Hind proximal suspensory damage - any positive outcomes?

[Timelyattraction]

So my 6 year old has been at the vets all day today having a work up. They have found damage to both hind proximal suspensories.

I was offered surgery as a treatment option to have the nerve removed. However i have opted for the laser therapy, shock wave and walking rehab treatment.

Has anyone been in this position and used the laser/ shockwave and what was the outcome?

I only got her at the end of august so ive been sobbing all afternoon and feel a bit heartbroken that everything i had planned for this summer is now no longer and i no longer have a horse i can crack on with

She was bought to show jump (plan was Eventually aiming towards 1.10/20s) but the prognosis on that doesnt look too good-does anyone have a horse that has returned to jumping after this diagnosis? Just looking for some reassurance really

 

[AWinter]

Yes by addressing the hoof balance. Have a look at the equine documentalist/holistic equine on Facebook. Many people are told the hoof balance is optimal when it isn’t and it has a knock on effect in the body, really opened my eyes.

 

[PinkvSantaboots]

One of mine damaged one suspensory in the proximal basically a hole he had prp and 6 months box rest, we re scanned and it was heeled and he was sound this was when he was 12.

He then went lame again behind when he was 18 and he had slight damage to both so he had a course of laser and was meant to have box rest.

I didn't box rest him he was just on field rest because he had a long period of box rest earlier in the year and he was so stiff, I won't box rest him anymore his body just doesn't cope very well.

His been fine his 20 this year although I just hack him now but his not gone lame again.

 

[expanding_horizon]

Join the PSD discussion FB group lots of discussion on the pros and cons of surgery, and some success stories.

If you havent already I would get foot balance x-rays and correct any foot balance issues, especially NPA.

PSD itself is normally secondary and caused by compension from a primary issue e.g. poor foot balance, sore teeth, poorly fitting saddle, working in poor surface, kissing spine, poor posture etc.

If you can figure out likely cause and resolve it, then rehabbing the PSD should be fairly positive.

If cause is hind leg conformation there is a poor prognosis.

 

[Timelyattraction]

I was told box rest but the mare is stressy when others are taken away and they also found grade 2 ulcers so she’s on 6 weeks medication for them so we agreed box rest isnt really a good option for her so i’m going to make a small pen in the field for her and hope she stays put

 

[Melody Grey]

Remedial shoeing to correct NPA was the course of action with mine. He’s only used for hacking and low level RC stuff, so couldn’t tell you about serious jumping/ competition potential as he was never destined for that anyway.

That was about three years ago and better than ever now (touch wood!)

 

[LEC]

I had one and went lame in front as it was bilateral behind - I refused to do the surgery as didn’t see the value or that it would solve the lameness in front so had 2 years off and has come back sound. She is mainly a happy hacker now with the odd lesson thrown in with her very unambitious loaner but is happy and sound.

 

[Timelyattraction]

She has her first laser treatment tomorrow im going to contact them today and ask if we can xray her hind feet to see of theres any imbalance there so that i can work on correcting that if there is.

Im also going to book her in for some indiba - is this better to do as a maintenance thing say monthly?

 

[LEC]

She has her first laser treatment tomorrow im going to contact them today and ask if we can xray her hind feet to see of theres any imbalance there so that i can work on correcting that if there is.

Im also going to book her in for some indiba - is this better to do as a maintenance thing say monthly?

Save the money for the farrier - it will cost you a fortune if you need to sort the axis out.

 

[sollimum]

My older cob damaged his RH suspensory in 2020 and had shockwave and rehab successfully. I changed farrier about 18 months ago and have had problems with his front foot balance - which we are in the process of sorting out. He has now re-damaged his RH suspensory, I believe as a result of offloading from his sore front feet. So definitely do foot xrays, make sure any balance issues are addressed and ensure your farrier and vet work together as a team.

As everyone else has said, the damage to the suspensories will be as a result of imbalance elsewhere.

 

[hock]

Join the PSD discussion FB group lots of discussion on the pros and cons of surgery, and some success stories.

If you havent already I would get foot balance x-rays and correct any foot balance issues, especially NPA.

PSD itself is normally secondary and caused by compension from a primary issue e.g. poor foot balance, sore teeth, poorly fitting saddle, working in poor surface, kissing spine, poor posture etc.

If you can figure out likely cause and resolve it, then rehabbing the PSD should be fairly positive.

If cause is hind leg conformation there is a poor prognosis.

Suspensories for me touchwood are something I have little experience of. Interested about the hoof balance and the NPA info, thanks. My question really is genetics? Forgetting conformation genetics etc can a like be predisposed to it? Thanks

 

[ILuvCowparsely]

So my 6 year old has been at the vets all day today having a work up. They have found damage to both hind proximal suspensories.

