Annular ligament surgery WWYD

[Louby]

Ive searched and read old posts regarding this but would just like a bit of reassurance and 'what would you do' please

My lovely 5 yr old basically took a beating in the field, she had numerous superficial injuries and what we first thought was swelling from a cut is actually annular ligament damage. It was caused from a kick which my vet has said in the grand scheme of things is better than the ligament failing. Im gutted.

Ive moved from that yard as we needed facilities for her to recouperate and all was going well in her little field pen, then she had a mad en and has damaged the ligament further The vet said its now bad enough to warrant surgery but to scan again in 2 weeks when the inflamations settled down but to start considering surgery. He is concerned if we leave her to recover and she does something silly again possibly months down the line then we are back to square one again. Her next scan is next Friday and Im preparing myself to make the decision as to whether she has a GA to cut the ligament or not.

I really dont know what to do, its all such a shame.

Any advice is much appreciated.

 

[BallyRoanBaubles]

What will happen if she has the surgery and then has a silly moment?

 

[ester]

On one that age I'd be inclined to, I'm not sure how easy they are to manage longer term otherwise (I have an oldie with chronic damage, not operated on but retired to hacking for a couple of years then fully retired, not entirely down to the annulars.

 

[Louby]

What will happen if she has the surgery and then has a silly moment?

I havent a clue tbh, the impression Im getting is that once operated on the annular ligament cant cause a problem. All questions I have to ask, its a nightmare and such a shame

 

[Louby]

On one that age I'd be inclined to, I'm not sure how easy they are to manage longer term otherwise (I have an oldie with chronic damage, not operated on but retired to hacking for a couple of years then fully retired, not entirely down to the annulars.

I cant believe this has happened, I really dont know what to do for the vest, although in my heart Im thinking I really dont have a choice. Ive read turn them away and they come right and also do the op and providing theres no complications, the future is promising. She such a lovely sweet mare and really didnt deserve this My vet is optimisitic that she will come right but its such a worry. Is it ethical in such a young horse, long term prognosis etc? Ive never had a ligament or tendon strain before so Im a bit overwhelmed with it all

 

[ester]

If you do a forum search you will find a fair few experiences albeit mostly with older cob types and most seem to have done well afterwards. I don't see why it would be unethical on a young horse.

 

[Louby]

If you do a forum search you will find a fair few experiences albeit mostly with older cob types and most seem to have done well afterwards. I don't see why it would be unethical on a young horse.

Thank you, my vet said its usually seen in cob types. Shes a sports horse lol. I just feel really mean, shes been through so much with other issues and Im concerned how this may all end, hence asking. Sorry the ethical bits more about operating on a 5 yr old and what impact this may have on her long term. I think I just want to wave a wand and her to be ok!

 

[HobleytheTB]

I can't help on the annular ligament front, but my mare underwent a GA for tendon surgery a few weeks ago to diagnose and treat her injury. I won't lie - surgery day was an awful day! I felt sick all day, worrying more about the GA than the operation! Thankfully surgery went smoothly and she's back at home now finishing her rehab. I was in a similar situation to you, in that she's a young mare and her ridden life was uncertain before surgery. I don't regret the surgery, as it was the only way to find out what was going on, but I'd be hesitant to go through a GA again.

Make sure you're clear on how much box rest etc she'll be needing and how you think she'll cope with it. Will you be able to hand walk her/ hand graze her?

 

[meleeka]

Mine had it done. In all honesty the hand walking was by far the worst bit, because I have no facilities so it was walking in the field. My boy was fine with the actual box rest but coming out twice a day was just too exciting and he had to be sedated for it each time.

In your shoes I’d do it if the vet thinks it’s a good long term solution. The op itself is pretty straight forward and it’s a tiny incision so the physical recovery should be straightforward too.

 

[Trouper]

Mmmm ... you don't say what all the "other issues" are that she has had to deal with. Are they physical? Are they likely to be impacted by box rest? Agree with others who say a young horse ought to benefit from the surgery but it is difficult to say without knowing her full situation.

