DDFT Injury

[JMacEquestrian]

Has anyone in this group successfully rehabbed a horse from a DDFT injury? My mare had a pretty severe one back in March 2022. One lesion to her SDFT and multiple lesions to her DDFT across her pastern. One "substantial" to the right lobe of the DDFT in the pastern. She was on stall rest for a month before we figured out what it was. She then spent the past 5 months at a rehab facility and on stall rest. She had minimal hand-walking twice a day and grazing. In June she started handwalking 10 min 2x a day, then 15 min 2x a day in July. Her last month there I paid for her to do the treadmill, but it was only 5 min 2x a day to start, then she did 15 min 2x a day for the last week there. While there she got 2 months of a class IV laser, 4 shockwave treatments, and 6 alpha2eq injections during this time. I just brought her home (to a very quiet barn) September 1. She gets hand-walked and grazed 2x a day. I've had great Vets and farriers to help and guide, but I've been doing my own research since she's been home and I have very little faith in her coming back. She will basically have scar tissue across her whole pastern area. Her next ultrasound is the end of October. I hate that she has been on stall rest for 6+ months. It will have been 8 months when she gets her next scan. I know that tendons usually take a year to heal, but if hers is all across her pastern I don't see how she'll ever jump again. If she can't handle trotting or cantering a little bit in a paddock, then how will it every be stable? I also feel like this long on stall rest is just torture for a horse. I really want to put her out in a small paddock (with a sedative) and start getting her outside again. She does get trazadone twice a day and ace if she seems too up to walk without being crazy. Would love input from anyone who has rehabbed one of these injuries. I care more about her quality of life than I do about the possibility of her showing again. Please feel free to message me too. Thanks in advance!!

 

[HelenBack]

I don't know but I'd be interested in hearing about other people's experiences. I guess it depends on the nature and extent of the injury and how well healing occurs but it does sound like quite a serious injury form what you've said. Have the vets not given you any prognosis at all? Have that also not given you a timeframe for when you'll be able to start turning her out again? I know protocols vary widely across vets and depending on the injury but back in the old days horses seemed to spend some time on box rest and then go out into the field for several months to finish healing on their own.

As I understand it from my physio tendons need movement to heal but it needs to be controlled movement and not the pratting about type of movement that horses like to do. She said that stall rest stops them mucking about but then the tendon heals weaker and is more prone to reinjury. I think the stall rest with hand walking is the best attempt at stopping them doing stupid things but giving them the movement to heal. They've got to get to a point where they can live in a field at some point though haven't they?

My old horse did injure his tendons many years ago but higher up in the back of his leg. He did three months box rest with in hand walking but I could take him for much longer than you've been allowed to and then we were told to turn him away for nine months. He just did a day in the paddock and then straight into the big field and he wasn't a stupid horse but I can't imagine he was an angel all the time either. He ended up being out for a couple of years in the end due to other stuff I had going on. I did bring him back into work for several years and the tendon stood up to it but he was older by then so we just went hacking. That did involve galloping and the odd jump for pleasure though. It was a long time ago though and I don't know how bad the injury was but you could see the scar tissue to look at it.

I don't know if that's vaguely helpful at all but I thought I'd share my experience anyway. I do know of other cases where the outcome has been less favourable though sadly.

 

[Cragrat]

You really have put alot into her rehab so far!

Luckliy, so far, no direct experience of this particular injury, but just wanted to say I really feel for you. It is such a dilemma as you say - and different vets will have different opinions. My motto for tendon stuff now tends to be based on 'chuck'm out and look again in 6 months', though I would use ice-vibe and arc-equine, especially in the first couple of months. I think more and more research, including in human athletes, points towards movement allowing a stronger repair - but as HB says, you can tell a human not to be stupid and over do it! My theory is that by avoiding the box rest, you avoid that stage where they've been boxed up for months and need drugging to go out - which makes them less in control of their bodies And turn out is nicer for them.

HOWEVER,your horse has done ALOT of damage, and you have have come this far.... what does the vet say about increasing the hand walking? I would now want MILES of hand walking before I dared turnout, to get not only the damaged tissue, but all the other supporting tissue, as strong as possible. Perhaps you can build up to ride and lead IF you think it can be done safely?

good luck!

 

[PinkvSantaboots]

My mare had a similar injury had lots of scar tissue in the pastern area I tried 3 times to get her sound, basically once I upped the work beyond walk she just went lame again.

After the 3rd stint of box rest and careful rehab I gave up and retired her she was 14 so not a great outcome from me I'm afraid ?

Vet told me that the problem with scar tissue is it is weak and its a vicious circle of each time it breaks down it creates more and it just gets weaker.

She wasn't a candidate for any sort of stem cell because of it and he said steroids could maybe have helped, unfortunately she had cushings and ems so I didn't risk it.

 

[JMacEquestrian]

My mare had a similar injury had lots of scar tissue in the pastern area I tried 3 times to get her sound, basically once I upped the work beyond walk she just went lame again.

After the 3rd stint of box rest and careful rehab I gave up and retired her she was 14 so not a great outcome from me I'm afraid ?

Vet told me that the problem with scar tissue is it is weak and its a vicious circle of each time it breaks down it creates more and it just gets weaker.

She wasn't a candidate for any sort of stem cell because of it and he said steroids could maybe have helped, unfortunately she had cushings and ems so I didn't risk it.

That is my fear... the scar tissue in that area is so concerning. A horse coming off a fence feels the whole impact in their pastern. She is also a cute mover at the trot and flicks her toes, which, again, is all pastern movment. I just don't see how it could possibly be strong enough for her to do any serious work.... also, 6 months of stall rest and at most 40 min a day of hand-walking isn't exactly getting that area moving and supple.

