I am consumed with guilt and worry

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sam72431

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Very very long story short following on from some very mild intermittent lameness my horse was booked in for annular ligament surgery and this was performed 12 weeks ago.

Surgeon shocked to find two ddft tears torn manica flexoria as well so removed manica did the desmotomy and debrided ddft. I was told long rest period 50/50 chance of being ridden etc.

Came home pretty sound and all fine, reaction to stitches which were removed early. Came sound again and then doing hand grazing on vets advice fine and had around 2-3 weeks no issues started reducing danillon on vet advice. Leg blew up in loads of pain as in agony leg boiling. Back up on danillon which made no difference after 1.5 she went back to the hospital for a week.

She had cellulitis and tendon sheath also inflammed but inconclusive if the tendon sheath was septic as they couldn't get a sample. Treated the cellulitis and then took on surgeons advice a calculated risk to do a steroid injection into sheath. This seemed to work and we have been in the clear for injection as this hasn't come back and steroids was 5 weeks ago which is when she came home again.

We had about 2-3 weeks completely sound with no painkiller and was just starting to do in hand walking when one morning she shot back (she is super fresh) the leg then swelled up and she got sore again after a few days so have been on danillon twice a day for a week. We then tried to take her off again over the weekend but she got sore unfortunately I was away so unsure just how sore! She's had shoes off ever since op as not been sound enough to stand on leg for long enough.

Farrier came today and I decided to go ahead with it as she was looking fairly comfortable again since continueing the danillon. Well I felt so guilty Farrier was very very kind and patient but you could see it hurt to weight bear on leg to get other leg done! I cold hosed her leg afterwards and in fairness she walked back in ok. Tonight I took her out for walk again and although stiff she was walking ok I iced her legs as well to keep inflammation down.

I am just feeling constantly guilty if I'm doing right thing. I speak to vet every day and follow his advice to letter but he has said he's not really dealt with a horse with all three injuries at once and not sure if it's normal for her to be up and down like this. She is bright in herself eating and wants to be here but is this fair?! She is only ten and I don't care if she is never ridden again as long as she is happy and pain free but she's been in three months now and it feels like it's never going to be over!

Non horsey bf thinks not fair to keep her in and can't be on painkillers forever (obviously) but vet saying just give her time. Other people saying get a second opinion and also should vet come and do scan to check nothing underlying since she went backwards last week?! I'm at my wit's end so any help much appreciated!
 
I don't really know what to advise as its not something i have had to deal with but just sending support. I know its nothing of the sort but my sister twisted her knee and although the scans showed nothing much Dr was fairly certain she tore a little ligament about 3 months ago and is still in bother with it frequently and not totally "sound" yet...it sometimes can just take a very very long time to sort. At 10 its maybe still young enough to have hope, but only you know your horse and know what they are capable of dealing with. I would definitely ask the vet if the think its time for a recheck or new scans etc but at the end of the day you have to trust them sometimes.
 
Yes, it is natural to worry. All you can do is to take professional advice, listen to your horse and make the best judgements you can. In many ways, there is a good parallel with human medicine here too. If you are being as wise as you can be, then there are no grounds for guilt, but of course it will be an emotional time. Chin up.
 
What a sad tale Sam. All I can say is don't beat yourself up about it, because you've done nothing wrong and it won't actually improve your situation or your mare's. Easier said than done. Hope you get a good result eventually.
 
All any of us can do is the best we can, as we see it at the time. Sometimes hindsight shows that we were right, sometimes that we were wrong but we made the judgement call in the best interests of the horse, as we saw it *at the time*, with the advice of the professionals involved. If the vet isn't sure, I hope he is speaking to other vets, maybe at vet schools to take advice, in order to be able to advise you.

All the best.
 
Thank you for all your kind replies, she seemed happier this morning with the shoes on. She walked out to grass quite happily and the leg seems to of gone down as well which is a good sign. Hoping I can now get her off the danillon and keep her comfy without it. I've had mixed advice, vet says just time don't use gadgets but only other person who I've found that has had a horse with similar used magnetic boots and thinks this helped! I am scared to go against vet but then at same time this particular horse had them and got better! I have got the ice vibe boots but vet said don't risk using the vibe part yet only the ice! I just feel like we have had all the bad luck in the world and she has been a really good patient so apart from other week its not even through her being silly its just been bad luck! I've been so so careful keeping everything clean etc and she got cellulitis!

I don't feel pts is right at this stage when she is bright and full of life but I constantly question if I'm just being selfish?!
 
