Front Ligaments

[sassyequine]

Im interested if anyone has experience with treating and prognosis for front feet ligament injury?
My 4 year old mare who I bought in October (full x rays) went suddenly lame on boxing day. It was so chronic we put it down to an abscess but shoe removal and subsequent x rays reveal no such thing. As it slightly improved and we nerve blocked her it started to swap over making her bilaterally lame in front. After 6 weeks rest she is slightly better although now 1/10th lame on hard surface increasing to 3/10ths on a soft surface, aggrevated further by lunging. Her heels have collapsed and she is being naturally balance shod to keep her walking.
We have x rayed again and no significant changes. She continues to be slightly lame and obviously uncomfortable in trot on a soft surface. If we block out at the DIP joint (coffin) she goes lame on opposite leg until you block that then is sound.
Next step is to put some cortisone and Hylauronic acid into the DIP joint and rest for 6 weeks further to see any improvement. Then its MRI territory and as a 4 year old a poor prognosis for return to eventing.
I would really appreciate any experiences?
Thanks

 

[lizzieuk1]

not sure you can really diagnose ligament injury from what you;ve said, if she is that lame then there would have been significant swelling with a ligament tear. ligament healing can take up to 18months+ depending on severity. my old boy went lame (only on one leg mind) and i also had all the above investigations, we got to scan srage and i just decided to turn him away for 6 months then reassess, since she's only 4 it may be worth doing this that should give enough time to assess whether there is a soft tissue injury or something more sinister going on.

 

[sassyequine]

Unfortunately with ligaments and soft tissue structures in the feet the swelling and heat is not visible except on an MRI. The diagnosis is not under question, newmarket are pretty convinced, the MRI will simply confirm the extent of the damage. And l agree as she is only 4 if they think turn away will help thats what we will do.
Thanks

 

[Marchtime]

I would highly recommend Newmarket for MRI's and treatment for ligament damage. My 7yr old TB Sammy was sent up there five years (days when MRI involved GA), was a very very long drive and stressful but the staff our lovely and very helpful. Sadly for our boy it wasn't good news and he was PTS a few months later.
However, there is hope. My new 9yr old TB (why did I buy another?!) has just been diagnosed via MRI (Liphook this time as nearer) with chronic wear to medial collateral ligament. The prognosis depends on whether the injury is acute or chronic. With acute injuries, such as Sammy's the prognosis is still very guarded. However with chronic injuries the prognosis is much better. Your looking at a long rest period - anywhere from six months to eighteen months but there is light at the end of the tunnel. My current boy had six months off and is now sound and coming back into work.
The key to recovery is primarily time combined with good shoeing (possibly heart bar shoes), cortisone injections into the joint and there is the possibility of either shockwave (which I used) or IRAP (I don't know much about this but if you search the forum there's some info, fairly new treatment).
Don't give up hope. Whilst it's a long road to recovery most horses now come back into work.
Also if your insurance will pay I'd recommend pushing for the MRI now. Both of mine improved with joint injections and so we put off MRI, which in the long run didn't help. You really need to know what you're dealing with before you start treating/masking symptoms.
PM if you want more info.