I was offered surgery as a treatment option to have the nerve removed. However i have opted for the laser therapy, shock wave and walking rehab treatment.

Has anyone been in this position and used the laser/ shockwave and what was the outcome?

I only got her at the end of august so ive been sobbing all afternoon and feel a bit heartbroken that everything i had planned for this summer is now no longer and i no longer have a horse i can crack on with

She was bought to show jump (plan was Eventually aiming towards 1.10/20s) but the prognosis on that doesnt look too good-does anyone have a horse that has returned to jumping after this diagnosis? Just looking for some reassurance really

Yes my mare recovering from torn Check ligament had it done, hoof balance is MEGA important as without a really good barefoot trimmer, you would be disadvantage, seen that first hand with my mare on recovery, as it was hoof imbalance that caused the issue, as per my thread https://forums.horseandhound.co.uk/threads/opinions-on-this-hoof.830344/page-2#post-15389803. nearly 1 year later with a good barefoot trimmer since July. The mare is now walking fine turned out small area for 2.1/2 hrs, aiming to get her out in her group in a month or so (checking with the vet first)

Pharma Horse Collagen is the building blocks for tendons and ligaments and without them we would not be where we are now (healing wise)

 

[Bellaboo18]

Save the money for the farrier - it will cost you a fortune if you need to sort the axis out.

Agree save the money on indiba and get the feet xrayed and sorted. Then see where you're at.

My mares had the surgery. For her it was the best thing we could have done but I didn't expect her to go back to the work she was doing that caused it in the first place (imo being overjumped in questionable/deep arenas before I rehomed her).

Feet, feet, feet would be my advise. Good luck

 

[Timelyattraction]

Yes my mare recovering from torn Check ligament had it done, hoof balance is MEGA important as without a really good barefoot trimmer, you would be disadvantage, seen that first hand with my mare on recovery, as it was hoof imbalance that caused the issue, as per my thread https://forums.horseandhound.co.uk/threads/opinions-on-this-hoof.830344/page-2#post-15389803. nearly 1 year later with a good barefoot trimmer since July. The mare is now walking fine turned out small area for 2.1/2 hrs, aiming to get her out in her group in a month or so (checking with the vet first)

Pharma Horse Collagen is the building blocks for tendons and ligaments and without them we would not be where we are now (healing wise)

Thanks just looked at your thread.
Interesting enough i posted some photos of her feet on here a week pr so ago and everyone said they looked really good so im not sure if her feet are the problem but will x ray them anyway. Waiting for vet to phone back about it

 

[lme]

I would get workup from a really good lameness vet to pinpoint the cause, with whatever Xrays they think are needed plus foot balance X-rays.

Once the underlying cause is addressed, I would have an intensive course of indiba and get a really good hoofcare professional to address any foot balance issues. I would also expect a year or so of walking, first in hand and then under saddle and not start any more serious work until my vet gave the all clear.

Going forward, I would expect to have regular scans / checkups with the lameness vet, regular foot bakance Xrays and frequent physio / indiba.

 

[RachelFerd]

Only the surgery has statistical evidence of improving outcomes afaik

 

[expanding_horizon]

Only the surgery has statistical evidence of improving outcomes afaik

I think that is long outdated view. Though you are correct in terms of published journal research. But there does generally have to be money to be made to fund the research.

 

[Timelyattraction]

I was umming and ahhing over surgery. She is a competition horse and i bought her for a purpose so i have been weighing up weather she has the surgery and hope that she comes out right and i could get 2-3 years of showjumping out of her but my insurance maxs out a 3.5k per claim and the surgery is around 4-5k and obviously thats not including any work up and xrays she’s had done in clinic already. Ive read a few stories where it hasnt worked and some more horrible stories about them not being able to feel their leg etc and it worries me. Im hoping we can try and fix her this way and if not maybe surgery will have to be an option further down the line if this doesnt work

 

[RachelFerd]

I was umming and ahhing over surgery. She is a competition horse and i bought her for a purpose so i have been weighing up weather she has the surgery and hope that she comes out right and i could get 2-3 years of showjumping out of her but my insurance maxs out a 3.5k per claim and the surgery is around 4-5k and obviously thats not including any work up and xrays she’s had done in clinic already. Ive read a few stories where it hasnt worked and some more horrible stories about them not being able to feel their leg etc and it worries me. Im hoping we can try and fix her this way and if not maybe surgery will have to be an option further down the line if this doesnt work

I would talk to your vet in detail. The surgery is not as you originally described 'removing the nerve' - it is not a complete neurectomy, it is a partial resection of the nerve and fasciotomy. Very different to, for example, neurectomy of the hoof. My info on effectiveness of outcomes is ~10 years out of date, but certainly at that point in time, shockwave was just something offered for the sake of 'doing something' rather than there being any evidence it helped in these types of chronic PSD cases.