Can you and/or your vet speak to the surgeons who carried out the procedures? They should have experience of the rehab process and the set backs that these types of injuries can incur. I have no personal experience of it but dealing with cellulitis is a nightmare on it's own never mind with everything else that's going on. As you vet appears to be lacking in experience in this area I would recommend liaising with the veterinary surgeons/vets at the clinic that operated.

I agree don't use the vibe part...there are no muscles below the knee so it's just a sales gimmick.

Re "being selfish" Try keeping a diary and mark her comfort levels daily to build a better picture. It's a hard call to make and when your heart is involved it is really difficult to see the bigger picture. Perhaps set a date guided by when the vets who performed the procedure would expect to see an improvement; if there is no marked improvement (refer to diary) then have one of those vets out/take her in for a further assessment and/or scans. Ask them how they would expect her to be after 12wks. The more information that you have then the easier (logically speaking) it is to make a decision based on long term prognosis. Hopefully once you speak to the people who know your horse and the process/procedure that will help, good luck with it all
 
My mare had ddft surgery in Nov 2017. Hers was a bit simpler and she was only 2/10th lame before the op, but she was still on box rest for nearly 6 months (with controlled exercise). She was a bandage destroyer so I got some of the PE stable boots and got the nanotech liners, no idea if they made any difference, but at least she didn't pull them off. A friend has used magnet boots for her horse with lymphangitis with success, but I would probably ask the vet before using. Luckily L was really well behaved and so I didn't feel too guilty (helped that it was winter).
I was given a surgical report that was quite detailed and a full rehab schedule. Did you get anything like this? The vet saw her at 1 week and then 12 weeks to put in place the next rehab stint. At 12 weeks we started to introduce trotting and she had, had a textbook recovery from a simpler injury, so 12 weeks isn't actually that long.
If your vet is so unsure is there someone he could refer you to speak to? Prior to the surgery L was completely sound for 6 months with a clear swelling (it was scanned etc). The swelling would go up and down, especially with changes in the weather, so if yours is comfortable then the swelling may just be her normal now.
You are doing everything you can for her and she is only young.
 
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It is a bit tricky basically I am with the same practice who did the op but I am liaising with the road vet who in turn is liaising with the surgeon. I did speak to the surgeon when she went back in a few weeks ago and he was happy with progress at that stage. I've had same road vet all way along and I have to say he has been utterly brilliant so supportive and always available to speak to me, I have no doubts on his capability but obviously all three injuries at once is fairly rare so not doubting his expertise in the slightest.

She was discharged the the full plan, but this has obviously shifted due to the various complications. So now I kind of feel like I don't know where we are up to in a weird way?!

Exactly the same with my mare she had some swelling but no lameness at all, got vet out as soon as she did go lame but this was just a niggling is she isn't she type so nothing definitive, she had some box rest came sound and it was decided that the swelling was a windgall as not hot and not lame. Sound for 5 months and had gradually built up to full work again not lame, then suddenly for no reason leg went bigger was a bit warm and she was about 3-4 tenths lame she had steroids in the leg to get swelling down in order to scan and was sound so no one not even surgeon thought it was possible to be anything other than the annular ligament. Surgeon said: "I've never seen a horse with so much damage be so sound".

All along she has pretty much not been normal but due to her being so sound this did give us all the hope that it would be good progress and good prognosis for recovery, vet said he expected her to have a better than published chance of recovery so maybe this is why I am questioning everything at the moment and I just need to be patient.

She looked better this morning so that makes me feel a bit better that getting the shoes on was the right course of action and will hopefully ultimately make things better.
 
I had this injury with my previous pony, she went in for elective surgery on the annular ligament as the vet felt it would begin to cause a problem & she has had the surgery successfully on another leg. When he looked inside she had a longitudinal tear to the DDFT & torn manica flexoria.

He removed the manica & debrided the tendon, we followed the rehab to the letter as we had previously, but she kept going suddenly badly lame. She returned to Liphook for a scan, & despite our best efforts she had a large adhesion. They wanted to operate again, but enough was enough & I had her shoes off & she retired to the field for about 5/6 years, she eventually went quite lame on that leg & I had her PTS.

Sorry to be the bearer of bad news & obvs all are different, but if she’s going lame I’d ask for a scan ASAP.
 
Rehabing a horse is stressful at the best of times - I do appreciate how difficult it is. My only advice would be to not worry about her being on painkillers. Being on painkillers for a week really is no time at all if a horse has been very lame.

