Collateral Ligament Damage

[Amy_08]

My mare has been back and forth to the vets since November with her LH. Between Nov and Jan she was on box rest for a hairline fracture of the cannon bone.

After this she still wasn't right with intermittent swelling around the fetlock and heat down the back of the leg. She was sound trotting up and on the lunge but was 2/10ths lame on flexion at the beginning of Jan then sound on flexion at the end of Jan. Vet scanned and found low grade tendonitis of the SFT. She's been on walking work since and a couple of hours turnout a day, not restricted. Went back today for rescan and tendonitis looking much better. Vet saw her on the lunge again today and trotting up and she was sound. He did flexion and she was crippled. Her leg was shaking when he was holding it up and when he let go she could barely weight bear. It was horrible to watch and we all stood there with our mouthes open as not what we were expecting.

Vet nerve blocked the fetlock joint, coffin and pastern. No change with the fetlock and coffin joints but 80% better when he did the pastern. He xrayed from the fetlock down and the foot, nothing. He said he could scan the collateral ligaments although he wouldn't be able to see much or down into the foot and for this she would need an MRI, but I wanted some idea of what we were dealing with so he did it. He said there was definately damage to the ligaments and that it didn't look good, but that he couldn't see the DDFT or into the foot so he couldn't see how far down it went and if it got worse. So now I am panicking. Everything I have read about collateral ligament damage doesn't look positive.

Vet has told me to keep walking her out as I have been riding her for the past 5 weeks, but to not turn her out. Now everything I have read has said box rest, so am in two minds as to what to do. I will be looking to get an MRI scan done asap anyway so I will have some idea what is wrong.

Any experiences/advice?

 

[misst]

MRI is definitely the way to go.

I cannot really give any positive experience of CL damage - lost one and had to retire one due to this but others have had more luck. Interestingly our vet scanned our lads as an experiment after his diagnosis to see if he could see anything as traditionally they are not seen on normal scanning. He could see thickening and changes but like yours not much else. He did it more for the interest of having a comparision for people who perhaps were not insured for MRI so we agreed if it would help someone else.

I have always understood rest, foot balance and restricted turnout to be the main treatments with no riding for a long time.

I saw you asked the cost of MRI and ours was covered by insurance but was just over £1000 at Liphook 3 years ago. I think it may even be cheaper now. Previously we had one done at the AHT when they were "new" for horses and they were done under a GA that was more than double the price.

Good luck x

 

[Amy_08]

Thanks Misst. Yes I wasn't entirely convinced with the scanning idea but the fact that he saw something has at least given me an idea of what I'm dealing with, so helpful in that way.

I think I'm going to ring around tomorrow and get some quotes. Liphook would be easiest as its close, but I am on a budget

And thank you, I think we will be needing the luck

 

[misst]

If you are not insured let Liphook know straight away. I got the impression that they might have an "insurance" and an "uninsured" price - might be wrong but just got that impression! They were very nice and our stressy lad was fine there. It is horrible isnt it not knowing what is happening, that sick feeling in your stomach.
Thinking of you x

 

[Amy_08]

Thanks she is insured but we will not be far off the 5k limit now, so may have to put money into it myself, so will mention this.

I know, I just keep thinking is this the end and then crying-LOL

My vet didn't sound very positive.

 

[misst]

Oh dont give up yet - the MRI may show no damage and your vet may be wrong, at least you will know. Our lad is paddock sound and very very happy and although he is an expensive paddock ornament he can still make us smile. It is very hard giving up those hopes and dreams though.
I hope you have some good news that you can work with. Keep us updated and I know there will be loads of support for you on here - we should form a club there are so many of us!

