Suspensory branch injury and eventing

[fivestrideline]

@Turfqueen

Other than buying lots of wine, what else should I do for the transition?

First off, I’m sorry to hear this. Horses can be so frustrating.

Drugs are your friend. I’m not sure if you had him on them (I didn’t go back and read), but my horse was BSC in the medical paddock. We put him on trazodone and it helped. Once he was out with calm friends, we tapered off the drugs. There were no dramatic YAY FRIENDS gallops or anything, due to being just a bit too sleepy .

He was not a candidate for turnout with the initial injury due to his tendency for stupidity in turnout, but the trazodone let us get him there after some healing without any shenanigans.

[Turfqueen]

Thank you. Has anyone just done stall rest with hand walking, then just paddock rest followed by turnout without any exercise rehab? I’m really just looking to leave him alone after the initial injury cools down. Of course I’m reading studies saying that horses have the best chance of coming back with controlled exercise. I just don’t know if I can do it again. It nearly killed him/me even with drugs.

[Live_Wire]

I did stall rest until he became dangerous even while living through chemistry (approxiamately 18 days until he was charging you from his custom built oversized stall…) and then kicked him out in a field with relatively well behaved citizens. Was it ideal? Heck no. Would I reccommend it? Absolutely not. Did it work? Magically.

[Jealoushe]

Time off does wonders. A year off just turned out might do the trick. As long as the turnout is good footing and what not.

[Turfqueen]

What do I have to lose? Haha. Thank you!

[Live_Wire]

I hate admitting this, and I’ll touch wood over and over again, but he’s one of the most sound horses I’ve ever had. He has taught me to quit looking for bigger problems. I think we oftertimes underestimate how self aware they can be.

[fivestrideline]

I’ve known one horse that got turned out for a year and came back to full work. No other therapies. The horse was very calm outside.

I’ve also known some who didn’t come back fully, but I do wonder if there was an underlying farrier or connective tissue problem for the majority of those. YMMV

[AskMyAccountant.17]

I also did the turn-out and wait after our initial rehab process.

Mine did a foreleg, and we did PRP, shockwave, then laser 2x/week for 6 weeks. (I LOVE laser for injuries. It cost me $75/session. So I could at least spread out the cost, and we would do one farm call/one I brought her in each week)

I think the rehab depends on the horse as far as turnout/under saddle walking. For mine it was 30-days complete stall rest, then hand-walking. This could be pretty explosive, so used drugs and then began incorporating the turnout in a roundpen, under supervision. (I just feel like once you’re on their backs, you may be inclined to push them)

Then, I sent her home to be bred, “try to be bred,” which was the best medicine. She came back into work in September after I failed 3x…

I want to say she was injured beginning of March '22, I did the rehab process of shockwave, then laser, handwalking. I would have sent her home to be chucked out in a field June '22? She sat in a pasture until September when I brought her back into work. A month of hacking, then slowly adding trot work, canter. We ran our first event back January '23.

I will add, end of October I had my vet evaluate her. She flexed and jogged sound on the intial injured fore, but flexed a touch off on the opposite fore. We scanned it and found some minor inflammation. We assume for compensating on the opposite fore. I did laser and rest on the opposite leg for a month. Then we resumed work. So, I would be wary of the pressure added when coming back from an injury and how a horse may compensate.

[beowulf]

@Turfqueen

Sad update. My horse fell in his paddock and reinjured the suspensory. A bit worse than the original injury. I’m devastated. I’m not going through the rehab again so I’m moving him to a small paddock then full 24/7 turnout. Gonna give Dr Green a try. Other than buying lots of wine, what else should I do for the transition?

Big hugs. You may find that Dr Green is good for him. I had one with a full front suspensory rupture come back to Novice level eventing after giving him two years on 24/7 turnout. This was before PRP and Shockwave - see where you are in a year or so. I am so sorry, injuries suck. Its hard too because we want to control the environment so they don’t reaggravate, but it’s also difficult because stalling comes with its own setbacks towards healing.

Make sure you really stay on top of the angles of this horse’s hooves. The older I get the more I’m seeing a relationship between hind suspensories and seriously advanced NPA.

