Hind suspensory problems

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Spanish Dressage

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After bone scans, injections, rest, my vet thinks my new horse has suspensory issues in his hinds - he said it's pointless scanning as often it doesn't show up. But he is sound now - so to ride him and then investigate further when he is lame again and send him for surgery. I am thinking of an MRI to give me answers rather than just doing guess work on probable PSD. Any experiences?
 
I've had 3 with suspensory issues. One was bilateral hind legs, later determined to be dsld. One had a hind, then a front - diagonals. Another had a front. The one which had dsld, there was no injury site but the suspensory's were totally disrupted, the others, specific injuries were found. It's never been suggested to me that ultrasound would not pick this up, and in each of my 3 horses the vets involved were very confident with their diagnosis.

How old is your horse? I wouldn't send one for surgery without a diagnosis.

ETA based on my experience with dsld I'd be sceptical about the surgery anyway and would want to rule this out with a bilateral issue before putting the horse through the procedure.
 
Thank you for responding - I thought it was a bit off that my vet said scanning hind suspensories was not reliable. I would have thought that was the next thing to do.
I think I will get a second opinion, before considering mri. My vet is incredibly experienced, so I find it a bit baffling.
My horse is only 5 bought in Feb - progressively did not want to go forwards in trot. Which got worse and worse.
He was lame on flexion on left hind but with rest is now sound on flexion. Looks off on the lunge but almost just weak but flexed sound on both hind legs yesterday.
He was lame on left hind, but my physio thinks he is compensating, so likely to be both hinds.
 
Scannng hind suspensories is a very mainstream procedure and I’ve not known it to not show up hind suspensory issues in the three horses that I’ve had scanned, going back to 35 years ago. It’s cheap enough, non invasive and can be done at the yard with a portable scanner.

Tbh I would not be wanting to continue using a vet who poo poos scanning - it is possible that some issues might be missed, but it’s not going show up a false positive. Maybe that particular vet has difficulty in diagnosing from scan images?

ETA my dressage horse with a hole running down the length of his hind suspensory trotted up sound in a straight line on the hard but almost fell over when gently asked to move over - I’m afraid he had to be pts age 8, he was already retired to the field.
 
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Scanning found the issue with my big mare. Took 2 attempts (& an argument with the vet because I'd guessed suspensory) but it was damaged right by her hock.

You've got to be able to read scans well tho. First vet told me everything was fine and I was just paranoid. 3 weeks later I had the senior vet out for a hock injection and she'd obviously looked at the scan results and disagreed with her colleague. She brought the scanner with her and did a second scan which showed the damage.
 
Perhaps the vet is not certain it is suspensories so wants to nerve block first (horse would have to be visibly lame). I had one with PSD in one hind leg, came sound after shockwave and box rest but I never risked much jumping after that.
 
He has already been to a big vet hospital for further investigations, bone scans etc. he nerve blocked to the hock area straight away and noticed the tiniest arthritic changes on x-ray so he had some steroid into joint but vet did say it could be suspensory as well but to slowly introduce walk work and reassess - we have just reassessed he has flexed sound. But just isn't right still on the lunge.
My vet now wants me to work him to make him lame again and then reassess and send him for suspensory op - but does not think scanning is accurate so not to bother. I disagree and would even rather MRI if needed than not scan, as want to know before jumping in.
 
Spanish Dressage said:
He has already been to a big vet hospital for further investigations, bone scans etc. he nerve blocked to the hock area straight away and noticed the tiniest arthritic changes on x-ray so he had some steroid into joint but vet did say it could be suspensory as well but to slowly introduce walk work and reassess - we have just reassessed he has flexed sound. But just isn't right still on the lunge.
My vet now wants me to work him to make him lame again and then reassess and send him for suspensory op - but does not think scanning is accurate so not to bother. I disagree and would even rather MRI if needed than not scan, as want to know before jumping in.
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I would honestly guess that vet is not confident reading scans and that is his main reason why. Personally I would have a second vet out to scan. Yes things can be missed but a competent vet who takes their time looking will be able to find if something is there. I question heavily how effective those surgeries are compared to good ole dr green and time. Outside of a complete tear or detachment
 
My vet also says scanning hind suspensories isn’t reliable and apparently the leading vet at Donnington Hospital says the same.