 

[cellie]

Hi just read your posts and have had experience of same thing.I exhausted my insurance my horse had lots of issues along with collateral and I decided it was in his best interests to retire as companion cant say I have ever gotten over it.My yard wasnt really suitable for turning away so I placed him in lovely home.The good news being that he is managing small hacks out and little trot work.He is barefoot which is unbelievable as he was very footy ex racer.He was 8 so wanted to give him chance of long recovery recuperation period,it looks like he might be more comfortable as light hack .I dont know what your dreams were but I settled on his quality of life rather than my ambition.
I have heard that stem cell could be way forward maybe you could ask your vet.I wish you lots of luck x

 

[Lainey123]

My boy Bailey is 8 and has a lateral collateral ligament strain to his near fore, it was diagnosed with MRI at Liphook. He has been on box rest sinse last July and has had IRAP therapy, he is now on controlled exercise and is sound. It has been a rather emotional year and I have had setbacks and loads of tears. No turnout and complete boxrest with controlled exercise is the key, there is a study that i read done and the ones that had best chance of recovery were the ones that went down this route. My boy also had natural balance PLR (performance leverage reduction) shoes which are designed with this injury in mind. Good luck, I take each day at a time and hope that he will come right. I did read about a horse in horse and hound a few weeks ago with severe collateral ligament damage that has come right so there is hope out there, and there are alot of us with this injury.xxxxxxxxxx

 

[Ludi-doodi]

My lad did his n/s fore in 2006. He had an arthoscopy to clean out the joint, knee high cast on for 3 weeks, another 3 weeks in a fetlock high cast and 4 months box rest before coming into walk work. By 6 months he was fairly sound on the straight but not on a circle. Three or 4 sessions of IRAP and he was completely sound. It took a year in total but ridden work from 5-ish months. He did his hind suspensories this year, but vet said front end was completely sound. CL damage is not all doom and gloom so keep your spirits up.

 

[Izzwizz]

M mare hasnt got the same injury as your horse but we did have MRI scans and they are definitely the way to go. She has a tear in her DDFT deep within her hoof and we wouldnt have known what was wrong if she hadnt had the scan. Im with NFU and they cover half the cost, the first scan cost me £512.91 and the re-scan £300.98 which is half of the cost.

Hope your horse comes right, its worrying isnt it x

 

[Darkly_Dreaming_Dex]

Link to my recent post on this inc MRI pictures:
http://www.horseandhound.co.uk/forums/showthread.php?t=356979

Last year Jacob had arthroscopy which went well,they removed a tiny bone chip and tidied the cartilage on the coffin joint.
Previously he had IRAP,Adequan,Cartrophen,Steroids,Various types of shoes and barefoot- still not sound
we did an MRI at RVC which was the cheapest bearing in mind we are well past the insurance money limit..

 

[smac]

I have had two experiences with the collateral ligament.

The first was our jumping pony, owned her 8years and she had never had a lame day, she was on loan, went lame and was buted on and off for 5mnths before I found out. I had my vet out who said 99% sure on ligament (scanned and xrayed) only way to be 100% was to MRI but she was almost 20, insurance were never gonna pay, and treatment would be the same, 6-9mnths box rest. I had similar issue as someone above, she barely coped stabled overnight so the thought of 6mnths+ terrified me. Vet agreed and said best option was 9-12mnths turn out (big field pure rest, idealy on a slight hill) we went for this option. 11mnths on a friend started pottering out on her, 6mnths of quiet hacking her kids started riding her. She now does pony club, back doing lower BSJA and is sound. Went lame 4yrs ago, she is 23 this year.

Other horse has been on and off lame since Sept 2008. he was sound one day, lame next. Chip was diagnosed on pedal, box rest etc, came back into work with egg bars and was even worse soundness wise. After chat with vet decided to turn him out for 4mnths. Came back in walking sound, then about to start trotting and got hit by car! so hampered for about 4months on off work (walk and trot) allowed to start canter work and next day fell in field, went through a fence and into the ditch (grr- watched him do it stupid horse!) anyway 3hrs later 12firemen pull him out and vet and phyiso get to work! 3months building back up to trot, he goes lame in front again.

