How long to heal hoof tendon/ligament issues? UPDATE

[J-Lu]

Hi All,

NOT MY HORSE but a horse I’ve posted previously about. Long story short, ~9 year old QH on and off lame (mostly lame) for 2 years in front. Owner’s old farrier did what he could and was happy to give the horse over to my farrier. Owner switched to my veterinarian. Owner has in time (in time) sank some money into diagnostics.

Owner has my vet (who is good), my farrier (who is good) and a local good equine podiatrist (DVM, PhD) all working as a team. Nothing points to structural problems but now to soft tissue. The horse is in plastic wedges and shallow rocker shoes right now to aleve pressure on the DDFT and other structures. Horse was pulled from his herd situation and put into his own paddock. The owner doesn’t want to restrict him to a small paddock like the podiatrist suggested and I gave his some ways to fence the pasture to help the horse move but not have room to run (for example, a lane following the perimeter or a block to the paddock). Horse is in the paddock maybe 8 hrs/day.

Horse is on previcox daily now. Scheduled for ultrasound with a good ultrasound. MRI is too pricey ($4K)

Anyone with experience with DDFT and tendon/ligament inflammation and how long it took to “calm down”? How did you manage your horse?

Thanks!

Again, NOT MY HORSE but a horse and owner I’m great friends with. Thanks!!

[Amy3996]

@J-Lu

Anyone with experience with DDFT and tendon/ligament inflammation and how long it took to “calm down”?

My WB had a core lesion of the DDFT. Guarded prognosis was 1 year of rehab, no guarantee of a return to more than pasture soundness. We didn’t get that far before losing him to EPM, unfortunately.

[Peggy]

My horse had mild injuries to his DDFT and collateral ligament and a bone bruise in May 2019 from stepping on a rock. Diagnosis was by MRI. Could not see anything by ultrasound. Plan was to treat and do rehab and see how it went; we would pay strict attention to how he felt and back off if he started to feel at all wonky. The DDFT would be the longest rehab of the three, but there was no way to tell which was causing the lameness. Rehab went great, we got him back in work, and then jumping by the end of the year. Showed at the beginning of March 2020 and a month later he was off again.

Did another MRI. Treated more aggressively. Tried to bring back into work twice over the next 6-7 months but the lameness recurred both times at 10 minutes of trot.

Pulled shoes and turned out for six months and then brought back into work very slowly, starting at 2 minutes of trot and adding a minute a week. Horse now doing full flatwork and starting to jump on beautiful footing and shod with ACR onion shoes.

Please pray to whatever deity or figure you prefer.

[IPEsq]

Without MRI there are so many different possibilities for the cause of the problem. With a QH, odds lean towards navicular issues. May or may not be able to see the extent of it on xray. Ultrasound is of limited value if the problem is within the hoof capsule. It is possible that this is not fixable, but if horse is correctly shod now, expect at least a year of rest. You could also try stem cells etc., but if MRI is too expensive, stem cells likely off the table.

[MsM]

The long term on and off lameness is concerning. Did radiographs not show any navicular changes?

My 7 year old was lame for two days when the vet came out, Due to the way he blocked and the radiographs, the vet thought it was early navicular syndrome. Of course I was devastated. I opted for an MRI (cost little more than half of your quote). That showed some irritation of the DDFT right at the coffin bone, as well as “inflammation consistent with navicular syndrome” elsewhere in the foot. Did special shoeing, and very small paddock turnout (sometimes with chemical calming). Then started hand walking etc after 3 months. He was sound through this. After six months and before trotting under saddle, we did another MRI which found “profound improvement”. We continued careful rehab and he has been sound an ind work for 3 years now.

If this horse has a similar DDFT problem, I really wonder if she can get healing without restricting his movement more.

[J-Lu]

Oh man. @Amy3996 I’m so sorry to hear this. Yikes.

@Peggy @IPEsq, the owner told me that MRI would cost around $4k. The podiatrist might have a MRI at his practice and I’m reminded that it might be cheaper at NC State. His horse’s shoes now cost about $230 every 4 weeks and the podiatrist is pretty pricey. Our vet uses a local ultrasoundographer with a system that can penetrate hooves fairly well but obviously, not deep tissue. They want to try that before MRI. Horse has had radiographs on all 4 read by our vet and the lameness specialist and both conclude there is no structural issue like navicular. Coffin joint injections are on the table as a potential direction.

Others have suggested pulling his shoes and turning him out for 6 months to a year but people on his team, including me, frowned upon that. The horse has not been ridden in about 3 months and before that was ridden maybe 1-2 times a week, maybe. Horse has never been worked hard. He lives outside like all of the horses. I think he’d be equally lame barefoot. In fact, he’s in all four shoes now and not just fronts because the vet and farrier thought some of the front lameness was due to soreness behind. Our vet is also a licensed equine chiropractor and worked on this horse and identified soreness in the hind end. Some horses just need shoe support.

I think the owner is slowly understanding how much a horse can cost so I wouldn’t say a MRI is off the table and the man isn’t poor. I think he’s just starting to wrap his head around things (this is his first horse).

