PRP for old suspensory lesion

[brightlights]

So, I’m losing my head, y’all. Anyone have any experience treating an old suspensory ligament lesion (my mare’s is branch, foreleg) with PRP and a successful outcome?

This injury was most likely present in my pre-purchase exam but mistaken for a foot balance issue (imbalance evident in x-rays, horse was young, unshod, had an old overreach
scar and slightly misshapen heel…). I’d unfortunately no experience with soft tissue injuries and didn’t request a scan.

I had her checked twice in the year I’ve owned her for unsoundness in this leg but no one has ever agreed, trainer or vet. I had occasion to lunge her a couple months ago for the first time since pre-purchase and the same “sub-clinical” lameness in one direction presented as before within a few days. We finally found an old (> 2 months) lesion after I insisted on a scan. I don’t mean to sound blame-y, I’ve just traumatized myself (dumbly, ugh), allowing trainer and vet to tell me to “push through” what they first perceived as imbalance, then as weakness, then as possibly a neck issue (vet was ready to inject her neck, fully expecting a clean scan).

The prognosis for recovery for her intended career is good, but I’m sick over the whole thing. How delicate a recovery/rehab is necessary for a successful PRP treatment? After two weeks of painstakingly following the incremental hand walking in her recovery protocol, my horse has had a crazy two minutes of bucking, spinning around me, and generally losing her head. She’s supposed to be on 20 minutes of controlled walking, so I honestly don’t know whether I’m being rational or not wondering whether we just undid the whole damn treatment?

[tipzythegreat]

I’ve heard of PRP working well on fresh cases.

My guy had an old injury and we did shockwave. The ligament had significant healing when compared to the other leg which received no shockwave.

Suspensory injuries are just tricky to diagnose. I think that’s why you’ve been having trouble finding the issue. My trainers also told me the same thing. “You just need to ride more forward” or “ride better” – so I totally get the blame thing. With suspensory injuries I think you FEEL it a lot worse than anyone on the ground sees it.

I don’t think you’ve undone the whole treatment. But I do think you need to be prepared for months of taking it easy. The injury is old and set, right? And you were working her regardless? So while it’s not ideal for any sort of silly behavior, I think you’ll be okay. Cold hose and wrap her to keep inflammation down when she’s naughty

I’m approaching two years since my diagnosis. I don’t think at this point my horse can return to his previous level of work. He just gets sore anytime I try to jump him. But mine is a hind proximal injury. But no lesion.

Good luck!

[brightlights]

Thank you for sharing. I’m sorry to hear about your horse, ligament injuries are so rough. I’m so frustrated with myself, I knew she wasn’t 100%, but she’s difficult in the bridle to the point that it was a chicken/egg thing as to whether that was creating the off feeling. The vet told me a lot of people would carry on competing with my mare as she isn’t visibly lame, which just astounds me. I’m willing to wait as long as it takes, I just hope acting a fool hasn’t screwed up the PRP :eek: Argh, horses

[joiedevie99]

Talk to your vet about drugs. Chances are you did no harm, but there is no reason to take risks. Older injuries are definitely more difficult to heal - sometimes needing multiple therapies - like shockwave and PRP - to get things moving in the right direction.

[twelvebelles]

You can do this. Put on gloves, carry a crop, and perhaps load up on some wine (for you) and ace (for the horse).

My horse had a torn meniscus that was missed in the pre-purchase exam. He would occasionally seem a little off, but nothing terrible that screamed “DANGER, LAMENESS!” My trainer was confused, and I was told by a vet that he was “sore” from work or didn’t “know how to use himself.” I found a different who also didn’t think there was much wrong, and I begged him to utlrasound “just in case” and that’s how we found it. We were worried it had been there awhile because there was some apparent calcification. In desperation, I threw stem cell therapy, shockwave and a year of rehab at it - and my horse was TERRIBLE for a majority of it. He was a holy terror to hand walk (rearing, spooking, etc.), and got a little ace for handwalking until he adjusted, and had to be sedated within an inch of collapse when he started getting ridden again. It was painful at the time, and I cried and wore gloves and clutched a crop any time I walked him out of his stall, but we made it. It’s been five years and he’s sound and happy as a clam jumping around.

[brightlights]

Thank you so, so much for you sweet comment. I should have said this then, and I apologize from the bottom of my heart for not doing so, because you were very kind and gave me much comfort. I was honestly struggling at the time and not well equipped to handle the anxiety over those few moments of equine insanity.

I thought about what you said often when I was near tears, walking the poor horse in near gale force winds, and it gave me a sense of camaraderie and resolution that translated to my horse for a better walk. Just to read that someone else out there had been through a very similar experience and came out the other side better for it was huge. So thank you again for providing me strength and humor, as well as reassurance—many friends and especially professionals here in my daily life are reticent over these types of injuries and it can feel lonely! I’m so happy, as well, that you successfully rehabbed your boy and he’s happy and sound

[SporthorseFun]

This a great story. Thank you for sharing. I helps to know that there is light to be found!

[brightlights]

In case anyone is ever fear-searching the forum in a cold sweat like I was and finds this post, I’m here to update: My mare is about 8 weeks post-PRP treatment for an old, calcified branch suspensory lesion on her front leg. After a rehab period that has been not without a few small dramas, her ultrasound image looks promising!

I was prepared to be disappointed going into our follow up appointment, so I’m thrilled. There were a few occasions I felt heat in her fetlock, and despite nearly holding my breath on her hand walks, sometimes with sedation (for her, though I could have used some), painstakingly trying to limit any possible misstep, I’d often find her spinning around her stall later in the day

Our vet was happy with her outcome and believes we should have full ultrasonic resolution of the lesion so long as we keep rehabbing in the right direction. They didn’t think this injury would heal without PRP, due to its age and evidence of failed prior attempts of healing. I really questioned whether it was possible with such an explosive little horse and am so glad we treated her. What a fantastic option.

[twelvebelles]

I’m glad my words brought you some comfort! I also found rehab to be very lonely depending on the barn/situation, so I’m glad my words helped someone else in a similar situation! Looking back, one of my issues is that I wasn’t rehabbing at the right facility for our needs. If you aren’t feeling supporting in the process, I’d consider another facility. Sometimes, I feel like when you don’t have a horse to ride and aren’t spending a lot of money, it is easy to get cast aside - and not everyone is like that. Also, however long the rehab is expected to be? Double it, and don’t let anyone push you and your horse because they want to get you back in their program. I honestly think one of the reasons I was successful was because I was extra cautious and doubled the amount of time for everything we did. It was maddening, but in the end I got the best possible result.

Best of luck for the future!

[SporthorseFun]

Awesome! Good job!

[brightlights]

Thanks so much! You absolutely did help me feel a bit less alone in the process. I actually keep and train my horses at home, so between lock down, recovering from my own injury, and this little mare rehabbing, there were very few occasions to be around my coach or other riders– certainly isolating.

Point well taken about our timeline. I agree! I was told I could start ridden trot work this week, but will give her at least another few before I get on. I don’t imagine we’ll see the inside of an arena until well into the new year. She’s certainly worth the wait.

Best of luck to you, too