Hind suspensory injury in an 18 yr old horse, what will the outcome be?

Jazy

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I've been through a hell of a time trying to figure out what is wrong with my horse, he was diagnosed with (almost) kissing spine and more hock arthritis in his TMJ (I think thats the name of the compartment). The vet came out 2 weeks ago to check how his rehab was going and I was cleared to ride a week later, however he didn't look right on the day that I was supposed to ride. The vet came out yesterday to do nerve blocks as he has come up lame on his right hind and when the suspensory was blocked he really improved. He's having it scanned on monday, so will find out severity then. I'm really worried that he may not be able to return to the level of work that I want, as he's 18 & I will not be able to put him through surgery or boxrest as he goes crazy, so will put him on a small paddock rest. The vet said that he could return to full work if on bute but that doesn't sound right to me. Is this possible? I just want to be able to canter on hacks & take him to fun rides.
 
I know this isn't what you're going to want to hear, and I'm sorry you're struggling with this, but I think at his age and with advanced hock arthritis that was first treated 3 years ago, maybe you should be looking at retiring him.
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Thank you, it is really heart breaking. His arthritis isn’t advanced as the vet said his x rays were not too bad at all, and he is a horse that loves work and I definitely don’t think he’s ready to retire. He’s so good and never naughty if he’s not ridden for a while but he does get grumpy and bored if not kept busy. I really hope that I can keep him working but I know this situation is really not ideal.
 
I've been through a hell of a time trying to figure out what is wrong with my horse, he was diagnosed with (almost) kissing spine and more hock arthritis in his TMJ (I think thats the name of the compartment). The vet came out 2 weeks ago to check how his rehab was going and I was cleared to ride a week later, however he didn't look right on the day that I was supposed to ride. The vet came out yesterday to do nerve blocks as he has come up lame on his right hind and when the suspensory was blocked he really improved. He's having it scanned on monday, so will find out severity then. I'm really worried that he may not be able to return to the level of work that I want, as he's 18 & I will not be able to put him through surgery or boxrest as he goes crazy, so will put him on a small paddock rest. The vet said that he could return to full work if on bute but that doesn't sound right to me. Is this possible? I just want to be able to canter on hacks & take him to fun rides.
Of course he can return back to work, paadock rest and then bute will be fine, depending on the outcome of the scan. Meanwhile I'd be icing/hosing/ice vibing and ice cupping the h*ll out of that leg and I would insist on a period of box rest so that limb can be rested and bandaged appropriately, particuarly the opposite one. He can have sedalin to keep him quiet. Then a controlled exercise plan with hand walking and a postage stamped paddock to start with, gradually increasing size over a period of a few weeks. This is how I've always rehabbed mine, the check ligament on my one horse showed a hole, three month later that had disappeared with the above regimen including borrowing a long wave therapeutic ultrasound machine at 10 mins a day down the injury site. If you are prepared to put the work in you will get a good outcome. The worst you can do is try it.

If you don't go down the box rest route you may not get as good a result. So if you decide to turn out your paddock will need to be very small ( so he can't build up speed) - I built a chicane with mine. And you will have to be really strict with this size, you can leave out hay/cut up carrot to enrich.

Bute is often prescribed to older horses, mine was on it a number of years after he received full treatment for hock arthritis.

If you want more info I'd be happy to advise via PM.
 
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Of course he can return back to work, paadock rest and then bute will be fine, depending on the outcome of the scan. Meanwhile I'd be icing/hosing/ice vibing and ice cupping the h*ll out of that leg and I would insist on a period of box rest so that limb can be rested and bandaged appropriately, particuarly the opposite one. Then a controlled exercise plan with hand walking and a postage stamped paddock to start with, gradually increasing size over a period of a few weeks. This is how I've always rehabbed mine, the check ligament on my one horse showed a hole, three month later that had disappeared with the above regimen including borrowing a long wave therapeutic ultrasound machine at 10 mins a day down the injury site. If you are prepared to put the work in you will get a good outcome. The worst you can do is try it.

Bute is often prescribed to older horses, mine was on it a number of years after he received full treatment for hock arthritis.

If you want more info I'd be happy to advise via PM.


I'm afraid there is absolutely no way of writing this without you accusing me of getting at you B, but if you are going to offer advice by PM then I've got to point this out. Several years back and under another name you were criticised heavily on this forum for continuing to ride, and jump, a horse which was clearly lame behind.

