Hind suspensory surgery

[ponyrider2024]

My 6yo showjumper has some damage to his hind suspensories, thickening and an uneven fibre pattern. One worse than the other. He’s only a little lame and sore on palpation. Blocked sound to them so we know the lameness is coming from them. I’m considering my options, he’s a young horse that won’t tolerate box rest so this is something I will not do for prolonged periods (over a month) as it is not in his best interests. Other horse has had shockwave and not impressed by results. This particular horse very much needs a job, so turning away for a year isn’t ideal either as I think he’ll probably do himself a much worse injury by titting about. Anyway, he competes BS so anything I do HAS to be legal. I’m keen on surgery, considering whether to ask for a fasciotomy on its own to allow the ligaments the space to heal, tho prolonging rehab time, or go for neurectomy and fasciotomy combined, as I’m under the impression this shouldn’t massively impact limb sensitivity, therefore he can still compete? Any experience with similar situations would be very helpful, and any ideas as to what rehab looked like for you (timelines etc?) as I’m keen to get my boy out doing what we both love, but not at the expense of his welfare!

 

[Bellaboo18]

I'm afraid my honest opinion is, at 6 if you take him back competing at his current level he won't stay sound for long. For his welfare, i'd look at a quieter life going forward.
The rehab isn't too bad. We did two weeks box rest then small pen turnout with hand walking that was built up weekly.
Ideally you need to find out what has caused the psd. Have you had his feet x-rayed?

 

[ponyrider2024]

I'm afraid my honest opinion is, at 6 if you take him back competing at his current level he won't stay sound for long. For his welfare, i'd look at a quieter life going forward.
The rehab isn't too bad. We did two weeks box rest then small pen turnout with hand walking that was built up weekly.
Ideally you need to find out what has caused the psd. Have you had his feet x-rayed?

Ahh I was under the impression from my vet that he will be sound as he can’t feel the pain? Either way I’ll give it a go as he’s insured and I have nothing to loose. Realistically as lovely as he is, I can’t afford to keep him as a field pet alongside my other older horse who requires maintenance so the alternative is a couple of years retired then PTS. Yes, nothing blindingly obvious and the damage is small. Vet thinks it predates me as he’s had a relatively easy life with me.

 

[Bellaboo18]

Ahh I was under the impression from my vet that he will be sound as he can’t feel the pain? Either way I’ll give it a go as he’s insured and I have nothing to loose. Realistically as lovely as he is, I can’t afford to keep him as a field pet alongside my other older horse who requires maintenance so the alternative is a couple of years retired then PTS. Yes, nothing blindingly obvious and the damage is small. Vet thinks it predates me as he’s had a relatively easy life with me.

That's a concerning view. It's definitely not a miracle cure, the nerve can grow back and unless the cause of the problem is found and rectified he will breakdown again. I wouldn't personally do the op without feet and back X-rays. You've not got anything to lose financially but ethically i'd want to know the chances of success before putting a horse through surgery.
At 6, he's very young to have psd.

 

[ponyrider2024]

That's a concerning view. It's definitely not a miracle cure, the nerve can grow back and unless the cause of the problem is found and rectified he will breakdown again. I wouldn't personally do the op without feet and back X-rays. You've not got anything to lose financially but ethically i'd want to know the chances of success before putting a horse through surgery.
At 6, he's very young to have psd.

I’ve been made aware of the possible side effects and that the nerve can regrow. I also was planning on doing some rehab and complimentary therapies to assist healing whilst he’s off so that the fasciotomy will allow the swelling to take place and then reduce, and the nurectomy will reduce the pain. He’s had his feet and hocks xrayed, absolutely nothing to indicate anything coming from the back at all, he’s an incredibly sensitive horse so quite good at letting me know where it hurts, so much so we picked up on the hind end lameness before it became a real problem.

 

[nutjob]

I think the rules have changed now. BD/BE/FEI are very clear that horse cannot compete after neurectomy. I'm not a member of BS but I believe they also follow this now.

 

[Bellaboo18]

I’ve been made aware of the possible side effects and that the nerve can regrow. I also was planning on doing some rehab and complimentary therapies to assist healing whilst he’s off so that the fasciotomy will allow the swelling to take place and then reduce, and the nurectomy will reduce the pain. He’s had his feet and hocks xrayed, absolutely nothing to indicate anything coming from the back at all, he’s an incredibly sensitive horse so quite good at letting me know where it hurts, so much so we picked up on the hind end lameness before it became a real problem.

