Horse has serious Suspensory and DDFT tears. Looking for advice

[CJB]

Hey everyone! I came here to ask for some help/advice. Sorry it’s so long.

Over the past eleven months, I’ve been rehabbing my boy. He is a 16-year-old Hanoverian x Thoroughbred Hunter/Jumper. Last year, he had a slight tear in his DDFT in his right front leg and was on stall and pasture rest. And I’ve been slowly bringing him back into work. He hasn’t been anywhere near perfect, but the month of January was very promising. I was up to 30 minute rides W/T/C and he was doing well.

Now here is my problem. Ten days ago when the barn owner was feeding, she noticed my horse was very lame. And I’m talking three-legged lame. On his left HIND leg. So, this is a completely different injury than before. Took him into the vet and x-rays look fine, but ultrasound showed tears (disruption of fibres) in BOTH his Suspensory and DDFT.
I’m devastated. This is my dream horse and we only had one show season together before he had the first injury.
Following the vet’s recommendations, we gave him 2 grams of bute twice a day for four days. Then have been weaning him down to 1 gram once a day which is what he’s currently on now. I think the higher dose upset his tummy a bit because he wasn’t eating as enthusiastically, but he seems to be eating better now. Vet also said to ice the leg and then poultice with Finish Line clay with a layer of plastic over top and then wrap. There is quite a bit of swelling and some warmth, but it’s down slightly from 10 days ago. What I’m extremely concerned about, is that he is still basically three-legged lame. He’s obviously in a stall, and when he stands he only rests the toe of his injured leg. He grunts whenever he has to move that leg, and it looks like it’s very painful. And when I walk him 15 feet to tie him, he puts pressure only on the toe of that foot, and then scoots his good leg forward. Today is the first day I’ve actually seen him try to put his heel down, but 90% of the time he’s only on the toe.
I realize that we’re in bad shape here, and that ever riding him again would take a miracle. So right now, all I want is to get him pasture sound and then go from there.

I guess what I’m asking for, is any information on Suspensory and DDFT tears that kind of applies to our situation. I’ve been reading lots, but can’t find good info for how lame he is.
-Has anyone had experience where a horse is walking and standing only on his toe?
-I’m extremely worried about laminitis/founder because of the incredible amount of weight he’s baring on the opposite hind, is there anything I can do to prevent that?
-Options for short and long-team pain management
-Is there anything different I can do to help him? I’m interested in hearing about treatment options – but my insurance doesn’t cover this, so I don’t have thousands of dollars to experiment with.
I’m very thankful if anyone actually read all that. Please if you have any info/advice, I’d love to hear it. Any help at all would be wonderful.

[Laurierace]

I share your concern about laminitis. I would want to get him standing square soon as that is the best way to prevent laminitis. Sounds like you need to talk with your vet about your legitimate concerns. Jingles.

[rideastar]

How about considering IRAP treatment? It’s quite expensive (if you have insurance they will cover it) but worth it. Also shockwave therapy. As bad as the lameness is, it sounds like you need to be aggressive in the treatment. Reducing the initial inflammation is important and the vet can’t start shockwave until a lot of the inflammation is gone. Never had DDFT injury but 2 of my clients have had issues, took a year to rehab. but they are both very sound now.
My horse had a suspensory injury (not as severe as yours, I don’t think), and the IRAP & shockwave did the the trick. Took a lot of care in the rehab, and I am now ice his legs after any hard work.

[AKB]

Our old guy had a splint bone fracture which severed his suspensory and damaged a flexor tendon. He slowly improved from barely bearing weight to being able to happily limp around the pasture. He also has navicular, arthritis, and other problems related to being age 27, so the limp might not be completely caused by the suspensory.

[CJB]

Thank you so much for the replies, guys.

[QUOTE=rideastar;8010245]
My horse had a suspensory injury (not as severe as yours, I don’t think), and the IRAP & shockwave did the the trick. Took a lot of care in the rehab, and I am now ice his legs after any hard work [/QUOTE]

I’m going to definitely talk to my vet about shockwave. I’ve never heard of IRAP – I’ll have to do some reading on that. If you don’t mind me asking – did the blood samples have to be sent away, or was it able to be done locally? And how soon after the initial injury were you able to start the IRAP?

Unfortunately I don’t have insurance for this, so I’m not sure what I’ll be able to do. But, this is an incredible horse and I’m not going to give up on him.

[AKB]

I would research carefully before using IRAP or shock wave. We have done IRAP on this horse for his navicular disease, injected in his coffin joints. It gave him several months of relief, but I am not sure it is worth the cost if the horse is uninsured. I think you need an opinion from a top lameness vet. Time in a grassy paddock may be your best treatment.

[Melissa.Van_Doren]

I’m very sorry you and your horse are going through this.

Your farrier and vet should discuss what’s best for your horse in terms of preventing laminitis. Until that can happen (the sooner, the better) you can help by providing him with a DEEPLY bedded stall. I would also speak to the vet about increasing his pain meds (and maybe trying something other than bute) to help him stand more normally. You can give supplements designed to help protect his tummy.