 

[Louby]

Hi thanks for all your replies.
Im told she will need 10 days box rest to make sure the wound heals well, then as far as Im aware light exercise is key to try and prevent adhesions. I asked the vet lots but there was too much to take in, so I will ask again next week. She had 4 weeks box rest last month with short walks 3 times a day, did get a bit eeeeek towards the end but she is currently turned out in a section of the field for a few hours to try and limit her running about too much. Life has been so much better and easier since we moved yards as the option of individual turnout in a small area wasnt really viable were we were before.

Mmmm ... you don't say what all the "other issues" are that she has had to deal with. Are they physical? Are they likely to be impacted by box rest? Agree with others who say a young horse ought to benefit from the surgery but it is difficult to say without knowing her full situation.

Shes had locking stifle from a 2/3yr old which has come with her growth spurts and has been managed with the usual poles, hill work etc, so box rest isnt great for her, also a stifle ligament strain which thankfully is improving. We'd had 2 injury free years, then this in the space of a couple of months. I wish we'd never moved to our last yard

Mine had it done. In all honesty the hand walking was by far the worst bit, because I have no facilities so it was walking in the field. My boy was fine with the actual box rest but coming out twice a day was just too exciting and he had to be sedated for it each time.

In your shoes I’d do it if the vet thinks it’s a good long term solution. The op itself is pretty straight forward and it’s a tiny incision so the physical recovery should be straightforward too.

Hows your boy doing? How long after the op could you start working him again. Ive already written off this year but shes such a busy horse and doesnt do well as a field ornament, I just hope she can behave herself until we are hopefully allowed to get going again

 

[Louby]

I can't help on the annular ligament front, but my mare underwent a GA for tendon surgery a few weeks ago to diagnose and treat her injury. I won't lie - surgery day was an awful day! I felt sick all day, worrying more about the GA than the operation! Thankfully surgery went smoothly and she's back at home now finishing her rehab. I was in a similar situation to you, in that she's a young mare and her ridden life was uncertain before surgery. I don't regret the surgery, as it was the only way to find out what was going on, but I'd be hesitant to go through a GA again.

Make sure you're clear on how much box rest etc she'll be needing and how you think she'll cope with it. Will you be able to hand walk her/ hand graze her?

Im dreading the GA more than the proceedure too! I had a horse years ago that had a GA and the waiting that day was awful! Hope your girl is ok and makes a full recovery

 

[mandyroberts]

My 5 yr WB had a constricted hind annular ligament - apparently unusual for a WB. They couldn't tell me exactly what was wrong as scans/xray were inconclusive but recommended key hole surgery which reveal the problem and it was cut. 9 months on he is doing fine but I don't know how much work his leg will take (just me worrying). He recovered OK but broke a few of my ribs while hand walking which delayed things. I don't see the ethical issues with a younger horse. I could hand graze him for a few minutes evry day so he wasn't completely confined to stable and could hand walk after 2 weeks. He broke my ribs at 3.5 weeks so I turned him out restricted turnout) but a week later he went out with others as he was being too silly. Do nothing and they could be lame forever. Worst case operate and they are still lame and have a happy life as field ornaments. Good luck and keep us updated

 

[meleeka]

[QUOTE="Louby, post: 14065071, member: 40776"

Hows your boy doing? How long after the op could you start working him again. Ive already written off this year but shes such a busy horse and doesnt do well as a field ornament, I just hope she can behave herself until we are hopefully allowed to get going again[/QUOTE]

He’s been sound for around 6 years now. He didnt come sound when expected and they eventually found a bone chip (which I think was there all along personally). A course of bute brought the swelling down and he was much improved. It took around 12 months before he was back to normal.

 

[Trouper]

Hi thanks for all your replies.
Im told she will need 10 days box rest to make sure the wound heals well, then as far as Im aware light exercise is key to try and prevent adhesions. I asked the vet lots but there was too much to take in, so I will ask again next week. She had 4 weeks box rest last month with short walks 3 times a day, did get a bit eeeeek towards the end but she is currently turned out in a section of the field for a few hours to try and limit her running about too much. Life has been so much better and easier since we moved yards as the option of individual turnout in a small area wasnt really viable were we were before.


