I’m still in a state of shock over this latest diagnosis on my horse, and feel defeated/like giving up. Please tell me everything you know about sesamoiditis, any treatment options you pursued, recovery time, etc.
The whole long history of my 17 yo OTTB’s past injury can be found by reading my old posts, but essentially in late 2018 he got severe cellulitis in his left hind fetlock area. The barn’s vet missed the diagnosis and he ended up with a 75% torn suspensory branch and a joint infection in the fetlock. After a long stay at the vet hospital, a surgery, PRP injections, 1.5 years of recovery and rehab, we were back doing local jumpers last summer, completed a BN horse trial, and he was feeling better than ever all winter. We were planning on coming out this spring in the .95m jumpers and he was feeling great.
The day before our first show this year, April 2, he came in from his private paddock with a fractured splint in the right front. The fracture had caused a wound and had clearly happened in the field (a private paddock where no one ever sees him run). I was baffled but freak injuries happen, and lucky for us there was no suspensory involvement. We waited 3 weeks (complete stall rest) for the wound to heal before going forward with surgery to remove the splint fragment. The surgery was very uncomplicated (it was done standing). He spent 2 more weeks confined, but I temporarily moved him to a rehab barn (same place he had been for the last rehab) and they had a nice set up with a small run attached to the stall. Then he had the staples removed, and then with the vet’s blessing we moved him back to the regular barn, into his normal private paddock and turnout schedule. The incision healed beautifully and the splint site was looking great.
We wanted to take it slow with his rehab, and after a week back in turnout, we started walking under tack. We spent 2 weeks just walking him, slowly building up to walking out on the hills around the property. He was walking on the trails for 45 min with me before I ever took a step of trot. He felt great, and he was already building topline. I started working in some trots on the hills and he felt good.
I started the trot work the following week with 2 sets of 2 minute trots, and then added a 3rd set later in the walk because he didn’t even feel tired. All was good. I relayed this to the trainer who helps me ride him during the week, and who helped me with his other long rehab. Unfortunately she misread my text and did a lot more trotting that week - I believe she did 3 min sets and possibly up to 4 sets instead of 3. In my mind I think this should have been ok, because he was very fit already.
That Friday (May 28) I came out to ride and he had a swollen spot on the inside of his left front fetlock (the opposite leg from the splint site). It wasn’t hot, and he was sound on it, so I wrapped it with a polo wrap and took him out for a short hack anyway (this was probably not a good idea). Then he had the weekend off and the vet came the following Tuesday (June 1) to look at it. By then, he was lame.
X-ray was inconclusive, and ultrasound showed no soft tissue involvement, so we gave him the week off but allowed turnout, but also with cold hosing and applying surpass to the area. The vet then sent the images to a track vet friend who suspected sesamoiditis. So this brings us to last weekend, when he was still lame and the swelling hadn’t gone down at all. We moved him back to a stall rest regimen (and keeping wraps on) and the vet decided to re-xray this past Friday, thinking if there was a hairline fracture it would show up. He’s not lame anymore, but there is still some swelling present.
No fracture showed up on the x-rays, but the official diagnosis is sesamoiditis. I’m debating whether I should have him re-ultrasounded at the vet hospital to verify there is no soft tissue involvement. The vet recommended 3-4 weeks of stall rest and then rechecking to see what we have.
Everything I’m reading sounds like this a very long recovery. At this point, i’m out of money to spend on expensive treatments and can’t bear the thought of him being on stall rest or confined for too much longer. I have the option of sending him back to the rehab place which has more options for small turnout, but it is very expensive and I can’t really afford to hold my stall at my regular barn for more than a few weeks. However, my regular barn is an active training and show barn and I worry about his stress levels while on stall rest there. I feel extremely discouraged and disappointed, and feel that this was likely caused by him compensating for the splint and us bringing him back too fast
Any advice or stories are welcome. I just feel like I’m at my wits’ end with the rehab and vet bills right now.