Vet sends us off to Bell Equine in Kent (lovely place) for MRI (£1364) dropped him off in morning and had a lovely day in Kent with the dogs and OH, 6hrs later took him home. On my doormat barely 48hr later is the report. Amongst a few other stress injuries is collateral damage to front feet.

Report is in front of me at mo- They recommened "a period of box rest with limited hand walking for 4-5mnths" then should be re-evaluated. Farriery options should be discussed, "other treatments that may be considered for the collateral ligament desmitis include
- Extra corporeal shockwave therapy
-IRAP therapy of the DIP joint
- Foot casting
It then goes on to say that "it must be recognised that none of these treatments have proven efficacy..."
My vets opinion was that none of the above were werth the money, as none are proven, and so we decided to let mother nature have a go. He was turned out in Oct and is coming home next week (so excited!!) I havent seen him in that time but the people who have him say he is trotting round very well at mo (and they have dry ground) Plan is to walk him for 6weeks and then see what happens, complete with special shoes. Watch this space.


Best of luck with you pony, I have leant the hard way that if mother nature can't heal it, modern veterinary hasn't got a chance. If payment maybe a problem, best to avoid Liphook as they require payment upfront. Bell and Rossdale will invoice at a later date.
Sorry VERY VERY long, mini eggs available if anyone still up?!

 

[criso]

OK my experience.

Had Frankie MRI’d (Bell Equine too) about 18 months ago now. Came back with slight damage to Collateral Ligament, DSIL and DDFT to both feet. Vet had suspected soft tissue damage. Recommendations very similar to SMAC.

He had extensive box rest followed by very careful bringing back into work. Cartrophen injections and joint supplements. Shoeing and foot balance were key. It seemed to be going OK ish in that he was coping with light hacking and schooling but he was not 100% sound when trotted on a small circle on hard standing,. Then towards the end of last year he starting going consistently lame on the front right. This was made worse when I turned him out and he hooned around even on a good surface like a sandschool and would hobble in on 3 legs but he’s a horse that hates being shut up and I wasn’t prepared to keep him in all the time.

So I heard about a project that is rehabbing horses with his sort of problem barefoot and at the beginning of Feb I send him off down to Rockley Farm on Exmoor and fingers crossed so far it seems to be working.
He’s barefoot and sound in walk and trot and lives out so I’m already ahead of where I was in January and there is talk of him coming back into full work and jumping which I am trying not to get too excited about.

Sending him away worked for me not only because of the previous expertise in rehabbing horses with his condition but with a full time job and a standard livery yard, I do not have the time and facilities to take him through the initial stages. He’s a tb and has been shod since before he was 2, he has flat feet and underrun, contracted heels so not the sort of horse you would immediately think of taking barefoot. I should say had because his heels and frogs have improved beyond recognition.

When he was first diagnosed my vet said it was very difficult to predict an outcome and that he had seen horses with bad tears come sound and other with very mild damage never come sound.

I do wonder if horse with relatively mild damage like Frankie, are the result of constant slight pressure on the tissues which unless you address the underlying cause never get a chance to recover whereas a bad tear could be the result of a one off traumatic event which once it’s healed is less likely to reoccur but that’s just a thought from a completely unqualified person.

So after all it’s looking a lot more positive that it did 6 months ago. If you go to http://rockleyfarm.blogspot.com/ and do a search on Frankie you can find footage of him.

Sorry didn't mean this to be so long.

 

[smac]

Hey criso, thats interesting about Frankie, and his bare feet. I had a brief chat with my farrier today for when my boy comes home, being ISH he has quite good feet so plan was to leave him barefoot behind anyway. I agree with what you say in regard slight pressure on tissues as apposed to a tear, which I think is difference between my two horses.

I may ring the people at Rockley Farm for a discussion, I would be happy just to keep him going as he is only 8 and we have had him since he was 3 so we broke him etc, would hate to see him waste away.

I think I understand there point its not about "trimming" but managing the horse and his individual way of going...?! Could I please ask, what was your vets opinion on the rehab project?! and when you bring him home, who continues the care of his feet?!

