007 (I think you chime in late in it) and it made me feel a little better. A common theme earlier in the thread was no improvement at all for 4 months. Well, I am almost at 4 months now (I am only counting from diagnosis and start of stall rest, like you said) so maybe mine will follow the same pattern and show more improvement soon. It sounds a lot milder than many other poster’s horses’ injuries, so that’s something.
It would be a lot easier to be patient and quietly hopeful if he didn’t also have these hind end issues (whether conformational or DSLD, who knows) that are supposedly likely to severely limit his usefulness in the long run. One of the vets regards him as a future trail horse at best and that is seriously discouraging. It makes me want to just turn him out so at least he can be a happy horse and I don’t have to spend my whole life cleaning stalls.
Maybe try to go at it in a methodical way. Get the actual diagnosed by MRI injury healed and then decide how to deal with what else might be going on? It sucks!
The three vets I worked with all told me he would most likely just be pasture sound. They were wrong. It took forever to get him back though but we did it. He then had another weird accident and did a number on himself all over, a bunch of really weird problems and a neck injury that required dex to get rid of swelling, well, he got laminitis from it and rotated about 9-10 degrees on the front left and 12-13 on the front right and almost died…so we’ve been a year and a half fixing that…sigh…I love my horse…I love my horse…I love my horse??? I guess I’m saying hang in if you can and if you can’t, don’t beat yourself up about it!
Here is the original MRI:
A linear, peripheral tear is present in the medial lobe of the digital flexor tendon. The tear
extends from the proximal aspect of P2 to the mid-navicular bone. The medial most aspect
of the digital flexor tendon is moderately enlarged, associated with the tear. The medial
aspect of the distal digital annular ligament, at the level of the tear is slightly enlarged.
The medial collateral ligament fossa of the disorder phalangeal joint is slightly irregular. The
collateral ligaments of the distal interphalangeal joint are normal.
No significant abnormalities are identified in the navicular bone. The navicular bursa
contains a mild amount of effusion.
The distal interphalangeal joints is within normal limits. Mild osteophyte formation is present
along the dorsal margin of proximal P2.
Mild sclerosis is present in the distomedial condyle of the third metacarpal bone.
“-Peripheral tear, medial lobe of deep digital flexor tendon (at level of P2).
-Mild navicular bursitis.
-Enthesopathy, medial collateral ligament, distal interphalangeal joint.
-Mild arthrosis, proximal interphalangeal joint.
-Mild sclerosis, fetlock.
The deep digital tear is the most significant finding”
My vet from home was most worried about the medial collateral ligament injury and the clinic vet was most concerned about the DDFT.
This is from the follow up MRI 6 months later:
The linear peripheral hyperintense tear in the medial lobe of the deep digital flexor tendon at
the mid aspect of P2 to the navicular bone has filled in with intermediate to low signal on T1
and T2 weighted images. The medial most aspect of the deep digital flexor tendon has
reduced in size. Mild effusion is the flexor tendon sheath remains.
The medial collateral ligament fossa on P3 remains slightly irregular and widened.
No significant abnormalities are present in the distal sesamoidean ligaments.
The navicular bone maintains good corticomedullary distinction. Mild effusion is remains in
the navicular bursa. The distal impar and collateral sesamoidean ligament are within normal
limits.
There is slight to mild effusion in the distal interphalangeal joint. Otherwise the distal
interphalangeal joint is normal.
The mild osteophyte formation on the proximal aspect of P2 is unchanged
Conclusion:
-Healing deep digital flexor tendon tear (medial lobe)
-Unchanged mild navicular bursitis
-Unchanged mild medial collateral insertional enthesopathy, distal interphalangeal joint.
-Unchanged mild arthrosis, proximal interphalangeal joint.
-Slight to mild distal interphalangeal joint synovitis."
Wow, JM, you have been through a lot!! So sorry to hear about the laminitis, that is the worst. I wish you two the best going forward!!
Yes, my plan was to get the LF collateral lig healed and then see what happens behind. This is just my theory but it seems possible that the (relatively mild) LF lameness is due to compensation from the more pronounced LF lameness. But since the hind end lameness and suspensory branch desmitis could also be due to something unrelated and irreversible (like DSLD and/or crappy conformation), it makes me wonder how much time, money, and stress I should really put into resolving the LF, and how much stall rest I should subject him to.
Vets have really different opinions on the hind end and his future prospects. So far I have two votes for “don’t put any more money into him”/“he’s going to break down no matter what you do,” one vote for “we have to resolve the LF because he could be a trail horse,” and one who won’t give me a clear opinion. Likewise, some think he definitely or at least probably has DSLD and others don’t think he does or don’t think it matters because his conformation is limiting in and of itself (but I do know and see sound horses with his conformation). Very frustrating!
