Sound or not sound? (updated)

[DawgLady]

This is the horse I recently posted about needing to step down. He’s 3 months into rehab from an injury to a lateral suspensory branch. Vet hasn’t been out to recheck for a couple weeks. Trainer says he looks good, just weak sometimes. I’m not sure. Would love some input from folks who have a good eye for lameness.

Vet is scheduled for a recheck in about a week I believe.

This isn’t me riding, if that matters. Someone else rode so I could video.

https://youtu.be/1rR9aRtwTLc

UPDATE 5/4:
The vet came for a recheck. He saw the video I posted first. In the video, he did see lameness – especially in the LF. The injury is actually in the LH. Anyways, the vet did flexions on all four legs, trotted him on hard ground, trotted him on the lunge line in the arena and…said he’s pretty sound.

I asked, “Wouldn’t it be a safer bet to let him have pasture rest for a few months?” The vet essentially said yes AND no. Pasture rest won’t hurt him, but it’ll make the return to work much, much longer. Something about the buildup of scar tissue, weakness, lack of fitness, etc. He thinks we should keep returning the horse to work – very slowly.

Now I don’t know what to do. I trust this vet, but I also trust my gut.

[secuono]

There’s no video.

[DawgLady]

Oh FFS, I can’t get the video to attach. I’ll try another way.

[DawgLady]

Updated with video link.

[Fin01]

I did not read the other thread you referenced.

I see something LH/ RF. Cant’ tell which. It’s mild but it’s there.
The thing with suspensory and tendon issues is that the recovery is never linear. Due to the nature of the injury, you’re going to do little bits of damage as the ligament/ tendon is used and stretches back to normal. Yes there will be scar tissue, which is why you want to go very slow. And why it’s so important NOT to step up work before the vet has done diagnostic imaging to determine progress.

So, it’s kind of irrelevant whether he’s sound or not. You’ll need the vet to u/s the injury site before you can feel 100% comfortable moving up.

[DawgLady]

@Fin01

I did not read the other thread you referenced.

I see something LH/ RF. Cant’ tell which. It’s mild but it’s there.
The thing with suspensory and tendon issues is that the recovery is never linear. Due to the nature of the injury, you’re going to do little bits of damage as the ligament/ tendon is used and stretches back to normal. Yes there will be scar tissue, which is why you want to go very slow. And why it’s so important NOT to step up work before the vet has done diagnostic imaging to determine progress.

So, it’s kind of irrelevant whether he’s sound or not. You’ll need the vet to u/s the injury site before you can feel 100% comfortable moving up.

Thank you. Good info.

[OverandOnward]

I see a horse who is a trier and is doing his best, and his best is pretty dang good.

But his ears, head and neck say “ow ow ow” to me. He’s being stoic because that’s what horses do. Dogs whimper and whine, horses don’t. And this one seems to have character and heart for his job.

You know him best. Be his advocate and his voice.

You are the only person whose only priority is his best interests. Even though others do mean well, they have a lot of other concerns that are also front of mind for them (and they may not be fully focused on this one horse).

A little more time off is far less impactful than coming back too early. For you, him and your pocketbook. :yes:

Going forward, I’d suggest keeping in mind that you have a stoic over-performer here, who tries more than maybe he should for any given recovery status. He may not clearly tell you how he really feels.

[DawgLady]

@OverandOnward

Going forward, I’d suggest keeping in mind that you have a stoic over-performer here, who tries more than maybe he should for any given recovery status. .

You have no idea. He is one in a billion. He has a fan club from coast to coast because he is the biggest-hearted, kindest trier ever.

And the lameness? I sense it more than I see it. You know what I mean?

[firefoot]

He doesn’t scream “lame” but he definitely seems off and uncomfortable. He seems like a sweet heart, what a trier. If you’re jogging to assess his progress, that’s one thing, but I wouldn’t say he looks good enough to go back to any sort of work. Soft tissue injuries can take a long time and rehab should be very slow.

[IPEsq]

He looks a little bit off on LH but not horribly, and he’s puttering along rather slowly. Would be good to see him go the other way, do some turns (if allowed at this stage), and go with more impulsion. Looks like a lovely horse. Hard to say whether he looks worse than he should for this stage. How long was he off? What was the status at the last recheck? Suspensories can take a really long time.

[OverandOnward]

@DawgLady

You have no idea. He is one in a billion. He has a fan club from coast to coast because he is the biggest-hearted, kindest trier ever.

And the lameness? I sense it more than I see it. You know what I mean?

Absolutely know what you mean. Everything about him looks just like that horse. (And he looks well-cared-for as well.)

You’re the mom, here. If Mama Bear says he has to stay on the sidelines, then on the sidelines he sits, secretly relieved and happy that his mom is standing up for him, and he doesn’t have to be brave just to please the coach and the other kids. :winkgrin:

[DawgLady]

Added update to the original post. Vet came for a recheck yesterday.

[Hilary]

If he’s older, I think that just turning him out might cause the rest of him to go to hell and that’s why the recovery to work will be longer. What’s his job? (sorry, didn’t see other thread). You seem pretty in tune with him. If he can do intermittent light work, which has 2 benefits over just turfing him out for a few months, you can monitor his improvement/worsening, and the rest of him will stay sort of in shape.

Sometimes you also need them to work after healing time - they will either thrive and get better or break down. when a human is doing PT they are not just sitting on the couch (stall rest) but they have to push themselves a little bit to make progress.

