Enlarged annular ligament

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HelenPolly

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My 22 year old mare strained the ligament and now has a permanently "enlarged annular ligament". She's been walking for 25 minutes since June every other day and only now can we do 10 strides of controlled trot. I ultrasound it as often as I can and she's on supplements galore from the vet.

The ligament hasn't gone down in size but the vet said that's good as she's coping ok with it, it gets scanned every 6 weeks. She has the odd stupid day in the field and comes in sore but never lame. I feel like this is taking absolutely ages and can't see us ever getting back to doing our dressage. Anyone else had this injury? Any timescales?

Am absolutely gutted by this injury as the day before her leg blew up we won our first affiliated prelim. Talk about cut down in your prime!!!
 
Is there no suggestion that it should be cut....

Kizzywiz on here is a bit of an expert on this
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Vet doesn't want to do that just yet, he wanted to give her a chance, my insurance on this leg runs out in January so am trying to think of the best thing to do, and for her in the long run, I've had her 19 years now. She's a cleveland bay x, is very upright and was fit as a fiddle when it went.

Hopefully kizzywiz will pass on some of her knowledge to me!!

Thx a lot
helen
 
Helen, do a search as there are a few posts on here re this type of problem.

I presume that if you don't decide on the op before your insurance runs out and then it becomes necessary you'll have to pay for it yourself.

You could always ask about a second opinion from another vet, perhaps one more of a specialist in this area?

Jane.
 
Hi Helen, saw your post. In my experience & from what my own vet & also the vet at Liphook told me, once the annular ligament is enlarged then it will gradually become more thickened until the horse goes lame, it will not improve with rest, & the only real option is surgery. My pony Meg has had this op on 3 legs, it was a long time ago & all were done by open surgery, she did really well, the aftercare was really intensive, but she is 19 now, sound & still dressaging & a bit of jumping for fun. My other pony Kizzy had keyhole surgery for the same problem 11 weeks ago, her aftercare was different, as no big wound to heal. She is now on normal turnout & has done 3 weeks walk work under saddle, she has a further weeks walking, then I can introduce trot. She has a scan in 2 weeks, but is sound & doing really well. I expect to be back jumping in January. I would advise you to talk to your vet again, as your regime differs from what I would have expected. I also work for a supplement company, & would be very suprised if there were anything available which would heal an enlarged annular ligament. I think surgery is probably your only option, & personally I'd get a move on before my insurance ran out, its nearly £3,000 for the op. Hop that helps.
 
get it cut.

my boy was operated on in 2006 aged 20. i was reluctant due to his age but he was getting gradually lamer despite rest so we went for it. he managed the GA ok, had a bit of a rocky recovery but was sound from day1. i dont think about him under GA as i find it really odd and i was completely terrified i'd lose him but it was worth it. he only came sound for 6mths before re-injuring it in the field but that was just bad luck. the surgeon said that is very very unusual. anyway, i did get 6more months of hacking out my lovely pony and after another 18mths turned away he is once more sound. i only hack at the moment, but i have vague dreams of him returning to the dressage arena in his late 20's. just dont know if i'm brave enough to ride him anymore than the odd hack just in case he re-injures it again. i'd still do the op again if i had my time again. it cost about £2500 and they did both back legs as they were both swollen even though he was only lame on one.
 
Thanks girls for all the advice. Now I'm really confused! It's a hard decision as she's never been lame on it, apart from when it swelled up the first week after our final dressage. She's been 100% sound on it ever since, but only with doing 25 mins walk every other day. She went a bit crazy at the weekend as I think she's so frustrated, so took her for an hour walking hack, she was a bit sore the day after but now seems sound again. What a decision.... Do I push the workload up and see how it goes? or take it steady? Is there really no alternative to having it cut? aghghhghg!!!!!
 
Think you will find that as you increase the workload she will go lame, my vet was very clear that this problem is like a timebomb waiting to go off, once the ligament is thickened then it will continue to do so over a period of time. He said that if I had rested Kizzy, as soon as I picked up the work again then the problem would still be there. The other thing that sounds a bit odd with yours is having it scanned every 6 weeks, if I were you I'd definately press him for more info about the surgical option. If you have it done now, you will be back riding in 8 weeks, so with a further 12 weeks fittening you could be dressaging in April & you will still be in your insurance period.
 