Since I have already spent 3+ months of money and work into stall resting him, I’m going to try to at least make it to 4-5 months before I make any big decisions. I do think I will back down on the handwalking though, for the sake of my sanity (we had worked up to 25 min 2x/day, which is a pretty big time commitment).
I am so sorry that all of this has happened to you and your horse! I just wanted to add a little input since I have been battling long-term lameness issues with my older guy as well and have been through the whole diagnostic ringer.
After reading through your posts and seeing all of the problems your horse has at such a young age, I personally would start looking at euthanasia. I know that is a hard decision, but I feel that that is the kindest thing you could do for him since recovery does not seem to be in the cards here. I say that because even if, by some miracle, you can get him reasonably sound despite the suspensory, multiple limb lameness, and arthritis, the nerves cut during the hind neurectomy will ultimately regrow and end the chance of him having a pain-free life. Plus, you have to take into account that all of his problems will probably only worsen with age leading to a horse that may have to go through his whole life in pain.
It breaks my heart to say this, but I feel that investing more money in a horse that will never be sound at such a young age with what seems to be multiple serious problems is a waste of time. I definitely don’t say that lightly as I would go to the ends of the earth for my horses as well. Sadly, there is only so much we can do for our animals - no matter how much money and time you put into their recovery. Boy, do I wish that wasn’t true!
Thanks. It’s been pretty rough.
Any chance you would feel comfortable posting a conformation shot since the vets have been talking about “crappy” conformation being a factor or influencing his future? Might be interesting to see what some of the experts here think…myself not included in that.
Perhaps that amount of hand walking is too much for him still at this point of his healing? My experience is that the hand walking is pretty crucial though. Maybe not 25 mins twice daily but perhaps confirm with a vet you trust about how much to back off. You could always justify that amount of time hand walking as being the same amount you would spend getting him ready and riding? I know, not really satisfying but might help you make it through.
One vet wanted me to hand walk three times daily for 20 minutes each right from the get go. My home vet and clinic vet both thought he needed to start healing more before he moved around so much. Different ideas. I went with the more conservative approach at the beginning.
My guy loved the Theraplate while he was on stall rest. The clinic had one and then we rented one when he came home and eventually ended up buying it. It helped take the edge off and relax him. Not sure it helped with healing of the actual injuries but helped get us through. We have “family time” on the vibrating plate, the dogs and barn cats and hubby all get on in the evening. 
@Libby2563, I was really expecting so much worse in the hind end and the fetlocks. I’m wondering what my non-educated eye is missing? Can anyone help me? The fetlocks are a tad long but not terribly…
OMG, sorry to hear about your filly! I hope she recovers well. I don’t know what it is about nice horses…I told my trainer I am “done with horses for a while” but I think what I really meant was, I am done with buying nice horses and having high hopes, LOL. Like your QH, I’m sure my cheapo Craigslist pony will be sound forever so maybe I will stick with that type for a while! (BTW that lovely saddle you sold me fits her fairly well, by some miracle, even though it was flocked for the 17.2ish Hanoverian!)
Thanks for the pic of your horse, that’s very interesting. I do see some resemblance too. When did his fetlocks start dropping? My guy’s have never changed but I wonder if we just caught it in the early stages because of his lameness (not that “catching it early” helps, since there’s not much to be done anyway). If they do start dropping at least I will have a better idea of what’s going on and how bad his prospects are, rather than just the best guesses of a bunch of different vets.
Love your hay nets in the shed too!
I am not sure when they started dropping, embarrassingly. I think it was over time very slowly and then one day years down the road I was like “that doesn’t look good…” They didn’t get much worse than in the picture though. I think they probably would have eventually dropped to a distressing degree…They were pretty looseish if that makes sense. on impact trotting they would sometimes look like he was landing off a huge oxer or something.
Maybe that is why horses with that straightish hock and then the long sloping pasterns end up with tendon issues. His hocks weren’t really “too straight” either but combined with those pasterns it wasn’t a good combination.
Glad the saddle is fitting the pony! I swear that saddle is basically magic, it fits so many horses at least well enough to be fine to use! I won’t part with my other one like it in case I get one of those horses with a tricky back in the future!
I think of the Trakehner stallion Ozkar II when I think of your horse… Straight though the hocks and long pasterns, but he eventually went to GP and at least one person on this board has an offspring of his.
CAD? Geek!!! :lol::lol::lol:
I wouldn’t give up on him given your investment. Horses continually surprise us. Maybe just thinking about the lameness issues right now? If the horse is continually lame after this period of treatment, perhaps an alternative path of thought is in order. But if time off seems to improve him, maybe more? Pretty much only you can decide what is best for you and what is best for your horse. If you horse can’t be comfortable with your excellent care, and can’t be comfy under saddle, well, I’m confident you will know what is best for your horse. No horse should live in pain.
What does the breeder say? There are enough foals on the ground that an estimation of the stallion and the mare must be evident. ??? Do sibling have this issue?
I will suggest/concur that breeding ones own foal is not necessarily a cheaper way to get a good horse. Ask me how I know!