I know it was with the advice of your vet, and I stacked it in my own database at the time as an example that vets aren't always right.

There is also a world of difference between healing a check ligament, which is probably the easiest ligament to put right, and PSD which is probably the hardest because of where it is. There is also a huge difference between buting up a bone issue that work won't make worse and buting up a ligament issue where it will.

The true prognosis is sadly that at this age, with three years of treatment for hock arthritis already, and the arthritis having moved into new areas, as per the OPs other thread, she will be lucky if this horse returns to the fast work she wants to do.

I know this post will upset you and I am sorry for that, but it has to be written for the sake of the other people who may read this thread in future, otherwise I would simply have PMd the OP.
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How long do you want to continue riding your horse? If it's a year, maybe 2 crack on, canter, do your fun rides, make the most of it. If you want longer, temper your level of work. Expect most hacks to be walking, not cantering, forget arena work. Even if the ligament repairs continuing with the same work it will go again, and again.
This is an older horse with some arthritis. We have to be realistic about our expectations if we want to keep our horses healthy and we'll in the long term
 
I'm afraid I too would be considering a very guarded process if it's anything chronic with the suspensories.

I spent 2 years and £££££ rehabbing a horse who was incredibly special to me, who was diagnosed with ulcers, mild hock arthritis and hind suspensory issues, the right side being worse than the left. Within the two years, there were periods of box rest, remedial shoeing, controlled exercise, shock wave therapy and very careful return to work. My belief is that the hock arthritis led to the PSD.

It was a bumpy journey with some points of hope but ultimately, we couldn't even get her field sound, and she was miserable, even on bute.

If I could have got her field sound, she could have retired with me, but the only option left was an N&F. I was not prepared to put her through a neurectomy and fasciotomy procedure, and considering the fact the bute wasn't helping (even before considering the long term effects of bute) I opted to PTS. Even if I could have got her pain free on bute, I wouldn't have ridden her though.

In your shoes, I would wait and see what the scan shows - in my experiences, there's a big difference in outcomes between an acute injury to the suspensory, or chronic PSD and you can only make a plan once you know which one you're dealing with.

Wishing you all the best, it's a painful and heartbreaking journey to go on.
 
Prognosis is definitely guarded, but a very similar situation did work out ok for a friend. Now, this is an example of 1, so keep that in mind.

Her horse had a suspensory injury at 19 and did have arthritis too. I wouldn't say that it was drastically worsening, but it was/is there. She did a very careful and slow rehab. Her horse came back into work, it wasn't the same work as before, but she was alright with that. She no longer jumps, is very careful about footing, and does a lot of hacking on good ground. That mare is still going at age 25 and I'm impressed with how well she's doing. She's very careful with her though.

She doesn't have any other conditions, and I'd say her arthritis is "typical" for her age.

So you can try, but you have to be diligent and you very likely won't be doing the same things you were before.
 
I've had poor outcomes with suspensory issues. One had ESPA/DSLD so was never going to come right, one had a diagonal pair of suspensory injuries, didn't come right, current horse has a front limb injury, a visible tear initially, he needed at least a year of rehab, stopped jumping him, got one season of low level dressage. He's lame again, this time it's mild arthritis in the fetlock, but it's the same leg.

Plan for a lengthy rehab and see how it goes.
 
Homey had a right hind suspensory branch injury at 17 came fully sound but my livery yard are rehab specialists and take in horses for rehab as well as having normal livery and he did do the box rest and controlled walking program.

He also had athramid for arthritis. PTS at 20 due to delayed gastric emptying as his stomach had stopped working properly. He was completely sound and vet said he was moving beautifully.
 
Have a look at indiba therapy for ligament injuries.
I follow a rehab page where the lady has has lots of positive stories.
Every horse is different & yours doesn't have age on its side, but its worth a look / discussion
 
Have a look at indiba therapy for ligament injuries.
I follow a rehab page where the lady has has lots of positive stories.
Every horse is different & yours doesn't have age on its side, but its worth a look / discussion

Yes interesting point, a vet friend is quite keen on Indiba and uses it on her own horse. She seems to feel it has benefit in some cases - and she definitely has her head screwed on right so I trust her opinion! Definitely worth a look
 
I rehabbed a suspensory ligament in one of mine, he did come sound on it for hacking but it was a front leg and I think they have a better prognosis. Even though he was sound, I decided that jumping/schooling for dressage was out for him.