Thanks a lot, you've given me the confidence to seek a second opinion and take it from there. I wouldn't mind taking it slowly with the hacking but my gut feeling is I'm just wasting my time, although the ligament hasn't increased in size during 5 months I don't feel we're getting anywhere and stuck at the 25 minute thing. My mare really is no where near ready to retire so I need to give her the best chance to continue from where we left off.

Thanks kizzywiz for responding, I might PM you if I have any more queries!

 
No problem, PM me if you want any more help, 5 months is a long time with no real improvement, & scans every 6 weeks are costly. If you feel this regime isn't having any effect, then I agree with you that a second opinion would be helpful. Whereabouts are you??
 
Its all on insurance at the mo, that's why I asked for regular scans done to check on the size, my insurance have unfortunately held me to a date (long story) but any claims for this have to be done by 31st Jan next year. Luckily my policy got upgraded last year to full cover again till she's 25 so I have up to £5k to claim on this injury so enough for the op. What a decision.....

We're in Kent, just near Brands Hatch. I saw everyone recommending Liphook but they're miles away.

You seem very positive about it all and talk sense!, glad yours are doing well, you clearly made the right decision for yourself. If only I could get some assurance that what I'm doing will work but as you say, its inevitable that it will increase in size which makes me feel like I can't even have a holiday for fear of a few days off making it worsen.

I'm also ultrasounding the area at least 4/5 times a week, it really soothes it and I do believe its held some of the scar tissue at bay, but its so time consuming, but I can tell by her face it has an effect. I work in London and live 30 mins away from the yard, my poor new husband barely sees me at the mo!

Just waiting for a call back from the local dedicated horse vets about a second opinion, Bell Equine in Paddock Wood.
 
Yes, you are miles away, I was going to recommend my vet for a second opinion, but he is in Newbury, Berks. I am sure the ultrasound is helping, but as I said I am pretty sure that if you increase the work, it will become thickened to such a degree that it will begin to rub on the tendon, this makes loads of fluid as the body tries to heal itself, this is what causes the lameness. If you want some time away, then I think you should take it now, post operative care is knackering. 6 weeks box rest post surgery, 10 mins walking in hand twice daily after 10 days, grazing in hand is ok as soon as home from hospital. So I did am, graze 20 mins or so, walk 10 mins after 10 days, muck out etc etc. Lunch, feed, water, skip out. Pm, graze 20 mins-1/2 hour, walk 10 mins, skip out etc etc. Ride other pony Meg, sort her bed out. Finish off, collapse!! After 6 weeks turn out in round pen, after 8 weeks, begin ridden walk work, building up to 45 mins daily by 12 weeks post surgery, pen turn out till 12 weeks post surgery, then in normal field & begin trot work for a further 4 weeks, then canter work for another 4 weeks, then hopefully if it all worked, back to normal!! So I'd whisk your gorgeous new hubby off for a weekend or 2!! Because after this lot you will be shattered but happy. Keep in touch, & I'll be interested to know how you go XX Oh, plus fitting in work as well, though luckily I am a sales rep, so pretty flexible as long as sales on target.
 
kizzywiz said:
No problem, PM me if you want any more help, 5 months is a long time with no real improvement, & scans every 6 weeks are costly. If you feel this regime isn't having any effect, then I agree with you that a second opinion would be helpful. Whereabouts are you??
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Just been reading this thread. My cob has had the op to cut his l h annular ligament three weeks ago and also had the manica flexoria removed too , he’s walking well inhand, he wants to prance and spin lol but am being v careful with him, he’s ok on his box rest too , but my worry is he still rests his toe up in stable, did your horse rest a toe, vet thinks he’s maybe feeling comfy that way , and as is only three weeks since op! He cud be a bit sore still inside his tendon etc ? He’s not on any meds now, no Bute or any antibiotics, the wounds lovely and healed very well, just a few dry scabs left? My info on how they hold foot wud be appreciated, I think also I’ll ring the equine hospital at malton in the morning, apart from this he is doing great
 
What’s exactly damaged on the scan .
One of mine (18 ) has some annular damage it’s respomded well to anti inflammatories and the swelling has reduced a considerable amount and the swelling is within the tendon sheath we are increasing work and he’s looks good go for hunting in November the vet advises that a steroid shot into the tendon sheath is a good idea just before the hunting starts .
This is not the desision I would have taken with a younger horse.
 
