hind suspensory problems in dressage horses

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Kelpie

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I came across this:


http://e-venting.co.uk/2013/09/influence-of-discipline-in-sport-horse-lameness/


very interesting article by the e-Venting team. I'll confess some personal interest due to my 5yo's PSD, so I'm always on the look-out for other experiences on hind suspensory problems.

What I was particularly interested in is the statistic provided by Svend Kold that:

"28% of all dressage horses have hindlimb suspensory problems to some degree during their career"

I'd love to know what study that statistic comes from, though?

Also, given that the neurectomy (now a common operation for PSD) is supposed to be illegal under rules, does this mean that vets are getting these horses sound using the operation and then they are being competed still anyway (after all, not sure how you can tell if the opp has been done?)??

Or does it mean that these horses that do come back to high level dressage work are getting sound some other way - if so how? (interestingly a recent lecture by Sue Dyson was quite direct about saying shockwave isn't at all proven to work.....).

thoughts??
 
I'm afraid I don't know too much about this so can't join the conversation too intelligently, but I do know that Gerd Heuschmann, the German vet and biomechanist, has some pretty interesting theories about this and the way horses work these days in dressage in particular. May be worth looking up his lectures, he is a good speaker )no matter what you think of his riding!).
 
Thank you - I've come across Gerd's stuff (and in fact it's one of the reasons I train in the French classical way......) :) ..... tho wasn't aware that Gerd particularly talks about hind suspensory issues? Would be really grateful if you could point me in the direction of anything of his particularly addressing that?
 
I am only responding to this thread to point out that ....

A BILATERAL NEURECTOMY AND FASCIOTOMY IS NOT ILLEGAL UNDER BD and BS RULES, just FEI rules.

Otherwise Horse and Hound would not have printed my Back from the Brink story last year. I am so fed up of people telling me I am cruel to have it done and that my horse is now illegal to compete. He hunted before I got him which I am sure contributed to his problems once I started to to do dressage seriously to answer the first bit of your OP.
 
My horse has PSD, attributed to a long and busy dressage career (competed PSG, trained to GP). He had shockwave, which considerably improved the fibre patterns, but didnt really improve his soundness, He still had a few lesions, which were treated with PRP (Platelet Rich Plasma), and last time he was scanned,there were new fibres being laid down across the PRP plugs. The vet said that she would consider the last set of scans to be good for a horse of his age/mileage. He has had the best part of 2 years off, and although he's sound most of the time - he does still take the odd dodgy step, and has definite off days. I doubt he'll ever compete again, but am hopeful that he will be able to play around a bit - he's fantastic fun to do party tricks on!
The thing that interests me is the fact that improving the damaged fibres didn't really make him much sounder - and I reckon it's the lengthy rehab process - lots of walking in straight lines on a hard surface, that is what seems to be the key to achieving soundness. I guess it's the time honoured "hardening of the legs" -maybe it reduces residual inflammation that is causing pain due to the small space available. Would the outcome have been the same if he hadn't had shockwave and PRP? I don't know - but I do know that those interventions made things look a lot better.
I also wonder a bit whether horses are competing with low grade/early PSD for a long time before anyone notices. I've watched vids of Alf when he was competing, and being placed - and I can see the subtle lameness, which is a bit scary!
 
Laafet said:
I am only responding to this thread to point out that ....

A BILATERAL NEURECTOMY AND FASCIOTOMY IS NOT ILLEGAL UNDER BD and BS RULES, just FEI rules.

Otherwise Horse and Hound would not have printed my Back from the Brink story last year. I am so fed up of people telling me I am cruel to have it done and that my horse is now illegal to compete. He hunted before I got him which I am sure contributed to his problems once I started to to do dressage seriously to answer the first bit of your OP.
Click to expand...

I'll display my ignorance here, but if a horse is competing at GP, wouldn't it generally also be doing FEI? (I am into eventing - which does specifically make a neurectomy illegal - rather than dressage so as I say, excuse my ignorance on that.....)
 
