Rearing up during rehab of hind suspensory swelling and minimal fiber fraying...

[emilyr817]

I bought my horse in February and a month later she came up lame. I was riding her and everything was going fine and then suddenly she would not go forward at the trot and stated to do small half rears to avoid going forward. Immediately got off and luckily a specialty lameness vet was coming by in two days so he took a look at her. Nerve blocked her and found by ultrasound swelling in the upper hind left suspensory along with minimal fiber fraying. Not a terrible diagnosis, but still a few weeks off and a slow rehab. Fast forward to the middle of April. Vet comes back and she is looking 99% sounder at the trot and ultrasound shows very good healing and minimal swelling and reattaching of fibers. Great news! Immediately could start walking her undersaddle for two weeks and then incorporate small bits of trot work. At the trot she seems maybe a bit stiff but otherwise sound. Until about ten trot steps in she starts doing a half rear and refusing to go forward. Walked for a few more days and tried to do it again. Same thing happened.

Before I bought her she had her back injected (December) and flexed mild positive for this hind left limb. I am curious as to whether you all think she might be over compensating for her back and that is why the suspensory swelling popped up, or perhaps it is just the suspensory and I am crazy. Regardless, for a horse that had such a clean ultrasound two weeks ago and have been doing nothing but walking (which she had been doing before in turnout), I’m stumped.

She tends to be very very sensitive when brushing or currying her and almost tends to seize up at the trot. I think she might have Lyme’s? She came down from NJ to SC.

I am having the vet re-look at her next week but I will be out of the country and would like some peace of mind or something of the sort… going crazy over here!

[GoForAGallop]

It’s just Lyme, and that’s certainly an option.

If she’s been on stall rest or bute or just stressed from being ouchy, I’d put a lot of money on ulcers. Luckily, if you don’t want to spring for a scope, it’s pretty easy to start ruling them out just by treating with Gastroguard.

[emilyr817]

I have her on U-Gard from Smartpak and she has been on Previcox. She was never really on stall rest as my Vet suggested a small paddock to keep her moving since she is so calm and never took an excited step. I’m just hoping we haven’t gone backwards with this suspensory injury. So frustrating :(. I’m just hoping I’m not missing another injury somewhere…

[Laurierace]

If she is already being turned out and being ridden this quickly that is likely the problem. I do stall rest with hand walking added in for at least six months.

[Pennywell_Bay]

http://www.equinepartnersamerica.com/research/Gillis-RehabTendonsLigamentsAAEP.pdf

I went through a suspensory injury with my mare. IMO, and by everything our highly specialized sports medicine vet and literature, you have rushed into riding her ( and possibly turning her out). Here’s an old article, still used by a lot of vets as a standard of rehab (at least this is what they gave to me to help me understand the process we were undertaking).

[findeight]

Never had a hind suspensory but been around a bunch of them and agree with above posters, too quick. She’s telling you by displaying the exact same behavior she showed when it was bothering her so…it’s bothering her. Ultrasound can reveal the physical condition but not how much it bothers the horse. Horses generally are pretty good at telling us what hurts. If we listen.

Suggest you call in a specialist for a second opinion. Maybe a clinic visit so they can use better equipment capable of a sharper image then what they typically have on the truck.

Have to be honest here…you just bought this horse 90 days ago and were told she had her back injected and “flexed a miid positive” in the same leg??? Coincidence??? And define “miid positive”, are we talking a 1/5, 1.5/5 or 2/5 and what was the diagnosis? What part of her back was injected and why???

Did you PPE and what imaging did you do, X Ray and ultrasound?

Just gives me pause there was a problem in that same leg six months ago. Would want more information on that and the back injection even if they seem to be unrelated.

[emilyr817]

I thought we were moving too fast with the rehab at first, but vet is very reputable and has a super detailed and expensive ultrasound machine that the big clinics use too. I have been following his rehab plan to a T and when he rescanned before we started walking the comparison images were very good.

In our PPE she flexed a very mild positive, so mild that my vet from back home saw no issue with it and passed her as clean. Her back was injected in December and this information was disclosed to me before purchase along with vet reports. They did an ultrasound guided injection of her L2-L4. They injected because she was trailing out a bit behind and after an extensive examination he determined it was her back. She went back to normal after this.

EDIT: to clarify, we x-rayed her back too before we purchased

I for sure want to dial back the rehab, but I went with the vet’s suggestion and everyone has nothing but glowing things to say about his success so I trusted thoroughly.

If this persists after another visit from the vet next week I will look into another specialist. I still do want him to look at her back too.

[IPEsq]

I did the rehab riding for a horse with a hind suspensory injury when I was in college. He had been getting some turnout by the time I rode him. I didn’t know him when the injury happened as I had tried riding at the IHSA team’s barn at first, but I think it was a good year until he was back to normal work.

I would also be suspicious of the back issue causing some of this behavior.

[joiedevie99]

It really depends on the exact injury. I had one with swelling but no fiber disruption. We did not take him out of work. He walked under tack for 6 weeks, had a 100% clean follow-up ultrasound, and gently started back into work. As far as I know, he never reinjured.

I’d not get too worried yet. Keep walking and schedule another exam/ultrasound to see how things stand now, and evaluate whether the pain may be coming from something else.

[emilyr817]

The fiber disruption for her was very minimal. Vet assured me it wouldn’t be a lengthy rehab but a round of shockwave was something that was necessary to speed things along. Mostly just swelling! He said that for the injury she had it was beneficial for her to keep being turned out in a medical paddock for an hour after stall rest for two weeks. The injury itself was caught in the acute stage so high hopes for rehealing quicker since it wasn’t old. We iced every day for two weeks and gave previcox before short turn out in a medical paddock every day for an hour. Then we shockwaved and stall rest for another week and a half before some more short turnout where she was watched. Just over a month later she was cleared for short tack walks and two weeks after walking he said try trotting two straight lines and this is when that started.

I am not getting too worried just yet, it just doesn’t help that I am going out of the country for a month and won’t really have access to my phone so I won’t know what is going on! THAT is what is stressing me out!

[ElementFarm]

just make sure you find a trusted friend THAT KNOWS HORSES and grant them Power of Attorney for the horse and her care. You will feel better away, if you know someone at home is monitoring progress and engaging directly with vets and/or specialists. Make sure that person knows what your budget is.

Also, if you’ll have periodic email access abroad, arrange for them to send detailed updates daily or weekly with how things are progressing, what the mare is doing and how she’s feeling.

As someone who travels out of the country a lot for work, I know that LOTS of information coming from home, even if it’s just reporting an absolutely-normal day, makes me feel much better and in touch.

[emilyr817]

I have a good friend that will keep an eye on her for me! I will have access to email and my phone but minimally. I will make sure she knows what my budget is and how to access our vet. I will also ask for weekly updates! Thanks for the suggestion.

[LarkspurCO]

If she’s sound on that leg then this could be behavioral, especially if you stop after she rears. Horses like to train their owners in this manner, and she may have even remembered this from the first time it happened, liked the results and repeated it

Even if she is doing this because her back hurts, or something else hurts, the behavior will be reinforced and she may continue doing it even when she feels good. So be mindful how you respond, and do not allow her to rear and get away with it.

[emilyr817]

Thanks Larkspur,

Her *old owner actually told me this. She said the mare is just so smart that if she is anticipating the pain from previous times she might be doing it because she knows she can get away with it. Its a thought.