Sometimes they need a much more sustained course to really deal with a) the inflammation and b) break the pain cycle.
 
Ditto about the painkillers. Some horses have to be on painkillers all the time, for arthritis for instance. I sympathise about the rehab, having had to do it once with my horse, it was a total nightmare. I don't know what the total rehab advice is, but it is amazing what a few months out at grass can do to heal, but I suppose that will only work if the horse is sensible enough not to tear around all the time.
 
I used to work on a rehab yard linked to a vet school - and three months is a very short period of time.
Just relax and go slowly. No rush to take her off Danilon until you are sure she doesn't need it. No rush to get her out in the field. Take pics/videos of her walking now, and then revisit once a month on the same date, ask yourself 'Is she better, the same or worse?'. That will help direct you.

In the meantime, I know this sounds weird but try to enjoy her - and make her time on box rest as pleasant as you can. Break up her day by grooming her, feeding her different forages at different times, treat balls, radio on, etc. And as soon as you can take her out for walks/grazing in hand, things will get easier. If she's naughty, don't get into a fight with her - just take her straight back to the boring stable (naughty step). She'll soon calm down.

Way too early to PTS IMO unless something catastrophic happens.
 
Gosh, the part about intermittent windgall type swellings without lameness, and then with slight lameness was very familiar to me! Similar story to my horse, except her surgery revealed... no damage at all, just a fairly uncommon type of old injury to the sheath.

I don't think there's any harm in having a scan done, it might just give you a better picture of what's going on. Hopefully the fact that the leg hasn't blown up since having the shoes, despite being sore at the time, is a positive sign.
 
Don’t know about the other injuries but one of mine had a torn manica which was removed. It took about 8 months for the leg to stop swelling every time she ran around and about half of that for the initial swelling to go down. Now sound and back competing just over a year later. So the manica will cause swelling, lameness probably from the other injuries.
 
Thanks everyone I am feeling slightly more positive that I just need to give it time and not panic as much. Trying to make life as nice as possible for her, treat balls and horslyx, she has also been having equilibrium on every day and a thorough groom. So hoping she isn't too fed up! I've also been doing some gentle stretches over her back to keep her from seizing up. I'll try and keep taking each day as it comes and be positive I'm doing the right thing. Will keep you updated on our progress!
 
Just a slight update, I have reduced the Danillon down to one a day and we are doing five minutes of hand walking in the morning and five mins of hand grazing in the evening. I've been icing her legs after the hand walking and it is getting smaller. She looks fairly comfy but is a bit stiff/sore as she first comes out of the stable for walking but by the time we get to the end of the barn she walks nicely and on the way in I think you would be hard pressed to see anything is wrong! Hoping we are on the right track and that things keep improving!
 
Old girl had the same surgery 18 years ago so things have moved on she spent the first 6 months not moving from the stable the next 12 months on box rest and slow walking. Once sound in the field she had bouts of intermittent lameness when ridden so decided as she was a rare breed we would have a foal while she was still young enough. Rode her properly when the foal was about 3 months old and she hasnt been lame since although turmeric keeps the achy bits under control as she again has bouts of lameness if she doesnt have the turmeric. So time is in my view the best course of action and when she is allowed out give her plenty time to recover. Hazel is still wnning in the ring and is as sound as a pound on no true drugs so good luck I hope it all works out for you. I will admit after 18 months on box rest she isnt keen on being stabled but that was a small price to pay. At 23 hr is still doing everything a horse does when younger wins at dressage does a spot of jumping and loves hacking out
 
windand rain said:
Old girl had the same surgery 18 years ago so things have moved on she spent the first 6 months not moving from the stable the next 12 months on box rest and slow walking. Once sound in the field she had bouts of intermittent lameness when ridden so decided as she was a rare breed we would have a foal while she was still young enough. Rode her properly when the foal was about 3 months old and she hasnt been lame since although turmeric keeps the achy bits under control as she again has bouts of lameness if she doesnt have the turmeric. So time is in my view the best course of action and when she is allowed out give her plenty time to recover. Hazel is still wnning in the ring and is as sound as a pound on no true drugs so good luck I hope it all works out for you. I will admit after 18 months on box rest she isnt keen on being stabled but that was a small price to pay. At 23 hr is still doing everything a horse does when younger wins at dressage does a spot of jumping and loves hacking out
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Wow this post has made me feel more positive than I have done in months! Thank you so so nice to hear a success story!



Thank you to all for your kind words and help!
 
