Swollen fetlock/pastern

Hi all,
I have a friend who has been carefully rehabbing a DDFT tear of his left front. Horse has been in a 12x20 medical paddock for the last month after 3 months of total stall rest. (He also had a keratoma removed). This week he got approved to start weaning into a 20x30 medical paddock.
Saturday, she gave xylazine and put him out. He wouldn’t stay quiet. Bucked like a fool, tried farting around etc. 5 minutes in and she moved him back to his 12x20. That evening, his right hind fetlock and pastern were swollen. She wrapped, gave bute and left him in the stall Sunday unwrapped. Let stayed cool and tight until Monday. Monday AM she put him back in the 12x20. By afternoon, vet said to try larger paddock again with 2ccs of ace. Same result bucked and farted around. He lasted about an hour before she moved him back to the smaller paddock because he started being stupid. Monday evening right hind fetlock/pastern is swollen again. She wrapped. No bute this time to see what it did. It came down. Vet said to put him in the 12x20 today. He was quiet all day but the fetlock/pastern blew up again with some heat. She used her Bemer on the hind limbs, wrapped and gave a gram a bute. He will stay in until the vet comes Friday no matter what now. She is freaking out that he tore something in that hind fetlock after being in for so long. All the vets think it is a tweak and that his antics weren’t enough to actually tear anything. He seems sound (she doesn’t want to risk injury jogging him at the moment)
Any thoughts about this and what he could have done? She really worried he tore another tendon/ligament and will be retired at 10 at this point.
Thanks all

Didn’t someone just post this exact topic? I swear I just read this story on these forums a couple days ago, but I can’t find it now.

I don’t have any advice for her present situation, but I know of many vets who don’t suggest turnout until the horse has started back under saddle (sedated) to prevent this scenario from happening. In theory, if they start to act up under saddle it is easier to get them pulled up and under control than if they are left to their own devices. Barring that, it sounds like the horse would need heavier drugs, or more time for the drugs to kick in. Oral or IM sedation will take longer to take effect, and the horse should be left to be quiet for the time it takes to kick in. It’s no good to give ace IM, and wait a few minutes but go on working with the horse and getting it worked up.


So back in November, my gelding came in with a front pastern/lower fetlock swelling (also was missing that bell boot and took a chunk out of his opposite hind hoof). I did bute/ice and didn’t like the look of it, even though he was totally sound. Got the vet out to ultrasound (she was rolling her eyes at me esp with him being sound). He had a large medial suspensory branch tear. It was right above the area where you would check for a pulse. Vet was a bit surprised…she had started the u/s going this looks great…until I was like, check right here! But I’ve owned him 14+ years, so I know what his legs feel like.

Not lame at all (thankfully), but did have heat and swelling in that area for some time.

She didn’t turn out right away. She waited about 10 minutes after giving the xylazine IV and 35 after giving the ace IM.
This horse isn’t safe under saddle at present. They are suggesting hand walking before trying this again.
Yes I posted this two days ago but I accidentally deleted it instead of editing. Haven’t had a chance to update and he swelled up again.

This is her fear since he’s been in the stall for so long. Although his swelling seems to be on the back of the pastern and up through the fetlock.
Would a major tendon injury respond to wraps? I would think some swelling and heat would remain when the wraps were removed. (Or at least that has been my experience)

Had they not been hand walking him already? Did they go straight from stall rest to sedated turnout?
I still think heavier drugs on board would be the way to go. A lot of horses will blow through Ace very quickly. I’d probably be looking at dormosedan, and enough that the horse was pretty dopey before trying to turn it out. With a vet’s consent of course.

I did standing wraps initially…but I actually used the hind wraps on the front and wrapped down further over the pastern. I also took an ice pack and vet wrapped it around the pastern. Also did some therapeutic ultrasound.

I ended up turning out from day one, since he was sound and just made sure he was not out as late in the day (he would get antsy at feeding time, so I would bring him in before feeding time…but he didn’t get fed until later.) I decided regular turnout would be less risky than cooping him up for a few months and dealing with what stupid things he would do to hurt himself in the stall.

We actually reultrasounded a few days ago…as I got on an walked him the first time and he swelled the next day (it’s been 5 months off). He doesn’t have a visible tear, but still has fluid and irregularity in the ligament fibers. Vet suggested this might be as good as it gets given the circulation to the area and to go ahead and start him back slowly and just monitor the amount of swelling and whether he stays sound.

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No hand walking. 12x20 paddock during the day. Stall and night. 20x30 was what they were attempting to move him to.
Vets are now saying to give up on the larger medical paddock and do hand walking but she’s concerned it is too late.
She has ordered dorm gel for when she needs it.

As I said; she is devastated since she has been so careful in following directions. The site of original injury looks great but this being a hind limb she’s worried he is done. This is the photo of the hind leg last night. Not hateful swelling, almost looks like scratches, but definitely is not.


Your friend is (understandably) over reacting and imagining the worst possible outcome. A mild sprain would respond just as you described.

I remember the day I had a tendon blow up after I took the no bow off for what was supposed to be the last time. I get it.

