Bone fragments in tendon and shockwave therapy - any experience?

Ravenwood

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I took my mare to an Equine Hospital yesterday for a full lameness diagnosis. The result being that she has bone fragments within the core of a ligament. At some point the ligament attachment has torn from the bone, creating fragments which have travelled up the ligament. The largest part that was found via ultrasound scanning is in her pastern.

The vet said that the only option to try was three sessions of shockwave therapy, 3 months box rest and another 6 months rest - but with only a 20/30% chance of recovery.

She is 17 yrs old and is in fabulous condition, all her joints are 100% clean and she is a very active/on the go type mare.

This is a very unusual injury but does anyone have any experience of this?

I'm very upset and don't know what to do. It was upsetting to see her bucking and leaping on the lunge once she had been nerve blocked - as if she felt a million dollars to be free from pain :(

There are a lot of questions I have thought of since yesterday - such as has the tear healed/will it create more bone fragments? Will the bone fragment continue to move?

And I have to say that box rest would be a nightmare - she is with just one other horse on a farm (not a large bustling yard with lots of activity) and she wouldn't be able to see the other horse from a stable. Plus whether I would find a supply of hay for the next three months I just don't know.

I would really appreciate any thoughts whatsoever.
 
Gosh, poor mare- sounds unusual and painful.

Personally, if she's not too active in the field, I'd be tempted to field rest her instead of box rest and go for the shockwave along with bute. Sounds like it's worth a try but you may not get her sound again, you could re-assess 3 months down the line.
Is she insured?
 
Thanks The Mule - she has already had 4/5 months field rest. The vet said that this proves that thats not enough :(

She is not insured but I am able to cover the costs.

I am really worried about the box rest because I work full time so during the week I would only be able to see her for half an hour at 6 in the morning and not again until 6 in the evening, and then not for very long - its not really good enough.

The lady at the farm is there 24/7 and she has had horses all her life but is elderly now and although she would be very happy to give her a pat and an apple over the stable door I wouldn't dream of asking her to do anything else.

Its such a nightmare :(
 
I was not sure from your post if she is in permanent pain or just when worked? If she could retire to the field with some bute would that be a compromise for you? I know she would not be useable and it is not a long term solution but it might give her a few years with the sun on her back if you do not want to part with her yet. I agree that box rest with uncertain outcome is probably not really fair. Good luck.
 
My old event mare had a very similar injury - she popped up what we thought were windgalls after a sticky cross country round, and 2 years, 2 seasons of BE and numerous intermittant, minor lamenesses later, she was finally diagnosed with a tiny hole in the deep flexor tendon and the windgalls were actually bone fragment and tendon fluid. We were given a similar option, surgery to improve her quality of life and a 30% chance she'd come back to any sort of ridden work.

Before we knew this we'd actually had the 'windgalls' drained and for 3 months she was INCREDIBLE, having always had a tendency to get underneath fences she was so bold and brave, and we were unbelievably excited about the eventing season! She sadly broke down at the end of her first BE of the season, having jumped a brilliant double clear, and that was when we decided to get it thoroughly investigated at Newmarket.

She wouldn't tolerate box rest AT ALL, we tried once for 3 days and she coliced, but the decision was made when my nutty alpha mare, who always galloped off across the field as soon as her headcollar came off, started to canter and then pull up in pain. Sorry to say we pts.

I'm sorry I can't give you a more positive response! It's such a rare injury, and for my mare retiring to the field wasn't an option, she thrived on going out and jumping and being involved. You know your horse better than the vets, so one day you'll realise you know what is the right thing to do
 
I was not sure from your post if she is in permanent pain or just when worked? If she could retire to the field with some bute would that be a compromise for you? I know she would not be useable and it is not a long term solution but it might give her a few years with the sun on her back if you do not want to part with her yet. I agree that box rest with uncertain outcome is probably not really fair. Good luck.

When she is just mooching about round the field you wouldn't even really notice and the fact that she in such great shape tells me that she can't be in that much pain as otherwise she would start to look ropey. She is perfectly happy in the field but she will have a sudden burst and canter around trying to wind up her friend :rolleyes:

But yes, complete retirement is the other option. And this is what I will do if the box rest is a no go until the right time comes :(
 
My old event mare had a very similar injury - she popped up what we thought were windgalls after a sticky cross country round, and 2 years, 2 seasons of BE and numerous intermittant, minor lamenesses later, she was finally diagnosed with a tiny hole in the deep flexor tendon and the windgalls were actually bone fragment and tendon fluid. We were given a similar option, surgery to improve her quality of life and a 30% chance she'd come back to any sort of ridden work.

Before we knew this we'd actually had the 'windgalls' drained and for 3 months she was INCREDIBLE, having always had a tendency to get underneath fences she was so bold and brave, and we were unbelievably excited about the eventing season! She sadly broke down at the end of her first BE of the season, having jumped a brilliant double clear, and that was when we decided to get it thoroughly investigated at Newmarket.

She wouldn't tolerate box rest AT ALL, we tried once for 3 days and she coliced, but the decision was made when my nutty alpha mare, who always galloped off across the field as soon as her headcollar came off, started to canter and then pull up in pain. Sorry to say we pts.

I'm sorry I can't give you a more positive response! It's such a rare injury, and for my mare retiring to the field wasn't an option, she thrived on going out and jumping and being involved. You know your horse better than the vets, so one day you'll realise you know what is the right thing to do

Thank you so much for your reply. I am sorry you lost your mare :(

They didn't offer me the option of surgery.

My mare is also bored stiff - she too is an active/on the go sort but she does look incredibly well at the moment. Three months of box rest with such a poor recovery percentage sounds like torture to me.

I have today though sourced a supply of hay and straw - if I decide to go down that route.
 
If she looks happy then she probably is happy:) Our lad had a year in the field on retirement and was pretty much sound 100% of the time. Like yours he had the odd hoon around but looked well and was relaxed and had no colic (he suffered a lot from spasmodic episodes several times a year). Suddenly one day he went very lame and looked very sad. That was the end. But the change was obvious and I am so glad we gave him the time to relax.
I hope your mare comes right for you though in the end.
 
If my vet only gave me a 30% chance of recovery even after the box rest, I would have the shock wave therapy, and keep her turned out, in a smallish pen/paddock. Fence it imaginitively, so she will find it hard to get a gallop on. Just leave her out. If she comes sound in 9 months, great, if she doesn't, it wasn't meant to be, at least she won't have had the torture of 3 months box rest. You could try giving her a mild sedative in the early days ?
 
If my vet only gave me a 30% chance of recovery even after the box rest, I would have the shock wave therapy, and keep her turned out, in a smallish pen/paddock. Fence it imaginitively, so she will find it hard to get a gallop on. Just leave her out. If she comes sound in 9 months, great, if she doesn't, it wasn't meant to be, at least she won't have had the torture of 3 months box rest.

Yep - completely agree with this great advice.
 
Thanks BigRed and Amymay

I really appreciate everyone replying.

Her field is very big but quite long and narrow so I could easily section it off and move the sections down over time - this probably sounds like the best bet. All food for thought.
 
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