Hi all, I recently purchased a broodmare with a known suspensory tear that happened about a month before sale in September. Since then we have shipped her from Oregon to her new home in Texas and her hind-leg has remained fairly swollen (about a grapefruit sized fetlock area now) and up till now it hasn’t seem to bother her too much. We were told by vets that there really wasn’t much we could do for her for this particular injury, but I really have no idea if this is true since I have never personally dealt with a suspensory tear. Lately, she has been in pain and is hardly able to put pressure on that injured hind leg. Now we are trying standing wraps for support and previcox for pain and also the Back on Track therapeutic boots. For people that have dealt with this, would you be concerned about her developing laminitis from her constantly putting her weight on the other leg and what can I do to help rehabilitate this injury and lessen her discomfort? What treatments have you found to work for this in the past? I am also kind of limited on the analgesics that I can give her since she is currently pregnant (i.e. not bute and others that could compromise foal)… Thanks in advance for any suggestions!!
Shockwave therapy. I had it done when my horse injured his suspensory ligament, and the BO had it done on a broodmare with an old hole in her suspensory. Both healed nicely with the appropriate additional care (hand walking, rehab program). I did also use Back on Track no bows on mine, after the initial poulticing to get the heat out period. I iced it twice a day as well.
Don’t panic, but I knew a mare in foal who injured a foreleg badly enough that she spent much of her time lying down for several weeks. The timing was unfortunate as the foal was large enough to be affected, was born deformed, and had to be euthanised. Get the vet involved sooner than later as she is just going to have more and more weight to hold up.
Water blister the snot out of it.
Anything you can do to draw blood to the area will help tremendously with healing.
You need to get an ultrasound immediately to find out what you are dealing with. Correctly rehabbed, she should be completely sound at the walk long before now if the injury was in September. Correct rehab at a minimum would have been stall rest with cold hosing or icing and wrapping at first with some hand walking added in as things progressed. If that was not done, it is not healing.
We have a mare that ruptured some of her suspensory ligaments in a front leg. Not sure how it happened. We assume she stepped in a hole or something of the like in the field. It came on suddenly and her ankle blew up like a balloon. VERY 3 legged. We have the luxury of having one of the best clinic/hospitals in the country not far from us. They recommended 2 different procedures. One was on the expensive side of things around $7,000+ that would pretty much guarantee she would be pasture sound. Don’t remember the exact details without digging out the file. Something like removed the damaged ligaments and fusing the joint. The less expensive procedure around $2,500+ was some of the above with a lower chance of becoming pasture sound. Or we could wait and see if things resolve to a degree that she would be comfortable given time.
We ‘do’ horse for a living so we HAVE to consider value for money. Money was/is tight so we waited for a while and kept her on Bute by and large. Do not believe all of the negative things you hear and or read about long term use of Bute. They are the exception not the norm I promise you. Not only my words/experience but also that of the top vets I have worked with over the years. Our mare was on Bute while in foal. She had a perfectly healthy foal. A by a VERY expensive stallion.
Unfortunately things did not resolve with time. The chances were slim anyway. We went with the lower cost procedure. We could keep cost down because we are experienced in re-hab so she didn’t have to stay at the clinic/hospital which adds considerably.
The procedure did not give instant gratification to us visually or the mare as far as soundness/comfort. She got better soundness wise a couple of weeks later. But she was off and on 3 legged and her ankle still large. But over time, around a year her ankle came down considerably and she stayed sound much more than she didn’t. Now several years latter her ankle looks pretty much normal and she hasn’t been 3 legged for as long as I can remember.
The above may or may not apply to your mare you didn’t give enough detail. Exactly where the injury is, what x-rays showed or didn’t show and what an ultrasound revealed. Are you using a general practitioner or a specialist? Did you have x-rays and U/S sent to a specialist for a second opinion and consultation? This is usually not very expensive.
To each their own on the above. Just telling the details of our experience.
Yeah when my mare tore her distal suspensory, she took a piece of sesamoid with it which required surgical intervention. She got PRP, shockwave and a year of rehab. She is sound…well, maybe a 1/4 on a bad day but is very active but her jumping career is over. She is a big girl. 17.2, 1400 pounds so that may play a roll. I agree with above who said you need an ultrasound to see what you are dealing with.
