OK so this is prompting an additional question: vet said “I’d call this an 8mm lesion” but did she say tear? Attached is the U/s screen grab - on the left is the lesion with a spot of initial healing (calcification?), on the right is the unaffected suspensory. Thoughts? (hope image large enough - forum seems to crush them…)
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Also is it better for him to be more deeply bedded on shavings, or somewhat thinly bedded on pellets right now? Rubber mats are in place of course.
My experience with not quite the same injury (no tear, chronic inflammation of LH suspensory)… These can take forever to heal. I like the idea of consulting with a second vet. Mine ended up having surgery and PRP, and I did not ride her for about 9 months. Then long, slow rehab, and while we didn’t return to much jumping, she did fine as a low level dressage horse and trail horse for several years, and now, 9 years later, is doing fine as a trail and “putzing around” horse at age 21. Had I been a serious competitor, I probably would have retired her not too long after rehab, because she wasn’t going to hold up to hard work.
Some tips:
Sedatives are your friends, especially if your horse is antsy in the stall. Mine was on Ace for early rehab and hand walking, at first in turnout, and then when I started riding her (although we didn’t need Ace for more than a couple of weeks.) Ditto extra control via a rope halter or chain over the nose. You need to keep your horse’s feet on the ground.
If you have an area very close to the barn where you can hand graze your horse, and you can get him there and back without any tight turns, that’s a good thing. But check with your vet. I was hand-walking my mare starting 5 days post-surgery, for 5 minutes, 2 and then 3 times a day (barn staff were very helpful here and I paid them for it.) Hand walks gradually increased to 45 minutes once or twice a day by about 4 months post-surgery.
I agree 100% on walking being on hard ground only, and flat to start with.
If you ever have a sense that what you’re doing is “too much,” listen to it. Patience is a virtue.
Shoes vs. not probably depends on the horse and what your vet says. Mine had been fine barefoot before I bought her, and then needed shoes mostly because New England terrain is full of roots and rocks. So we pulled her shoes, put fronts back on (as she’d had before surgery) when I started riding her again, and added hinds when it seemed like her rehab had stalled out. She has been shod all around since then.
Medical paddocks are a good thing, when the vet clears your horse to move around in a slightly bigger space. Mine started turnout about 4 or 5 weeks post-surgery, in a pen made of 6 round pen panels so twice the size of a stall, but set up roughly in a circle with no sharp corners. It was close to the barn so the barn workers could keep an eye on her and bring her in if she got silly.
Be prepared for “A Year with Dr. Green” if things are not going well after hm… the period of time your vet told you to expect to rehab. I did not end up doing this, but at times wish I had.
Good luck!
Oh, one more thing: keep an eye on the leg diagonal to the injured one. In my mare’s case, this was the RF. She compensates for her LH problems by stressing her RF, and she’s had a number of problems in that leg. Nothing career-ending, but certainly a few scares.
I would do shavings. Not any deeper than what is normal for your barn. Only reason I would not do pellets is the slip factor; you don’t want him slipping for god knows what reason - and pellets can be slippery until they are fully broken down. I always used shavings for horses on stall rest only because I found pellets too dusty – but I do love pellets in regular stalls that horses are not spending all their time in.
My horse and I are going through Proximal Suspensory Desmitis in his right hind now. I am eight months in and my horse is not completely sound. He has “thickening of the suspensory” and no tear. I’m on my way back to the clinic for a re-evaluation. My advice is to take this very, very seriously from day one. I now know that these are very hard to heal. I was told to give 3 months of turnout. I did four. He was injected at the clinic and we followed up at home with four shockwave sessions. I was told that I did not need to ice, poultice, laser or wrap. I went to the best, but I think they thought it was more minor that what it really is. Now REGARDLESS of what I’m told, I’m doing it all. While waiting for the appointment, I’ve started icing 20 minutes twice a day with real ice. My local vet said that ice boots are not going to get the leg cold enough. You need to use real ice. Dover has ice boots for $75. The best ones are the Soft Ride Ice Spa Boots, but they are very expensive. I’m going to get a laser. You can rent one from Respond systems for a little over $1050 for 3 months. I poultice daily and leave it on for about 8 hours when he is in his stall. I can feel a difference after just a few weeks of this routine. I wish I done it from day one. You live and you learn…
The problem with this injury is that you may have inflammation in the tendon and from what I have learned it can put pressure on the tendon sheath which causes pain. The tendon is too big for the tendon sheath. The other problem is that because the tendon is too big it can put pressure on the nerve, again causing pain. The surgical fix is to put slits in the tendon sheath to relieve pressure. They can also cut the nerve to the suspensory. I have heard that the rehab is very long and hard, but surgery has an 85% positive outcome. I am not jumping into surgery.