From your posts it doesn't sound like he's sensitive but in a lot of pain.

 

[ponyrider2024]

From your posts it doesn't sound like he's sensitive but in a lot of pain.

No. He’s sensitive. The minute I felt something was off I had the vet out. He has an incredibly small amount of change on the ultrasound, almost insignificant in one limb. My original post asked if anyone had any experience dealing with rehab after surgery, or positive outcomes without surgery. Do you have either? I’m not trying to be rude but replies such as this are actually not very helpful. I’m working very closely with several vets to make a decision as to what is best. Had almost completely decided on surgery, and then had a wobble over whether that was right. If I can’t get him sound, unfortunately I will have to eventually have him PTS so it’s actually not a decision I’m going to make lightly.

 

[ponyrider2024]

I think the rules have changed now. BD/BS/FEI are very clear that horse cannot compete after neurectomy. I'm not a member of BS but I believe they also follow this now.

They have been changed but state that changing the sensitivity of the limb is banned. Tested by palpation. As the suspensory is often not reactive to palpation, and the nerves often regrow (once the injury has “healed”) I’d imagine by the time he’s back out competing he will be sensitive again? I’m not against him being a low level BS horse, I don’t want to do loads with him, just want to get him back out doing what he loves.

 

[Bellaboo18]

No. He’s sensitive. The minute I felt something was off I had the vet out. He has an incredibly small amount of change on the ultrasound, almost insignificant in one limb. My original post asked if anyone had any experience dealing with rehab after surgery, or positive outcomes without surgery. Do you have either? I’m not trying to be rude but replies such as this are actually not very helpful. I’m working very closely with several vets to make a decision as to what is best. Had almost completely decided on surgery, and then had a wobble over whether that was right. If I can’t get him sound, unfortunately I will have to eventually have him PTS so it’s actually not a decision I’m going to make lightly.

I've got experience of the surgery hence I gave a brief explanation of the rehab. I've also got a positive story but I didn't expect my mare to go back to the work that caused the problem (before I owned her) which is why I think it's been a happy ending.

I'm sorry if you've not found my replies helpful but I stand by what I've said.

Personally;
I'd want back and feet X-rays.
I wouldn't expect him to go back to jumping affiliated.
From your other threads, he sounds in pain.

Good luck. There's a helpful group on Facebook if you search psd.

Eta. The BS ruling is a tricky one. I know people do compete after n&f but my understanding is they shouldn't but the rule always caused confusion so I'm not 100% sure.

 

[ponyrider2024]

I've got experience of the surgery hence I gave a brief explanation of the rehab. I've also got a positive story but I didn't expect my mare to go back to the work that caused the problem (before I owned her) which is why I think it's been a happy ending.

I'm sorry if you've not found my replies helpful but I stand by what I've said.

Personally;
I'd want back and feet X-rays.
I wouldn't expect him to go back to jumping affiliated.
From your bitting thread, he sounds in a lot of pain.

Good luck. There's a helpful group on Facebook if you search psd.