It’s been four days - anything, any injury of a sprain or strain variety that swells that much initially needs more time than that to heal. Ice, cold hosing, wrapping are beneficial for minor strains, and helpful in removing excess fluid for better imaging should it be more serious.

My advice: Breathe. Do what you can and wait for Friday’s vet assessment and recommendations.

I am surprised the vet did not advise handwalking, as it is integral (moreso than standing in a paddock) in the rebuilding and strengthening of the tendon or ligament.

As someone who’s GP horse suffered a tear- I don’t think she’s overreacting in far as I would want a lameness specialist vet to look at my performance horse to evaluate.

Heat and swelling seems to be at the back of the pastern/fetlock. Bemer this AM and when she noticed it swelled back up, she iced and wrapped him again. Will ice/poultice him tonight. She’s hoping a vet can get out there today to ultrasound so she doesn’t have to drive to a clinic.

She was very hesitant to do this larger medical paddock but was told it would be okay. (3 bucks later it’s not)

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The incrediwear stuff is amazing. I’ve had great success. Those equicrown wraps looks super interesting. I’m tempted to buy a set for around here.

I don’t want to hijack the main thread, but if you’d be willing to PM me more details about your success(es) with the incrediwear products, I’d be very grateful!

We do rehab so many horses are stuck in stalls for extended periods of time. The incrediwear wraps have been great for keeping stocking up at bay. They have also been hugely beneficial in the healing of wounds on lower limbs. They don’t seem to encourage the growth of proud flesh the way BOT seems to.

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This isn’t as bad as I thought. YES to a regime of hand walking. Yes to ice boots. Horses don’t want to move much on Dorm (I use this for farrier) so I suggest a 1/2 dose and moving up or down from there. It only lasts 1-2 hours, though. For MY horse, I groom for the 45 min-1hr before it sets in to get him to relax and become susceptible. If he doesn’t get that, it’s as if I gave nothing. (He’s hot) Can she use wired tape plugged into a hot wire to slowly increase the space for this horse so he doesn’t see his “get out of jail free” card? That has worked for several horses I’ve known.

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He has an outdoor 12x20. He did this as they tried to move to a 20x30 foot space. He’s now basically on hand walking for several months instead of attempting a slightly larger space.

So a month after my last post on this, the horse had a bucking fit in his tiny paddock and tweaked his right hind suspensory at the origin. >25% disruption. Thickened to 1.54cm. No visible tears. Back to total stall rest and hand walking. Vet prescribed 10 minutes of hand walking a day and 30 minutes small paddock turn out. (Has he not payed attention at all?!) she’s just been hand walking twice a day and things have been going well until today. starting at week 5 (last Thursday) vet added in 5 minutes of walking over ground poles in hand. He’s been doing this for a few days and now has started dragging that hind toe. Am I wrong to be questioning this horse’s vets? His owner is devastated as he’s been in stall since the end of October now. Personally, I want to tell her to find a new vet for his rehab process because this is getting ridiculous.

Any medical treatment for this new injury happening? Shockwave, cold laser, etc?

IMO poles after only 10 mins a day is a bit early. But you could add something like the Equicore system with a surcingle. Start with 5 mins max then remove bands and continue for the next 5 minutes. Every other day. On off days start increasing time on flat hard ground to 15 minutes. Then work up to 10 minutes in the bands on band days, 15 mins without. Then 15 minutes in the bands, work up to 20 mins without. Increase one thing at a time each week, max. So each phase above takes 2 weeks or more. From there you can add poles, but I’d start with a single pole or a couple spaced far apart, don’t do measured tight distances until later. The bands should help with toe drag though don’t be surprised if the horse is more shuffly at first as they get used to it and build strength. You might not even be able to do 5 minutes the first session with both bands on.

Totally different injury (but been in the box for 6 months now), but my guy is now up to 20 minutes in the bands, 20 minutes over poles, or 15 minutes over poles plus bands (a new combo just started) 25 without. I’ve gone a little faster in this phase than I did at the 5, 10, and 15 minute increments. Partly because he can tolerate the work better now with less fatigue, and partly because the vet’s goal is to add some trot in a couple more weeks and he wouldn’t have been ready for that if I held longer at the previous level. He also could do a full 45-60 minute flatwork ride in the bands before the injury so knows what they are all about. Because this horse’s injury was bone and not soft tissue, he’s also progressing faster, but of course everything is at some risk for injury now with so much rest. With a more fresh soft tissue injury/reinjury, I’d go slower. Or break it up into 2 sessions/day not all at once. Ice after.

He did 10 mins twice a day for two weeks then 15 minutes twice a day for two weeks. This past week he started 15 minutes of hand walking AM and ten mins walking PM + 5 minutes walking over poles. There were four poles down a long side several strides apart. Nothing measured at all. I read the paperwork and she got ZERO guidance on how many poles. In fact, they just said she would have to walk him twice a day since she couldn’t put him in his medical paddock. They did not give her a set amount of time to be walking him.
2 days after the injury, the area was injected with PRP and he has been getting Bemer.
She has decided to send him to a rehab facility but is absolutely gutted and feels failed by her vets at this point. She said he is lamer now than when this injury first occurred.