Extensor Tendon? Talk me off a ledge please :)

Some background: Horse is a 4 year old Thoroughbred gelding, came off the track September 2017, I purchased in October 2017. No PPE (don’t believe it’s relevant in this case but someone always wants to know :)) - history was very straightforward (one owner/trainer, retired due to being unable to break maiden in 10 starts, ran consistently over the span of a year), legs were clean and tight, and there was nothing in his way of going or demeanor that suggested there was anything to worry about. Has been sound since coming home except for some minor footsoreness after pulling shoes (at farriers recommendation) in the beginning of December.

Two weeks ago barn manager called to let me know that my farrier had been out to trim Q’s feet and they had discovered his left front leg to be stocked up and swollen, particularly around the top of his knee and above. There was some heat around and above the knee but he was moving soundly on it and stood with no issue for the farrier. We iced it, magna-waved it, and then poulticed it and gave a gram of bute. Due to the fact he was moving soundly and not in distress and the swelling responded to the ice and magna-wave we elected to wait overnight and reassess the following day before calling the vet. He had been in his stall for nearly 24 hrs prior to this due to bad weather so our belief was that he probably knocked it somehow or got up awkwardly from laying down and just aggravated it - it was clearly non-emergent.

The following day the swelling had abated everywhere except for just around the top of the knee so we followed the same course of action with some supervised turnout to see if movement would help it go down the rest of the way. The morning of the third day saw no change so we called the vet.

Vet examined and determined the tendon sheath was inflamed, prescribed 10cc of Banamine paste for 3 days and 3D cream (DMSO, dex, and something else that starts with D that I can’t remember the name of) to be applied to the area and then poulticed over top of. He said the swelling should dissipate within the next four days and that he could then go back to work. Swelling/heat was gone completely by day 3 but we continued with rest and restricted turnout (turnout in one of the indoor/outdoor arenas with a chill buddy instead of his regular pasture where the footings frozen/uneven and his mates are rowdy) for about 4 days after.

This past Sunday I tacked him up and lunged before I got on (less than 5 minutes, just enough to see how he was moving and where his brain was since he had been off for so long) and observed he was sound at the walk but still off (slight limp and a head bob) at the trot. At trainers recommendation I tack walked him around the arena for 15-20 minutes to get him some exercise/stimulation. Afterwards I checked his knee/leg for heat/swelling and there was none (I continued to check every so often for about 3 hours afterwards and there continued to be none). Trainer recommended checking it again the following day (yesterday) before calling the vet back as she felt he might just be stiff from having been off and it being so cold or he might have been having some footsoreness as I had slacked with the Durasole since he hadn’t been on hard footing.

Yesterday evening I checked the area and found (what I believe to be) his extensor tendon to be inflamed with some heat. Still moving sound at the walk (did not attempt to jog him), full weight bearing, and unbothered by me palpating the area or lifting/flexing/extending the leg (inflamed area feels squishy to the touch). Sent images (below - they’re not great as its not really an easy thing to capture on a dark horse will a cell camera) to trainer who sent them to the vet (haven’t heard back). Went back to original treatment plan and DMSOed/poulticed in the interim. Will be calling vet out today though we’re in the middle of a winter storm so unsure if he’ll be able to make it out today.

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Wow, that got really long haha. I guess I was just curious if anyone’s dealt with anything similar or had any words of encouragement/suggestion. I did a lot of reading last night on here and elsewhere about severed tendons and other gnarly things and promptly freaked myself way out even though this seems relatively minor in comparison.

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Well since you took so long to write all this out, and no one else has replied for you, I’ll do what I can here.

Looks like a soft tissue injury above the knee. Tendon or muscle, strain, tear or bruise. Not severed or gnarly. It will take a minimum of 6 weeks to heal. Or longer. Bring back into training slowly. But should heal up just fine and disappear. No treatment required if your horse is comfortable enough with it. Tincture of time will heal it. If he’s a bit tender on it, that’s not a bad thing, will keep him a bit quieter if he can feel some pain. Keep him from doing too much on it and making it worse before it heals. Let him feel that it is there so that he can take care of himself appropriately.

Yes, I’ve had one that looked like this. On a six year old racehorse, who stepped in a hole at a gallop. I tried to bring him back into training too soon, and it got worse, tore more. I gave the horse the rest of the year off, at pasture. He was quite lame when it tore worse. Healed up fine, horse went back into race training the next year, and continued as a race horse until retirement at 13 years old. Then a dressage/trail horse/pleasure horse until death at 24.

I have one who severed his long ET (hind leg), and completely recovered. I boarded with a gelding who severed his ET on a front leg, and returned to doing Jumpers.

Tendons which are inflammed due to swelling can take a long time to return to normal. This one isn’t a weight-bearing structure, just an extension aid, so the fact that he’s sound isn’t surprising. I’d do cold therapy as long as it’s warm, then ask your vet about using Surpass at some point

My OTTB strained his common extensor last Nov. It started out has a small lump just above his knee. Vet came out ultra sounded and said no tears. Put him on stall rest. Well that didn’t go well. HE.WOULD.NOT.BE.STILL. Bucking, rearing, kicking, spinning…everything except REST. I changed his stall rest to the run in shed with a small paddock (20’x20’ total area). Gave him long acting sedation. He still would be toe dragging lame, because of his antics. I discussed with the vet. We turned him out in a large paddock (80’x100’) with the thought that maybe he would chill after a few days and it would allow him to finally begin to heal (that was mid Jan 2017). He was able to go back to tack walking in March and full work by June. By Sept you couldn’t find the lump on his knee even when he was flexed.