Shes had locking stifle from a 2/3yr old which has come with her growth spurts and has been managed with the usual poles, hill work etc, so box rest isnt great for her, also a stifle ligament strain which thankfully is improving. We'd had 2 injury free years, then this in the space of a couple of months. I wish we'd never moved to our last yard


Hows your boy doing? How long after the op could you start working him again. Ive already written off this year but shes such a busy horse and doesnt do well as a field ornament, I just hope she can behave herself until we are hopefully allowed to get going again

So difficult to give an opinion on someone else's horse and I think you are right to go thro' everything again with your vet to make sure you have all the information you need. IF you are sure that this is the only problem she has and IF you can manage the post-op care for her, then I think youth is on her side and I would be tempted to go ahead. I am not a fan of box rest but I did do it for my horse's KS op. However, the daily 10 min walk was rewarded with at least 20 mins hand grazing before returning the prison cell and towards the end of the month i took a garden chair and sat with him in a small paddock while he free-grazed for up to an hour. Kept us both sane and meant that the eventual turnout was not "so exciting". Think most folk thought I was mad sitting with him but it kept him calm and it was surprisingly relaxing for me having a purpose to a sit down!!! Good luck.

 

[Goldenstar]

I would manage the the ten days post op with the help of sedation I had to when one of mine was in plaster it helped enormously.
I would also consider doing the ten days post op at the vets .

 

[Louby]

My 5 yr WB had a constricted hind annular ligament - apparently unusual for a WB. They couldn't tell me exactly what was wrong as scans/xray were inconclusive but recommended key hole surgery which reveal the problem and it was cut. 9 months on he is doing fine but I don't know how much work his leg will take (just me worrying). He recovered OK but broke a few of my ribs while hand walking which delayed things. I don't see the ethical issues with a younger horse. I could hand graze him for a few minutes evry day so he wasn't completely confined to stable and could hand walk after 2 weeks. He broke my ribs at 3.5 weeks so I turned him out restricted turnout) but a week later he went out with others as he was being too silly. Do nothing and they could be lame forever. Worst case operate and they are still lame and have a happy life as field ornaments. Good luck and keep us updated

Thank you, so pleased your boy is doing well. Shes out in a smaller area atm for a few hours a day which is great but really hard to juggle with working, she did 4 weeks box rest when it was first diagnosed and has been really good confined to the pen until she had a silly moment last week and made it much worse hence the surgery suggestion now. Its actually looking really good, the swellings gone down massively this last week as it trebled in size after her mad 5 mins Scan again this Friday so we shall go from there. Thanks again

 

[Louby]

So difficult to give an opinion on someone else's horse and I think you are right to go thro' everything again with your vet to make sure you have all the information you need. IF you are sure that this is the only problem she has and IF you can manage the post-op care for her, then I think youth is on her side and I would be tempted to go ahead. I am not a fan of box rest but I did do it for my horse's KS op. However, the daily 10 min walk was rewarded with at least 20 mins hand grazing before returning the prison cell and towards the end of the month i took a garden chair and sat with him in a small paddock while he free-grazed for up to an hour. Kept us both sane and meant that the eventual turnout was not "so exciting". Think most folk thought I was mad sitting with him but it kept him calm and it was surprisingly relaxing for me having a purpose to a sit down!!! Good luck.

Thank you, I hate box rest too and no this isnt her only problem She had a lameness work up back in May and had a slight stifle ligament strain, vet initially wanted box rest but we agreed as she has had locking stifle we would take her shoes off and turn her out 24/7, give her the Summer and re scan, then she got battered in the field and took a blow above her fetlock which damaged her annular ligament. Its all been a nightmare and is such a shame as she isnt a trouble causing mare, shes just young, doesnt do the field ornament very well as she thrives on doing something.
On a positive note, the stifle ligament has been rescanned and has improved. I think I need a rocking horse next!!!