 

[criso]

@smac I was going to pm you then I though this might help other people.

It was a relatively easy decision to make, he would have good and bad phases but look how lame he was when I sent him down.

http://rockleyfarm.blogspot.com/2010/03/more-rehab-footage.html

My vet was a bit sceptical but he did refer us, he hoped it would work but was not convinced it will. The prices compared really well to part livery in Herts so the only downside was how much I would miss my boy. I do go and visit about every 3 weeks and ride of course.

And some more clips of his progress. The ridden clip was at the beginning of March and the first time he had been ridden since Jan. We are now just over 8 weeks in and he's improving all the time.

http://rockleyfarm.blogspot.com/2010_02_01_archive.html

http://rockleyfarm.blogspot.com/2010/03/rehab-updates.html

Give Nic Barker at Rockley a call or email, you're not committing yourself and a chat won't hurt. It's not like you even have to decide at once, I mulled it over for a couple of months first as he was going through a good patch.

As for when he gets back, well I'll have to keep the work up over a variety or surfaces, I was already trying to feed him a forage based, sugar free diet so no huge changes there and I will need to be careful with grass so will turn him out at night in the summer. He will need minimal trimming from time to time so need to get someone to do that.

Good luck

Cristina

 

[shirley123]

hi Amy
i would just like to be aware that sometimes damage collateral ligaments can get better, although not as good as new ! But my horse is still sound and competing in dressage, showing two years after damaging his - medial in one front hoof and the lateral in the other . it was diagnoised via M.R.I. i realise that i am one of the lucky ones and 'god' knows how long my luck will last, but don't give up make sure that you do all your rehab correctly (it took me 12mths and i suffered lots of stress and nearly got killed - i won't pretend it was easy) and take plenty of time over it. Having said that i will never risk jumping my horse again, have become 'miss paranoid' i am very careful over foot balance and not letting him become over weight. good luck x

 

[ofcourseyoucan]

well MRI is expensive and only a diagnostic tool. mother nature is your best bet esp if at the top of your insurance limit. (and going to get an exclusion anyhow) so i would take its shoes off rough off into a field, keep feet very well trimmed and balanced (every 6 weeks) and leave be for 12 months! as to bringing back into work well you cant beat the old school of walking for 6 to 8 weeks then introducing trot, and make sure you do the pavement pounding! a walker is fine for the structurally sound but is not the answer for any horse with joint or tendon or ligament problems! and keep him on the light side of light!!! best of luck

 

[Darkly_Dreaming_Dex]

well MRI is expensive and only a diagnostic tool. mother nature is your best bet esp if at the top of your insurance limit. (and going to get an exclusion anyhow) so i would take its shoes off rough off into a field, keep feet very well trimmed and balanced (every 6 weeks) and leave be for 12 months! as to bringing back into work well you cant beat the old school of walking for 6 to 8 weeks then introducing trot, and make sure you do the pavement pounding! a walker is fine for the structurally sound but is not the answer for any horse with joint or tendon or ligament problems! and keep him on the light side of light!!! best of luck

WE have done this for 2 years with Jacob and he is still lame he came "sound" after the first year and was very slowly rehabbed but went lame after 6 weeks gentle work so went back out in the field for another 9 months. He has also developed a box foot where he isnt bearing weight evenly

 

[ofcourseyoucan]

Darkly dreaming dex why had he developed a box foot? i would ask your farrier? sadly the minimum do become knackers but the majority do come sound to do a job! and yiu need a fabby farrier!

 

[ofcourseyoucan]

and a box foot doesnt equal lame! you just cant shoe the fronts as a pair! get a farrier to assess and shoe and balance as req(each foot in its entirety)

 

[Darkly_Dreaming_Dex]

Darkly dreaming dex why had he developed a box foot? i would ask your farrier? sadly the minimum do become knackers but the majority do come sound to do a job! and yiu need a fabby farrier!

