Suspensory Rehab Question--Pasture Rest vs. Walking under Tack

[cnd8]

After reading the long thread on here regarding suspensory rehab and the Carol Gillis article for rehab protocols, I have some questions and was hoping you may be able to share your experiences.

Horse “may have” a mild injury to left hind suspensory from spooking and sliding on the pavement. Suspected high suspensory because there was never any heat or swelling and he became quite sound within a couple of days. In pasture he appears sound at all gaits. Under saddle, he is sound at a walk, but trotting short on the left hind.

Have not yet done an U/S. Trying a bit more rest first.

This leads me to my question: one vet is telling me to walk under saddle for multiple weeks before reevaluating. This vet is widely considered a lameness expert. The other is telling me to give pasture rest for multiple weeks before reevaluating. This is a local vet with less experience.

Expert claims walking under saddle is less intense than anything he can get himself into in the pasture turnout. Local vet claims rest is needed because footing is too soft in the arena in which I have to ride.

I lean toward the expert’s stance, but I’m worried I’ll do more damage. He seems completely sound at a walk under tack, for what that’s worth.

Thoughts?

[Live_Wire]

The proper way to rehab a suspensory is stall rest and then incrementally building strength under saddle.

Turning out poses a great risk of worsening the injury or improper healing. FWIW I’ve done it successfully for a horse that would do more harm to himself in a stall than he would turned out, but I still wouldn’t reccommend it.

[joiedevie99]

I would not make any rehab decisions without an ultrasound. He’d be on stall rest with hand walking until then. I think tack walking instead of hand walking is probably reasonable.

Ideally, though, that walking will be on very firm footing - like the driveway - so I can see why local vet might make a different decision. I don’t think the alternative, at least in the short term, is turnout though. Lots can happen out there. Once you know what you are dealing with, you may calculate risk/rewards and choose turnout, but that’s a conversation for later.

[cnd8]

Thanks. He has had two flexion tests and has been observed twice and he is sound to all. It just shows at trot mildly only under saddle. Both the expert and the local vet think whatever this is is quite mild and turnout is fine. He is accustomed to pasture 24/7 and would move far more in a stall than the pasture.

[cnd8]

Mine is the same. 1400 lb, 16.1 accustomed to pasture 24/7. He’d run circles in a stall, especially because we have no other horses in the barn. He’d go nuts. Pasture is far safer option in this particular situation and for this horse. He’s very laid back in pasture.

[cnd8]

I’m just curious about walking under tack vs. pasture rest.

[IPEsq]

Have you done any imaging at all? Or blocking? Including riding after blocking? With lameness only under rider weight, I’d consider things in the foot to be a reason you didn’t see any swelling, for example.

Controlled exercise like tack walking can be good if you have the right conditions to do it in. If the local vet thinks the footing is too deep for this phase, then I’d be inclined to go with the local vet. But I am skeptical of the diagnosis.

[steelerino]

You can’t pick the proper rehab without a diagnosis. You are just guessing at what you are dealing with and the proper way to rehab it.

[cnd8]

I’m not talking a long term rehab plan. Both say its good to reevaluate in a month and go from there with U/S, etc. I actually had her out to do the U/S and she did a lameness exam and said to wait. Apparently COTH disagrees with two vets though. lol

[fivestrideline]

COTH is a lot of experienced, knowledgeable people, but not all vets. You’re right on that. And none of us have seen your horse.

We HAVE, however, chased mystery issues on our own horses - both on advice of vets and otherwise. Or watched threads unfold as others do the same. The reason you see so many posters pushing for a diagnosis is we have BEEN there - and it’s almost always cheaper, quicker, and less heartbreaking to get a diagnosis than it is to play a guessing game.

If your horse is unused to a stall, stays 100% quiet in turnout (no dinner time buck-and-fart sessions with his buddies!), then you may be okay leaving him out. Tack or hand walking will help keep his soft tissues flexible, and if there is a mild strain it’ll help progressively reload those tissues and prevent further tearing.

[joiedevie99]

@cnd8

Apparently COTH disagrees with two vets though.

