Hind Suspensory Neurectomy - Outcomes/Views Please?

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PercyMum

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Well, I did say he was a total nightmare and it would seem that the Knobber has really done it this time with his titting about.

Diagnosed with scarring on L Hind suspensory, most likely due to his pratting about in the field, probably caused over time and before I had him and it's now just tipped over the edge of what he can cope with, combined with an increase in the level of work he was doing. We have just come to the end of 6 weeks of box rest, shockwave treatment and walking in hand (or taking my life in my hands as I think it's more aptly known as). Re-examined yesterday and there isn't one bit of improvement, so the options left are PTS (he is absolutely not suitable as a pet) or surgery.

I'm being jokey but I am utterly devastated as he is a lovely boy, notwithstanding his epic quirks. What I'm curious to know is the outcome of this surgery as my vet is being quite circumspect about it, which worries me. I have yet to get hold of the surgeon who will be doing the op if I proceed so clearly I still need to ask him. What is the likelihood of him returning to full work in your experience? What are the downsides to the surgery? I have to fund this myself as he is exempt on insurance so the £3k is a lot to try and find if there is not a good certainty of a positive outcome. He hates not working, so if I can't be sure of a reasonable outcome then PTS will sadly be my only option as I think he will go slowly mad as a pet, as well as being dangerous to handle.

Thanks in advance.
 
Sorry just to add I had a horse with PSD and I wish I'd turned him away for 6 months instead of boxrest, shockwave and hand walking. It didn't make a jot of difference and that 6 months of his life might have been so much happier spent in a herd living out
 
The neurectomy will only remove the pain and not resolve the issue that is causing it.

My lad has just had the surgery on both hinds after a lot of other investigations. He has hock arthritis, SI pain and ulcers, the latter of which have been treated but keep recurring. He went for more investigations is November and blocked to the suspensory, looked at his case history and wasn't sure whether it was secondary to the other issues or the other issues were caused by PSD - either way, Toby was lame and was offered surgery or minimum 6 months box rest. Opted for surgery as he is young and prognosis was initially good but since starting veeeeeeeeeeery slow rehab (20 minute walks and some stretches) he has gone lame again and physio is now suspecting stifle issues (having the shoes off this weekend to make sure they aren't causing the issue). I won't put him through any more investigations as I don't think he will ever be able to do the level of work he was able to so going to continue with slow rehab and hopefully get him to a point where he is sound to hack and then make a decision. I looked into retirement but after thinking about it I don't think it would suit him either so if he won't come sound to hack, he will be PTS and not fair to keep him in pain.

I would recommend joining the PSD discussion group on FB, lots of really great advice and lovely people! Good luck, I hope it works out for you. This is of course just my experience, there are tonnes on the group who have had really successful cases!
 
I’m no expert on it by any means.
Ethically I have no issues with the surgery - it’s straightforwards and I found the rehab fine.
PSD is a funny thing though as it is often one of 2 or 3 niggly physical issues and it’s not always easy to isolate the primary. In my limited experience horses with PSD are just a bit ‘crocked’ all over.

I had one done by Andy Bathe in Newmarket. After rehabbing to the letter, he felt not a jot different when he started working. He wasn’t hoppy lame, just too crock to be a performance horse. He went hunting in the end.

I’d probably give the op a go if covered under insurance.
If it was out of my own pocket, well I think I would want to be pretty sure there wasn’t anything else going on and it would be on a horse Ivreally liked and had done a good job for me. (And it would be with the view to get the horse comfortable for a lesser job)
 
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Be prepared for a lot of negativity everywhere. I think it works brilliantly for some, and not so for others depending on a whole range of factors. Mine is coming up 7 years post op in November, sound and competing at Elementary, I wouldn't push him further. There is a lovely group on Facebook if you are interested that provide support for whichever route you take.
 
We are 4.5yrs post surgery - I don’t expect a huge amount from mine, hacking and schooling. But, And I’m loathe to say it and jinx it - she’s good. I was given pretty poor odds for anything, but surgery was her best chance, we had incredibly cautious rehab but it does seem to have been worth it.

Definitely have a look at the PSD group on Facebook. Fabulous group!
 
my horse was done 16 ish years ago it was a new diagnosis then but has been fine - touch wood - but as others have said he has lots of niggly issues. but has competed and done very well. Lots of others i know have not done well.
 
