OTTB with suspected sesamoid fracture - any advice welcome.

[4THEHORSES]

Hi All,

I have just agreed to adopt an OTTB who would otherwise be headed to auction. I wasn’t seriously looking for another horse but something about this guy appealed to me, in spite of his very badly swollen fetlock.

To cut a long story short there are no existing X-Rays or ultrasound however, I strongly suspect he had a sesamoid fracture.

I’ll be asking my vet to X-Ray when I get this boy home however, purely to help me understand a little more about this type of injury, I’d appreciate if you could share your experiences in this area.

The only info I have so far is that he last raced late May and the injury (hind fetlock) happened during that race. He appears to be walking sound on it now but is obviously lame at the trot. According to the lady who is trying to re-home him the swelling isn’t going down.

Has anyone seen this type of injury before? How did you rehab? How long did it take? Did the horse ever come sound, even just for light riding?

Appreciate your thoughts/expertise. This is a beautiful gelding and I really hope I can help him.

[betsyk]

Please do have this vetted before committing to this horse. My gelding (that I bought as a 2-y-o, so he’s with me for life no matter what, now) had what appeared to be a suspensory injury last fall. We put him on stall/pen rest for the winter, and he never really came sound on it. Closer examination this spring and we found an avulsion fracture at the back of the fetlock, involving the sesamoidean ligament and another (name escapes me). Expensive surgery, lengthy rehab, and I’m hoping he’ll be sound for light riding. You don’t need to buy/adopt an expensive lawn ornament - start with a sound one, they have enough ways of hurting themselves.

[moore4sure]

Is it a hind fetlock??..if so you may have fighting chance of him being riding sound. Not going to lie sesmoids are real tough but that doesn’t mean that he will be lame for life by any means. Not having a x-ray you in the dark…def get a picture done, also good advise give him some stall time I love turnout as much as the next but a lot of people get lame TBs and turn them out. If there a fracture it needs time to set appropriately. I had a horse with a small sesmoid fracture after running that events and foxhunts now so until you have a savy vet(one that’s a lameness specialist) look at a picture its hard to say.

[ryansgirl]

I did a vet check on an OTTB years ago - his trainer said the horse had green osselets but something didnt seem right. One front leg was fine (old/set) but the other was on fire. I mean burning up - seriously lame. I had an X-ray done and it turned out the poor gelding had a fractured sesamoid - trainer never did X-rays :mad:. The vet told me his prognosis was not very good for even just being a pasture pet. Thankfully another vet took him to her farm to retire - she was going to try and help him but if not then she was going to put him down. Not sure what the end result was but at least he was “safe”.

[Laurierace]

Just stop speculating and get a diagnosis. I have seen sesamoid fractures that required immediate euthanasia on the track and some who have come back to race successfully after time off. Some who were show horses after surgery but wouldn’t hold up for racing. So you have the entire spectrum there.

[4THEHORSES]

Thanks everyone for your replies. It’s really good to hear some other perspectives.

betsky: Sorry to hear what happened to your 2 year old but kudos to you for keeping him with you. I guess the main reason that I’m willing to take a chance on this guy is that I already have 2 sound riding horses and I have my own ranch so if he did turn out to be unrideable it’s not too much of a loss to keep him around. His job can be keeping my youngest horse company when the other one goes off for trail rides and shows. That said, I’ll still do whatever I can to get him sound. I’ve re-trained horses off the track before so I guess I just feel I have the skills and opportunity to give him a chance.

moore4sure: Yes, the injury is hind end. I too believed that this gives him a better chance of recovery although there are obviously no guarantees. I agree completely that stall rest would benefit him too

ryansgirl: Your vet is an angel!! I know there’s always a chance this guy could have to be euthanized too and I’d never keep a horse going if his quality of life is badly compromised. If it came to that I’d rather pay to have him put to sleep humanely than see him end up in an auction with a glaring injury that will most likely send him straight to the slaughterhouse.

Laurirace: I agree 100% that X-Rays are a must. He’s still at the track right now and irrespective of the result of the X-Ray I’ll bring him home so I’d rather work with my own vet on that one. He’s very good with lameness (did an amazing job with a friends Arabian mare, among others) and he’s open to working with my trimmer to figure out the rehab process. I’m just looking to gather some information while I wait for him to leave the track. Even if the issues turn out to be something other than a sesamoid fracture (very possible), it’s a great learning experience hearing everyone’s feedback.

I’d also be interested to know whether any of you have info on nutrition for a horse that is trying to heal an injury. I feed my two a combination of alfalfa and grass and am a firm believer that the vast majority of a horses nutrition should come from the right amount of good quality forage. However, in circumstances where the horses is in rehab from an injury are there and feeds, minerals, supplements, etc that help calm inflammation, encourage bone grown/healing and so on. Again,. I ask this partly out of curiosity and party to arm myself with as much information as possible that may be of help to this gelding.

Thanks again for all the replies. It’s great to be able to share ideas.

:yes:

[betsyk]

Sounds like you have the perfect setup and realistic expectations. Here’s my take on the nutrition side of things: part of what started this whole mess was that my boy (he’s actually 7 now) got really obese and was on the verge of being laminitic - so I pulled him off the pasture, kept him in a pen for a week or two til the heat went out of his feet, and then the vet said to get him on an exercise program. Cooped up horse + pal + round pen = two boys who played much too hard while I was busy doing something else and didn’t see it happening. He was lame the next day. That was the beginning of it, last fall. The vet wanted him to lose a couple hundred pounds, so we put him on thyroid supplement and limited amounts of grass hay in small hole nets and kept him on stall/pen rest all winter, no blanket. He lost the weight by summer (6-7 months) and looks great now, but since he’s still essentially on stall rest I have to continue to be very careful about what he eats.

