Yet another fractured splint bone thread (Dec '23-July '24)

[Knubbsy]

Saturday afternoon, my mare was kicked by a pasture mate and ended up with a broken splint bone in the RH. The barn manager saw it as it happened and pulled her right away, called me, called the vet, etc. Mare was most definitely off on RH (she also had a laceration on LH fetlock, but that bothered her less). Rads were taken confirming the break and sent off to Nori Adams at Leesburg for the consult. In the meantime, sutures were placed in LH laceration, and both hinds were pressure-wrapped with no bows and gauze & vet wrap & elastikon around the cornet bands for the laceration and other cuts. Nori agreed with a cautiously optimistic assessment of no surgery but stall rest for 6-8 weeks with pressure wraps to keep swelling down and the bone stabilized. We are doing new rads in 2-3 weeks, around the same time as the sutures coming out. As of last night, when I rewrapped, the only significant swelling is in the RH hock and some puffiness (relative) in the cannon bone. She’s already due for Cooper Williams to come out this spring for new hock and SI rads and probably new hock injections (been two years) so we need to figure out timing for that now.

So right now, I feel okay - I think. Thanks to a pasture injury in January we also spent the start of the year on stall rest (mare is now banned from field board and will get small pasture turnout 12 hr day once released from stall rest), my horse costs this year now match last year… and last year I bought a horse and a saddle and showed twice as much. Mare is on bute and has a stall right by the tack room so is getting lots of attention so she feels okay.

So, for you all, after my trauma dump - what are your favorite, low-cal, low-sugar ways to keep a horse amused on stall rest? Favorite way to recover from a bone fracture? Favorite way to alter diet during stall rest? This spring, her coat looked fantastic coming out of stall rest, but she lost topline muscle that was a pain to rebuild (we have a passoa system, but we can’t use therabands because half I’m allergic to and half she’s allergic to). She has a savvy feeder hay box that she likes to toss around, and she can’t hoover hay up from, so that’s something to keep her occupied some of the time. I’m debating if we need Cooper out as she’s coming back into rehab or wait until she’s fit. I’m trying to keep both of us on a good track forward. What am I missing?

[JB]

@Knubbsy

low-cal, low-sugar

lots of ideas here

ECIR-Safe-Treats.pdf

@Knubbsy

Favorite way to alter diet during stall rest?

what’s she eating now? If she’s eating 5lb+ of a regular feed, you could switch to a ration balancer to reduce calories, keep her from getting heavy, and add a couple pounds alfalfa pellets if she needs a boost. If she’s already a hard keeper, then feed according to her weight in moderate work which will help cover her protein needs, or feed the light work end and add some alfalfa pellets

@Knubbsy

This spring, her coat looked fantastic coming out of stall rest, but she lost topline muscle that was a pain to rebuild

Keep protein high quality (which means good levels of AAs) and it will at least minimize the loss

[Knubbsy]

@JB

what’s she eating now? If she’s eating 5lb+ of a regular feed, you could switch to a ration balancer to reduce calories, keep her from getting heavy, and add a couple pounds alfalfa pellets if she needs a boost. If she’s already a hard keeper, then feed according to her weight in moderate work which will help cover her protein needs, or feed the light work end and add some alfalfa pellets

Currently on:1 qt Cavalor Action Mix and 1 qt Sentinel Performance LS (“½ scoop”), 1/2 cup flax ( each per meal) plus 3oz Cool Calories,1 T salt, 2 scoops SmartCombo Senior Ultra Pellets, and 2 scoops Uckele Sport Horse Grass (in the morning). We added the fat this summer and that seemed to help. I forget how we altered her diet for the spring stall rest, I think it was down to just 1 qt Action, without the Sentinel

She used to be an easy keeper when she was just bopping around BN type work a couple times a week but as I focused on dressage (schooling 3rd/4th) she’s been a harder keeper (BM says she turned into a princess)

[IPEsq]

I use a silica product for bone healing. There is Platinum Osteon which is a lot of powder. Or if you can store it somewhere it won’t freeze, HorseTech’s OrthoPur SI which is a liquid.

After the fracture is somewhat stable, shockwave can help. And PEMF.

[Knubbsy]

@IPEsq

I use a silica product for bone healing. There is Platinum Osteon which is a lot of powder. Or if you can store it somewhere it won’t freeze, HorseTech’s OrthoPur SI which is a liquid.

