Suspensory Ligament Strain *advice Needed
Posted 10 June 2009 - 10:06 PM
I have a 6 year old mare that recently injured her suspensory ligament in her left hind. She is a 1D barrel horse and injured herself while running. Ok so for around 3 days after her run she had a good bit of swelling and heat in her left hind pastern and fetlock area. I gave it a few days cold hosing it and aplying liniment which didn't seem to help at all. I also kept her in the stall these few days and when I would lead her out of the stall she would litterally be three leggedd lame for the first few steps and was very reluctant to bear weight on the injured leg until she was able to walk a little ways and once she did put weight on it she would bear most of the weight on her toe. At this point I called my vet and she came out and did an ultrasound and diagnosed her to have a MILD strain to her suspensory. She said to cold hose it twice daily or more if possible and had me apply Surpass to the area twice daily. She also recomended stall rest and hand walking for at least a week and said she assumed that the mare would need at least two months off before we rode her and that it would have to be gradually re-introduced. She also told me that I could turn her out under supervision as long as she did not cut up and act crazy in the pasture. Ok, so I have been diligently following her directions and hand walking the mare as well as putting her on Recovery EQ w/ HA to try and help a bit also. I have been reluctant to turn her out because she is the type to act frisky in the pasture. So she has been on TOTAL stall rest and hand walking for going on 2 months now. Well, the other day the leg was not swollen and I felt no heat so I decided I would let her out in the small arena to move around a bit. She of course tore off bucking across the arena and ran a few laps. I instantly regretted the decision I had made and took her back to the stall. Well the next day she was swollen again and had a little heat . I told the vet about it and she seemed unconcerned and just said to be careful and has told me to take her off of the surpass creme and just stick with cold hosing and stall rest. I am just concerned that the strain may be more than MILD. But like I said the vet did a thorough examination and didn't act like it was that big of a deal. I will post some pics tomorrow just to show the current swelling.
So my question is, have any of you dealt with similar situations? How long and what treatments seemed to work best for you? And my biggest concern is, do you think she will be able to continue her career as a barrel horse after she heals or will this injury be to likely to reoccur and make barrels to risky for her?
"Ryshays Gold" AKA Bugz: 2003 APHA/PHBA Palomino Mare
"Prayin For Gold" AKA Harli: 2008 AQHA/PHBA PalominoFilly
Eli: 1996 Chestnut Morgan Gelding
Hank: 2008 Miniature Donkey Jack
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Posted 11 June 2009 - 09:04 AM
Last year my horse lightly strained his lower suspensory. He had 6 weeks stall/paddock rest (paddock only if it wasn't muddy). He had one shockwave treatment. Usually they do 3 but he was healing so well with just rest that he only needed one. After 6 weeks we slowly brought him back into work (after the vet ok'd it) and he hasn't had an issue with that injury again and has been back up to jumping his usual height (3'9ish)
BUT OF COURSE, being my horse he VERY lightly strained his upper suspensory this year. (so mildly that no one thought he was lame, I could just feel a SLIGHT difference from his usual movement. We are currently on stall/paddock rest (paddock when not muddy) and we will be going to our first shockwave session tomorrow. We are on week 4 (would have done the shockwave earlier but the vet that did the ultrasound thought shockwave wasn't necessary but the 'regular' vet thought it would be a good idea)
Specially since you found something on ultrasound they should know where the injury is so can target it specifically (they could not find any injury on my horse's ultrasound this last time, but confirmed it was the suspensory through blocking. he has had no heat or swelling because of this they will have to do the entire back of his leg with the shockwave).
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Posted 11 June 2009 - 09:07 AM
She was originally hurt in early November, so obviously it's been a long road. We started out exactly how you did- pulled out of work, cold hosing, and stall rest. When she was showing no signs of improvement we hauled to her vet for ultrasounds and got the bad news.
From there our vet suggested shockwave therapy to the suspensory, which we did. After a few weeks of that (1 treatment/week) he told us about an "experimental" treatment they had been using for their track horses. PRP, or Platelet Enriched Plasma, essentially they pull a vial of blood from her jugular centrifuge it and re-inject just the platelets into the injured suspensory. (you may want to google this, because it's been a while since I've been over the process) The idea is that this will help built up strength in the area.
So while all of this was going on she was on absolute stall rest for about 4 months, no handwalking or anything, and also being wrapped "permanently" in Back on Track wraps, another suggestion by the vet. After those 4 months and completing her dose of the PRP (I think she had 4 or 5 total treatments) we took her back for an ultrasound. Vet saw a great deal of improvement and told us to keep going. Still on stall rest, still getting shockwave treatments to the area.
Starting the middle of April I want to say, she was allowed 10 minutes of handwalking each day, while on a sedative. With her being extremely high strung and out of work for so long the vet didn't want her to do anything to risk that leg. So she was handwalked for about a month. Took her BACK to the vet for another ultrasound, even MORE improvement vet said said go ahead and give her 30 min of turn out/day on the sedative. Did that for a few weeks then took her back where we got the okay to get on her and do some walking to build strength up in the leg.
It's what...the second week of June? We can get on her 4 days a week or so and work her at both the walk and trot for about 30 minutes or so with lots of walk breaks in between trot sets. No longing, so she's still on the sedative sometimes.
It's been hard, but this mare is a big $$ mare and had we lost the use of her, it wouldn't have been good. The vet told us that had we not pulled her out when we did and started treatment that the ligament would have torn beyond repair and she would have either required to be put down or complete retirement.
Even now she takes about 9 of 10 good steps on that leg and we're not out of the dark with her, but we're past the point that she'll never do her job again which is what we were looking at a couple months ago.
Honestly? I would take her to a big clinic such as at a University or something and get a second opinion. I HATE suspensory injuries and I just don't like to mess around with them. I would be re-ultrasounding that leg regularly as well. Also talk to your vet about turning her out while sedated to keep her playing to a minimum.
Whether or not she'll be able to continue her job is a waiting game, which sucks, I know. But this is something that you don't want to push at all or it could end badly. My mare is to be used for jumping (we had only had her about 7 months before she hurt herself and we were the first people to have consistent training on her) and while the vet said at this point there's no doubt in his mind that she'll jump again, it's just going to be a very long road to GET there. From now how she's going to require a lot of maintenance and a lot of monitoring.
She's on a supplement for ligament and tendon health now too, SmartTendon from SmartPak...we're doing everything we can to keep her sound and healthy.
Posted 16 June 2009 - 08:46 PM
A suspensory tear, no matter how mild, usually means a year or more off with confinement. Nowadays, things can speed up healing such as Stem Cell, shockwave, etc.
We also were told 6 weeks until better, at the end of January for "mild desmitis" of the lateral branch of the right hind suspensory. Stem Cell was administered March 17th and we are hopeful for a slow return to full work in another month. I am told that this suspensory will be stronger than it was before and to be careful of the other leg!!
Have you been advised to place a standing wrap? Poultice? Cold hosing and icing is good, as is handwalking, all at the times prescribed by the vet. Good luck and keep us posted
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Posted 16 June 2009 - 08:50 PM
We're re-ultrasounding when we get back from Kentucky and are expecting a good report as things have just kept on improving at home. Hopefully we'll be given a time frame for returning her to work over fences.