Yes, I would be very concerned at this point. I’d want a vet to see her ASAP. Until then, stall rest, cold hose or ice at least 2x day, stable bandages the rest of the time, and whatever NSAID you can safely give.
Sounds like you may need an ultrasound and anew vet. Or someone’s not being quite square with you. Although I’m sure the trailer ride did little helpful.
Agree with everyone else (have dealt with suspensories too). That amount of swelling and pain is pretty concerning. You need to get a good lameness vet to evaluate ASAP. Not sure you can ultrasound and see anything with that much swelling but you need to get more aggressive with this now.
Update: So we had the vet out again yesterday and he was skeptical about how much we would be able to do to rehabilitate her leg. The common consensus among all of the vets we have spoken to is that she will not be able to recover completely, but after reading these responses it sounds like a horse can come back from a suspensory injury to be at least pasture sound? She did receive several rounds of shockwave therapy in Oregon; however, our general equine vet does not have a shockwave machine and I don’t know of any local vets who cater to orthopedic issues specifically so that is out. We gave IV previcox and got a 5 days supply of paste to give daily for pain management. Also, we have put standing wraps on and have placed her in a smaller pen so that she isn’t moving around as much. The vet suggested hydrolonic acid (idk if I’m saying that right…) injections–has anyone had experiences/success with this? Also, do you think that the back on track boots will do anything for this injury like increase circulation?
I have had horses come back from suspensory tears to race again let alone be pasture sound. Without an ultrasound it is all speculation however.
She may have had shock wave but I wonder if she was rehabbed properly. Rehab took a year for my mare with the first 6 months being most intense. Without proper rehab, she could have re-injured herself.
OP, I’m sorry to say it seems like you’ve gotten bad advice all around. I wouldn’t have shipped that long distance +/- 4 weeks after what sounds like a serious suspensory tear. It also sounds like she hasn’t been in a rehab program since she’s been with you.
The first 6 months to 1 year you’d typically see a horse on stall rest, with cold hosing, standing wraps, and in time, limited hand walking. Stem cell, IRAP, and PRP can be put into the lesion to aid in healing, and shockwave can be used to manage pain and stimulate bloodflow. With good management, I’ve seen horses recover from suspensory tears and return to competition at high levels.
Given what you’re describing, I would guess you have a re-injury that needs to be treated as if it just happened.
Post an ISO thread with your city and see if someone can help you find a vet that is used to treating these sorts of injuries. Given the critical nature of the situation with a 3-legged lame currently in foal, I’d hope that someone with some knowledge would be willing to drive out to you (even if you have to pay extra mileage/call charge to make it happen).
In the mean time, you need to do everything in your power to bring the swelling down so the ultrasound can tell you what is wrong. We cold hosed one for 15 minutes every two hours for two days to get the leg as small as possible for the ultrasound. The drugs your vet gave you will also help.
ETA: Hyaluronic Acid (Legend) is for joint issues - not suspensory issues. I don’t see how it would help this injury at this point. It honestly seems like an odd recommendation.
Yes, a horse can come back from a suspensory injury to be pasture sound.
Rehab for a suspensory can take a long, long time. Rehab for a suspensory will take a good year. It can l take months for the pain to go away.
If this horse is in pain or discomfort, I would put her in a stall or in a place where she has very limited movement. Very limited. Previcoxx, cold hosing, shockwave and time. I would put her in a stall for a month. It’s the best and cheapest thing you can do for the horse.
My horse was feeling considerable pain from a high hind suspensory for several months. She is now pasture sound and rideable. (The horse is currently in her 20s.) It seems important because the mare is pregnant, that you get the pain under control ASAP.
The prognosis of returning to use or even soundness depends on proper diagnosis.
Your first step is stall that horse and cold therapy
Then call the vet
Be ready to shell out money for an ultrasound
Be ready for a long haul of stalled horse, a lot of care
This is an old article but my vet gave it to me to understand protocols for controlled exercise.
http://www.equinepartnersamerica.com/research/Gillis-RehabTendonsLigamentsAAEP.pdf
I don’t think HA is going to do anything at this point. This sounds like a severe injury or re-injury. I don’t see how 5 days of pain management is going to be sufficient.