Please keep us informed of your gelding’s progress and pitfalls.Not every horse has access to a good researcher or veterinarian. The combo is ideal.
What I notice in these pics is that, while the fetlocks aren’t really as low as my horses were, I see a wider hind leg stance as if the are putting a hind leg more squarely under their hip or corner… in an almost parked out position.
Did these horses lean their butts on something for rest?
back up in order to do so? One of the first thing I noted, a very clear pair of parallel tracks of the hind legs/feet dragging backwards in stall footing.
stand in a hole with hind toes pointing down, heels higher than toe?
Mine certainly didn’t. When that pic was taken he was schooling 3’ and second level dressage sound, really quite a lovely horse.
Maybe I missed it but, but did you give him a year on Dr. Green before you nerved him?
Has he had any significant time just turned out?
Mine doesn’t do that either, but that’s definitely a thing that DSLD horses do when they start to be in a lot of pain, from what I’ve read. If he gets to that point, I will not let him keep suffering. 
I don’t think the breeder knows anything about DSLD, to be honest. I know two other horses out of the same dam that don’t have issues (one is her current broodmare, the other is a really lovely PSG horse). The sire (Bugatti) has some offspring out there doing FEI successfully and doesn’t look dropped behind himself, as far as I know, though I understand he was sold to the RCMP some years ago and it seems he has fallen off the grid.
Well I’m not sure about that theory, mine lived in retirement another 6 years comfortably after the sitting on things and standing in holes.
It’s why we shod him with heel lifts, because getting the heel higher than the toe offered relief.
And he was really quite a lovely horse too… 
Good update for once! On the 10th day after the coffin joint injections, I took video on the longe and sent it to two of the vets. He actually looks pretty good in the arena, a bit ouchier on hard ground. One vet replied and said that “the degree of improvement is quite remarkable. He actually takes a number of sound steps on a circle.” He said I need to just keep “waiting it out.”
I still don’t have much hope but at least there’s finally been some improvement.
ETA: video here if anyone is interested: https://www.youtube.com/watch?v=QKwvsYNWylw. Hard ground (packed stonedust) is first, then soft ground (arena footing).
I just wanted to say I’m sorry I kinda know the feeling. I rescued a 5 year old TB and he was off slightly then really off after a trim. x-rays show a shattered carpal bone. He will never be a performance horse but he is sound at the walk, not currently in pain and sweet as can be. I can’t see putting him down and that would eat me up. I weighed the other options too and we are leaning towards donating him to a rescue to be a therapy horse. Have you thought about doing that? Or is he way off at the walk? I want to keep mine so bad and maybe we can find a way but I don’t have a horse property and it’s hard to pay monthly board on a horse that can’t be ridden. Good luck in what you decide, it’s so tough!
I’m sorry to hear about your horse. 
My understanding is that therapy places want sound horses. Most get a lot more offers than they can accept and can only take the horses that are the best prospects, mentally and physically. Can you find somewhere that offers inexpensive retirement pasture boarding?
I agree the degree of improvement between the two (hard vs soft) is remarkable. He looks much better in the soft ground - more elastic through his entire body too. In the first portion I noticed an awful amount of tension especially going to the right. On hard ground I noticed he is much shorter on the RH which surprised me because of the hind suspensory; I would have imagined he’d have a harder time on the softer footing.
I saw right away overall body discomfort but the discomfort he has up front is coming and going. The discomfort he has behind is more obvious and consistent to my eye.
After seeing that video, I’d be pushing for neck rads. I know you mentioned them in the other thread. The amount of stumbling and slipping he is doing on the hard ground, which is then non-existent on the soft ground, makes me jump immediately to something in the neck. One of the first symptoms of CA in my gelding was that he was funny about footing changes and got very tight and tense on the harder ground, which was slicker. The neck injections fixed that behavior, btw.
I am sorry you are going through this. And what a disappointment too because he looks like such a lovely, promising horse. I hope you can get to the bottom of it. The pictures you posted of his pasterns don’t alarm me yet. I find that once the leg as a whole gets straighter from the EPSA that’s when you need to worry; I’ve seen plenty of (riding) horses with pasterns at that angle.
I have a fairly new-to-me 13yo Hanoverian mare whose hind pasterns look quite similar to your boy’s (the worse photo, where’s he’s resting the other) and she’s sound as a dollar. She did low level eventing before I got her, and now trail rides, hunter paces, and does some local hunters. There’s zero indication that she’s in any discomfort, and if anything, she’s on the forward side. I do wonder, like Beowulf said, if maybe the hind end is a red herring, and the actual lameness is coming from something else. I have a (different) mare with very mild kissing spines, and it’s a long and drawn out tale to explain how we got to the actual diagnosis, but I do have full understanding of how neck and back issues can present very subtly.
anyway, continued Jingles to your handsome boy.
And we need a pony update!
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