My bitting thread was written coming out of winter when my horses were all full of the joys of spring. He was incredibly green when he came to me. The ducking out was a result of me not doing anything before a fence. I had the vet out who did a full work up with flexions and found absolutely nothing of note. He also had physio and chiro. Both of which found nothing of note. He then went absolutely beautifully when I found a nice snaffle that he enjoyed with less tongue pressure. The same vet then came to do the work up this time when I noticed him struggling a little with the push in trot and ever so slightly not tracking up correctly on one rein through one limb. He was positive on flexion and palpation of the suspensory and looked much lamer on the soft then he’d done out hacking which is where I noticed the lameness. He is physioed once a month and only this month did the physio feel compensation elsewhere. Until then he’s been clean as a whistle. I think the step up to slightly more intense work possibly aggravated a previous overstretch of the ligament, paired with a deep arena due to the weather. My horse is young and this is the better alternative to the otherwise inevitable because quite frankly I cannot support two horses through retirement and my other horse takes priority as I’ve had him a very long time, he’s much older and doesn’t have any soft tissue injuries that may cause him to be uncomfortable in a field. I don’t expect this horse to go and jump the 140s, I’d like him to potter round at 1/1.10 forever more as that is what makes him happy. He lives for his jumping. If I can’t keep him sane then what kind of a life is that for him? He won’t live out 24/7 through winter, he tits about and will injure himself badly. He’s had his feet xrayed and everything looked fine. Mild bit of arthritis in hocks, find me a showjumper that doesn’t have arthritic hocks! Moves beautifully through the back, no uneven muscle development, no atrophy, completely negative to palpation of any kind and quite frankly not something I have the capacity to do right now. If I had any and I mean ANY inkling that his back was contributing in anyway whatsoever I’d have already xrayed. He has slightly straight hind leg conformation so this could be contributing, but I’m talking mild. I’m not talking about a suspensory with a lesion in it, that’s a different matter. He has an uneven fibre pattern and enlargement of some areas. It is an incredibly mild amount of damage. Being on the showjumping circuit I can name at least 10 horses that have had a nurectomy out competing at higher levels than myself, a lot of them had surgery before the most recent rulebook came out, hence my asking about how much attention is paid to horses that have had nurectomies. I wholeheartedly disagree with denerving pretty much anywhere else in the limbs I really wanted a rehab timeline more than anything as I’ll take any veterinary advice off of my team of vets.

 

[Red-1]

I think the rules have changed now. BD/BE/FEI are very clear that horse cannot compete after neurectomy. I'm not a member of BS but I believe they also follow this now.

I called BS after experience with a similar issue with a suspensory and they were clear that it would not be possible to compete after a neurectomy.

 

[TheMule]

My bitting thread was written coming out of winter when my horses were all full of the joys of spring. He was incredibly green when he came to me. The ducking out was a result of me not doing anything before a fence. I had the vet out who did a full work up with flexions and found absolutely nothing of note. He also had physio and chiro. Both of which found nothing of note. He then went absolutely beautifully when I found a nice snaffle that he enjoyed with less tongue pressure. The same vet then came to do the work up this time when I noticed him struggling a little with the push in trot and ever so slightly not tracking up correctly on one rein through one limb. He was positive on flexion and palpation of the suspensory and looked much lamer on the soft then he’d done out hacking which is where I noticed the lameness. He is physioed once a month and only this month did the physio feel compensation elsewhere. Until then he’s been clean as a whistle. I think the step up to slightly more intense work possibly aggravated a previous overstretch of the ligament, paired with a deep arena due to the weather. My horse is young and this is the better alternative to the otherwise inevitable because quite frankly I cannot support two horses through retirement and my other horse takes priority as I’ve had him a very long time, he’s much older and doesn’t have any soft tissue injuries that may cause him to be uncomfortable in a field. I don’t expect this horse to go and jump the 140s, I’d like him to potter round at 1/1.10 forever more as that is what makes him happy. He lives for his jumping. If I can’t keep him sane then what kind of a life is that for him? He won’t live out 24/7 through winter, he tits about and will injure himself badly. He’s had his feet xrayed and everything looked fine. Mild bit of arthritis in hocks, find me a showjumper that doesn’t have arthritic hocks! Moves beautifully through the back, no uneven muscle development, no atrophy, completely negative to palpation of any kind and quite frankly not something I have the capacity to do right now. If I had any and I mean ANY inkling that his back was contributing in anyway whatsoever I’d have already xrayed. He has slightly straight hind leg conformation so this could be contributing, but I’m talking mild. I’m not talking about a suspensory with a lesion in it, that’s a different matter. He has an uneven fibre pattern and enlargement of some areas. It is an incredibly mild amount of damage. Being on the showjumping circuit I can name at least 10 horses that have had a nurectomy out competing at higher levels than myself, a lot of them had surgery before the most recent rulebook came out, hence my asking about how much attention is paid to horses that have had nurectomies. I wholeheartedly disagree with denerving pretty much anywhere else in the limbs I really wanted a rehab timeline more than anything as I’ll take any veterinary advice off of my team of vets.

I would not expect any 6year old SJer to have arthritic hocks, particularly not one jumping 90cm/1m.

Your best chance of getting full return to athletic performance is probably the N&F, but don’t expect a total guarantee and it's likely that whatever has led to this initial suspensory damage will continue to cause other problems for the horse if you can’t identify and rectify it.