After the fracture is somewhat stable, shockwave can help. And PEMF.

Thanks for the suggestion of adding on. Have you found any studies on silica/silicon for bone healing? I found some early positive and some more recent mixed studies on its benefit for developing young horses, improving bone density, and preventing further development of osteoarthritis, but nothing on repair. Most of what I saw in studies on bone repair was in line with what @JB said as far as AAs, collagen, etc., which I think are well covered but definitely open to hearing about what I’m missing!

We have a Magnawave rep at my barn, and I’ve already talked to her about starting that once we have the second round of rads (also red light for the suture location).

[JB]

I’ve searched quite a few times on research showing supplemental silica helps repair, and can’t find anything. Probably because a silica deficiency has basically never been identifified.

[IPEsq]

I haven’t but thought it could be a might help, won’t hurt kind of thing. i had used Osteon in the past for other issues on a vet’s recommendation, but there was no way that amount of powder was going to fly for my horse with a broken scapula. So I got the OrthoPur. I was already feeding decent nutrition as far as AAs etc, just cut back on overall calories. I did feed HorseTech’s hoof supplement during that time as well which I was already buying for my other horse which provided a little bit of a boost for aminos, minerals, and collagen. By ultrasound, he formed minimal bone callus (which was the goal), and the fracture healed as well as we could have hoped.

I also had a broken finger (avulsion fracture in the knuckle) during this time, and holding the Magnawave loops on my horse had a significant positive impact on swelling and quality of healing.

[MapleFarm]

A Review of Three Decades of Research Dedicated to Making Equine Bones...

This is the closest I’ve found for a study regarding bone repair/turnover - there is a section reviewing the existing studies on silicon and bone health generally.

I used Osteon when my mare fractured her coffin bone, per my vet’s recommendation. Did it work? No clue, as I also put on bar shoes, got her ProStride, Adequan (the break interfered with the joint), HA supplement, and BEMER. No stall rest - we just limited the field to be smaller. Whatever we did worked as it healed with 0 arthritis and no lameness.

[Knubbsy]

@MapleFarm

This is the closest I’ve found for a study regarding bone repair/turnover - there is a section reviewing the existing studies on silicon and bone health generally.

This is in line with the rapid synthesis I did this week. There’s plenty of anecdotals that silicone, shock wave, etc could have helped fracture repair but the research evidence is often mixed null to non-significant positive.

My mare already has a good range of evidence-supported (or suggested) supplements between her combo and her m/v supplement that I don’t see value in adding more after seeing the research out there. We did drop the cavalor action mix from her feed while she’s on stall rest to avoid adding body mass. It’s a bit lumpy on the lateral side where she broke the bone, but swelling is controlled, she is moving okay in her stall, and seems comfortable so I feel okay at the moment with the direction we’re going at the moment. Recheck on the 9th with new rads that I imagine will get sent to Nori for consult to make sure we’re on the right track and don’t need to drive over.

[IPEsq]

While I do think that shockwave may or may not help the bone healing significantly, it can really help the soft tissue edema and periosteal swelling and reactivity around the splint bone quite a lot (also for non-fracture splint injuries).

[Knubbsy]

Just an update in case someone stumbles on this thread while dealing with their own fracture and wondering all the possible variations in healing:
We’re at 8 weeks and are “behind on healing”. The callus is mostly set and there’s some visible remodeling (the wedge-shaped chunk is now fuzzy on xrays and not as discernable). SMZs and then another antibiotic I forget the name of for 2.5 weeks, originally it was one week but then some pus erupted and we were worried about a fracture infection. 1g Bute twice a day until week 7, and then we stepped it down to once a day to keep inflammation down. Daily stable wrap changes, which will continue to support the leg. We’ve been doing weekly PEMF (magnawave) on her legs but I don’t know if it’s actually benefitting her. My vet recommended I consider a homeopathic comfrey pill but I don’t love the research evidence I saw so haven’t pursued it. She is getting bodywork today to see if that helps her mood.
She is finally cleared for handwalking and small paddock turn-out, which is better for everyone’s safety and sanity. She mostly behaves for me for grooming and hand-grazing but is a bit of a terror for the barn manager (nippy, bucking in her stall, threatening to kick) so the more time away from people and near other horses, the better.
Recheck with xrays in another 4 weeks.

[Posting_Trot]

I realize that this is now a somewhat older thread so this suggestion might not be useful to you, but it might be useful for someone else.