Auslander said:
My horse has PSD, attributed to a long and busy dressage career (competed PSG, trained to GP). He had shockwave, which considerably improved the fibre patterns, but didnt really improve his soundness, He still had a few lesions, which were treated with PRP (Platelet Rich Plasma), and last time he was scanned,there were new fibres being laid down across the PRP plugs. The vet said that she would consider the last set of scans to be good for a horse of his age/mileage. He has had the best part of 2 years off, and although he's sound most of the time - he does still take the odd dodgy step, and has definite off days. I doubt he'll ever compete again, but am hopeful that he will be able to play around a bit - he's fantastic fun to do party tricks on!
The thing that interests me is the fact that improving the damaged fibres didn't really make him much sounder - and I reckon it's the lengthy rehab process - lots of walking in straight lines on a hard surface, that is what seems to be the key to achieving soundness. I guess it's the time honoured "hardening of the legs" -maybe it reduces residual inflammation that is causing pain due to the small space available. Would the outcome have been the same if he hadn't had shockwave and PRP? I don't know - but I do know that those interventions made things look a lot better.
I also wonder a bit whether horses are competing with low grade/early PSD for a long time before anyone notices. I've watched vids of Alf when he was competing, and being placed - and I can see the subtle lameness, which is a bit scary!
Click to expand...

Interesting - and I have also wondered that about the walking rehab....

Also, now I know a bit about what I'm looking for, I swear loads of horses aren't right behind, probably due to suspensory issues - but then maybe I'm now paranoid?!
 
Kelpie said:
Interesting - and I have also wondered that about the walking rehab....

Also, now I know a bit about what I'm looking for, I swear loads of horses aren't right behind, probably due to suspensory issues - but then maybe I'm now paranoid?!
Click to expand...

If you're paranoid, I am too! I have turned into a hindlimb lameness psycho - particularly my own horse. I got in a panic this summer about him, only for his previous owner to say he looked better than she'd ever seen him in the 4 years she knew him!. He's a bit of a common sort (sorry Alf!), so doesn't have particularly extravagant movement - and he's got other issues, so on his off days, he is a bit of a square wheeled bike!
 
That's fine, the rules are a little unclear to most. I know there are BE horses that have had it done and horses that compete at FEI that have had it done too but as you say there is no way of proving it. With dressage there seems to be a lot of medication (I say Dressage as that is where my experience lies) of joints etc and the work is predominantly based on getting the horse on his hocks. There are a number that are treated with heart bars on the hinds too to combat this.
I read the Sue Dyson article too and found it very interesting. Just the other day a vet was saying to me, at work, that IRAP was not all that they'd hoped.
 
Laafet said:
There are a number that are treated with heart bars on the hinds too to combat this.
Click to expand...

Sighs - I completely forgot the single thing that made a MASSIVE difference to Alf. He had Jim Blurton hind sports bars on behind, while the vet was there, and went from 2/10 lame to sound in three trot ups!
 
Auslander said:
My horse has PSD, attributed to a long and busy dressage career (competed PSG, trained to GP). He had shockwave, which considerably improved the fibre patterns, but didnt really improve his soundness, He still had a few lesions, which were treated with PRP (Platelet Rich Plasma), and last time he was scanned,there were new fibres being laid down across the PRP plugs. The vet said that she would consider the last set of scans to be good for a horse of his age/mileage. He has had the best part of 2 years off, and although he's sound most of the time - he does still take the odd dodgy step, and has definite off days. I doubt he'll ever compete again, but am hopeful that he will be able to play around a bit - he's fantastic fun to do party tricks on!
The thing that interests me is the fact that improving the damaged fibres didn't really make him much sounder - and I reckon it's the lengthy rehab process - lots of walking in straight lines on a hard surface, that is what seems to be the key to achieving soundness. I guess it's the time honoured "hardening of the legs" -maybe it reduces residual inflammation that is causing pain due to the small space available. Would the outcome have been the same if he hadn't had shockwave and PRP? I don't know - but I do know that those interventions made things look a lot better.
I also wonder a bit whether horses are competing with low grade/early PSD for a long time before anyone notices. I've watched vids of Alf when he was competing, and being placed - and I can see the subtle lameness, which is a bit scary!
Click to expand...

Interesting your point about things "looking better". I was talking to a vet recently who said more or less the same thing - while there is an obvious correlation between good scans etc and success, it's not always that cut and dried.

Ditto re the rehab. Not far off the old practice of blistering so people would give the horse six months off... . .
 
