Suspensory Rehab Therapies

[frisky]

I am wondering what therapies people are using on their horses for Suspensory rehab.

My horse was just diagnosed with a high medial front Suspensory injury. She had a Suspensory injury about 10 years ago that I rehabbed meticulously. The vet also recommended PRP and one shockwave that he did on the same day. Otherwise, we did the slow, consistent rehab with several ultrasounds.

My vet now is recommending 3 shockwave treatments (edit) and one PRP. This will run me around $2500+ plus the 2 diagnostic trips. I’ll admit that I am super depressed about my barn environment on many levels. It’s been an exhausting year at a new barn. My horse is older now (20) but I am worn out financially and otherwise.

I would appreciate it if people would share what therapies other people used to give me a sense of perspective. Thanks.

Also, I do not know why Suspensory is capitalized.

[ThreeBarPocoGal]

One of mine had a suspensory injury years ago. From what I recall, after the original diagnostic it was several weeks of stall rest, anti-inflamatories and light hand walking, increasing periodically. I don’t remember, and I can’t imagine having the time, to have hauled him in for multiple ultra sounds. I did ice wraps and calming paste, he was a nut in the stall.

[zany1]

IME, PRP is amazing and definitely worth it. Used it on my horse’s suspensory and rehabbed beautifully with no setbacks whatsoever. We only US’ed it 2x though, once initially and once when doing the recheck to see if she was ready for under saddle work. Maybe see if that’s an option to cut costs?

Also used shockwave on that injury, which like I said, resulted in a very smooth rehab process.

I’ve also used Alpha 2, but that is a considerably more expensive option, albeit effective.

Once back undersaddle, we started very conservatively, with ice on the injury site after every ride (my vet likes the small gel packs polo wrapped to a leg for injury-specific icing as it is more conforming to the limb)

I’m so sorry you’re dealing with this. Lots of hugs to you and your girl!!

[Bonnie2]

It partly depends on what level of work you would like her to do after rehab and on how cooperative she is about staying quiet. If you are willing to retire her and she will quietly tolerate stall rest then small paddock then larger turnout with a low likelihood of risky behavior you don’t need the gold standard of treatment. If you would like her to resume a performance career then the suspensory needs every advantage to heal its best. Both PRP and shockwave are proven to improve healing. 3 shockwave treatments is pretty standard. There are also other biologic treatments but none of them are cheap. Re ultrasounding is critical to evaluate healing, soundness is not a reliable indicator. No easy choices with horses!

[lintesia]

When my horse got a suspensory (high proximal), therapeutic ultrasound was part of the initial treatment. I don’t remember how many treatments he had. I had sent him to a layup barn for his recovery and since it was run by a vet, the ultrasound treatments were covered by insurance. (This was 20 years ago, though, and before PRP was common.)

[Feathered_Feet]

My horse had bilateral high suspensory surgery for PSD last year. We did 3 rounds of shockwave, but there was still a little inflammation in one limb so we did PRP. Inflammation was gone at the next recheck 4 weeks later. Certainly made me a PRP believer!

[SBrentnall]

My horse was diagnosed with a mild suspensory tear last July. Here’s what we did:

• 3 Shockwave
• 1 PRP
• 2x weekly laser
• 3x weekly VitaFloor (similar to Theraplate)
• 2x weekly PEMF blanket
• Osteon from Platinum Performance

No turnout, 1x daily handwalk and 1x daily tack walk 5 days per week.

Once the tear healed, he still didn’t feel right so we x-rayed his back, neck and rear end. Found arthritis in the stifles, so we injected.

They he started moving beautifully behind, but crooked. It was as though he couldn’t get his front end out of the way in time for the now free-flowing hind end. X-rayed the front legs and found bone spurs on both pasterns. Injected those, and are now bringing him back.

[touchstone]

I may be slightly out of date, but the last time I looked at the literature, the evidence base for PRP in soft tissue injuries was pretty thin, but the evidence for shockwave was stronger. If it was my horse, and I was trying not to just throw every dollar I had at the problem, I would probably do the shock wave but not the PRP.

I think really putting the time into doing a slow, progressive rehab with lots of walking is probably the difference maker in a lot of these cases. I also really like aquatred for that period between walking and real under saddle work, because it can muscle them up without requiring as much loading. It also tends to make them less bonkers when it does come time to go to work.

Most of the other fancy therapies just don’t seem to have much evidence to back them up.

[keh]

I’m sorry about your horse’s injury. Is it a strain/lesion/tear?

Are you questioning your vet’s recommendation?Confidence in the protocol will give you peace of mind, if nothing else.

I’ve heard great things about shockwave for these injuries. Unfortunately, I believe the standard is 3 treatments done 2 weeks apart, early in the recovery, so the cost will be split up by only 2 months, if you’re lucky. I don’t have a lot of PRP experience. Everything I read suggests shockwave.

What’s going on at the barn? Depression is normal with injuries, but if you don’t fit in there, maybe you can look into a rehab facility. Are there other riding opportunities for you there? Or maybe volunteering?

I’ve been through many rehabs & they suck. My best advice is to get the grieving over with & then make a plan forward. Set some attainable goals for yourself & use them to pass the time. Whether you teach your horse some tricks, work on your own fitness or engage your horse with rehab exercises.

You two still have each other - enjoy the time to bond in different ways. Hugs, we’ve all been there.

[Feathered_Feet]

@keh

You two still have each other - enjoy the time to bond in different ways. Hugs, we’ve all been there.

I have to agree with this. My horse’s rehab was slow and boring, but I just love this horse and focused on how lucky I was to have such a wonderful animal to share my time with. We grazed, we did stupid little trick (smile, nod your head, etc) in her stall. We went for hand walks together around the farm (as much as dictated by the rehab schedule). My horse loves scratches so I spent lots of time doing extra currying. I learned some Masterson method massage techniques. It was really nice to just get to hang out without the pressure of “doing stuff”.

(It helps that my horse loves people and wants to hang out. Having known a few horses with more challenging personalities, maybe I would have felt differently with them. But then again, maybe quality time spent without expectations might change their outlook on people-time.)