Hind Suspensories

Hannahgb

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My rising 6 year old has been diagnosed with bilateral hind PSSD. He has also got arthirtus in both hocks.

His ultrasound scans show tears in his suspensories rather than holes. He also has a small avulsion fracture- vet said this was only small.

Due to his age we have been advised against the neurectomy surgery. We have had a look at the fashiotomy surgery instead which looks a more successful op for him.

However, due to the avulsion this also has a reduced success rate. But have also been told turning away without any of this does not look hugely successful.

I just wanted to know if anyone has any ideas/ experiences on the best route to take?

Horse is a 17.3 warmblood. He has been very slowly brought on. We have invested in an arcequine which he has been started on. Just have too many conflicting theories being thrown at us at the moment!
 

applecart14

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Your horses bone spavin is presumably remedied with steroid injections and once his hocks have been medicated it will help him considerably as he will not be in pain. I assume the PSD is as a result of the spavin; an overcompensatory problem? I know the prognosis is not so good in the hind limbs but this website http://towcester-vets.co.uk/a-surgical-update-on-proximal-suspensory-desmitis-psd/ gives some promising information, claiming 94% of 84 hind limb cases have returned to previous work using their technique of removing a portion of the nerve branch that supplies the sensation to the proximal suspensory region (deep branch of the lateral plantar nerve, DBLPlN) and release of the fascial tissue overlying the ligament under general anaesthesia. :

I can't comment on the fashiotomy its not something I have ever experienced or even heard of until just and I have googled it as I was curious.

I have heard of the Arc Equine machine though! I know that is something which has been given some good reviews on this forum and from recollection my own ACPAT physio rates it highly too. I understand that it reduces swelling and inflammation and can also reduce scar tissue within tendons and ligaments so promoting healing.

I wonder whether the IceVibe boot may be of benefit to your horse? The website claims: The ICE-VIBE boots are rechargeable vibrating boots that help to boost circulation in horse's legs by creating a massage effect. They combine the effects off cooling and massage therapy to effectively treat strains, ligament and tendon damage. The massage effect helps to stimulate the lymph system to remove soreness and swelling as well as improving circulation. Everyday wear and tear on joints can be managed with daily use of the boots and rehabilitation through injury can be achieved more effectively.

Certainly I can recommend the ICE Vibe boots. They have been very effective with two of my horses suspensory branch injuries and they are very useful prior to exercise, as they give elasticity to the tendons and ligaments by loosening them due to the vibration used. Unfortunately I am not able to use the ice packs anymore due to lack of freezer space at the yard, which has been a huge blow so I am now using instant ice packs underneath although these are extremely expensive to use on a daily basis.

I know you are not at that stage with your horse, I am just thinking of the longer term picture.

Good luck I hope it works out for your boy.
 
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Hannahgb

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Thank you. Forgot to mention he is already using the IceVibe boots too! He is also been medicated in his hocks, although they think the suspensories are not related to the hocks and have been niggling for a while. He hasn't shown a days lameness, just disunited in canter on the lunge behind.

Unfortunately we have been told by a specialist at newmarket, that due to his age, the nerve branch op is only likely to work for a year or two. For that reason I dont feel comfortable to go ahead with it, as it tends to result in a much larger issue afterwards.

So gutted, my older horse is already retired with bilateral front suspensories- he wrecked them in the field!
 

milliepops

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I really feel for you especially with him being so young. FWIW I would feel the same about the neurectomy though I know loads of people do go ahead with it, it just doesn't sit well with me.
I was told that the fasciotomy was basically done to give the inflamed ligament more 'room' which should reduce much of the pain of it being compressed. Are you doubtful about going down that road, or is it just the reduced success rates due to his fracture that is putting you off?
 

Hannahgb

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Yeah I really dont like the idea behind the neurectomy!

I am happy to go ahead with the fasciotomy if we think it will work- we are just getting conflicting views on the success rate. Especially with the fracture throwing a spanner in the works.

Due to the limited signs he was showing, we have already spent our insurance money so anything now is self funded- I am more than happy to pay for an op, just would be reassuring to know of any success stories or alternative ideas before committing to it.
 

Hannahgb

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The more I look into the fasciotomy- as long as it made him more comfortable, even to live a life in the field- then I feel that is the route to go down regardless of whether he will come back in to work again.
 

applecart14

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Thank you. Forgot to mention he is already using the IceVibe boots too! He is also been medicated in his hocks, although they think the suspensories are not related to the hocks and have been niggling for a while. He hasn't shown a days lameness, just disunited in canter on the lunge behind.

Unfortunately we have been told by a specialist at newmarket, that due to his age, the nerve branch op is only likely to work for a year or two. For that reason I dont feel comfortable to go ahead with it, as it tends to result in a much larger issue afterwards.

So gutted, my older horse is already retired with bilateral front suspensories- he wrecked them in the field!

Gosh you have been incredibly unlucky to have two horses with the same problem, I really feel for you. Glad you have the Ice Vibe boots, they are worth their weight in gold. Everytime I google PSLD I can only find information relating to both fasciotomy and neurectomy together and nothing about just fasciotomy.

I hope you find someone who can offer you some advice. There must be someone on here who has had this operation for their horse.

Sounds like you are doing everything you can at the moment. I hope it works out.
 

stencilface

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My horse had PSD on one of his hind legs, luckily it was I think relatively minor and treated with shockwave and box rest, the rehab walking. However, I took his back shoes off a couple of years later (injury in 2011, shoes of 2013) and the leg that had the PSD developed a flare in the hoof on the inside, I presume to balance out the irregularities in his leg higher up.

I would say have a look and read into and consider taking his shoes off (unless they're off already obviously, in which case - ignore me! :) ) as if he's going to be turned away it won't hurt. I think he could come back sound, although you've said you've taken it slowly, he's obviously a big boy and perhaps needs another year or two to grow into himself. This isn't a criticism, hindsight is always 20/20 :)
 
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