Hind Suspensory Injury & Chances of Recovery

[Twisted_River]

[QUOTE=vicarious;6435636]
The amount of scar tissue laid down by the injury, no matter how careful the initial handling, or subsequent rehabilitation will have a big effect on the actual return to usefulness.[/QUOTE]
This is not a true statement. Perhaps vicarious didn’t mean for the sentence to be worded as such?

The injury does not create scarring. A scar is the result of healing. When you skin your knee, you have a wound. As it heals, a scar develops. How well you manage the wound during healing dictates how big/ugly the eventual scar is. The initial injury does dictate potential for scarring (which is perhaps what vicarious was getting at?).

I’ve got a few scars on my knees from skinning them as a young child. As the scab developed I would pick it off. That would lead to some bleeding, more scabbing, more picking, more scabbing, picking, etc., etc. In my adult years I don’t have a single noticeable scar because I don’t pick them and I use creams, etc.

A horse’s tendon can be paralleled to a skinned knee. You want the very first initial scar that develops in the tendon to be the one that heals all the way to completion. Every time the horse has a yahoo moment on the leg, or stomps particularly hard to get rid of a nasty fly (or a million other possibilities), the scar tears a bit and requires additional healing. The more yahoo moments or stomping, the more scarring.

A big, nasty tear that has a textbook perfect healing process will have a better long term prognosis than a minimal tear that re-tears a few times during healing and goes back to full work/jumping prematurely.

Scar tissue will be present. By definition the tendon will heal with a scar. The goal is for it to be a minimal and malleable as possible. PRP is a huge influence in accomplishing this. Scientifically, it creates more malleable, flexible tissue then when not used. It also decreases healing time. Because horses have unpredictable brains of their own and like to move around we could deduce that maybe every few weeks throughout the healing process, a minor tear will develop in the new fragile scar tissue (he’ll spook, or stomp a fly, or slip when getting up from a good nap, etc.) The faster the leg heals, the less minor tears. If he heals in 6 months instead of 12, that’s potentially a literally 2x stronger scar. Of course the body is not cut and dry, black and white and every individual is different.

[merrygoround]

To be absolutely correct I should have said the amount of scar tissue laid down by the healing injury. The purpose of keeping the horse moving under controlled exercise is to encourage the fibers to be laid down in an organized fashion.

Unfortunately many horses by nature tend to have explosive natures, and coping with them can be difficult.

[Herbie19]

Twisted River while I 100% agree with you life is not always perfect. Some people cannot afford the time or the money to stall rest a horse for a year. I think it also depends on the horse and how well they behave in turnout. I did have a horse at my farm that had a moderately large lesion that the owner opted to turnout for a year that did come sound with very little scar tissue. Horse was a saint in turnout and lived in a two acre paddock with a small pony.

The horse I’m working on right now is a different story. I cross my fingers when he’s turned out when he’s NOT injured! His a$$ is on full lockdown.

I do think it should be all or nothing as far as turnout is concerned.

[TSWJB]

OP how did your horse end up healing wise?

[Spotless]

^^ Curious as well. My gelding has healed from a suspensory tear and a lesion in one of the branches (both in hind leg). When it happened, our goal was just “get him sound and comfortable again”. Happy to report we’ve been back under saddle for almost two years. Undoing the year of stall rest/limited turnout has been our biggest challenge.

[TSWJB]

How long did your recovery take and why did you have to undue damage from stall rest? What happened,? I am just starting my journey with a hind suspensory. 6 weeks in. It’s mild. My trainer caught it early. She kept insisting he was not right even though he did not feel laklme to me.

[Gumby80]

I knew a mare with a high hind suspensory lesion, they did PRP and shockwave, 60 days stall rest, then slow return to work (ie from handwalking up). She didn’t really come 100% sound. She was then moved to a new barn, I think they flatted her for a while, and now she does ~2’ with lesson kids. She looks to be comfortable enough, not noticeably lame, but I doubt that you could return her to her previous level of work (3’9-4’ jumpers) without it recurring. The vet said that that injury in that location is often chronic. But it’s good you caught it early. In this mare’s case, there was some calcification around the lesion, suggesting (if I remember rightly) that the inflammation had been going on for a long time.

I am not an expert, but from my experience working with a biomedical scientist looking at stem cell research in humans (spinal cord injury etc), this therapy is not really there yet. It’s not just a case of sticking some stem cells into the injury site and waiting for the magic to happen. They seem to require an extra “signal” to start healing damaged tissue effectively. There’s been some positive results published in the literature, but nothing very good quality. This seems to be about the state of things:

https://www.veterinaryevidence.org/index.php/ve/article/view/50/120

My farrier in NJ seemed to think that hind shoeing practices can help with hind suspensory issues, not sure if that’s true, but perhaps worth asking about. There’s been some long threads on here previously about people rehabbing suspensories, might be worth a search.

[Spotless]

@TSWJB

How long did your recovery take and why did you have to undue damage from stall rest? What happened,? I am just starting my journey with a hind suspensory. 6 weeks in. It’s mild. My trainer caught it early. She kept insisting he was not right even though he did not feel laklme to me.

He was boarded at a show barn which (understandably) didn’t have small turnout options to reintroduce him to turnout. It was around 12 months until we were able to find an accommodating barn and move him. He still got daily hand walking and trotting in hand, but he was still very stiff and had a lot of muscle atrophy from not being turned out. He’s still tight and takes a little longer to warm up, but is tremendously better than he was even a year ago (he’s been turned out/under saddle for two years this summer).