@MsM, the horse blocked to the hoof. Hmmmm, I’ll tell the owner to inquire at NC state. I noticed that the horse was restricted to the small paddock today after I mentioned that the horse was running in his own pasture now and suggested ways to use temp fencing to stop that. Horse shares a run-in shed with my horse and I notice that there is more poop along that fenceline so at least my horse is spending some time keeping him company. Owner is worried about “quality of life” issues for his horse and one has to slowly introduce ideas and let him mull them over. He is slowly resolving his idea that horses enjoy living in herds with the fact that he purchased a halter-ish bred QH who’d likely be dead if born on the range. The podiatrist really talked with him about all of the problems with inbred QHs and that this horse will have to be managed more carefully than the owner originally thought.

Thank you all for relaying your stories and information! I will gently relay this to the owner. He’s mostly frustrated and doesn’t have the horse ownership experience to fall back on. At least now he is engaging a great team to help guide him.

[IPEsq]

From Hoof Testers to MRI – The Horse

[J-Lu]

I’ve seen this before but just sent it to owner. Thanks!

[MsM]

I learned from hard experience with a previous horse that it may be cheaper and is certainly more efficient to pull in the"big guns" early to get the best diagnostics. I messed around with some local diagnostics that weren’t specific and lead to more tests and treatment dead ends. And possibly more damage.

As long as there are differences in treatment strategies for different possible problems, I would invest in the best diagnostics.

[J-Lu]

Update to this and my other threads about this horse.

Owner recently brought on board our vet, a lameness specialist, my farrier (his now, too) and a DVM with a somewhat deep imaging ultrasound.

Synopsis from owner, who has a limited understanding of things.

Ultrasound showed thickening of ligaments proximal to the coffin bone and inflammation in the navicular bursa. Also, nodules are present. All indicative of an older injury that didn’t heal well. The injury could have been due to many things (riding/ 24/7 turnout in a herd, genetics due his QH self, etc.) but prognosis is now that he can mildly w/t/c in large figures and easy lines. His real riding career is over at something like 9 yrs. He had injections into the bursa and is on previcox. Both of those permanently, according to the owner. He’s in his own pasture sharing a run-in with my horse now, and had been confined to the run-in dry lot until recently. Happily, my horse spends significant time with him at the fence and in the run-in. He’s incredibly more comfortable now and even I can see that.

Shoeing is currently to cut the toes, put him in plastic wedges to support the heels and mild rocker shoes so the horse can choose the comfy balance point. The plan to really spread his front hoof was curtailed, moving him from a O to a 1 and not a 2 in the rocker shoes. My farrier had been moving him to a 2 to spread the base of support from his former freakishly small-kept hooves.

All involved think a MRI won’t change the course of action and can at most confirm the current prognosis and all argue against the real need for one at this point.

Earlier aggressive diagnostics may have helped but alas, they are where they are.

Just an update for anyone interested in the saga of this QH.

[walkinthewalk]

At least this is a pretty good outcome, all thanks to a team of 20-star professionals. Not everyone has the privilege of access to such highly qualified help but I am always amazed at the people who do and won’t spend the money up front, as as already been alluded to. Thank you for gently pushing the owner and for him listening to reason:)

That said, I might suggest a kick-it-up-a-notch idea to give the horse a little more comfort:)

My IR/Cushings horse has serious residual issues from old founder, now healed torn ligaments from when the first so-called rehab farrier took too much heel in one trim, a twice fractured sacrum, and this year’s new diagnosis was Low Ringbone in the RF. He is a train wreck but the untrained eye wouldn’t know it because I have him on a strict low starch/low calorie diet, am also fortunate to have a great team of professionals to help him, and a wonderful husband who is ok with me spending every penny of my S.S. Retirement on my two remaining horses:)

The therapeutic farrier who minds his hooves has been caring for both horses four years this month. 18 months ago she put this horse in composite shoes with a plastic 3/8” full wedge pad and a full hoof of DIM packing between the pad and the sole.

That package has performed miracles in reducing concussion. So-much-so, The Boys gave me heart failure Sunday racing down the several hundred feet of fence row that keeps them permanently separated. There was some bucking and some spinning (reaching for the oxygen, remember the 2X fractured sacrum) and I-Feel-Good blowing.

The IR/Cushings horse is 26, the other horse is 27 - they evidently forgot how old they are for a few moments. They walked in the barn completely sound that night, so I only lost half a night’s sleep wondering what I would find the next morning. What I found was both horses standing up, ears forward, waiting for breakfast. The IR/Cushings horse sashayed himself out of the barn in great Walking Horse style (he is gaited).

The bottom line is that I can’t say enough good about composite shoes and their benefits to horses with hoof and/or leg issues. My farrier uses a model the EasyCare Versas but there are other brands out there:).

Best wishes in seeing continued improvement with your friend’s horse:)

[J-Lu]

Thanks for relaying your experience!!!