We put him on SmartPak Recovery (I think that’s what it was) for a while last winter. Kept him on Remission, which he’d been on for a couple years anyway – lots of magnesium, which he responds to very well. Reserpine as needed. That kept all 4 feet reasonably connected to the ground, most of the time. After his surgery this spring, we changed a few things – discontinued the thyroid supplement, since his weight issue has been resolved; switched from Remission to Quiessence in hopes it might have more of a calming effect; took him off flaxseed (rainrot prevention voodoo, seemed to help last winter); bought another pail of SmartPak Recovery. I think the heat and the fact that his ankle still hurts have done the most for keeping him grounded this summer - he only acts stupid in the pen when the flies start bothering him or he wants to come in to stand in front of his fan! He has become a princess…

Future nutrition for this guy, who will probably always struggle with being sound enough to get enough exercise to manage his tendency to gain weight: grass hay, ideally in limited quantities; minimal pasture as available; stall board, so we can control his intake; mega joint support stuff, since the fetlock arthritis will be an ongoing issue; something for insulin resistance, and he responds really, really well to magnesium for calming purposes; whatever he needs as far as vit/min, flaxseed, or whatever to balance the grass hay without adding a lot of calories. Not sure how much of this is relevant for your guy who probably has a VERY different metabolism! This is a horse who’s never needed “grain” beyond a handful of oats to mix with his pellets and powders, so I’m not much help there.

[Laurierace]

When you say he is still on the track do you mean in training? If he is still training it can’t be broken.

[4THEHORSES]

betsyk: thanks for all the info. Sounds like you’ve really done a lot for your boy. I swear they’re like kids in some respects, you turn your back for two seconds and bam, they do something silly. I’ll look up those supplements and keep them in mind. Even if they don’t benefit this boy the advice may be relevant to my other two one day. They’re both draft’s and put on weight just looking at food!

Laurierace: He’s still living at the track but not training. Just hanging out in his stall. The owners are out of State just now running their other horses so I’m waiting for them to come back so we can arrange to have him brought to my place. Will add a pic of his fetlock too.

[4THEHORSES]

Actually, you can see the pic here:

http://www.canterusa.org/index.php?option=com_content&view=article&id=8181:slokkie&catid=42:s-cal-trainer-listings&Itemid=281

[animaldoc]

Laurie is right - there’s no way to speculate without films. Could be fine with rest or surgery, or could be a walking time bomb or might never be sound… Looks like from the picture an annular ligament desmotomy may need to be part of the treatment. Whatever is going on, the longer it goes with no definitive care the worse the prognosis.

[4THEHORSES]

animadoc: totally agree about the films (and whatever other ultrasound etc may be required) and it’s poriority number 1 when i get him home. I also realise that the longer the injury is left undiagnosed/untreated the less likely he is to recover well. Just looking to educate myself to the possibilities and move forward armed with as much info as possible. Am I correct in saying that annular ligament desmotomy is severing the ligament to release fluid?

[merrygoround]

[QUOTE=Laurierace;7082771]
Just stop speculating and get a diagnosis. I have seen sesamoid fractures that required immediate euthanasia on the track and some who have come back to race successfully after time off. Some who were show horses after surgery but wouldn’t hold up for racing. So you have the entire spectrum there.[/QUOTE]

And some who were show horses without surgery. But you need a Dx. It may not even be a sesamoid.

[Laurierace]

That was what I was saying, it could be any thing from time off then a lifetime of no problems or life threatening.

[animaldoc]

[QUOTE=4THEHORSES;7083671]
Just looking to educate myself to the possibilities and move forward armed with as much info as possible.[/QUOTE]
What I was trying to say (like Laurie) is that the possibilities are endless…

@4THEHORSES;7083671

Am I correct in saying that annular ligament desmotomy is severing the ligament to release fluid?

Well, if the annular ligament is thickened, then it doesn’t allow for normal movement of the tendons and can constrict the area, so releasing the ligament constriction will allow for normal movement. It looks like in that picture there is a little “notch” at the back of the leg where the annular ligament is constricting the area. So the swelling could all be from a tendon/tendon sheath issue and not have anything to do with the sesamoids…

[4THEHORSES]

Thanks Laurie and animaldoc for the realistic perspective. Looks like he’ll be at my place by the weekend so I’ll get those x-rays and take it form there.

Fingers crossed for this guy

[4THEHORSES]

Hi Folks,

Wanted to post an update on this guy, now that we have a diagnosis. It ain’t pretty!! :eek:

He has damaged both suspensory branches (the outside being the worst) as well as the deep digital flexor tendon (deep, deep down where it connects to the inside of the hoof!). There is also damage to the sesamoid bones. I found out that the original injury was sustained in 2011, was not diagnosed, treated or rehabbed appropriately and looks there were two attempts made to return him to racing!! The most recent being in May of this year. Due mostly to the lack of appropriate rehab none of these injuries have healed well. There is a MASSIVE amount of scar tissue on the ligament and tendon and the sesamoid bones have healed ragged.

The positive side is that he’s pasture sound however he’s at risk of the DDFT completely rupturing and causing a catastrophic breakdown.

Next move is to see whether anything can be done to reduce the amount of scar tissue and stabilize the DDFT.

Poor guy!