Good luck.

[khall]

I would be looking into DSLD if your horse has two such injuries and stem cell therapy.

[CJB]

[QUOTE=AKB;8010709]
I would research carefully before using IRAP or shock wave. We have done IRAP on this horse for his navicular disease, injected in his coffin joints. It gave him several months of relief, but I am not sure it is worth the cost if the horse is uninsured. I think you need an opinion from a top lameness vet. Time in a grassy paddock may be your best treatment.[/QUOTE]
I really appreciate all answers I’m going to be extremely careful with my boy. I’m sorry if I’m sounding clueless about this stuff. I just want to gather as much information as I can, just so if my vet throws something out there, I know before hand what options I’m looking at. I guess I’d rather have too much info, then not enough, when it’s about something so important to me.

[QUOTE=Melissa.Van Doren;8010721]I’m very sorry you and your horse are going through this.

Your farrier and vet should discuss what’s best for your horse in terms of preventing laminitis. Until that can happen (the sooner, the better) you can help by providing him with a DEEPLY bedded stall. I would also speak to the vet about increasing his pain meds (and maybe trying something other than bute) to help him stand more normally. You can give supplements designed to help protect his tummy.

Good luck.[/QUOTE]
Thank you for your concern
We’ve got a couple vets dealing with us right now, since our regular one is out for a couple weeks from a surgery of his own. Each one has some different ideas, so I’m just wanting to hear some experiences from horse owners who have been through something similar – and what they decided to do.

In terms of pain management, what have you found to be a good/better alternative to bute?

[FineAlready]

Shockwave is pretty reasonably priced when compared to IRAP, and does have some pain deadening impact. I had great results with it on a front suspensory. If it makes you feel any better, I knew a horse that did not properly weight bare on a hind leg for months due to having stepped on a nail. He had “street nail” surgery. I was sure he would become laminitic, but he didn’t. He did end up with some deformity of the opposing hock, and was never riding sound again (due to the nail), but he’s still pasture sound to this day.

Good luck. He’s lucky to have someone that loves him as you do.

[CJB]

@FineAlready Aw, that’s very sweet of you.
It’s good to hear that you had some luck with shockwave, and about the horse with the nail. Do you know of anything they did to prevent laminitis with him? I’m hoping luck is on our side with laminitis, even though the odds are against us. I’m getting my farrier out right away to talk about some options to try.

[QUOTE=khall;8010940]
I would be looking into DSLD if your horse has two such injuries and stem cell therapy.[/QUOTE]
That’s a very scary thought, but definitely could be what we’re dealing with. My vet hasn’t mentioned DSLD, but through the reading I’ve been doing, I came across studies on that and it would make sense for what’s happening. But, I sure hope it isn’t DSLD. And my vet did mention Stem Cell, so that might be an option for us.

[findeight]

A little surprised Bute is the only painkiller your vets have recommended? There are many newer ones out there that are much more effective. Bute does help with inflammation where some if the other don’t but there are certainly many other options now used and recommended by vets. Some are safe to combine with bute…and you should be on ulcer meds.

I imagine your guy hurts.

[FineAlready]

I don’t think they did anything other than maybe bute for the nail-in-hoof horse. He really never put weight on the bad one, yet ended up okay.

[HappyTalk]

I have a horse that bowed BOTH front legs while out in the pasture. The first thing my vet did was to test for Cushings Disease. He said there was an association between soft tissue injuries and the disease. That particular horse was negative but I have seen injuries in another horse that was later diagnose with Cushings. This horse suffered suspensory injuries in both front legs that involved him being out of work for about 2 years. Shockwave and rest did not help him. He finally was able to return to work after injecting the lesions with ACell and another lengthy rest period. I thought this horse had Cushings based on some subtle signs, but he always tested negative. It wasn’t until he developed minor haircoat issues did he test as barely positive for the disease.

There is a link between Cushings Disease and ligament injures in dogs. I suspect it might be the same in the equine.

[OnePerfectRide]

My boy is about 1.5 years out from a hind suspensory injury. Shockwave helped temporarily, but didn’t do anything long term. He developed some mineralization in the ligament that had to be surgically removed and we also did stem cell at that time (in June). He’s fairly sound now. He looks the worst when just standing around and then asked to move. He was never as lame as your horse, so I’m not sure why the right course of action is, but it is definitely going to include some very long lengths of stall rest (months), NSAIDS, and vet bills. It can be tough, but stick with it.

I think your concern about laminitis is a valid one. Soft Ride boots can help. Keep a very close eye on his digital pulses. If the DP in the supporting limb starts to increase, ice the foot right away and around the clock if possible. Your vet and farrier can help you from there.

[GaMare]

So sorry you & your boy are going through this. I’ve been there on the DDFT & my guy made a miraculous recovery.