Thanks All.

I'm not on Facebook so may have to ask a friend look for me. I'm usually pretty sensible and clear cut about these things but I really have no idea what to do in this situation. To not even try and PTS seems terribly hard-faced but it is £3k I don't have (except for a credit card). I do love him but he is a tit, can be tricky to handle and ride and is stupidly high maintenance. He also has melanomas so I don't know how quickly they could start affecting him. Or am I just looking for things to try and force my own decision.

So incredibly stuck its untrue.
 
PercyMum said:
Thanks All.

I'm not on Facebook so may have to ask a friend look for me. I'm usually pretty sensible and clear cut about these things but I really have no idea what to do in this situation. To not even try and PTS seems terribly hard-faced but it is £3k I don't have (except for a credit card). I do love him but he is a tit, can be tricky to handle and ride and is stupidly high maintenance. He also has melanomas so I don't know how quickly they could start affecting him. Or am I just looking for things to try and force my own decision.

So incredibly stuck its untrue.
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Would you like me to post your original Q on the Facebook group for you and update you with answers? Happy to do so, I so feel your pain at the moment!
 
I've a 20 year old horse, diagnosed with PSD aged 11. Went to have surgery, and found other issues (stifle and SI) which meant not suitable for surgery. For us rehabbing the foot balance and the SI in the long run fixed the PSD by taking pressure off. We went on to do two British Dressage Regionals, post diagnosis first aged 16!

The this horse has always been compromised and hard to keep right, and huge amount of effort and commitment.

I'd say, the key thing with PSD is less how you treat it, and more working out what the underlying cause was and whether that can be resolved or not, to help decide what to do. PSD is nearly always a secondary response to a primary problem. The primary problem causes horse to be compromised, and this compromise shows up as damaged suspensories. Could be working surfaces / foot balance / pain anywhere / conformation / etc.

Some horses when remove cause (if is removable and not say conformation) improve, and resolve PSD issue (like my horse). Others I think primary issue cannot be fixed (in which case surgery not going to help much). Others still you fix primary problem but scar tissue and swelling in PSD ligament areas remain, and also need surgery to make more space and stop small nerve pressing in this area, and go on to do much better post surgery. But be warned sometimes after a number of years the branch nerve cut grows back and pain returns.

I think you need to try and figure out which category your horse falls into. If you are self funding, then no reason cannot wait and see, if can address primary issues if improves, and turn away first, and then have surgery as a back up option.

You can join Facebook just to join the PSD discussion group without setting up more than a restricted profile (but might want to PM a moderator so know it isn't a spam account).
 
My other thought is whether it is worth shopping around for surgery quotes? £3K seems high to be, but I might be out of date. I had in mind more £1,500 plus some after care and bandage changes?

As an aside I have recently taken another horse to a uni vet college (versus an independent one) and the difference in costs was astounding. Far cheaper!!

Worth asking your vet!
 
PercyMum said:
Thanks All.

I'm not on Facebook so may have to ask a friend look for me. I'm usually pretty sensible and clear cut about these things but I really have no idea what to do in this situation. To not even try and PTS seems terribly hard-faced but it is £3k I don't have (except for a credit card). I do love him but he is a tit, can be tricky to handle and ride and is stupidly high maintenance. He also has melanomas so I don't know how quickly they could start affecting him. Or am I just looking for things to try and force my own decision.

So incredibly stuck its untrue.
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I know how you feel, one of my horses had a psd diagnosis years ago, it was very minor so the op wasn't necessary, I did the shockwave and rehab process and it made no difference, she was turned away for 18 months and came back like nothing had ever been wrong! She is in full work now ready to compete etc, I probably wont be doing as much as I did before as I am conscious of what happened but I am happy she had the long break. She had her shoes removed for the break and was more level from that too, so I am now trying to manage her barefoot aswell.
My friend had her horse diagnosed with the same and had the op, he has had lots of problems since but still hacking and in low work, she has Rob Jackson treat him a lot and swears if she met him earlier she wouldn't have had the op done.
Look him up I can imagine the majority of his work is treating psd horses with other connecting issues x
 
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