 

[PinkvSantaboots]

That is my fear... the scar tissue in that area is so concerning. A horse coming off a fence feels the whole impact in their pastern. She is also a cute mover at the trot and flicks her toes, which, again, is all pastern movment. I just don't see how it could possibly be strong enough for her to do any serious work.... also, 6 months of stall rest and at most 40 min a day of hand-walking isn't exactly getting that area moving and supple.

I don't know if there is any other procedure they can do now for this type of thing as my experience of it was in 2013 so a long time ago.

It might be worth looking into it with your vet or maybe speak to a specialist at one of the big equine hospitals.

It's just so disheartening when you work so hard on the rehab and it doesn't work, my vet actually thought my horses injury was fairly old because of the amount of scar tissue so she probably initially did it before I bought her, I know she had a BSJA record and jumped a fair bit all over Europe before I got her.

I don't know if it is a common injury for horses that jump but it certainly looks like it could be.

 

[JMacEquestrian]

I don't know if there is any other procedure they can do now for this type of thing as my experience of it was in 2013 so a long time ago.

It might be worth looking into it with your vet or maybe speak to a specialist at one of the big equine hospitals.

It's just so disheartening when you work so hard on the rehab and it doesn't work, my vet actually thought my horses injury was fairly old because of the amount of scar tissue so she probably initially did it before I bought her, I know she had a BSJA record and jumped a fair bit all over Europe before I got her.

I don't know if it is a common injury for horses that jump but it certainly looks like it could be.

The last I spoke to her vet was before I brought her home and he said the injury was still pretty bad. I sent her ultrasound scans to the new vet and he said he was "surprised it is still this bad"... which really doesn't give me hope. The alpha2Eq injections that she got are similar to PRP. The way the vet described it, it's actually a step up from that. The laser treatments helped the most, and the shockwave therapy too. At this point it has really come down to cost. There was just no way I could afford to keep her at the rehab facility... and now, having the feeling that she may never recover fully, it seems like I'm keeping her on stall rest for a tiny ray of hope that she could be ridden again there really isn't any other treatment I can do for her. It did not qualify for surgery (she had MRI, multiple ultrasounds, and tenoscopies done... so I feel they should have a pretty good idea of how bad the damage is). She had no previous scar tissue in the area... and I didn't jump her bigger than 2 foot. The vet at the rehab barn said that this is usually seen in eventers or big jumpers. So, it really doesn't fit with what I was doing with her. I just came out one day and she was 3-legged lame and no one had any idea what happened... she also had an earplug in one ear and I never rode her in ear plugs... Needless to say I removed her from that barn as soon as I could, but the damage was already done.

 

[JMacEquestrian]

You really have put alot into her rehab so far!

Luckliy, so far, no direct experience of this particular injury, but just wanted to say I really feel for you. It is such a dilemma as you say - and different vets will have different opinions. My motto for tendon stuff now tends to be based on 'chuck'm out and look again in 6 months', though I would use ice-vibe and arc-equine, especially in the first couple of months. I think more and more research, including in human athletes, points towards movement allowing a stronger repair - but as HB says, you can tell a human not to be stupid and over do it! My theory is that by avoiding the box rest, you avoid that stage where they've been boxed up for months and need drugging to go out - which makes them less in control of their bodies And turn out is nicer for them.

HOWEVER,your horse has done ALOT of damage, and you have have come this far.... what does the vet say about increasing the hand walking? I would now want MILES of hand walking before I dared turnout, to get not only the damaged tissue, but all the other supporting tissue, as strong as possible. Perhaps you can build up to ride and lead IF you think it can be done safely?

good luck!

Thank you! Yes, it is for sure a dilemma. We did everything that my insurance covered in the 5 months that she spent at the rehab facility. It is a top-notch place and she received phenomenal care... most of the horses there are very expensive and can afford to be there for way longer than I could. I had only planned on her being there for 1-2 months max and ended up doing 5. When I brought her home, it was against the advice of the vet and rehab barn owner, but I just couldn't afford it anymore. I have put absolutely everything into her recovery. Her next ultrasound is Oct 26. So, I am very impatiently waiting until then... but now seeing her in person every day, it is so much harder to be ok with the stall rest aspect. She does ok hand-walking, but also has days that she is more up and needs extra drugs to walk sanely... I feel like the longer I put off turn-out, the worse it is going to be.

 

[PinkvSantaboots]

The last I spoke to her vet was before I brought her home and he said the injury was still pretty bad. I sent her ultrasound scans to the new vet and he said he was "surprised it is still this bad"... which really doesn't give me hope. The alpha2Eq injections that she got are similar to PRP. The way the vet described it, it's actually a step up from that. The laser treatments helped the most, and the shockwave therapy too. At this point it has really come down to cost. There was just no way I could afford to keep her at the rehab facility... and now, having the feeling that she may never recover fully, it seems like I'm keeping her on stall rest for a tiny ray of hope that she could be ridden again there really isn't any other treatment I can do for her. It did not qualify for surgery (she had MRI, multiple ultrasounds, and tenoscopies done... so I feel they should have a pretty good idea of how bad the damage is). She had no previous scar tissue in the area... and I didn't jump her bigger than 2 foot. The vet at the rehab barn said that this is usually seen in eventers or big jumpers. So, it really doesn't fit with what I was doing with her. I just came out one day and she was 3-legged lame and no one had any idea what happened... she also had an earplug in one ear and I never rode her in ear plugs... Needless to say I removed her from that barn as soon as I could, but the damage was already done.

She has had quite a bit of treatment fingers crossed for you that it has worked.

I suppose if the scan is not good I think in your situation I would think about turning her away for a year and see what you have then.