There have been several studies that show aggressive icing can reduce the risk of laminitis so instead of icing just the injured leg, ice them both. It’s probably worth getting a pair of these https://www.equipro.com/IceBoots.html
and these http://www.chicksaddlery.com/page/CDS/PROD/2100/IH4303?utm_source=shopzilla&utm_medium=cpc&utm_campaign=shopzilla%2Bdata%2Bfeed When I had my guy at UGA they had a strong preference for plain ice over all the gel packs- said it got colder because water is a better conductor of temperature. A 5 lb bag of ice should cover 1 pair. If you hose the inside of the boot before you put it on, it will get the leg cold faster. They also said that it takes longer for the cold to penetrate to the DDFT than we would expect so I left them on for 30-40 min. That was in June/July though so you might want to go for a bit less time now!

Also, talk to your vet/farrier about changing shoes. I’m not sure how the suspensory complicates things but putting a wedge on both heels can take the pressure off the injured DDFT and make standing evenly more comfortable.

Depending on the location of the tears, IRAP or shockwave might not help. I was told shockwave can cause some swelling immediately after treatment. In the hoof area, the lack of space to accommodate swelling can cause additional tissue damage. (Again from UGA vets).

Was he 3 legged on the 2 grams of bute or has that been continuous? If it was helping him, I would talk to the vet about whether it’s worth putting him back on the 2 gm. Add Ulcerguard to help his stomach with the bute. I also added a probiotic, just in case. Alfalfa can also help with stomach upset (high levels of calcium). It can make them hot but if you’ve cut his grain to accommodate for the stall rest, you should have some wiggle room- especially with this cold.

One of the best things I did was create a detailed chart to track everything. I hung it on his stall door & had notes on daily bute, etc. When he started his hand walk rehab I used that to let everyone know how many & how long to walk each day & record how he looked. When he suddenly went lame again a month into rehab (from an adhesion breaking loose) the data was a big help to the vet.

I hope some of this helps. Feel free to PM if there’s anything else I can do.

[purplnurpl]

icing is awesome but if there is noticeable swelling I would be sweating the crap out of that leg.

I’ve rehabbed some pretty nasty injuries. But I was lucking and none of them have had associated edema.
I’ve heard hind suspensories are the worst and that surgical thing they do where they split the tendon is what works…

I’m a PRP fan. Not IRAP or stemcells. PRP and shockwave if the lesions are in spots where the vets can get to them.

It’s going to be a very long haul for you. My heart goes out to you…I have been there far too many times and I know exactly what you are going through.
hugs.

[btswass]

So sorry about your horse. My last horse had a career ending suspensory injury in his hind right. After 8 months of stall rest it was determined that he had concurrent fetlock drop and would maybe trot again. We ended up donating him to Cornell and they use him to teach vet students how to diagnose a ligament tear. I did TONS of research on tendons and ligaments. The biggest issue when it comes to healing is the lack of blood flow to the area. So its a very slow process. And while icing is necessary it also decreases blood flow to the area. I would get a pair of ice vibe boots http://www.horseware.com/ice-vibe/ and use them on both legs once a day (for at least half an hour) and then wrap both with poltice. I would definitely do stem cell therapy if you can afford it as well as therapeutic ultrasound. Both can be very beneficial for healing of tendons and ligaments. I would also talk to your farrier about remedial shoeing options to take some of the stress of the ligament while it heals. Once swelling and heat is gone I would get a pair of back on track quick wraps and use those every night. They work wonders for increasing blood flow. Once your horse is feeling better make sure to try your best to keep him mentally stimulated so he doesn’t get destructive or crazy. The biggest problem I had was my horse was so sick of standing in a stall that every time I would hand walk him he would rear, buck, bolt, and roll and I think this was one of the major reasons his suspensory didn’t heal. Don’t be afraid to ace him if you have to. Find a good regimen and stick to it. Its a lot of work and I know how hard it is but it will be worth it in the end! Good luck

[FoxyRoxy1507]

Im fighting with rear DDFT tear right now, my horse is healed but now we are trying to build up the muscles around his fet lock. He is a pasture horse, could not be stalled. My vet had me do a poultice of furazone and dmso then wrap with plastic wrap and then stable bandages every day to support both legs. Its been 1 1/2 years for him to heal but we sweated the leg for about a week, one day on one day off. then the stable no bows every night for a couple of months for support. we’ve also kept a very close eye on his hind feet and making sure the toe is rockered and short to allow an easier breakover.

[Cindy_s_Warmbloods]

So sorry to hear about your boy. My filly went through a collateral ligament injury this fall and was non-weightbearing for about 2-3 weeks on it. I am not sure how much was from the actual injury and how much for the cellulitis she also developed in the leg. At times she wouldn’t even put her toe down, just held it up in the air. We had her on Banamine iniitally but it didn’t seem to even touch the pain and we could only leave her on so long. We treated her for the cellulitis and she was still really sore and then about a week later she suddenly overnight she started to weight bear on it again and I was SO relieved. Like you I was really worried about laminitis in her good leg but I bedded her stall down well and she spent a fair amount of time down and resting so I think that helped for sure.

She was good through most of Dec/Jan but reinjured it slightly again the beginning of Feb and was again only weighting her toe for about a day. Now she is back to walking on it fairly comfortable again but we still have a long road ahead of us.