 

[Louby]

I would manage the the ten days post op with the help of sedation I had to when one of mine was in plaster it helped enormously.
I would also consider doing the ten days post op at the vets .

Thank you, luckily we are stabled right next door to the vets I had thought about asking to leave her there. Tbf to her, she coped really well on box rest, the walks got slighty hairy on the 4th week. She did however turn into a proper princess lol.

 

[Louby]

[QUOTE="Louby, post: 14065071, member: 40776"

Hows your boy doing? How long after the op could you start working him again. Ive already written off this year but shes such a busy horse and doesnt do well as a field ornament, I just hope she can behave herself until we are hopefully allowed to get going again

He’s been sound for around 6 years now. He didnt come sound when expected and they eventually found a bone chip (which I think was there all along personally). A course of bute brought the swelling down and he was much improved. It took around 12 months before he was back to normal.[/QUOTE]

Thats great news, so pleased hes ok

 

[Northern Hare]

Hi, years ago I had a lovely middleweight cob - he was Welsh D x Hackney x TB. He was a great RC horse. Anyway he strained one of his hind Annular Ligaments larking around in the field. He responded well to cold treatment and especially the Bonner Bandage (ice bandage). He came back into work but re-strained it a year or so later. We took him up to Rossdales in Newmarket for the surgery but they didn’t feel it warranted it, so we took him home and turned him out for a few months and the brought him back into work very slowly and he never had any further problems.

My current horse (now 27 and still in light work) is TB X WB and he strained his near fore annular ligament 12 years ago. I dug out the (very old by then) Bonner Bandage and it seemed to work it’s miracles again and the vet was amazed at the results! At first she had been guarded on the prognosis but we got him slowly back into work and he never had any problems again.

Sorry, I haven’t answered your question ref whether or not to go for surgery with your lovely sounding horse. However, with the first horse, the vet was sure surgery was the right thing, hence the referral to Newmarket, but when we got there they were adamant surgery wasn’t required. So, what about asking your vet for a referral to a specialist centre for a second opinion?

 

[Louby]

Hi, years ago I had a lovely middleweight cob - he was Welsh D x Hackney x TB. He was a great RC horse. Anyway he strained one of his hind Annular Ligaments larking around in the field. He responded well to cold treatment and especially the Bonner Bandage (ice bandage). He came back into work but re-strained it a year or so later. We took him up to Rossdales in Newmarket for the surgery but they didn’t feel it warranted it, so we took him home and turned him out for a few months and the brought him back into work very slowly and he never had any further problems.

My current horse (now 27 and still in light work) is TB X WB and he strained his near fore annular ligament 12 years ago. I dug out the (very old by then) Bonner Bandage and it seemed to work it’s miracles again and the vet was amazed at the results! At first she had been guarded on the prognosis but we got him slowly back into work and he never had any problems again.

Sorry, I haven’t answered your question ref whether or not to go for surgery with your lovely sounding horse. However, with the first horse, the vet was sure surgery was the right thing, hence the referral to Newmarket, but when we got there they were adamant surgery wasn’t required. So, what about asking your vet for a referral to a specialist centre for a second opinion?

Hi, thank you so much for replying. So pleased your boys came right without surgery, that would be my choice really. Initially my vet said surgery was the last option and said she didnt warrant it, the dammage was 60mm?? on the scan, he was confident she would come right with rest, then the silly sod and a mad 5 mins in the field (pen) and it ballooned. Her scan was due the following day, vet wasnt going to do it as he said the inflamation needed to settle down to give a true reflection but was shocked at how bad it now looked. I said scan anyway and it had gone to 90 odd mm. He said she was noe a candidate for surgery His concern is if we leave her to heal and she does the same again, weeks, months down the line then we will be back to square one. He hasnt pressurised me either way, said to give it a lot of thought and we will see what next weeks scan shows. I really trust his opinion, hes also an orthopaedic surgeon so Im lucky there. Its actually now looking really good from the outside, Im amazed how much its gone down as it was a big hard lump only last week.