I ended up retiring the best horse I’ve ever had over a high hind suspensory issue that looked pretty minor, despite doing everything right. I’m just hoping to spare someone the heartache, and 3 years of stress from diagnosis to retirement decision, I went through trying to help him recover.

[cnd8]

I certainly get that. Thank you.

[foggythistle]

I’m in this space right now so I feel your pain. I had an u/s about 3 days after my horse showed lame in mid-January. He has a LOW suspensory injury, medial branch, right hind. This is the second time he’s injured the same spot. Now considered ‘chronic’.

Because of the weather in the northeast, I am reduced to him being in a stall, where he’s been for the last 7 weeks, and handwalking 15 min/day. Applying surpass/voltaren daily for about 4 weeks. His turnout is too large for him to go out in and the ‘hospital pens’ are alongside the barn and are currently filled with ice and snow from the barn roof, so no turnout there. I don’t want him to go out and start being stupid and running on the snow/ice/mud and put additional holes in the suspensory.

Over the last 6 weeks, there has been good healing. He now has the clear to ‘tack walk’ and increase the amount of time gradually, but I am opting for long-lining for increasing lengths of time up to about 30 min before I get back on. I am not a flyweight and I would like to have some more strength/fitness on his part before I crawl back on. I also want to wait for a WARM day for a first ride. I’ll probably also use a little chemical help and a ground person in case he gets carried away.

I can trot him for lameness checks, but no work at the trot until the vet comes back for u/s #3, which the vet doesn’t want to happen until

1. I am on him and walking
2. He gets egg bars on behind

The vet does want me to send her a short trot video before and after he gets his eggs on.

Back to your questions… Personally, I would not turn out unless I could ensure that he would not be silly and do something that might increase any damage, like being able to confine him to a space where he can’t get up a head of steam. I would opt for hand walking.

Sorry for the long reply.

[SBrentnall]

My horse was never lame, never had heat. Just an occasionally slightly puffy hind and not as willing to sit in collection as much as before.

An ultrasound showed a small suspensory tear. The vet said if we’d continued working, it would have grown bigger and become career-threatening.

Since it was small, we were able to start with a 30-min tack walk on solid ground 1x daily and a hand-walk 1x daily. NO turnout since it would make the tear bigger.

[Calvincrowe]

I’m quite surprised your vet(s) didn’t diagnose via ultrasound. Every suspensory injury I’ve been associated with used ultrasound initially.

My mare had a front suspensory. Lameness vet says no turnout, tack or hand walk only on a progressive plan with repeat ultrasound checks. Tack walking proved to be the best choice for her— she was happier and less explosive as time went on.

[hut-ho78]

I rehabbed one with an upper and one with a lower suspensory. The vet said controlled exercise. It was handwalking, then riding at the walk, then riding at the trot. I could finally start turnout after some time of riding at the trot. It was quite challenging. LOL! They were maniacs in turnout and the footing was what the footing was in the arenas. They have lots of stuff now to help with healing but I think controlled exercise if they horse will tolerate it is a tried and true method.

Good luck.

Edited to add that lunging was started at the same time as turnout.

[cnd8]

Yeah, on the first visit when he was very positive to flexions, she said give him a week before we proceed. Then when I called her for US she came out to do it and he seemed so sound that she didn’t deem it necessary any longer. Fast forward 3 weeks and he’s slightly short on the back left at a trot under saddle.

I’m going to have the expert do an U/S at the end of the month. This will see if a little more rest will resolve whatever it is, and then will have a definitive answer to move forward as this vet can handle all issues there may be.

[Bonnie2]

Being peacefully out in pasture 24/7 will be better for him mentally and physically than 30 minutes of tack walking. A moments spook/startle/spin could worsen the injury whether in the field or under tack. Ring footing may be an issue with a more significant injury or a more demanding work program but shouldn’t be a problem at walk with horse sound at walk. Turnout footing should also be a consideration if it is icy/snowy/muddy. Hope this is all academic and he is well soon!

[cnd8]

Thanks. Yeah, I think I’ll just leave him rest in pasture until the u/s in a couple/few weeks. Just in case. No snow, ice, or even mud here. We are in South Georgia and he has a level pasture with firm sandy footing that drains really well immediately. We don’t get slippery. We are lucky in that regard.