My old mare had exactly the same - she went in for an annular ligament chop and they found a tear on the manica flexoria so removed it. She was quite lame with a big leg for ages after the operation but had steroids in the leg to bring swelling down. She was fine and back in full work after 6 months or so. Don't panic - they have set backs but seeing as there isn't actually anything damaged left as it were, it heals.
 
Well I was all ready to post a glowing update report of how well she was doing. She has been doing 2 x 20 mins walks each day as well as only being on 1/2 a danillon twice a day yipee!!

I put her on horse walker last week after vet saying ok to do as it is a very big circle it is a nice step towards going out and being able to get some energy out of her in a slightly more controlled way. We are about 5.5 months post op now and aim was to get out in a small pen week after next. Vet said to do horsewalker every evening this week plus the morning walk. She went on fine on Sunday and yesterday morning walked well, yesterday went up to put her on the walker and she was a bit sore, vet said to expect this and still ok to do, well she came off no better and I gave her an extra danillon as she looked so sore. This morning she is hobbling and again I am super guilty and confused!! Spoken to vet and he said not to panic and up danillon for rest of week with reduced walking to get her back on track. We both feel that once she is out things will improve but that now feels a long way off again.

Sorry for long rambling post just feel upset and back to doubting if I am doing the right thing again!! Vet said too early for more Steroids and that will take time which is what the surgeon also said. I'm guessing no one else has ever had so many set backs for one injury? Any glimmer of hope or commiseration much appreciated :(
 
Having rehabbed a blown tendon and having horse lame then sound then lame then sound and the box rest not agreeing to the point she cost me a fortune in daily sedation i have to say I don’t think I would do it all again. I was stressed, guilty , sleepless nights, doubting myself and after it healed up then I lost my job and she had to be moved on watching her new owner take her to her new stable was a weight gone. One I didn’t realise I had been carrying.

She has blown it again twice and had three owners and that I feel terrible for. I wish I’d had the frame of mind to just say stop.
Good luck OP been where you are.
 
I think I would avoid the walker in the future, especially I she looks a bit sore to start with. When she is in-hand you can adjust the walk as you will feel that she needs to go a bit slower. A walker will just keep her going at a speed she did not choose (even if it looks 'slow' to you).

If she has been managing hand walking then I would stick with this. Even if one of the walks has to be in an arena with the dark nights.

Although I would not pay for an MRI, I would attempt an ultrasound and/or X rays to see if this gives any insights. It won't tell you that everything is OK, but it may save you heartache and time if something is drastically wrong. They don't cost so much comparatively.

Once the horse is able to do 2 or 3 40 minutes walks then I think I would look to turn away. It would have to be a stable heard, shelter etc, but that way the horse can do as much, or as little, as she wants. Some livery yards have a small run in area behind the stable, that would be useful. They can be in when they want but still have a change of scene, and commune with others over the fence.

I think gentle movement at the horse's pace is what is most beneficial. But not play!
 
Obviously I'm not a vet but I would say the walker wouldn't be on my top list of things to use during rehab. Not that it is definitely wrong but I just feel like its too much on a rehab. I also tended to add extra time on to what the vet said, so if she said walk for 6 weeks then start trot work, I would do at least 8 weeks walk. Time is the biggest helping hand you will get.

Rehabbing is so hard, and it can be two steps back and one step forward. You know your horse and you just need to try and listen to her as much as you can.

I would maybe get a second opinion as well if this is an option, and probably get the leg scanned after the incident.

I really feel for you as its never easy.
 
Thank you, leg has been scanned about 3 or four times now for various reasons and sadly nothing can be seen so very much having to go by how she is looking which makes it even harder. Just can't be picked up on scanner for that part of the leg as the tears run 3-4cm up from fetlock. I'm hoping a few days resting will get her back on track and then we can start walking, will definitely be avoiding the horse walker and hope to get her out in next couple of weeks as feel that it is going to make all the difference.

Feel very tearful this morning at work after seeing her so sore this morning it just brings all of the old worry and guilt rushing back. I think almost worse as thought we were on home run after so many set backs. She is so sweet and full of life, you can see she wants to keep going and has been an absolute super star through the rehab pretty much impeccable behaviour!
 
I wouldn't have thought that a walker could possibly be a big enough circle to be worth using, I am surprised at the vet's advice tbh. Don't worry about giving her Danilon, it isn't just a pain-killer it is an anti-inflammatory, if her leg is swollen, it is inflamed so an anti-inflammatory is indicated.
 
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