I just read an article that usef put out regarding veterinarian guided rehab. (https://www.platinumperformance.com/articles/veterinary-directed-rehabilitation) at the bottom of the article they talk about this specific injury and say that there has been success treating it with regenerative laser therapy along with salt water treadmill.
I will see next week what the vets say, but my plan is to do everything possible to get rid of the inflammation. I think it can be done, but it will be a long road ahead.
Right front suspensory injury in May. Did 3 series or shock wave and turned out until end of year with recheck. I am a big believer in Dr. Green, since I’m old school. This will be the third rehab since I’ve had to deal with collateral ligaments tears in both fronts. I really consider myself a pro rehabber now.
TG they are good at watering the pellets at this barn. Tried shavings and they were all scooped out in a matter of days so I slipped the barn help a tip and I get lots of pellets added now, that I bought.
Ordered a stall toy and some Sweet PDZ. Told the vet to fire up the shockwave and get me a quote for Prostride or IRAP or whatever. Got quotes in rehab facilities. Got the nose chain and Ace out. Cleaned and put away all my bridles and my boots. Just settling in for the horrid duration… :no: 
Thanks again for all the support folks - it helps. It really does. I can’t believe how many of us are in the same boat… :no:
Right hind suspensory branch strain confirmed by ultrasound. No gaps or lesions, no calcification, but he avulsed the shit out of it and it blew up quite large. I read all the literature,asked questions on here and elected for a year of Dr. Green as the horse is very sensible and because you want some passive resistance to keep the healing fibers from bunching up and caclifying. He had a slight reinjury at 2 mos so went back to cold hosing and wrapping poulticing for a bit. Other than that, no shockwave, cold lasering, stem cells, magna wave, blah blah blah. He’s 3 weeks from one year of pasture rest and appears completely sound. Canters down hill like his brothers at feeding times. His leg looks great and reduced back down to near normal. He does have some thickening over the branches but if i didnt point it out to you, you probably would not notice it. Will start him back to light work soon. No he wont be upper level anything at this point but i think he will hold up to still be fun. Time will tell. I was underwhelmed by the literature purporting that shockwave, stem cell, prp work. YMMV
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I don’t have a question about suspensory injury and rehab per se - but I’m wondering: to the ammies who are currently or have rehabbed their mounts from an injury that takes 6 mos plus to rehab - what did you do in the meantime to stay sharp? Catch ride for friends? Take lessons here and there on some of the school horses?
After many years of riding, I am in all likelihood facing my first long-term rehab situation with my current mount (suspensory). I am a typical AA at a boarding barn. Not sure I could swing both a second board and an adequate shockwave/IRAP regimen for the broken one. Not trying to sound insensitive to anyone who just received a shitty dx - but I am really interested in hearing y’alls perspective. :no:
I’ve done rehab with this horse twice now - 6 and 8 months. I wasn’t in a position to buy and board another horse, and the rides offered by quite a few people weren’t doable. Mostly because I was working full time and rehabbing a horse 7 days a week too. So I basically barely rode, which sucked. That’s something I’d like to change this time but I don’t see how!
Maybe a part lease or lessons on a schoolmaster? Opportunity to do either seems slim here though, for horses other than trail etc.
I have way too much experience with this.
About ten years ago when my horse hurt a front suspensory and ultimately turned out to have collateral ligament damage, I was lucky to get the ride on another amateur’s horse. They wanted someone who was going to make some mistakes so the horse got used to it, but not traumatize the horse and be able to ride out of the mistakes. That was the best deal ever as I had pretty much zero expenses on that horse, got to show, and the ultimate goal was met with his owner being able to show over fences by the end of the summer.
That horse re-injured himself a few years later and I gave up on trying to keep him in work after about a year of struggles ; then the horse’s alleged replacement got injured and spent almost two years rehabbing and re-rehabbing. At that point, while paying for one retired horse and one horse on very casual layup, I half leased my trainer’s lesson horse for over a year and was able to ride and jump pretty frequently. It was a pretty good deal as it was an expense-only lease and my contribution was to pay for the horse’s board. That also held the stall open for my horse, though he ultimately never returned as we moved barns. My expenses on my rehabbing horse plus the lease horse just about added up to one horse’s full expenses plus training.
When the replacement horse went lame again and ultimately had to be euthanized, I spent 2-3 months riding the new barn’s lesson horses and a friend’s horse.