Laafet said:
That's fine, the rules are a little unclear to most. I know there are BE horses that have had it done and horses that compete at FEI that have had it done too but as you say there is no way of proving it. With dressage there seems to be a lot of medication (I say Dressage as that is where my experience lies) of joints etc and the work is predominantly based on getting the horse on his hocks. There are a number that are treated with heart bars on the hinds too to combat this.
I read the Sue Dyson article too and found it very interesting. Just the other day a vet was saying to me, at work, that IRAP was not all that they'd hoped.
Click to expand...

Yes, the Sue Dyson article was kinda scary in a way - though at least she has a reputation for saying it how it is!
 
on he heart bar shoes...... so why is it that they help the suspensories then?

.... and gland I'm not the only paranoid one out there then :) :)

on hardening the legs/ giving time off....... just a little muse, but could this be something that goes against most dressage horses? At least eventers traditionally get a winter break and often brought back into work with road work, whereas dressage horses often don't even hack and it is more unusual for them to get a good stint of down time?
 
Kelpie said:
on he heart bar shoes...... so why is it that they help the suspensories then?

.... and gland I'm not the only paranoid one out there then :) :)

on hardening the legs/ giving time off....... just a little muse, but could this be something that goes against most dressage horses? At least eventers traditionally get a winter break and often brought back into work with road work, whereas dressage horses often don't even hack and it is more unusual for them to get a good stint of down time?
Click to expand...

I see it as the heel support reduces downward forces and takes a bit of strain off the suspensories/other soft tissue structures - less movement reduces pain and helps them heal.

I'm not sure about the downtime - think its more prevalent in dressage horses, particularly high level ones, because they are asked to work in a more advanced frame with a lot of sit behind. BUT, it's true that they don't get the long rests, and maybe they should, to allow any minor damage to heal.
 
My ex-racer has PSD and had the double neurectomy (diagnosed by Sue Dyson). she said the same thing to me about the shockwave.

The surgery cost £2k and diagnostics cost £2k which only left £1k for the follow up scans etc under insurance. I think the shockwave was about £1k as well if I wanted to try it, but most horses then went on to have the surgery so I felt it was prolonging it. My horse's suspensories were fraying at the top and there was no way of repairing them. I actually had to keep him box rested for 6 months as he was a nightmare to lead in hand and just wouldnt be sensible in the field (no matter what size it was or who he had for company).

He was 13 when diagnosed and had spent the last 6 yrs doing dressage with me - up to Medium. He lacked oomph and gradually I felt he was not stepping under enough and there was no true sit in his collection. He then started to disunite in canter (he also has a SI strain) and then we took him to see Sue.

You can just see the scars on his back legs from the surgery. I wont every compete him and he will not jump again. He is not really back into work, 2 yrs after the surgery. If I had the choice again I would have had him PTS; he is just too hot to keep in light work and he doesnt have the mentality for retirement (he is spooky and stupid when not in work).
 
On a slight tangent, Rachel Murray of the AHT, stated at the BD trainers convention, that they are now seeing the same prevalence of psd in dressage ponies, as horses. They believe this is partly due to the ponies now being mini warmbloods, and many junior riders simply too large for a pony of that build.
 
I think the main problem is that we are asking the horses to do something they aren't designed for. Naturally they would take more weight on the forehand, but we ask them to do the opposite and take the weight on the hind legs so we are getting more hock and SI injuries in the dressage horses.
 
We also have to remember though that diagnostics and available treatments have developed exponentially in the past 20 odd years. Not that long ago, there were many now "common" maladies we didn't even know about, let alone have the resources to diagnose is the general population. (I suspect insurance has something to do with this, as well - don't forget that veterinary science is industry driven, not just altruistic.) Treatment ties into it, as well - there is a much bigger incentive to diagnose conditions it might be possible to treat.

I'm not saying there isn't something to the idea that these conditions are on the rise, but I think we have to be a bit careful to draw conclusions about the relationship between them and developments in horses, training etc. We simply do not, and cannot, accurately compare. Horses have always gone lame. Some have responded to treatments - or management practices - available at the time, others have not. Some have come back after extended rest and careful rehab, some have not. If anything, the ability to "do things" has increased the number of cases floating around - we used to have a much more accepting view of these things when there was less that we could do.
 
