Experiences with torn tendon sheath

[One_Big_Holiday]

My gelding has had a puffy LF (inside of leg) between pastern and knee for several weeks with zero lameness. The vet checked twice over last month and finally we ultrasounded last week - torn tendon sheath but the ligaments and tendons are fine. Vet drained it and injected a steroid last thursday and now we’re keeping him in a standing wrap. He lives in a 16x16 stall open to a 16x40 run. My problem is that when his buddies are turned out (every other day), he does lovely walk to canter transitions and airs above the ground so we’re contemplating turning him out with them in a boot since he has grass out there and loves grass. For 6+ weeks prior to the diagnosis he was in full work and in turnout (but he clearly was not healing…). I’m worried about him doing more damage in turnout, but it feels like a crapshoot because I KNOW he will canter around his small run if hes upset. He actually injured it in his run playing over the fence…he’s a 7 y.o. 17+h OTTB too so he’s not exactly chill. I’m willing to send him to a rehab facility if I need to but I would prefer not to because I love my barn - there just are not many options for him to be calm and confined there. My vet said we’d re-evaluate his rehab/confinement routine on 6/4 for his re-check.

Just looking to hear from others that have managed/rehabbed this type of injury - what worked well? How is your horse now?

Thanks!

[JB]

Treat the horse in front of you When my guy was 3, he tore his flexor tendon sheath on his RH. My vet said the ideal treatment would be 2 weeks or so stall rest, but he was also dealing with UFP so stall rest would have been terrible for that. It was Fall of his 3yo year so I just turned him out for the Winter, and he healed just fine.

That said, mine was a quiet horse already, so that wasn’t a big deal. Ask your vet about Reserpine to give him some long-lasting chill, and give him a couple months. I would ask about hand walking as well, to give him something to do besides hang out. Look at clicker training to give his mind a workout too - that’s tiring!

[beowulf]

totally agree with JB - treat the horse in front of you! there have been tons of times I have had to go against the “ideal” because a horse was not a good patient, for whatever reason. Your main goal is to keep him as quiet as possible; figure out how, and work from there at the suggestion of your vet.

If you know he will be more quiet in a herd… see if your vet is on board. I had a gelding with a full suspensory rupture, and the “ideal” rehab for that was very controlled management, 100% stall time, for months… I knew the horse really well and after a week or so of him practically crawling out of his skin and being miserable in the stall, pacing, rearing, etc, we turned him out… He was 100% different, way more quiet, and returned to a higher level of work post injury (Novice/Training eventing). I think if we had stuck to the stall routine he would not have come back so strong, because he was way more likely to reaggravate the injury acting up in his stall.

And… having been someone who has had to rehab tons of injuries for boarders and, unfortunately, quite a few of my own horses… they might act stupid in turnout, and it’s second nature to wince and think they are going to snap their little legs… but a romp or two, is usually not the end of the world… and most horses are not as quiet in a stall as boarders think they are, and do plenty of those shenanigans inside too. So long as they are not running around for ten or twenty minutes at a time, that is when reinjuries can easily happen.

Clicker training was a boon for me, for one of my rehabbers with a medial/lateral collateral ligament rupture in hind leg. The plus side of all of that time I spent with him, is that he became a wonderfully well-mannered horse, and is very trained now on the ground. I’ve always been a stickler for ground manners with my own horses (as a BM, I lament most horses have exactly zero manners!!) but the clicker-training I did with this gelding produced something else entirely; made a very workable horse that wanted to listen vs just listened because I said so. :encouragement:

[Lord_Helpus]

@One Big Holiday

My gelding has had a puffy LF (inside of leg) between pastern and knee for several weeks with zero lameness. The vet checked twice over last month and finally we ultrasounded last week - torn tendon sheath but the ligaments and tendons are fine. Vet drained it and injected a steroid last thursday and now we’re keeping him in a standing wrap. He lives in a 16x16 stall open to a 16x40 run. My problem is that when his buddies are turned out (every other day), he does lovely walk to canter transitions and airs above the ground so we’re contemplating turning him out with them in a boot since he has grass out there and loves grass. For 6+ weeks prior to the diagnosis he was in full work and in turnout (but he clearly was not healing…). I’m worried about him doing more damage in turnout, but it feels like a crapshoot because I KNOW he will canter around his small run if hes upset. He actually injured it in his run playing over the fence…he’s a 7 y.o. 17+h OTTB too so he’s not exactly chill. I’m willing to send him to a rehab facility if I need to but I would prefer not to because I love my barn - there just are not many options for him to be calm and confined there. My vet said we’d re-evaluate his rehab/confinement routine on 6/4 for his re-check.

Just looking to hear from others that have managed/rehabbed this type of injury - what worked well? How is your horse now?

Thanks!

In the “old days” we would give the horse a shot of long-lasting (10 days) tranquilizer. Reserpine was the perfect drug for that, I used it when I got OTTBs off the track and some of them were very nervous,

It was also the perfect drug for calming horses at shows and was abused so frequently (the ‘massacre’ at Devon, anyone?) that it might be hard to find. But similar drugs must be out there.

[jmbaumgardner]

Thanks for the helpful advice. My gelding gave me “the crazy eye of too much rest” yesterday and I emailed my vet and he said we could start controlled walking. The vet knows my gelding well and agreed that for now turnout in grass with a good boot with a quiet buddy will keep him calmer in this environment than keeping him locked in.

We tried oral reserpine with him for a previous injury and 2 months stall rest and it had zero effect. I was too chicken to do the shot though. He is weird on ace as well, more angry than calm. I am going to treat the horse in front of me and re-evaluate at our recheck 6/4.

[IPEsq]

You could try Prozac for some of the crazy. My vet says they don’t make the injection anymore (it lasted about 3 weeks), so you’d need to dose it orally. It is obviously not a tranq but it can help them not get so wound or anxious. Mine gets the crazy eye even with turnout if he doesn’t have a job, so I totally understand.

[One_Big_Holiday]

Update and still looking for folks input with similar experiences, esp. with PRP

I had the re-check 6/4 and we were cleared to walk/trot and keep him in turnout because the tendon sheath looked good. Then the area around the tendon sheath became more swollen about two weeks into that routine :(. He has been extremely sound the entire time though thankfully. Stopped riding him around 6/20. Recheck on 7/3, my vet wanted to do PRP since the tendon sheath looked better but not fully healed and its been going on a few months now. I opted for the steroid injection again since it seemed to have worked about 50% when we did it mid-May and was 1/3 the cost of PRP. My gelding has been confined for 3 weeks to paddock and no riding (he is NOT happy) but really hoping this rest will help. Vet will be out next week. Any experiences with PRP for a tendon sheath? It seems like the jury is still out to me on it and its $$$ so Im still leaning towards time/confinement vs dumping money into this lemon that I love.

[mlb722]

No experience with prp but curious about the swelling. Did it look bowed? Just on inside? Going through my own tendon injury hell—tendon sheath inflammation is one possibility. Ultrasound in a few days…

[adultponyhunter]

I did PRP on a suspensory tear this winter and the results were excellent. Had to turn horse out earlier than ideal due to other health issues, and at his 4 month ultrasound the vet was blown away by how incredible the area looked. It was not very costly (in the grand scheme of things, anyways) at around $500 for the ultrasound guided PRP injection done at Cornell University.

[Martina]

I thought I read somewhere that PRP is best done within 3-4 weeks of the injury. I would look into that before pursuing. Also, have you discussed special shoeing (adding a wedge) to reduce pressure on DDFT?