 

[Tiddlypom]

This is the spooky and quirky young horse who has had you off a few times?

Almost certainly pain at the root of all this. I’m afraid that you are almost certainly just firefighting atm until or if you can identify the primary issue which is setting this up.

 

[nutjob]

This is the spooky and quirky young horse who has had you off a few times?

Having looked through op's previous threads, this was the first sign that my young horse age 5 had bilateral hind suspensory issues. He wasn't obviously lame when I took him to the vets. I'd had him since a 2yo so I knew the behaviour was very much out of character for him but it can be easy to find something else to blame.

 

[ponyrider2024]

This is the spooky and quirky young horse who has had you off a few times?

Almost certainly pain at the root of all this. I’m afraid that you are almost certainly just firefighting atm until or if you can identify the primary issue which is setting this up.

Yes I am aware and have always had my suspicions. He has had multiple, thorough vet work ups by different vets over the course of the 15 months I’ve had him. I bought him cheap as a project, he was advertised as sharp. He is sharp. You move his Haynet in his stable and he has a meltdown. He is a sharp, spooky horse in general but I have always had my suspicions about pain. The hock arthritis is a result of another problem I was 100% aware of when I bought him and he’s been medicated for. I expected it, I’m not worried about it. They’ll eventually fuse as my older horses have and he’ll he completely fine I would imagine. I do wonder whether these were the cause of the suspensory issues as he’s been working incorrectly for a while I’d guess. The having me off was however a me problem, I gave my other horse a spin round a course and realised what I was doing, hopped on new horse, fixed it, problem done and gone. He’s still reactive to random things in our home arena but he’s gone out and won most things we’ve entered at shows. I absolutely do think the suspensorys may have been the cause of the problem initially, maybe niggling away for a long time, but I did all I could by getting multiple vets to work him up, all of whom found nothing. I kept looking til I found the issue

 

[ponyrider2024]

I would not expect any 6year old SJer to have arthritic hocks, particularly not one jumping 90cm/1m.

Your best chance of getting full return to athletic performance is probably the N&F, but don’t expect a total guarantee and it's likely that whatever has led to this initial suspensory damage will continue to cause other problems for the horse if you can’t identify and rectify it.

He has another condition I was aware of pre purchase which has caused the changes in his hocks. They’ve been medicated and I’m not at all concerned as they’ll eventually fuse and not be painful, until then they’ll be medicated every year as my older horses are. I have a very strong suspicion that this has caused the suspensory issue as it is worse in the hock that is more arthritic. He’s had feet xrayed and nothing to note, vet not worried about his back and he’s giving no indication that it is painful at all. I am very much leaning towards the surgery as otherwise we don’t have another option, he won’t retire in a field without turning himself inside out and the kindest thing to do would be PTS so I’m willing to give it a shot. Trust me, I am the FIRST person to agree that no behaviour occurs for no reason, and the reason is almost always pain. It just took me a while to get to the bottom of this. Not for the want of trying.

 

[misst]

Sadly my experience of hind suspensory issues is that they are often secondary to something else. Even if it's not the hocks causing it, it might be foot imbalance, back issues SI problems etc. Having got one "sound" he quickly went on to show SI pain and was also then subtly bilaterally lame in front. This was not obvious until blocked. I would want a complete work up done before any treatment. I haven't seen one go back to jumping more than very low level stuff.

 

[ponyrider2024]

Sadly my experience of hind suspensory issues is that they are often secondary to something else. Even if it's not the hocks causing it, it might be foot imbalance, back issues SI problems etc. Having got one "sound" he quickly went on to show SI pain and was also then subtly bilaterally lame in front. This was not obvious until blocked. I would want a complete work up done before any treatment. I haven't seen one go back to jumping more than very low level stuff.

He’s had the full works including blocks and were very confident there’s nothing else going on other than the hocks and the SI issue which is obviously secondary. I’ve worked in showjumping a long time and can count at least 10 that I know of that have had the surgery mine is going in for and are jumping what I want to, and one jumping bronze league/1.20 stuff. I also know a few eventers at novice and above that have had it. I think if you look at the whole picture which my vet and I are doing, and leave no stone unturned then it is possible to get them back. His alternative is PTS so atp I’m willing to give it a shot. Unfortunately I think those who have had success stay quiet as it’s pretty taboo still, and some still see it as unethical.