Its such a worrying time as my hearts in my mouth when shes out. I know I cant stop her running and Im trying my best to let go, keep telling myself what will be will be. Hard though.

Off to look at the Bonner bandage

 

[AandK]

My now 22yo TB had the AL op exactly 4yrs ago today. He also had a tear in his sesamoidian ligament so had PRP for that at the same time. He had 2 weeks box rest until stitches came out and then into a pen for 6 weeks and starting walking. 5 min week 1, 10 min week 2 etc until he was at 30 min week 6. If it was just AL at this point he could have carried on building up the work but due to the other ligament injury he then went back out in the field for 2 months field rest. He was sound when reviewed in Dec ‘15 and returned to low level Eventing. I would not hestitate to do the op on a 5yo.

 

[Louby]

My now 22yo TB had the AL op exactly 4yrs ago today. He also had a tear in his sesamoidian ligament so had PRP for that at the same time. He had 2 weeks box rest until stitches came out and then into a pen for 6 weeks and starting walking. 5 min week 1, 10 min week 2 etc until he was at 30 min week 6. If it was just AL at this point he could have carried on building up the work but due to the other ligament injury he then went back out in the field for 2 months field rest. He was sound when reviewed in Dec ‘15 and returned to low level Eventing. I would not hestitate to do the op on a 5yo.

Thank you so much!! Just lovely to hear success stories and that she could come right. So pleased your boys ok

 

[muddy_grey]

My mare had a ddft injury and during the surgery the AL was cut, so they could access the damaged tendon. She was 6 at the time. The rehab was more extensive than others, but obviously she had a tendon injury. That was 18 months ago and she is back in full work including jumping. The leg is ugly, but she is sound

 

[eggs]

My friend's wb is currently in rehab following an annular ligament op back in mid July. The instructions from the vet are box rest with in-hand walking and grazing starting at five minutes and slowly building up to an hour over 12 weeks. Best if the hand walking can be split into two sessions. I believe that the walking can be done ridden from them middle of next month but no turnout.

 

[Louby]

My mare had a ddft injury and during the surgery the AL was cut, so they could access the damaged tendon. She was 6 at the time. The rehab was more extensive than others, but obviously she had a tendon injury. That was 18 months ago and she is back in full work including jumping. The leg is ugly, but she is sound

Thank you Muddy Grey, so pleased shes come sound. How is her leg ugly, if you dont mind me asking? I appreciate shes had more than the annular ligament cut but was so hoping mine wasnt too badly blemished

 

[Louby]

My friend's wb is currently in rehab following an annular ligament op back in mid July. The instructions from the vet are box rest with in-hand walking and grazing starting at five minutes and slowly building up to an hour over 12 weeks. Best if the hand walking can be split into two sessions. I believe that the walking can be done ridden from them middle of next month but no turnout.

Thank you eggs, great news its going well for your friend. Im a bit yikes at the thought of getting back on my girl without any turnout! The silly sod zapped herself on the electric fence before and has been bucking in her pen, not good! I really do give up and feel theres not much else I can do, bar hobble her to the ground lol. My vet did mention riding further down the line in walk too, there was just too much to take in at the time so I need to quiz him again.

 

[meleeka]

Thank you Muddy Grey, so pleased shes come sound. How is her leg ugly, if you dont mind me asking? I appreciate shes had more than the annular ligament cut but was so hoping mine wasnt too badly blemished

Mine has a normal leg now. Granted he’s a hairy cob so hard to see but his leg was clipped for the op so plenty of time to see it before it all grew back. I suspect the tendon injury is what caused the ‘ugly leg” above.

 

[AandK]

Mine has a normal leg now. Granted he’s a hairy cob so hard to see but his leg was clipped for the op so plenty of time to see it before it all grew back. I suspect the tendon injury is what caused the ‘ugly leg” above.

Same here, my boy's leg looks normal. Puffed up a bit to start with but it settled down after a while.