I think you need vet resources beyond your local vet.
[QUOTE=asterix;8531337]
I don’t think HA is going to do anything at this point. This sounds like a severe injury or re-injury. I don’t see how 5 days of pain management is going to be sufficient.
I think you need vet resources beyond your local vet.[/QUOTE]
Agreed ! And be aware that shockwave has been used on horses with injuries, and then they promptly have been raced. It has a masking as well as a therapeutic effect.
Not being snarky but you have given little to no detailed information other than she has a suspensory injury and her ankle is large and painful.
Just saying she has a suspensory injury is kind of like saying the horse has a broken bone in her leg/body. There are a lot of “bones”.
The suspensory ligament covers a lot of ‘territory’ of the lower leg.
Given the fact that her ankle is large we can only assume the injury is in one of the branches? Which is what happened to one of our broodmares in my previous post. Though her’s was in the front leg.
I assume given the fact she is in foal and you call her a broodmare all you are hoping to do is get her pasture sound and comfortable.
Which is exactly what we wanted and accomplished with ours.
The information needed and I don’t know how any vet could tell you what can and can not be done with out is an X-ray/s to see if in fact it is a suspensory branch tear and if it came away ‘clean’ or took some bone with.
Or the possibility of a sesamoid fracture and or chips in the ankle. This would cause a lot of discomfort and swelling.
An ultra-sound will tell you a lot also. Regardless of the amount of swelling/edema as long as it is ‘state of the art’ machine and the person performing the exam is a specialist not a general practitioner using a borrowed machine. This is best done at a clinic. If the suspensory branch has is detached it will most likely require surgery to clean up. Just guessing based on the limited information given.
This is what I do for a living not a hobby. All of the above is SOP in my world of horses and vets.
Like a lot of things with horse injuries it comes down to how much money you can afford to throw at it. I gave you a real like direct experience and the costs. We got lucky.
I find it surprising that you vet has not given you a detailed written report of their findings. But I have read a lot of surprising things that vets do and or do not do in other parts of the country on this forum. I thank my lucky stars I am located where I am.
If you can get good x-rays and Ultrasound and the vet/s in your area feel it is beyond their level of expertise fair enough. But these can be easily emailed to a specialist somewhere in Texas. But that’s assuming they are working with reasonably current equipment. 5-10 year old used portable digital x-ray equipment can be had for $5-10,000 not talking a lot of money in the grand scheme of things.
Shock wave IMO and experience is of little value at this point. Depending on the machine and the person using it will make her her comfortable for a couple of days because it numbs the area. Save your money instead of help pay off some vets machine.
An ultrasound shouldn’t cost more than $250 I pay less. Digital x-rays around $50-100 per view plus the BS ‘set up charge’.
If she is not comfortable on the meds your are given her. I would do her a favor and put her on Bute. There is NO reason not to. For the record this is not advise just what I would do and have done and is what my vets would do.
If you can get the above I will be happy to put you in touch with the surgeons I have used at the New Bolton Center in Pa for a inexpensive consultation. It is one of the leading clinics in the world.
Barring other complications, I don’t think I’ve ever met a horse who couldn’t come back from a suspensory tear to be pasture sound when given a heavy dose of time.
It’s more a matter of how much time, effort, and persistence you’re willing to put in to keeping her comfortable in the meantime. Things can look ugly for months… and months… and months…
Update: after about a week of standing wraps, pain medication, and rest, I have seen a substantial improvement in the amount of swelling on her leg and her pain level seems to have decreased. However, she is definitely still hurting and the swelling is still present. Obviously I am not expecting any immediate improvements and am in this for the long haul, but I was researching different treatments and I came across several articles talking about fetlock support shoes to help relieve the stress put on the fetlock to help speed the healing process. I am definitely willing to try the aforementioned treatments but I am really intrigued by this, and was wondering if anyone has tried these shoes before and if they have found success with this extra leg support? Thanks in Advance!
Here is the link to one of the published articles: www.americanfarriers.com/articles/218-fetlock-support-shoe-helps-suspensory-ligament-injuries