If he can do a little work every few days with you monitoring him, you will notice if he’s getting stronger or getting worse and that can help guide the rest of it.

[tipzythegreat]

Walk him often and on harder surfaces.

Keep him moving, but I’d keep the actual work to a minimum. My local vet was much the same with my suspensory – keep him moving & bring him back. In my heart I knew he hurt and wasnt ready. So we walked for many months and yes it took a long time to bring him back but Dr. Gillis said 3 or 4 months just isnt enough time.

I’d rather take it slow & know it healed vs pushing it and having to start from scratch if he aggravates it again.

This is an 8-12 month injury IMO!

Good luck!

[DawgLady]

@tipzythegreat

Walk him often and on harder surfaces.

Keep him moving, but I’d keep the actual work to a minimum. My local vet was much the same with my suspensory – keep him moving & bring him back. In my heart I knew he hurt and wasnt ready. So we walked for many months and yes it took a long time to bring him back but Dr. Gillis said 3 or 4 months just isnt enough time.

I’d rather take it slow & know it healed vs pushing it and having to start from scratch if he aggravates it again.

This is an 8-12 month injury IMO!

Good luck!

I love that you said this. Thank you. The vet is more eager than I am, which I find odd. I understand why we’re staying in light work, but my gut says take it slower. The horse is doing about 35 minutes tack walking and 15 minutes trotting currently. I think we need to stay at this level (or even less) for quite some time before pushing further. There’s no such thing as rehabbing too slowly.

We are at the three month mark today.

(I guess I should add that the injury is not a tear or lesion. It’s a strain of a supposedly already-injured suspensory from long ago. The vet sees a lot of old scar tissue on the ultrasound.)

[sonestra]

Hi OP,

I’m sorry you’re going through this. I’ve been there, and your vet is correct. You can’t wait for 100% soundness to bring him back to work or the scar tissue will build up. It’s a fine balance of keeping flexibility and gaining strength without causing more disruption and inflammation.

It’s sooo very hard to know when the rehab is doing damage versus the normal discomfort he might need to push through. I had the vet out constantly because it’s hard to know, but my horse made a complete comeback and hasn’t taken a lame step in 2 years. She has 2 hind high chronic suspensory strains and we did surgery for it. She also was turned out after 2 months in a very small area, gradually made larger.

Just think if humans conditioning themselves or doing PT for an injury. It’s never without some pain or discomfort. It will get ouchy before progress is made.

[DawgLady]

@sonestra

Hi OP,

I’m sorry you’re going through this. I’ve been there, and your vet is correct. You can’t wait for 100% soundness to bring him back to work or the scar tissue will build up. It’s a fine balance of keeping flexibility and gaining strength without causing more disruption and inflammation.

It’s sooo very hard to know when the rehab is doing damage versus the normal discomfort he might need to push through. I had the vet out constantly because it’s hard to know, but my horse made a complete comeback and hasn’t taken a lame step in 2 years. She has 2 hind high chronic suspensory strains and we did surgery for it. She also was turned out after 2 months in a very small area, gradually made larger.

Just think if humans conditioning themselves or doing PT for an injury. It’s never without some pain or discomfort. It will get ouchy before progress is made.

@sonestra , did your vet have you cold hosing, icing, or wrapping after rehab work? Just curious.

[sonestra]

@DawgLady , he had me using back on track standing wraps. While not old, he is old-school in the sense that he does not believe in doing anything extraneous unless there are studies that show otherwise. I also used liniment gel , but I agree with my vet that it likely made me feel better more than it actually did anything. However, until her stitches came out I was wrapping and icing aggressively. Her surgeon actually told me to stop, as sometimes too much cold can cause more inflammation (dead of winter with single digit temps at the time). We did 3 rounds of shockwave afterwards too, because there was a lot of swelling and disruption of the fibers. That seemed to do the trick.

We had a fitness plan from her surgeon that starting with a gradual increase in hand walking time, eventually walking under saddle, over ground poles, then trotting, and trotting over ground poles. I was very careful to vary the footing and I
think that was key. All walking was done on hard packed ground, unless we had to go over ground poles. Then I set some up in the arena and on the hard ground. Trotting was more in the arena because she would get too amped trotting around the property most times, but I did always try to include one straight shot of trotting on the hard ground. The whole process took almost a year before we cantered, but that was longer than it should have taken. I had no indoor, so everything was delayed due to the weather.

[DawgLady]

@Sonesta I’ll send you a pm

[beowulf]

He is sounder than a lot of horses I see.

That being said he is weaker on that LH, he will not push off with it the same way and he is striding shorter.

He is also somewhat altered on the LF, which is confusing because, usually if the injury is on the LH, the RF will stride shorter to compensate.

He is not what I would call terribly lame. At best that LH is a 1/5; the LF is possibly a .5/5.

What are you doing management wise to keep him comfortable? Is he older? What is the schedule your vet has for this injury? How much turnout is he getting, and can he get more? I have had really good luck rehabbing suspensory injuries by maximizing their turnout as much as possible (24/7, even). It seems to condition the leg very well so that the return to work is much less complicated.

Another thing with suspensories - make sure his hind angles are very good. You may have to browse online (or ask some of our members) to figure out what a good, healthily shod foot looks like. It’s been my experience a lot of hind suspensories are caused by really bad trimming behind.