So say it’s hard to read suspensory scans and know what is causing an issue and what isn’t.. I had already had her suspensories scanned by a lameness vet prior to speaking to that vet.

I wouldn’t operate on suspensories based on ‘think it’s that’ I’d at least nerve block and go from there.
 
We have already nerve blocked and done all of that - both the specialist and my vet said it could be suspensories if it's not the start of arthritis. We all agree now it is most likely suspensories after ruling out everything else. I would rather spend the money on MRI if scanning is not reliable. I will not go ahead with anything without a proper diagnosis.
 
Spanish Dressage said:
We have already nerve blocked and done all of that - both the specialist and my vet said it could be suspensories if it's not the start of arthritis. We all agree now it is most likely suspensories after ruling out everything else. I would rather spend the money on MRI if scanning is not reliable. I will not go ahead with anything without a proper diagnosis.
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MRI is the best way to rule out suspensories. My friends mare blocked to the suspensories, at a big equine hospital.. they considered the op but MRI scanned first.. suspensories were perfect!! Turned out some of the nerve block went into the hock and the MRI showed actually has some low hock changes.

Medicated the hocks, tons of improvement.
 
I really hope we move beyond having to work horses to make them lamer, so often the dysfunction, the precursor to lameness, is visible to eyes experienced in looking for compensatory movement.

Good luck with diagnosis and prognosis etc (and I'm absolutely not telling you to ignore what the vets want you to do!).
 
My horse with hind suspensory problems certainly showed up on scanning , was scanned at hirds in Halifax , he also wasn’t operated on but had think in house days irap as an alternative ( think prp would be more common now ) he did have his hoove mri at the same time as also had a collateral ligerment injury .
Luckily at that time he was insured .

He did come right after extensive rehab and rest and went back to eventing ( be100 )
 
sbloom said:
I really hope we move beyond having to work horses to make them lamer, so often the dysfunction, the precursor to lameness, is visible to eyes experienced in looking for compensatory movement.

Good luck with diagnosis and prognosis etc (and I'm absolutely not telling you to ignore what the vets want you to do!).
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I am not going to work him to make him more lame - he is 5 - what is that teaching him, that riding means pain. I thought the vets had moved past this as well! He is compensating already in his posture and musculature behind.
Thank you - we will get to the bottom of it eventually.
 
lannerch said:
My horse with hind suspensory problems certainly showed up on scanning , was scanned at hirds in Halifax , he also wasn’t operated on but had think in house days irap as an alternative ( think prp would be more common now ) he did have his hoove mri at the same time as also had a collateral ligerment injury .
Luckily at that time he was insured .

He did come right after extensive rehab and rest and went back to eventing ( be100 )
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Thank you - I am going to ring another vet practice tomorrow and see what their thoughts are on scanning suspensories. I will get them out depending on their answer.
Thank you for the positive story - I am really hoping we have a little bit of hope left after putting my other 5 year old to sleep a month ago with chronic uveitis.
 
My cob was lame (throwing hind outwards not moving from the hock). Vet wanted me to try and work him through it but I asked to scans. Xrays of hocks etc clear but ultrasound showed inflammation of the suspensory. Vet said cobs have thick skin so was very difficult to notice but scanners at the RVC are much more specialist and give a much clearer picture as their equipment is much better. We are 16 weeks in, had laser therapy twice a week for 4 weeks, alpha 2 injection into the ligament, ice boots, boswellia etc to reduce inflammation. Started back into lightwork in straight lines. Had physio today and he had a pain response, reluctant to flex and throwing the hip again in walk. She has said go with my gut as an owner and my gut is saying do more scans and find out if the inflammation is secondary so we are doing nerve blocks and rhen potentially scan at the RVC. They can do ultrasound or CT of lower limb but of CT of Si, Stifle etc needed it woud need a GA. Its so complex when they're not hopping lame but you know your horse is telling you something is up, we have to listen and go with our gut xx
 
I know that primary/secondary is the standard way to view these things but it's worth keeping a second line of thought that these are both/all just symptoms of compensatory movement patterns, the original cause could be anything going right back to possible birth trauma.
 
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