I had some good results with a rehabbing horse with giving her SmartFlex Rehab Pellets:
https://www.smartpakequine.com/ps/smartflex-rehab-pellets-15239

On that same page there’s also a link to two studies of supplemental silica in horses:
O’Connor CI, Nielsen BD, Woodward AD, et al. “Mineral balance in horses fed two supplemental silicon sources.” J Anim Physiol Anim Nutr (Berl). 2008 Apr;92(2):173-81.
Lang KJ, Nielsen BD, Waite KL, et al. “Increased plasma silicon concentrations and altered bone resorption in response to sodium zeolite a supplementation in yearling horses.” J Eq Vet Sci. 2001 Nov;21(11):550-5.

[horses25]

Hi!! My horse recently fractured his RF coffin bone with some joint involvement. Can I pick your brain? Was your horse on bute for a long time/ did you switch to equioxx eventually?

What I’m doing sounds very similar to what you wrote - he is on stall rest though. He has a bar shoe with casting material on, doing class IV laser 2x a week, red light therapy 2x a day, Polyglycan injections. The only thing that the vet at the clinic said to not do is pemf / magnawave. can you give me any insight into that? I’m throwing everything I can into healing him

[MapleFarm]

Hello!

We didn’t do any bute/equioxx, actually. My mare was sound at walk, and relatively mild unsoundness at trot - and no other “symptoms” of acute pain, so perhaps that is why it wasn’t recommended?

The turnout was limited - but to my smallest, flatest pasture. The vet indicated she was more worried about issues due to being on stall rest than due to movement (they can do a LOT of circular movement in their stalls, after all) as she was only 4 when it happened, but pretty quiet in the pasture - the most excitement is when dinner time rolls around.

I wonder why PEMF is discouraged by your vet? Did they give a reason? All it really does is increase blood flow, which can’t hurt any wound, I wouldn’t think. Also, red light therapy is generally for more shallow wounds, so not sure how much that will help. Easy to say now that I’m on the other side of it - like you, I pretty much threw everything I was offered/had access to at it so I would probably do the same. I used the ProStride as it seemed most likely to help based on the information I was given at the time.

I am now 2 years out from the injury and she is sound; we haven’t had any problems. She is actually not in shoes right now for the first time; we took off the bar shoes last May (after more xrays) and put normal shoes on, and I took them off entirely in December rather than use pads this winter. She tolerated it well, though I will be putting shoes back on her next cycle as she is probably about 1800lbs (18.2) and her heels wear very quickly. At my last check up in May last year, the vet said she thought she had the “same risk” as any other horse for getting arthritis at this point as the bone had knit as much as it would and there was no indication of arthritis then. I am thinking of getting another set before putting shoes back on just to see if there has been any additional healing, but I hope that she is correct.

I did not do the Pro-Stride again at the 1 year mark, as again, the vet indicated that there should not be more active healing at that point so it would be a pointless $1000. Top xray is from May 2023.

ETA: when the injury occurred, my vet was NOT optimistic about the arthritis. The two vets who were on the case were both very happy with the successful healing. Apparently these always remain on x-rays and rarely “disappear” completely, so you have to go more off of soundness for long-term prognosis.

[horses25]

Thank you for your response! My horses’ fracture is much worse so he is on bute right now. I will have to call the hospital vet and get clarification as to why on the PEMF.

How soon did you inject Prostride? We are tossing around injecting either Prostride, Alpha2 and Amnion in there. Not set on one yet but leaning towards Amnion.

I am glad your horse is all healed up and sound! That is wonderful news. When you did PEMF, did you see drastic improvement on X-rays sooner?

[MapleFarm]

Oh, I’m so sorry to hear that it is worse! I send you jingles for your horse.

We did the prostride within 2 weeks of diagnosis. It was more a matter of the vet coming to me (didn’t want to trailer her up to the clinic) and scheduling. Keeping the inflammation down in the joint is key to keeping the arthritis at bay. I didn’t see any soundness difference with the Adequan treatment specifically, but honestly it isn’t that expensive and I didn’t push her to “check” during this time either.

I actually remember now regarding bute/etc - we didn’t want to mask pain too much as we wanted to minimize her pasture antics. If you are on stall rest with a larger fracture/more pain then this is obviously different.

