Ddft injury options - Surgery/Rockley/Field?

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Hi all, sorry this is a bit long, I am looking for some experiences with the above please.

I have a beautiful 7yo mare who was first lame in January last year with no heat/swelling/obvious cause. She came sound after a period of box rest and we carried on working her over the summer (although with hindsight she was never completely happy).

She was lame again in September, box rested, and finally mri’d in October. The mri showed a moderate tear to the ddft from mid pastern down into the foot, and vet advice was further box rest with controlled exercise on the walker and wedges, plus catrophen injections. This was followed until she got fed up with box rest and she’s now out in a small paddock for a few hours a day.

Vet returned yesterday for a check up and, whilst understand tendon issues take time, there’s been very limited improvement and as she’s so young I want to make sure I’m doing everything possible to get her sound, even if only able to hack in the future.

I’ve been looking through old threads etc and have found Rockley - I’ve dropped Nic a text and also forwarded her more details but she’s away for a few more weeks travelling so can’t do a call for a bit.

I’ve also got a second opinion on the mri from a friend who’s a surgeon at newmarket and they think she’d be a good candidate to clean up the tendon via a burscopy. This would most likely be keyhole surgery, 5-10days in hospital, followed by another period of box rest/limited turnout whilst it heals. I have roughly enough left on insurance to cover this but would need to act quickly as my 12m time limit is up in early Feb.

Other option is to simply turn her away for a period and keep everything crossed that time helps.

Does anyone have experience of surgery followed by barefoot/Rockley? Or would you typically try Rockley alone? Really struggling to decide what’s best for her and gives her the greater chance of healing.

Thank you!
 

splashgirl45

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from what you say, i would get the surgery done before your insurance runs out otherwise that option wouldnt be available for you if turning out doesnt work....is your friend a vet surgeon? if so i would go with his option. if not i would get a second opinion from a vet hospital. its a difficult one but as she is only 7 it would be worth doing everything possible if there is a chance she could come right enough to do everything you want to...good luck
 

ester

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Tricky, I'm not aware of anyone having tried the surgery as an option, I know plenty of barefooters who are at least much more sound than they were though they don't all end up perfect.

What is the rehab protocol post surgery?

I would also potentially ask this question on the fb groups barefoot approach to whole horse health group in case anyone there has (group run by Lucy Priory who is a trimmer that used to post on here).
And hoof rehab help which is Pete Ramey's group and has a lot of traffic.

Is she still wedged/what do her feet look like currently?

I presume insurance paying for rockley is going to be out of time anyway so doesn't need considering. Rockley makes some things easier and gives them an accelerated start though it does seem that some then struggle/need some adjustments returning home. It is possible to do the rehab at home in the first instance but probably beneficial to have someone on hand to hand hold when required (I had such a person so even though there were only a couple of minor panics in myself they were resolved fairly quickly).
 
Joined
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Tricky, I'm not aware of anyone having tried the surgery as an option, I know plenty of barefooters who are at least much more sound than they were though they don't all end up perfect.

What is the rehab protocol post surgery?

I would also potentially ask this question on the fb groups barefoot approach to whole horse health group in case anyone there has (group run by Lucy Priory who is a trimmer that used to post on here).
And hoof rehab help which is Pete Ramey's group and has a lot of traffic.

Is she still wedged/what do her feet look like currently?

I presume insurance paying for rockley is going to be out of time anyway so doesn't need considering. Rockley makes some things easier and gives them an accelerated start though it does seem that some then struggle/need some adjustments returning home. It is possible to do the rehab at home in the first instance but probably beneficial to have someone on hand to hand hold when required (I had such a person so even though there were only a couple of minor panics in myself they were resolved fairly quickly).
Thanks very much for both your thoughts - so hard trying to decided what to do!
 
Joined
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Have you read all the Rockley posts about ddft? If not just Google it and read away. It will probably help you make an informed choice. I would always go down the barefoot route. Remedial shoeing and box rest doesn't work. I'm less clued up about surgery but I'd never do it to my own. Whether you send to Rockley or not depends on your facilities at home. Hooning round a big grass field isn't ideal but miles of walking on tracks with varied terrain and roadwork is. If you can replicate this at home (plus the right diet, no trimming, ignoring your vet and farrier and anyone else with 'helpful' advice and using hoof boots if needed), then save the money and do it yourself.
 

ycbm

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First, I know quite a lot about barefoot rehab but I have never heard of one where the tear was from the mid pastern downwards. They are normally inside the foot. Because it extends so far outside the foot, it suggests to me that the cause is less likely to be solely related to the health of the hoof.