Got a new, and current horse. We had a pretty good run for over a year, but have spent the last three summers doing some sort of rehab. The first summer was a check ligament and I formally half leased a horse in the barn, but gave up the lease for assorted reasons after a few months. I got the horse back in work and jumping, but never felt like either of us got as good as before the injury, in part because we were still fighting the quarter crack. I showed once that spring, before the quarter crack became unmanageable. Since it was kind of off and uncertain how long he’d be out of work–we kept thinking it was going to be OK, and then it wasn’t–I didn’t even try to lease. I rode a friend’s horse, including in some lessons, and hacked the lesson horses. Did a show late last season, then a casual schooling event and three shows. I finally felt like my riding and showing were back to where they’d been two years ago before the check ligament injury. But that was the show where he stepped on the Really Evil Rock at the show grounds to which we will never return. I really thought about blowing a chunk of my carefully saved money on a nice paid lease for the summer, but ultimately I was too cheap and needed to replace a car, so I am again hacking what’s available and jumping low fences very occasionally. I’ve been doing a fair amount of two point while tack walking my horse. We have now done a week of trotting. Hopefully it won’t take two years this time to get back to where I was, since I’m starting to run out of years.
Sometimes I think about what I could do with this very nice, and possibly unlucky, horse if I could get in more than 6-7 months a year of solid riding and lesson time that always seem to happen during the rainy season.
OK I asked my vet and she said horse can go 1 or two shoeing cycles with no shoes as he will be in the stall and only walk on pellet bedding, or asphalt, for the next few months (ie fairly firm, flat footing). And this directly contradicts what you guys are saying so I’m very confused.
He does not appear lame at the walk, and wasn’t lame at trot in straight lines, or even very lame in circles on firm footing. Vet thinks he’s quite stoic.
I’ve asked Dr Gillis for an u/s consult - thanks for that tip @tipzythegreat
So much to digest here…
I did a couple of care leases, neither of which worked out (one on an older gelding I’d ridden a lot around the time I bought my mare – but he’d aged quite a bit and wasn’t really sound enough to ride, and one of a grade Morgan mare who was a project to put it mildly, and really hard to manage on the trails.) After that, I was able to part lease one of my BO’s school horses for 1 lesson and 2 additional rides per week. At some point I started taking weekly dressage lessons at a different barn.
There was a point with the quarter crack last summer and then again with the diagnosis this time that I pondered giving him back to his breeder and walking away from horses.
In 2013, I was gifted a 14 year old Hanoverian gelding that had a left rear hind suspensory injury that occurred in 2011 while he was on a lease. I was told it happened in part by being lunged in deep footing with a Pessoa bitting rig. It was an avulsion fracture and tear. He went off to the Oasis rehab sanctuary in Ocala Florida. I can’t remember all the therapies he had, but he did swim a lot. He was sound when I got him, but I was under no illusion that he would not re-injure it at some time and he has, but they have only been strains due to being turned out, slipping off a trailer ramp and one time at a show with really crappy footing where he slipped going a around a turn. Osphos has helped him along with a wonderful farrier and vet. He was always allowed to walk and I had a supply of ace pills to keep him chill. My daughter showed him in the A/O’s, equitation/medals and derbies. He was officially retired from jumping at the end of 2017 as he had a fantastic last show by winning the $5,000 National Hunter Derby and low A/O Classic. He was 18 and sound. Today he is 20 and is still very sound. He wears bar shoes behind, gets one Equioxx pill daily and has his hocks done yearly if needed. His hocks had some arthritic changes due to his long show career. I am now his primary rider, which is not much of a work out for him. I am thinking about doing low level dressage as he already knows everything. Hunter/jumper shows are too expensive for just flat classes. He has exceeded all my expectations and when I think he is done, he surprises me and comes back fine. I have no idea what his future will be, but right now he his doing great.
How great to hear he came back so well! So the hock injections, Equioxx and bar shoes are just in case? Or is he sore without them?
The bars shoes are for support. He has sloping pasterns, so the shoes help with that immensely. He would sometimes trip behind. He had a huge show career before I got him. His USEF record is 25 pages long. He also competed in Germany before he was imported in 2008. He started the Equioxx in 2015 along with hock injections. He would be sore without them. He likes to work and is still pretty athletic. I have no idea why he is still able to work, but being fit helps him immensely. The barn I am at has good footing and the trainer who helps me as I work and need proper instruction, rides properly with an adequate warm up.
i am lucky, but my I know my luck can change from day to day. I just do one day at a time. I figure if he is sound and his bodily functions are normal it is a great day.
I personally got the tip from the lovely members here @Xanthoria 
As far as no shoes, I am sure the vet is saying you COULD get away with no shoes. I feel like if you ask vets things they are usually like “yes, if you want you could do that” and aren’t necessarily saying “yes, definitely do that”. Does that make sense?
See what Dr. Gillis says 
I bet she’ll want him in shoes!
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