 

[nutjob]

My horse had a sdft injury on a front foot, followed by suspensory injuries on first one, then the other hind legs. Possible due in part because of how long he was struggling with the front tendon injury. Also had pain / tension in his back. He did have shock wave treatment for the suspensory problems but it didn't help to any significant level. Sadly PTS aged 16 as too many problems.

I also had one with EPSA / DSLD who was PTS aged 6 as he was not considered a candidate for surgery and his fetlocks had visibly dropped. If your horse has definite injuries and not just a general degeneration of the ligaments then it won't be this, but degeneration at age 6 is worrying.

 

[Lucky Snowball]

My mare was diagnosed with PSD about 16 years ago. Not insured so she was rested then brought into work slowly. No further issues or lameness. She did BS and BE. Don’t give up.

 

[JoA]

My horse had damage to the SDFT at insertion point mainly in right hind but also slightly in left hind when she was 13. Bilateral mild lameness. She is slightly sickle hocked and moves close behind. She had a course of shock wave therapy and after two weeks no riding she was back to walking out and we progressed slowly during the summer of that year to a 15 mile pleasure ride (it was difficult as she does nothing slowly). The following year we resumed our endurance career. I retired her sound, fit and well before Christmas at the grand age of 30. I know this is not jumping as you are hoping, but it is just an example of success with suspensory ligament damage. At diagnosis I felt my world had caved in.....what I'm trying to say is that not all cases end negatively. I was fortunate my story was a success...and I will keep my fingers crossed for you that your situation results in success too. I really feel for you and your situation

 

[ycbm]

Only the surgery has statistical evidence of improving outcomes afaik

The trouble with surgery outcomes is that they so rarely seem to follow up for any decent length of time. It's not enough for the surgery to bring the horse back into work, and I've heard anecdotally of many surgery "successes" that have broken down within a short space of time when back in regular work.
.

 

[ycbm]

I know a horse which is back doing BE 90 which had the hocks medicated and shock wave on damaged suspensories.

My problem would be that I don't think I could put a horse I knew had those problems under that strain.

Even if she does return to jumping, how will you feel if the jumping breaks her again?
.

 

[Gaby&Oreo]

So my 6 year old has been at the vets all day today having a work up. They have found damage to both hind proximal suspensories.

I was offered surgery as a treatment option to have the nerve removed. However i have opted for the laser therapy, shock wave and walking rehab treatment.

Has anyone been in this position and used the laser/ shockwave and what was the outcome?

I only got her at the end of august so ive been sobbing all afternoon and feel a bit heartbroken that everything i had planned for this summer is now no longer and i no longer have a horse i can crack on with

She was bought to show jump (plan was Eventually aiming towards 1.10/20s) but the prognosis on that doesnt look too good-does anyone have a horse that has returned to jumping after this diagnosis? Just looking for some reassurance really

I'm going through the exact same thing with my rising 7yo mare (added a pic below) right now- it is the most horrible feeling in the world not knowing what is going to happen. I was planning to step her back up to 1.20+ this year but it's looking like she is going to have this year off. Sending good vibes your way, I really hope things work themselves out.

 

[Timelyattraction]

I'm going through the exact same thing with my rising 7yo mare (added a pic below) right now- it is the most horrible feeling in the world not knowing what is going to happen. I was planning to step her back up to 1.20+ this year but it's looking like she is going to have this year off. Sending good vibes your way, I really hope things work themselves out.

I will let you know how our rescan goes in 5 weeks, sending you positive vibes too. Completely heartbreaking when its your only rideable horse too You cant be far from me if rossdales is local to you as im cambridgeshire area too and my mare was going to go there if she had the surgery but i opted for the other options first. X

 

[Gaby&Oreo]

I will let you know how our rescan goes in 5 weeks, sending you positive vibes too. Completely heartbreaking when its your only rideable horse too You cant be far from me if rossdales is local to you as im cambridgeshire area too and my mare was going to go there if she had the surgery but i opted for the other options first. X

Yes, definitely let me know how your mare does - talking to people about there experiences is a massive help.

 

[hock]

I don’t know if anyone on this thread has watched the Gillian Higgins conference. She has Sue Dyson talking about confirmation and suspensories etc. She has done studies on the correlation between hind limb angle and wither/croup difference (either should be higher). I’m not summing it up very well as I’ve just watched 7 hours of the conference back to back but worth a look.

The more I’ve been looking into soundness the last few months the more importance I’m putting on hoof balance. Obviously it’s always been vital and mine are barefoot and trimmed every 6 weeks like clock work and low sugar. But more than that, trimming to X-rays is something I’m going to consider. Touchwood everything we have is sound but there’s a nag about varying degrees of soundness - and my huge horse is approaching 20 and I want him to be his very best.