I would hesitate to box rest a horse of this age due to strict box rest likely making the hocks stiffen up more. I think your idea of small paddock rest is best.

If he were to come sound on bute then I would have no issues with steady hacking over the summer with that, but with the knowledge that I may be making it worse and hasten a time where the horse would be PTS. That isn't something I would be too worried about though, as I believe a summer steady hacking and then PTS isn't the worst thing that can happen to a horse.

Unless the issue is really slight in scanning, I would not expect the horse to return to the previous level of work. Even if slight, I think it unlikely.
 
Coblet has bilateral ligament surgery on both hinds to try to rectify 1/10 lameness last spring and despite box rest, followed by small paddock turnout and extensive walking rehab he hasn't come sound enough to even be a happy hacker. He's a very "expressive pony" (read explosive if he isn't happy!) under saddle I just knew he wasn't comfortable. Vet suggested riding on 1 bute/day but personally that didn't sit right with me so I retired him at xmas and he's in the process of being roughed off and turned away for the summer. At the point he's not even field sound I will PTS. He's 17 btw so I would suspect has low level age relevent arthritis also. Sorry its not a better outcome but I think soft tissue damage just doesn't heal well in an older animal?
 
Dr. Birker2020 MRCVS ? ?

Lets leave it to the dedicated professionals who train for years before going on to dedicate their lives to the care of our horses, to give relevant and appropriate diagnosis and treatment plans.
Wow please put your claws away. I said depending on the outcome of the scan to ascertain the damage.

Postage stamped paddock advised by vet small enough to prevent build up of speed. Ultrasound and icing/ice cupping/hosing advised by physio.

And initial box rest followed by controlled exercise is what vets recommend these days.

Box rest allows the horses body to focus in repairing tissues and reduces inflammation in line with compression bandaging and cold therapy.

Controlled exercise improves circulation, prevents stiffness and aids healing.

Oh and the other nasty comment about buting to compete, just to get the other side if the story and to get it into perspective.

The horse had been diagnosed with hock arthritis which had followed a comprehensive lameness work up at an equine hospital. Horse had been medicated with steroid which wasn't successful so then went on to receive 3 x Tildren infusions over a period of a year which didn't give the desired effect so he went onto to have a very successful hock fusion using ethanol which was the method of choice back in the day. Horse was subsequently rehabbed by being brought slowly back into work and was signed off by the vet to go back jumping and low level unaffiliated jumping. He was assessed continously throughout the journey by both my vet and my physio and I was told by the vet that I could pop a sachet of bute in his breakfast the morning of a show to prevent any stiffness after. It was more often half a sachet which when used on a 720kg horse is very minimal. It didn't make him jump higher or faster and if he'd been in pain or I'd not bothered going through the whole process of getting him treated I could understand the comments. Whole lot cost me around 12k on insurance. But there are just people that cannot help themselves on this forum which is a reflection on them and not me.

Your choice OP who you wish to believe, random people on a forum who have history with being unkind or someone with experience of rehabbing her horses along with very experienced vet and physio input. I'll leave it up to you to decide but good luck either way 😉
 
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Gutted. I had a false hope that as that post was a few days ago Birker had actually learnt something recently, as in when to back down quietly and not fan the flames. Nope, still can’t read the room.
I have just stumbled across this and I am very dismayed and disheartened that my name is being dragged through the mud once again. I am really sickened by the comments tbh. If I hear anymore unkindness I shall make my second report in 24 yrs to admin. There is just no excuse for such unkindness levelled towards another poster. I am trying to help this poster with my experience.

Just because my experience isn't the same as some 'others' on here doesn't make it any less unworthy. It's a forum and we should be able to relate and express our opinion and our experience without being jumped on. I really don't care whether you agree or not. It is my experience and I will tell it. No excuse for dragging up the past or insinuating I don't have experience, to paint me in a bad light.

Shocking behaviour. 😡

And please don't patronise me IHW, it makes you sound very silly. Elevating yourself to tear down others isn't clever or kind
 
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On the basis that we were recently told not to fight battles in public I have already reported this thread with my comments and advise everyone else to do the same.