My friend is a fairly new horse owner and rider. He purchased this horse as a late 3 year old and really has never had the time to ride more than 1-2 times/week. He’s a western rider and “I” wouldn’t have ridden the horse like he did with a horse in such low condition, but I’m a super-anal dressage rider who is always thinking about legs and joints and admit I’m super anal about legs and joints. I’ll not that it took the owner 2 years and much gentle prodding on my part to gather a team of experts. He had other advice to “pull thee shoes and turn the horse out for a year” and I kept saying “what if he needs shoes? What if turning him out will just make this worse?” Did I mention I’m an anal dressage rider who thinks about legs and joints?

I think he’s being shod like your horse except with the addition of rockers. I’ve held the horse a couple of times for the farrier when I could be at the barn and he couldn’t, and I was introduced to a level of shoeing I very fortunately have never been introduced to before. Luckily, my farrier doesn’t mind my litany of questions and explained everything. The owner had the DVM podiatrist come out when the farrier was coming out for the last shoeing and taking the toe off and working with the farrier with the shoe size made all the difference. Plus the prevacox from the vet. I noted to the owner because I see the horse regularly how much sounder he seems and how much his attitude is perkier and like how it used to be. The owner is really accepting the horse’s limitations and is just happy that he’s now comfy in a pasture and kind of back to his old self mentally. Sadly for the owner, I think the idea of keeping their horses in a mix-sexed herd is over. They were really into keeping them in a herd (which I pointed out many times was a disaster for this horse now…it was great before, but not now).

In any event, the horse is so much more comfy these days and I’m glad the owner could swing all of this. And I think everyone here wants 26 and 27 year old loved horses with previous issues playing along the fenceline! That says so much about your horse management!! That’s what we all want.

It makes me feel so terrible for the horses with owners who can’t swing all of this, or more importantly who thinks the horse is just being sullen and “a jerk”, and pushed to work especially if they are the stoic types when they actually hurt very much. Or with owners who just don’t know enough to ask the right questions at the right time. The vets assured my friend that he could rack his brain all day about things he could have done differently. No one knows. It could be from an issue under saddle, or out in the pasture with a mixed sex herd, or because of his seemingly halter-bred x show QH breeding that notoriously have bad feet. How could this beginner owner with a fairly decent farrier to begin with know?

Thank you again for relaying your experience, and thank you if you read through this missive. I’ve loved helping my friend because he has so much going on with his teen/early 20s kids right now that he has such little bandwidth!!

[walkinthewalk]

There was a time frame to where I had to carry my horse to the lameness vet every five weeks for x-rays and for his farrier to do the shoeing (steel Natural Balance shoes back then).

A lady about my age would bring in a long two year old QH (looked halter bred to me but I never asked) who had navicular so bad, the vet was doing everything in his power to save the horse but I could tell every week was sadness and a big strain on him.

I never knew the ultimate outcome as, by then, I found my current therapeutic farrier, plus my one lane farm road does not have winter maintenance and that can mean a slidin’ down off the top of this hill - sorta fun in the car, no fun at all pulling the stock trailer😳

I also know waaaay more about special needs horses and therapeutic shoeing than I ever wanted to know. I was raised with cattle and horses, and was used to everyone running together without issues. My grandfather raised Welsh/Morgan’s, they all ran with the beef cattle. Only the stallion had his own three acre paddock. Granddad didn’t over produce anything, so there was no shortage of grazing and running room. Only the producing mares were kept, so the mixed herd (geldings and fillies) didn’t last more than year as grandad had a waiting list in those days:) My cousin & I did most of the training under grandad’s watchful eye, which made the young horses even more desirable for families with children.

Imagine that we fed home grown Timothy/mix, oats and corn all year and nobody got sick, lol.

I am a lifelong trail rider, so good legs and hooves have always been important to me, as well:)
I always wanted to learn Dressage but any training barns, good or bad, were a couple hours away. These days I still wish, but I am doing good to walk with a cane and still clean my own stalls, lollol.

IUpdates on the horse & it’s owner would be great if you have the time​:grinning:

FWIW, I have posted this pic before but, this is the shoe my foundered horse wears, to give you an idea. These don’t look like the toe has much of a rocker. My farrier keeps his toes pulled back, fairly good. Most folks may even have heart failure but his issue requires it and he always walks out of the barn saying “YES!” . If he had thumbs he would give a thumbs up​:+1:.

Your friend really-REALLY owes you:). I hope one day he is able to deeply understand/comprehend how much you have done for him and his horse😇. This sort of thing is a learning experience none of us wants to live.

[J-Lu]

What interesting shoes. I recognize that heel lift. I have learned so much talking with the vets and farriers as we shared farm calls, I held his horse, rode his horse in between recent jobs and I happened to be there at the time some came. The horse’s owner’s goal was to do trail riding. His wife purchased a safer trail horse for this goal (her mustang was not a safe trail horse) and they purchased an older trailer with living quarters so they could camp about 2 years ago when the horse first started going off. They are sooooooo bummed.

I will post updates! I’m just so happy I’ve been able to help the owner and his horse. He’s a good friend and has done a lot for me! So has his wife. You want to help out your good friends as best you can!