High Suspensory Ligament Treatment

[dieseldog]

My Horse might now have High Suspensory ligament injury in the hind leg. Will find out for sure on Friday.

The Vet has said that you can either have an operation that severs the ligament or Shockwave treatment, but he doesn't really know a lot about Shockwave as they don't do it at their practice.

Has anyone here had the same problem and what treatment did you use and how successful was it, and how much did it cost you?

Thank You

 

[star]

my horse had shockwave, box rest and controlled exercise. 3 sessions of shockwave at £150 each including sedation each time. each session 2wks apart. also on box rest with inhand walking. over 6 months increased exercise and was back competing successfully at prelim again after that time. gradually worked back up to Medium and added in jumping - no further probs on leg. was his right hind affected, but quite mildly - hardly lame, although hopping after flexion test. would almost always go for shocjkwave over surgery to start with - much less risky and expensive.

ps - the surgery doesn't cut the ligament!!! it's cuts the nerve supply to the ligament so the horse can no longer feel the damage - the actual damage is still there.

 

[dieseldog]

Thank you Star, I more than likely misheard what he said re cutting things.

She is about 2/10ths lame and I would want to jump her again, do you think that would be possible?

Did your horse do his leg before he did really well at the nationals or after?

 

[alisonpook]

My horse was diagnosed with Proximal suspensory desmitis of both hind legs about 5 years ago at the AHT. As it was thought to be a mild case (not obviously unsound just didn't feel right, vet in fact at AHT said he would have passed him as sound for a vet exam) the suggested treatment was box rest for 2 months then treat as if a tendon injury for bringing back into work. This we did with regular scanning by local vet. After 6 months we asked to be referred back to the AHT as despite local vet's assurances that things were ok we felt nothing had improved. This time he was seen by Sue Dyson who is one of the pioneers of PSD diagnosis and treatment. We were totally devastated to be told that he was in fact worse and that all the efforts we had made had made the situation worse.

The treatments offered were then shockwave treatment, operation or bute. I think the shockwave treatment was 3 sessions at set periods apart. As the box rest had changed his temperament and magnified his pre-existing anxieties we felt that neither he nor us could face another prolonged period of box rest. Also back then both the operation and shockwave therapy were still pioneer treatment so success rates and long term prognosis were unclear. We therefore went for the bute option as the best choice for him. He was coping with this until a stupid accident in the field (somersaulted in a slipped rug) resulted in his retirement.

His 2 visits to the AHT involved a trip through the nuclear bone scanner each time (as initial problem was thought to be sacro-iliac, hip or pelvis. We therefore reached £2,000 pretty quickly (fortunately insured).

I think treatment has evolved since our diagnosis and the operation may not be as drastic as totally cutting the ligament. Andy Bathe was also a pioneer in PSD treatment so may be worth googling both Sue Dyson and Andy Bathe. I think some people nowadays try the shockwave therapy first and then the op as a final resort. Sorry no idea as to current costs.

Would think spa treatment could also help.

Sorry it's an epistle - the trauma of the box rest haunts us still.

Hope it's good news for your horse on Friday.

Best Wishes

 

[star]

[ QUOTE ]
Thank you Star, I more than likely misheard what he said re cutting things.

She is about 2/10ths lame and I would want to jump her again, do you think that would be possible?

Did your horse do his leg before he did really well at the nationals or after?

[/ QUOTE ]

Dan got PSD back in 2002, when it was still quite a new diagnosis and surgery was always very much a last resort - nowadays some people go for surgery quicker, but i'd always consider any GA in a horse as a last resort - i did have it done last year for his other ligament problem, but it was that or pts due to the pain he was in. he came back really well after the shockwave for the PSD - like i said above he was back at prelim and winning 6months after the diagnosis, affiliated him 4 months later, held off with jumping for a year or so but we didn't do much to start with anyway - by the time he got this other problem last year he was jumping 3ft at home no probs (that was our height limit anyway, nothing to do with his leg) and was back competing Elem, working Medium. He did the Nationals, then a sponsored ride with 30 jumps before damaging his other ligament in the field 2wks later. Many people are not so lucky with PSD though - it can be quite frustrating to treat - in general rest and bute do nothing, you have to either go for shockwave or the surgery and if your vets aren't experienced in the condition (which if they dont have shockwave then i would suggest they're not), i think you should ask for referral. Anyone at Newmarket is worth seeing. That's where Dan ended up last year for his op. His shockwave was done locally though, but at a very good first opinion centre.