And when and if you bring back to work, stay out of the ring for the first 6 months and try to find places that are safe for you to hack – even gradually increasing to 1 hour hacks around the farm is better and less likely to reinjure than ring work.

[wanderlust]

I’m a big fan of kicking them outside. Have had two that I’ve kicked out to the pasture for 6-ish months that came back fantastic. One I had no intention of ever bringing back to work, he’d had so many failed injuries and rehabs. 6 months turned out on a hill and he was a different horse. The other had done both branches of a front suspensory and healing had kind of stalled on a stall rest/tack walk schedule. Out he went, and when he came back in the vet could barely find the original lesion sites on ultrasound it had healed so well.

[Turfqueen]

Thanks, Wanderlust. I’m making plans to bring him home after I get the rehab protocol from NBC. I’d rather not do riding unless they feel like it would make a big difference at the end of the day. Plan was to do stall rest to get over the initial hump, then small paddock turnout, large paddock, then a field. This time I plan to keep him on trazadone or some other sedative when he transitions to each stage. I think that was my biggest mistake was to sedate him for only a few days for each turnout. He’s fairly quiet but when he explodes, he goes big time, hence the reinjury. Hoping to get him to the large turnout by the end of the summer?

[Live_Wire]

You may consider foregoing stall rest altogether.

[fivestrideline]

FWIW, mine stayed on the trazodone until he was integrated into full turnout in the herd. It wasn’t all that expensive, but he’s a lightweight and responded well.

[Turfqueen]

3 weeks post blow up and although horse did reinjury the branch it was only a small injury. Almost a sprain with a few disrupted fibers. The bad news is he is back on stall rest snd controlled tack walking for 6 weeks but good news is the branch held! The surgeon said this is a great sign for future soundness. The plan is to rehab him for 6 more weeks, another check and the surgeon thought 4-6 months of just turnout would be the right path. I’m very thankful and happy to just get him out. He is a relatively quiet horse but has explosive movements and I’m hoping 24/7 turnout will mellow him out and give him time to heal.

[Curly_Feather]

Mine strained both front suspensories a few years back. Total rehab time was 9 months. Against the vet’s advice, he was turned out in his paddock (medium-sized, no other horses) from day one. He’s not a crazy guy, mostly he potters around and stands eating, but every few days he would have a lazy zoomie and a huge buck. For me, that risk was more acceptable than possible pacing when confined to a stable.

[Turfqueen]

Another update! It’s been 18 mo the since original injury. I decided after last check in July 2023 to turn him out in a big field after I saw he was still off. Fast forward to March 2024 I took him back to NBC for a check where he trotted off slightly off (1-1.5) after flexion but the ultrasound showed a completely healed injury with minimum scar tissue! Vet thought we should try putting him back into work! So recommendation was to shoe him with egg bars behind, a loading dose of Adequan as well as polygylcon injections. Give EQUIOXX for a few weeks and start to build him up. I’m cautiously optimistic. Happy to hear that the branch is healed but know I still have an immersive journey ahead of me with no guarantees. So final point, Dr. Green is amazing. He got me to this point so I encourage anyone if the original injury has cooled off and you have the blessing of your vet, 24/7 turnout is the way to go, if you can swing it and be able to not hyper focus on your horse during the process.

[Larbear]

Wow that’s great! Fingers crossed for the next steps in rehab!

[Turfqueen]

Another check at NBC and my horse is sound! Ultrasound shows a tiny spot of activity but it may just be my horses new normal on the branch. We start jumping next week, just small cross rails but it’s been over 2 years since I’ve jumped.

[Larbear]

That’s awesome! Love seeing the updates!

[Najakb2015]

Hi Turfqueen,

How is your horse now ? I have followed your journey because my horse is having a similar course. He is 14 yo OTTB; went lame at the end of March and was diagnosed with a medial left hind suspensory branch injury with a core lesion. We hand walked for 4 months and he seemed to be coming along. But we had a day where he ran out and now has a lateral branch injury on the same leg. So we are starting over ! It’s disheartening ! So I’m very curious how your horse is now almost two years out ?? Hope all is well !