Damaged annular ligament and had manica removed too! He’s doing great today, had Sarah a equine massage therapist out and gave him a massage, he was so chilled lol I’m going to ring vets at malton as they said he wud get a **** of cortisone or h a shot once stitches are removed
 
Anyone with a horse suffering from this it is strongly associated with hoof pathology, so although fixing the feet won't fix the ligament, it may contribute to slowing down the condition. Vets are great but are GPs, you want a hoof FUNCTION expert to advise.
 
sbloom said:
Anyone with a horse suffering from this it is strongly associated with hoof pathology, so although fixing the feet won't fix the ligament, it may contribute to slowing down the condition. Vets are great but are GPs, you want a hoof FUNCTION expert to advise.
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What kind of hoof pathology? So I can look it up , and speak to farrier
 
My horse has had this op. It took a long time for her to become sound after (about 9 months). Although a relatively straightforward op every GA has itsrisks, perhaps more so for an older horse and opening up the tendon sheath has its risks as well. For this age horse I would consider more rest or retirement if that doesn't work. My insurance has quite a few limitations on a horse once it reaches its late teens and beyond, so it might be worth checking if they would pay. My horse's op cost about £1700 but she did one week of bx rest at vets.
 
Marigold4 said:
My horse has had this op. It took a long time for her to become sound after (about 9 months). Although a relatively straightforward op every GA has itsrisks, perhaps more so for an older horse and opening up the tendon sheath has its risks as well. For this age horse I would consider more rest or retirement if that doesn't work. My insurance has quite a few limitations on a horse once it reaches its late teens and beyond, so it might be worth checking if they would pay. My horse's op cost about £1700 but she did one week of bx rest at vets.
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Hi, my cob is doing great at the moment apart from still having a bit fluid in his fetlock, he’s had another scan when he had his steroid and hyarulonic acid injection, the vet took sample of fluid and confirms it was synovial fluid although it was very thin and watery rather than stringy and gloopy, she hopes the hyarulonic acid injection will help to thicken the synovial fluid. Also he’s on daily turn out still in his own penn but I extend it every week So it is getting bigger and more room for him, he is sound at walk and was 2/10 lame at trot when he was last scanned think that was theee week ago,I’m still doing his inhand walking around stable yard on a night when he comes in, I’ve just e mailed rainbow vets today to see if he can now be ridden at walk as this will be easier for exsercising him, he had a bait of a fandango in his paddock yesterday. A little canter round and a few bucks snorting like a dragon, he came in ok no limping etc, I think even tho vets gave him 50/50 recovery chance he is doing fabDD687FD7-EE9B-4D39-8BEE-FB3E50372E80.jpeg
 
Also his fetlock has gone down in size although not massively but is noticeable, he has cold laser therapy twice a week too, and I’m sure that is helping him lots, I don’t doubt he’ll be rideable , we only do light hacking anyway and I think he will eventually be up to that
 
15 months down the line from the op, my horse is now cantering again and we do our first prelim in two years this weekend (fingers crossed nothing else goes wrong). For her, it's been time that's been the key factor. I didn't worry too much about keeping in small pen after the initial 6 weeks were up. She was only sound to ride after 9 months and its taken this long to get her back to cantering. Never going to jump though.
 
Lyndab22 said:
Also his fetlock has gone down in size although not massively but is noticeable, he has cold laser therapy twice a week too, and I’m sure that is helping him lots, I don’t doubt he’ll be rideable , we only do light hacking anyway and I think he will eventually be up to that
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My mare's fetlock is permanently enlarged. It will never go back to how it looked before because the annular ligament was cut.
 
Marigold4 said:
My mare's fetlock is permanently enlarged. It will never go back to how it looked before because the annular ligament was cut.
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Yeah mine won’t go back to normal size but the defenituon of his leg is a lot nicer looking from side, I’ll see if I can post a recent picture
Marigold4 said:
15 months down the line from the op, my horse is now cantering again and we do our first prelim in two years this weekend (fingers crossed nothing else goes wrong). For her, it's been time that's been the key factor. I didn't worry too much about keeping in small pen after the initial 6 weeks were up. She was only sound to ride after 9 months and its taken this long to get her back to cantering. Never going to jump though.
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I’m so tempted to put him in paddock with the other two on our livery, I just don’t want him doing the fandango lol, I’m not in a hurry to ride, as I’m pretty much a fair weather rider lol, it’s an awful injury isn’t it?my boy had full g a to have his op, and he had complications when they got into his leg as his manica had at some point torn and caused scar adhesions to his annular so he had 2/3 of the annular removed , they cudnet cut any more as too adhered to tendon sheath, so I think for what he’s had done and how big an op etc and the risks with g a he’s done fab I love him and I hope too one day to be able to canter again
 
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