He has been back into full work and working hard as a first flight fox hunter with no issues.

My guy had an inflamed extensor tendon sheath, except it was swollen on the front right of his cannon bone and his the front of his knee. Vet did xrays/lameness exam and put him on stall rest for a week. It didn’t help. It’s been at least 5 months and he will have off and on swelling, it mostly happens when he doesn’t get out. I put him on 1600 ICU of Vitamin E daily and that seems to have helped.

Bringing him back to work was very slow. You need to strengthen the tendon again so do lots of walk/trot work and over poles. We had just started cantering in December until he hurt himself, again, and landed on stall rest, again.

Of course Bernie never took a lame step through all of it. He just looked like he couldn’t fully extend his leg.

If it is a tendon injury (do tendons attach to tendons, or are they the ones which attach to bones? I can never remember), then take it very seriously. My Goober had a problem that we dickered around with for 6 months before it was correctly diagnosed. During that time, the suspensory injury turned into a tear and Goober, at 6 years old, turned into a pasture pet. :frowning: .

Ask around about PEMF (?) . Goobs has had 3 sessions and is standing on that leg when resting in his stall!!! At this point I am worried about opposite limb laminitis, so standing square is a big deal.

The PEMF lady said that she wished she had gotten to it when it was new; it is now bad and she does not know how much better she can make it.

But DO NOT FREAK until the vet looks at it again. If he/she even thinks it might be an extensor tendon, I would ask him/her [we now need a collective, non-sexist word] to do an ultrasound, which show up soft tissue. I am just sick that I did not know enough to ask the right questions…

If money matters you can go the slow and steady route. But I did and it has cost me 30x as much and a horse who has no future.

PS: Goober was never really lame. He had a slight toe drag when turning. I never freaked until it was too late.

The is a many page long thread about Goober if you want to know the trials and tribulations of the course of a soft tissue injury.

Now, aren’t you glad you asked? :slight_smile:

Tendons attach bone to muscle.

Not all tendons are created equal. Weight-bearing tendon injuries are much more serious than non-weight bearing, for obviously reasons.

ETs aren’t weight-bearing. They are responsible for helping flip the foot up in the extended phase of the stride.

Suspensories are ligaments, connecting bone to bone. Some ligaments have more minor responsibilities, while others have much more serious ones. Suspensory ligament injuries are serious. Flexor tendon injuries are serious.

Thank you all for your stories!

Vet came out yesterday and said that the leg looks fine. He didn’t see anything abnormal and said that part of what appeared as inflammation was actually just a really big vein. We actually thought it might have been a vein at first but the way it wraps around and protrudes from his knee is a bit strange and asymmetrical from the opposite leg.

Vet did not want to see him move and semi-frustratingly (okay a lot frustratingly) didn’t seem to think him being off was connected to the tendon having been inflamed and instead pointed to the fact that he doesn’t have shoes on (even though he’s been sound without them since a week or so after we removed them). Said that if he continues to be off he will come back and block him but that it was too cold to do it yesterday. This guy is a big name lameness guy in this area so I’m inclined to trust his opinion but as is the case with big name anything’s the bedside manner was a bit lacking and after he left I mostly just felt dumb and didn’t have any more answers than I started with.

Tack walked him again tonight and trotted a couple straightaways just to see and he is still off but less so than he was. At the moment I plan to just approach it as though this is a tendon issue and we will do a lot of walking over the next several weeks and gradually add in more trot as long as he continues to improve. If not then we will reassess if he needs to be blocked/ultrasounded (probably with a different vet).

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If he is lame I would suggest having another vet come out and look at him. Extensor tendons aren’t weight bearing so they shouldn’t be off so it may be something else. I’m surprised the vet you had out didn’t at least flex him…

my lameness vet rarely flexes anything. And unfortunately I’ve got lots of experience watching him diag issues.

Do you have hoof testers? That could be a way to rule out the hoof as contributing to the lameness. If he does have a reaction that makes it seem hoof sore for being barefoot, you could use Venice turpentine or pack the foot with magic cushion. If it’s only one area of the hoof that’s sore maybe he has a stone bruise or abscess.

When end my horse was at the worst of his tendon sheath swelling for his common extensor, he was lame, toe dragging lame. As it got better, he was still noticeably lame. The tendon couldn’t “slide” through the sheath smoothly, so it caused a hitch in his get along. Movement was important so that he didn’t get a scar tissue built up that would restrict his range of motion. The vet had me bend the knee to the point of resistance and hold it for a few seconds 10-15 times 2-3 sessions a day on top of hand walking. At first I couldn’t get the knee to a 90 degree angle, much less all the way up to his armpit. 5-6 months post injury I had all but 10 degrees of full range of motion. 9 months post injury he was back to 100% full range of motion.

Even thouh the the injury started out as something minor, we went through some iffy points in his recovery.