Hind Suspensory Rehab After Surgery

[TequilaMockingbird]

For any of you who have a horse they brought back after hind suspensory surgery, what was your rehab like? And your outcome? How long did it take before you could tell the surgery had been successful or not?

My horse had the surgery on both hind legs right after Thanksgiving. I just got the OK for limited turnout a couple weeks ago. My vet said I could start working her after 45 days from surgery at a walk only.

Did you start out with any in hand work at all or straight to walking under saddle? Did you start out at walk on a totally loose rein, just a small connection or on the bit? I was thinking I might wait to ask for anything on the bit for at least a few days in.

So far her recovery has been uneventful, thankfully.

[Libby2563]

Subscribing! I was just thinking about this myself. My young guy also had hind suspensory surgery on both legs shortly after Thanksgiving. My vet told me to do a month of stall rest (first two weeks with handgrazing only, next two weeks after the stitches and bandages came off I could handwalk too), then a month of small paddock turnout, then a slow return to work.

As far as the return to work, the dismissal says: “Usually a period of increasing exercise and strengthening are required before full activity commences. One month of walking and increasing trotting is recommended, followed by at least 2 weeks of cantering before jumping resumes.” I think that’s kind of vague and would like more guidance. I can say I do not plan to be jumping within 6 weeks! I was thinking 2-3 weeks of increased walking before we trot, then another 2-3 weeks of increasing trot before we canter. Jumping can wait a few months, I’m not too worried about it. Does that sound right?

@TequilaMockingbird

Did you start out with any in hand work at all or straight to walking under saddle? Did you start out at walk on a totally loose rein, just a small connection or on the bit? I was thinking I might wait to ask for anything on the bit for at least a few days in.

I think I will try to do some handwalking during the small paddock month. It’s hard this time of year when it gets dark so early though. In our case, I only weigh 7.5% of what he does, so I don’t think there’s much difference between riding him vs. handwalking.

As far as whether to walk on the bit, I will probably start with some connection (some contact, with a following hand), for safety reasons. I think starting a not-even-5-year-old back under saddle in February will be interesting enough without trying to stay on a totally loose rein!

I am also curious to hear from people how their horses looked, soundness-wise, at different points in time after surgery. I haven’t jogged my guy since he’s still on stall rest, but sometimes it looks like he takes the occasional very short step behind and that makes me nervous that he might actually look worse than before the surgery. Hopefully just my imagination!

OP, have you read this thread? https://www.chronofhorse.com/forum/forum/discussion-forums/eventing/106655-proximal-suspensory-surgery-advice-updates-at-end? Lots and lots of info.

[TequilaMockingbird]

Don’t have the time to read that whole thing but it’s interesting that other people had followup ultrasounds. My horse had to have clean ultrasounds on both hind legs before they would even perform the surgery. Although my horse did not have tears, thank god.

My horse could easily handle a walk on a loose rein, even in February, provided she’s getting some turnout. She’s pretty sane thankfully. It’s only that stall rest that’s made her a bit silly.

[Libby2563]

@TequilaMockingbird

Don’t have the time to read that whole thing but it’s interesting that other people had followup ultrasounds. My horse had to have clean ultrasounds on both hind legs before they would even perform the surgery. Although my horse did not have tears, thank god.

Interesting. My horse didn’t have any tears either, thankfully (although from what I’ve read, ultrasounds can be only 40% predictive, which is why MRIs are now the gold standard). Which procedure(s) did yours have? Neurectomy, fasciotomy, desmotomy? Mine just had the neurectomy.

[sonestra]

My horse had the same surgery on both hinds, also after Thanksgiving. It was a fasciotomy, neurectomy, and the desmoplasty. There was no tear, only a strain, with the right hind having a worse strain than the left. Our protocol thus far was strict stall rest until the sutures came out, which was filled with bandage changes and icing daily. Once the sutures were removed, I was told to ice daily for 2 weeks and keep her in standing wraps. I need to handwalk daily (5 min for the first week, and increasing by 10 minutes each week,) until the follow-up ultrasound at week 6. She is permitted to go outside in a small turnout the size of two stalls as long she she remains quiet and I can supervise. As for riding, I was told on week 8 I could begin riding at the walk but that’s all I know. She has been a good girl for the most part, but the stress is killing me. The recovery period was very much underplayed by my vet, granted I still would have chosen surgery over shockwave. I just wish I was more prepared seeing that I rough board at a barn with no amenities and I have to lug everything to and from work daily which I am sure they aren’t happy about. I don’t have an indoor so I won’t even be able to ride at week 8 since everything is ice and snow.

[Libby2563]

Funny how different the post-surgery recommendations can be! I was not told to ice or handwalk at all (when I asked if I could handwalk, they said yes, but it was not specifically recommended), and not to turn out at all for a month even though I also have a paddock the size of a couple stalls. I guess there are many roads to Rome.

I hear you on the stress, Sonestra. I keep mine at home so at least there’s no commute and I can store things wherever I want, but I am spending so much more time on chores now, between the extra stall cleaning (he’s a freakin pig, of course), handgrazing, and wrapping, not to mention making time to ride my one sound horse. Winter is a crappy time of year for layup and rehab, for sure. Will you have some safe footing for walking at least?

[TequilaMockingbird]

She had a bilateral fasciotomy and neurectomy.

[merrygoround]

Here are a few pages:

https://www.chronofhorse.com/forum/forum/discussion-forums/eventing/106655-proximal-suspensory-surgery-advice-updates-at-end

[merrygoround]

Google: Proximal Hind Suspensory Surgery-COTH.