He leans away from his bad foot- almost pointing it. this lack of blood flow has caused the foot to contract and over the last 2 years has become increasingly small/boxy. the other fore has spread considerably.Jacob is not overweight but being clydesdale X is a heavy breed.

I have an excellent farrier who trained with these brothers:
http://www.forgeandfarrier.co.uk/shoeingaroundcoffinjoint.htm
He is fond of barefoot trimming and has disuaded me from trying more shoes on Jacob so i do trust him PLUS when Jacob was at Lambourn last year and RVC this year, both said how well balanced his feet were. I wish he did have cr*p feet and a cr*p farrier as that would give me something to improve but both seem superb"=

PS thanks for calling my horse "knacker" i have tried EVERYTHING including Adequan,Steroids,Cartrophen,IRAP and an arthroscopy operation.Its not for want of trying..We have spent £3000 of our own money ontop of the insurance and he has been to 2 different horsepitals.He may be a hopeless case but we adore him and would do anything to get him right.

Charming

 

[Lainey123]

PS thanks for calling my horse "knacker" i have tried EVERYTHING including Adequan,Steroids,Cartrophen,IRAP and an arthroscopy operation.Its not for want of trying..We have spent £3000 of our own money ontop of the insurance and he has been to 2 different horsepitals.He may be a hopeless case but we adore him and would do anything to get him right.

Charming

I felt a bit sick to the stomach after reading that too. :-(

 

[shirley123]

yes for your horse to called a 'knacker' when you are experiencing this emotional rollercoaster is the last thing you need. Most of us love our horses dearly and would do anything to have them well and sound again. The thing with this and other ligament injuries as in my case was my horse looked fantastic - in coat and general condition, he's a quality horse with that look at me quality/pressence - till lame had alot of potential and even when lame was quite 'up' for showing off and strutting his stuff. It's very hard to deal with, but we have to try.

 

[criso]

@darkly_Dreaming_Dex
I do sympathise, we didn't try as quite as many things with Frankie (didn't do IRAP or adequan) but the history sounds familiar. I too spent the best part of a year box resting and bringing him gently into work but he wasn't staying sound.
I'd sort of given up when I sent him off to rehab but he's a lively horse in the field and I wasn't prepared to keep in him for 23 hours so I could ride him in walk for 1. He hates being in. Plus as I said the rehab livery was less than my part livery so it's not cost me anything.

I'd got to the stage where it felt like I was going to have to make the worst sort of decision but fingers crossed he doing well in rehab and there is talk of jumping him.

The foot shape thing is interesting too. Frankie has alway had one foot that flatter, one that's more boxy. When he was lame he would go lame on one foot at a time. Depending on which foot it was I got lots of theories from vets and farriers about that.
In the end the MRI showed identical damage in both feet.

 

[Marchtime]

ofcourseyoucan that wasn't a very thoughtful reply and made me very angry.
I'm misst's daughter (see her replies above). Like Darkly Dreaming Dex we tried so many things over a period of two years and Jesper came sound initially but never stayed sound for longer than eight weeks. We spent a year battling and trying everything with the vets assistance but in February last year I accepted it was time to call it a day. We have a very good farrier but unfortunately these things do seem to come down to luck. Our vet advised we could carry on and that there were many people who would continue to work him as he's only 1/10th lame but to me that still means he's in pain. Since retiring he's put on condition and is happier than ever so I have no doubt it was the right decision.
It's heart breaking to lose all your dreams and have your ambitions crushed but I count myself lucky to still have him and would certainly never refer to him as a 'knacker'.
Darkly Dreaming Dex - your horse is very lucky to have such a caring owner.

 

[brodiefender]

my bay mare brodie, has damaged her deep digital flexor tendon, its horrible! she is such a lovely pony and has always done everything i have asked. after 8 months of scans, operations staying at leahurst we have been told she will not be ridden again i am absolutally gutted she is still my baby though and now finally after all this time we have been told she is alowed out in the feild, she was looking very depressed in her stable and was very bored! i love her though and she will always be my baby!