I started the PEMF immediately as well- my friend has BEMER and lent me the leg set so I used it every day for the first few months at least. I can’t be certain since it isn’t a double blind study - but my vet was VERY surprised by the initial 1 and 3 month xrays, so I believe it did help. My computer that had all of these images is not currently working, or I’d add the images of the change between those specific months compared to longer term.

When I was asking my vet about supplemental therapies, she worded it as: balancing cost to impact, the biggest improvement will be from the shoes/care regimen, second from the injection into the joint, and then the Adequan/supplements/PEMF as a group of additional therapies generally to assist the other treatments.

Another note, my mare’s breeder owned a different mare that had multiple fractures of the coffin bone on the track and went on to be her hunt horse for almost 20 years, so take heart. That was before any of these options were available and all they did was bar shoes.

[MapleFarm]

Oh, and if you choose to try Platinum Performance CJ, I recommend asking them for samples of the flavors first. I couldn’t get her to eat even a pinch of it in a massive bucket of feed, and she will happily eat 29 antibiotic pills straight in her food. This one was recommended by the vet but I couldn’t get it into her any way I tried so I just used the Osteon instead.

[horses25]

Thank you!!! This is so helpful and gives me hope. That is the second story I’ve heard of a horse with a worse fracture going on to live and be sound for 20+ years.

I have Platinum CJ, equine elixirs Pro Bono, and Lysine. I haven’t started the Platinum CJ yet, taking things slow. He’s also getting Polyglycan shots.

It’s really weird, I almost bought Osteon. Before this happened, I had a sent in a hair sample for mineral testing and my horse has high lead. I had the consult with the vet after this had happened and he said Zeolite (that’s in osteon) would actually chelate the lead in the bone, and advised me not to feed it yet. Super weird and interesting.

[Knubbsy]

We’re onto another month of stall rest. The xrays definitely show improvement but she’s still not at 100% and ready for reconditioning. My vet said she’s never had a horse this fractured in her practice before, love to feel special like that. We introduced round pen turnout and 10 mn hand walks mid way through Feb and she’s going to spend longer outside in a grass paddock in sight of other horses but no shared fenceline and longer hand walks starting this week. The mare is definitely happier with more time outside - the vet even commented on how she seems more herself.
The image won’t embed but here is a composite of the 4 main rads (I don’t have the set from 1 week after)

[Knubbsy]

Okay, we’re finally at rehab!

There is still calcification to be done but Dr. Adams has given us clearance “No restrictions, treat like a normal horse” for which the mare is very grateful because she is bored with handwalking. The first two real rehab rides show that she came out with decent fitness, able to carry herself in the baby trot sets reasonably well, and walks with good (for her) overtrack. She definitely needs hock injections as the rads show arthritic changes, and it’s been 2 years since her first injections. She has a private, lush field (wearing a muzzle) where she shares a very hot fence with some other horses and in view of others, but much less chance of damaging herself (she also gets trees for shade, her own large water trough since she’s secretly a hippo, and is the first to be brought in for breakfast - she is spoiled).

I’m following a variation of the Equestrian Canda post-covid rehab plan that looks like this:
May 2-9: Tack walk for 20-25 minutes, marching, 20m circles as turns
May 10 - 16: End goal of 30 mn walk, 3-4 mn trot (in 20 sec pieces), low level lateral work (shallow leg yields), 20 m circles
May 17 - May 23: End goal of 30 mn walk, 4-5 mn trot (in 30 sec pieces), 2 mn canter (in 20 sec pieces), 15m circles, increase transitions, introduce the baby hills around the farm
May 24 - 30: End goal of 30 mn walk, 10 mn trot (in 1 mn pieces), 4-5 mn canter (in 30 sec pieces), decrease diameter of circles, increase transitions and lateral work
May 31- June 6: End goal of 30 mn walk, 15 mn trot, 10 mn canter, start to reintroduce mediums and lengthening
June 7-13: End goal of 2nd level work, increase normal conditioning work (building up over time to longer trot sets)
June 14: Return to lessons, assuming no hock injections disrupting plan

Hock injections are hopefully happening this week, but it depends on Dr. Williams’ availability since we have 3 horses that need to be evaluated at the farm. I’m probably not getting my bronze on her this year, but she at least can spend the year working instead of getting fatter which is good for her mental health (the girth is rather snug now despite cutting over 750 calories from her daily ration several months ago once it was clear she wasn’t dropping weight on stall rest like last year).