That should bring it up. I never have luck with the Search function on the COTH

Oops! I just tried it, and it did come up.

[Samantha37]

My OTTB had the fasciotomy with neurectomy and PRP on bilateral hinds in 2011. I don’t remember our rehab exactly anymore but I know we had to start walking him under saddle early because he was stocking up pretty badly in his stall. He had the surgery in April so unfortunately we had to deal with stocking up due to heat and standing still. He handwalked 3x per day every day he was on stall rest. After he was good to walk for a certain amount of time and we had started trotting under saddle, he got turned out in a small paddock. I followed the vet’s instructions to the letter and everything went fairly smoothly. We did a couple of follow up ultrasounds and an ultrasound done in 2015 showed the ligaments looked almost completely normal for a horse his age/size/work history.

Since the surgery he has competed to Novice eventing, the 3 ft H/J and we are currently showing 3rd Level dressage.

[Libby2563]

^ Great to hear your success story! I believe you contributed on the thread I linked previously, and there may have been more details on your horse’s rehab there.

[Samantha37]

@Libby2563

^ Great to hear your success story! I believe you contributed on the thread I linked previously, and there may have been more details on your horse’s rehab there.

I have for sure! I try to tell my horse’s story because I know it can offer some encouragement to people going through this horrible issue.

[Libby2563]

How are everyone’s horses doing? Mine is 4.5 weeks post surgery now and is finally starting to act like a 4-year-old on stall rest in winter. He’s actually very good for the most part but has been having little tantrums during our 5 min of handwalking that threaten to turn into rearing now and then.

Has anyone been been told by their vet when we will know if this worked or when it’s safe to try a short jog to evaluate soundness? My guy is occasionally stepping really short on his right hind, usually in the stall. It’s worrying but I don’t think he much likes the standing wraps so it could just be that.

[sonestra]

It is so funny how the aftercare is so varied! I won’t have a safe place for even walking, because of all the snow and ice. Handwalking has proven difficult, mostly because she will do these giant spooks and pull backwards, or she will try to trot in place. I was told no trotting, at all, not even to check soundness. I now have her in a very small turnout during the day with ace on board, which has been working well. There is still swelling on her right hind (the worst leg) and she seems irritated with the icing and standing wraps. I notified the surgeon who did the procedure, and he said this is completely normal, but of course I still worry. I also worry about the times when she has been spinning around or spooking in her stall when there are hay deliveries, because I know that’s how she usually reacts. Ultrasound is in 2 weeks, which I am so nervous about.

[joiedevie99]

Mine had the surgery on the RH in February 2017. We did 60 days of stall rest with increasing amounts of hand walking daily. Then 60 days of tack walking. Ultrasounds every 60 days. If he had been sound, we could have started trotting at 4 months, but he was not, so we opted for another 3 months of tack walking. We are now trotting about 10 minutes.

[Libby2563]

@sonestra

There is still swelling on her right hind (the worst leg) and she seems irritated with the icing and standing wraps. I notified the surgeon who did the procedure, and he said this is completely normal, but of course I still worry.

That reassures me too because my horse also has swelling around the (healed) incision on the right hind and I haven’t been able to get in touch with anyone to tell me if it’s normal or not, due to the holidays I guess.

[sonestra]

Libby, I wasn’t able to get in touch with anybody for over a week because my surgeon was visiting family out of the country. So many specialists weren’t even returning emails or calls until after the 2nd. Th surgeon told me to stop icing and wrapping if she’s bothered by it, since it’s been over a month at this point. I sent another email to get some clarification, so I’ll update once I hear back. We are being slammed by a storm right now and I can’r even get to the barn until tomorrow evening probably, so she’'ll have to skip a day of treatments

[Libby2563]

Well my horse looks awful. Much shorter behind than before surgery, when you wouldn’t even notice anything wrong if you saw him trotting in the field. Does anyone know if this is normal 5-6 weeks after surgery? Waiting to hear back from the surgeon, and worrying. (He was not concerned about the swelling mentioned above.)

[LPG]

Ugh…I have nothing to add to help, other than my best wishes for a great recovery to you all going through this! One of mine went through 6 weeks at the vet clinic, another 6 months of stall rest followed by a very slow return to work. It never did work out, but it was a way different injury and the prognosis wasn’t great from the start, but it was worth trying. Fingers crossed for you! Looking forward to hearing your progress reports!

[TequilaMockingbird]

I find it interesting that my aftercare has been very different from most people here. My horse had bandages changed every 5 days, antibiotics and was on stall rest for 3 weeks. Once the staples came out she was cleared for turnout in a small paddock. Due to issues with my barn she just started getting turned out again in a small pasture for the first time yesterday.

She is limited to this small turnout until 45 days after the surgery. I’m going to give it an extra week though. I took her on some short walks in hand the last two days, which I’ve been told is fine by my vet. The turnout made a HUGE difference in her behavior of course. I can start riding her at the walk only for a maximum of 10 minutes after 45 days.

My vet was an equine orthopedic surgeon for almost 20 years at the local university teaching hospital before starting his own practice.

Besides being extremely excitable my mare seems to be moving about the same as before surgery at the walk. She never showed any issues previously except in the trot, which I haven’t been having her do for obvious reasons. She had slight edema near the incisions in the first 10 days after surgery but nothing since then. As far the the incisions healing, I think they’ve gone textbook perfect. I hope that’s a sign of things to come.