We cannot allow the forum to become a place where incorrect advice is not challenged for fear of being accused of bullying.
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I have to say that I would have a very guarded prognosis for your horsey (so sorry to be the bearer of bad news) xx

Personally I'd retire as coupled with the arthritis it seems as rehab etc could be a bit difficult as you want to rehab correctly, but then could risk setting the arthritis off or exacerbating it, although small paddock rest seems the best scenario as your horse keeps moving which means the arthritis won't have chance to flare up etc.

I don't agree with riding a horse on bute (I'm not saying that you're considering that for a moment so please don't get upset x), so I'd retire your lovely horse and if funds allow look for a share or something that you can do fun rides with etc.

If funds don't allow it and your horse recovers enough to be sound for in hand walks, you could always pack a picnic bag for you both and walk out on hacks - granted it won't be the same as riding but you could find a really pretty spot for a snack break and some piccies xx
 
Wow please put your claws away. I said depending on the outcome of the scan to ascertain the damage.

Postage stamped paddock advised by vet small enough to prevent build up of speed. Ultrasound and icing/ice cupping/hosing advised by physio.

And initial box rest followed by controlled exercise is what vets recommend these days.

Box rest allows the horses body to focus in repairing tissues and reduces inflammation in line with compression bandaging and cold therapy.

Controlled exercise improves circulation, prevents stiffness and aids healing.

Oh and the other nasty comment about buting to compete, just to get the other side if the story and to get it into perspective.

The horse had been diagnosed with hock arthritis which had followed a comprehensive lameness work up at an equine hospital. Horse had been medicated with steroid which wasn't successful so then went on to receive 3 x Tildren infusions over a period of a year which didn't give the desired effect so he went onto to have a very successful hock fusion using ethanol which was the method of choice back in the day. Horse was subsequently rehabbed by being brought slowly back into work and was signed off by the vet to go back jumping and low level unaffiliated jumping. He was assessed continously throughout the journey by both my vet and my physio and I was told by the vet that I could pop a sachet of bute in his breakfast the morning of a show to prevent any stiffness after. It was more often half a sachet which when used on a 720kg horse is very minimal. It didn't make him jump higher or faster and if he'd been in pain or I'd not bothered going through the whole process of getting him treated I could understand the comments. Whole lot cost me around 12k on insurance. But there are just people that cannot help themselves on this forum which is a reflection on them and not me.

Your choice OP who you wish to believe, random people on a forum who have history with being unkind or someone with experience of rehabbing her horses along with very experienced vet and physio input. I'll leave it up to you to decide but good luck either way 😉
How did all that work out for you?
 
Please stop editing your posts multiple times Birker.
I always edit my posts, always have done. I can edit them as many times as I like as often forget to add things or have typos.

Can you not think about doing something more constructive with your time than putting others down? Surely it's easier to be kinder and emphasise than it is to be combative and antagonistic.

You saying " I had a false hope that as that post was a few days ago Birker had actually learnt something recently, as in when to back down quietly and not fan the flames. "

I intepret it as heck, I failed to reel her in that time.

I also read it quite clearly as it not being I who is fanning the flames.
 
It might be worth for some to take a deep breath, step away from the keyboard & remember that this isn't a post about them but a post about someone's much loved horse and their future - most of us have been there and know how stressful and heartbreaking that can be, without any added drama.

If Jazy is still here, then I'd have a guarded prognosis too based on your first post.

There will always be horse's that are exception to the rule, but I'd be preparing myself for the possibility that limited light hacking may well be a really good outcome for this horse.

Wishing you all the best as it's a very difficult position to be. Hoping for a positive outcome for you 🤞
 
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It might be worth for some to take a deep breath, step away from the keyboard & remember that this isn't a post about them but a post about someone's much loved horse and their future - most of us have been there and know how stressful and heartbreaking that can be, without any added drama.

If Jazy is still here, then I'd have a guarded prognosis too based on your first post.

There will always be horse's that are exception to the rule, but I'd be preparing myself for the possibility that limited light hacking may well be a really good outcome for this horse.

Wishing you all the best as it's a very difficult position to be. Hoping for a positive outcome for you 🤞
Thanks MM but I was answering a question I was asked by AM whilst enquiring about the OP who I'd spent time and a great deal of empathy trying to help.
 
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