Auslander - interestingly, my PSD mare prefers to re-arrange her bed such that basically she has a bank act the back to stand on.... I spoke to a physio about this and apparently it is to do with that relieving the pressure from the hind suspensories..... do the heart bars also have a raising effect?

Would love there to be more research into downtime and how much use it is..... tho for me, my mare was diagnosed as a 5yo with little mileage so apparently it is either conformational (though other than a very slightly odd raise to her spine in her lower back, I generally thought she has good confirmation) or it is some sort of in-built pre-disposition :(

CBAnglo- so what are you doing with your horse now? I keep debating whether to do the surgery but apparently where SI pain is also present (as in my mare also) the successe rate is less than 40% and I jusrt don't know if I want to put her through it with that success rate (and anyway she seems field sound.....).

Christine48 - it's a fair point - but then again horses aren't designed to be ridden full stop :(

TS - funnily enough I was talking with my regular vet recently (I like him, he's very honest) and he was of a similar mind in that yes we have a lot more diagnostic tools nowadays but in treatment terms, our abilities are way behind our diagnostic ability :( Apart from some cases of surgical options, basically the main factor tends to remain time and Dr Green.

Sometimes I wonder if we and our horses were better in the days of chucking them out in the field for a year or so and either they got better (and got ridden) or they didn't (and got retired/ shot).....
 
I think mine ( not a dressager!) had psd for a while before I or anyone else noticed tbh, he was just classed as lazy behind. I'm hoping now with shoes off he might be happier and he might start to work better from behind.

I think there are many eventers out there who've had the op too fwiw, competing illegally.
 
Kelpie said:
Auslander - interestingly, my PSD mare prefers to re-arrange her bed such that basically she has a bank act the back to stand on.... I spoke to a physio about this and apparently it is to do with that relieving the pressure from the hind suspensories..... do the heart bars also have a raising effect?
Click to expand...

Alf used to stand on his banks too! He had wedges on behind, but they didnt suit him - the sports bars definitely do. They aren't heart bars - look similar, but the frog v section is shorter, so that the support is concentrated on the heels, but there is still a bit of frog support. They don't raise the heels, just support them in their entirety - bulbs and all. I know that some would say barefoot would be best, but he was unshod behind for a very long time, on a barefoot-friendly diet, but was still lame. I felt that it was worth a couple of cycles in the sports bars while he was healing, and he's now out of them, and still sound. His foot shape has changed considerably - he now has nice big feet with good heels, where he had funny little bullnosed hinds and collapsed heels before the sports bars went on. He has no shoes on at the moment as he's not doing much over the winter, and is hacking out with no footiness, but I will have no hesitation in putting the sports bars back on if he needs them when is workload increases.

Another interesting development - his legs always blew up when he was in the stable for more than a couple of hours (you can see how puffy they are in the pic below), but they went right down within an hour of the sports bars going on, and haven't blown up since!

580932_10151553622140730_1277008907_n.jpg
 
I've been trying to think what you meant by 'sports bars'! Where I'm from they are drinking establishments that have a sport theme and show pro sports, usually full of drunk men yelling at the many, many enormous tv screens! :D

I would call those 'heart bars'. Learn something new every day!
 
TarrSteps said:
I've been trying to think what you meant by 'sports bars'! Where I'm from they are drinking establishments that have a sport theme and show pro sports, usually full of drunk men yelling at the many, many enormous tv screens! :D

I would call those 'heart bars'. Learn something new every day!
Click to expand...

Lol - I like the sound of your sports bars more than mine!

They are different to heart bars in that they have extended heel support, making them similar to an egg bar, but the heart bar style frog support element as well. I reckon they look like heart bars too - but you can see the difference when you put them next to a proper heart bar.

These are the beasties - http://www.jimblurton.co.uk/hind-sports-bar/
 
Wow, not the sort of sports bars I would usually use either ;) .... However, thanks for the tip, will see if my farrier thinks they may be worth a go with my girl :)
 
Kelpie said:
Wow, not the sort of sports bars I would usually use either ;) .... However, thanks for the tip, will see if my farrier thinks they may be worth a go with my girl :)
Click to expand...

They certainly worked a charm on Alf. The decision to put them on was a vet/farrier collaboration, and both were surprised at just how good he was in them!
 
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