Incidentally, it's the one type of injury where I would agree with wedges, to take the tension of the tendon and allow it to heal. Just like someone with an Achilles tendon injury is advised to wear a slightly higher heel for a while.

I know of only one horse that has had the surgery, and it did not recover to its previous level and I'm not sure whether it recovered at all.

But I'm not sure you really have a choice here. It's a severe injury which isn't healing, and you have nothing to lose because your insurance will pay. However, after surgery I would certainly go barefoot. . I hope it works out for you.
 
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My Gelding was diagnosed by MRI at the RVC with a torn DDFT, collateral ligament damage and navicular bursitis in October 2016. We were offered the option of the surgery with the caveat that it had a 50% chance of helping healing but wouldn’t totally mend the tear. My own vet advised against it results were starting to show that it was not effective. He also advised against wedged shoes as they transfer pressure onto other soft tissues and tend to cause more problems with those down the line.
We agreed that barefoot was worth a try and he was supportive of sending the horse to Rockley. I spoke to Nic but she had an 8 to 10 week waiting list so I decided to remove the shoes and start rehabbing him myself.
We didn’t need Rockley in the end because I did all the work myself through daily walking in hand on different surfaces. He was so much sounder pretty much straight away, his posture changed as he relaxed and he became much less spooky and sharp. After 6 months he was able to start ridden work and has been back in work ever since.
I have also done a lot of straightness training and groundwork with him to help him strengthen his core and lift off his forehand. All the trainers that knew him before went lame have commented how much stronger, straighter and sounder he looks now.
 

ycbm

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How high did the tear go, PD? Your result is pretty normal for ddft damage inside the foot, though congrats on achieving it by yourself.
 
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How high did the tear go, PD? Your result is pretty normal for ddft damage inside the foot, though congrats on achieving it by yourself.
It was in the foot at the point where the DDFT passes the navicular bone. It had probably been there for a while before he went totally lame as there was granulated scar tissue and fibres attached to the navicular bursar that were rubbing the tear and preventing healing.
The surgery was offered to debride the scar tissue and fibres to try and help the tendon heal, however the consultant made the point that there was only a 50% chance of it working at best and the long term prognosis for the horse returning to work was poor.
 

MDB

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My mare had a suspected DDFT tear although it was not confirmed on scans. She was lame in the field for a good 5 to 6 months although continued to slowly (very slowly) improve during this time. She lives out 24.7 so we decided to just give it time and leave her be. She was field sound by about 7 months but I gave her another 10 months off riding, because I tried riding her at a gentle walk and she just didn't feel right, although it was nothing obvious, but my gut said she needed a lot more time. She is back to riding now after 18 months of being left alone in the field and 3 months gradual build up. 21 months in total so far but it is going well. Edit to add she is barefoot.
 
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Have you x-rayed her feet?

I committed to barefoot life when my mare at age 5-7 kept having recurring lameness as well. We would x-ray, find a negative palmar angle, add mechanics to the shoe, come sound, then go lame again for nearly 3 years. Finally I got sick of it and had an MRI and a chat with a US equine podiatrist, as she was also having DDFT issues that related to the crushed heels. I ended up taking the shoes off and rehabbing her slowly. (It will take time, it was 3 mos before she was fully sound walking over all surface, and another few months before I could ride anywhere except a sand arena.) It's also a learning curve- my farrier said my horse "wouldn't grow heel" but what it was is she had grown SO MUCH heel that it folded, and the actual buttress was well out in front of the cannon bone. it would be like lifting your toes off the ground and walking on your heels all day- I was only shocked she wasn't lamer sooner.

I will say that if you have crushed heels, NPA type issues that you think are contributing to the DDFT issue, taking the shoes off is the "fastest" way to allow the foot to correct itself over time, and for me it's been the best long term solution. After a year I was able to compete in showjumping and do everything I could do before when she had shoes. Three years on, and I have had ONE abscess- finally almost NO FOOT RELATED LAMENESS. I'm super happy with it.

When you talk to Nic you'll find out that just taking the shoes off isn't enough. THere's things like working out the diet, and keeping them in work (you can't just ride for an hour once a week and then take them out hunting without making them sore without shoes- not that you should do that with shod horses either, but you have to continuously condition the feet with work to keep performance up)... but that all comes in time.
 
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