 

[ihatework]

My now navicular horse also has this! (okay, he well and truely falling apart!)
It was the reason I got him in the first place, couldn't have afforded to buy a horse of his calibre that had nothing wrong!
He got is when he was 6 and out novice eventing. Had rest, shockwave therapy and controlled return to exercise.
The vets (and don't quote me on this) said something about him having a bit of residual scar tissue in the area that meant he looked fractionally stiff until fully warmed up, although to be fair very few people would notice!
4 and a half years on and he hasn't had a further day off work due to his PSD. However I would say he has his competitve limits due to it - elementary dressage and not much more than 1.10m SJ. Until his nav diagnosis he was also doing OPN.

 

[ecrozier]

Our vet suspected this with big mare, but had nerve blocks etc last week and she came sound after a 4-point block, so he said he now doesn't think it is high suspensory. Still not entirely sure what it is though!
Anyway, girl I know has a horse who did both hind suspensory ligaments about 9 months ago, horse now back out at BSJA, XC etc as normal, believe he has ultrasound treatment - is that the same as shockwave? May possibly have had that too, I don't know them that well, jsut thought a positive story might be good to hear!

 

[dieseldog]

Thank you everyone. She was on 2 bute a day and it had no effect at all. My Vet would be refering her for either the operation or shockwave treatment as they don't do it. Obviously it might not be PSD but if I have to make a decision as to what to do is great to hear how everyone else has got on with the treatments.

With the surgery am I right in thinking that they sever the nerve so therefore the horse can't feel it anymore but the damage is still there?

 

[ihatework]

Yup, they are denerving.
However it's not as extreme as denerving the foot, I would consider the former but not the latter. I think I would be inclined to try the shockwave first though, especially if you have insurance cover.

 

[dieseldog]

I have no insurance...

 

[star]

[ QUOTE ]
I have no insurance...

[/ QUOTE ]

i would definitely go for shockwave then - the op is likely to cost £1500, shockwave more like £500.

 

[dieseldog]

The vet came today and he finished doing his tests and it is PSD. She was lame on the front as well to start with but once he had nerve blocked the back she came sound on the front and the back. On the scan you could see the darker area, and the other leg looks to have some as well. He's going to give Willesley a ring as she would need to go there for either the operation or Shockwave. But he says he wouldn't do either as she is getting on, got a bad dust allergy so box rest isn't going to be fun, Shockwave treatment hasn't been that successful in back legs and the operation is about £3k per leg so that is £6k and it just isn't worth it.

 

[Pidge]

Oh DD what a nightmare

don't know what else to say

 

[dieseldog]

[ QUOTE ]
Oh DD what a nightmare

don't know what else to say

[/ QUOTE ]

I wish she had spavins, is what I'm thinking

 

[Pidge]

bloody awful situation

I really do feel for you and for Dolly

seems a lot of money for something that may not work and with no insurance that's a hell of a lot of money

Good luck with deciding what to do next. Have you decided yet what to do about the dealer?

 

[star]

[ QUOTE ]
The vet came today and he finished doing his tests and it is PSD. She was lame on the front as well to start with but once he had nerve blocked the back she came sound on the front and the back. On the scan you could see the darker area, and the other leg looks to have some as well. He's going to give Willesley a ring as she would need to go there for either the operation or Shockwave. But he says he wouldn't do either as she is getting on, got a bad dust allergy so box rest isn't going to be fun, Shockwave treatment hasn't been that successful in back legs and the operation is about £3k per leg so that is £6k and it just isn't worth it.

[/ QUOTE ]

shockwave worked on my horse's back leg and i know of several people on saddle-up who've had good results on back legs too, so dont write it off. i didn't do box rest with mine either - i made a small pen for him in a field and he went out there during the day and in at night - it still worked. not quite sure why the op would be that expensive either - my horse had both hindlegs operated on at newmarket last year for £2000, including pre-op scans, trot-ups etc. slightly different op, butcant see why there would be that much difference in price.