Ligament damage

[connemaraponies]

My pony was diagnosed with swelling in her collateral ligament, ultra sound scans show that there was an enlargement of 0.1mm! She has since been on box rest and turnout in ménage and walked out daily in hand, this has now been going on since December. My pony I'd now getting very bored, as up to the injury was walked most days, has anyone else's horse had this happen, if so how long did u rest them? She is walking fine with no signs of lameness, my vet want the box rest/ walk outs to continue for another 3 months but my pony will do her nut in!

 

[Uniique]

Hi

In March 2010 my horse came in from the field unable to bear weight on his near fore. He was diagnosed rapidly due to the severity of lameness. After nerve blocks, xrays and mri he was diagnosed with desmitis (inflammation/ swelling) of collateral ligament. Box rest didnt suit him so I turned him out as normal for short periods i.e 9-3 to keep him sane. He was 6/10ths lame initially and within 12 weeks he was only 3/10ths lame, within 24weeks he was sound and back in work. However in Jan 2012 he pulled a shoe in the field and sadly is off again with collateral ligament damage. However I would recommend you explore the following options for speedier recovery (in order of most effective - in my opinion);

1. Looking into remdial shoeing. Mine wore performance leverage reducer shoes (http://www.totalfootprotection.com/index.php?option=com_content&task=view&id=114&Itemid=45) which support the collateral ligament fantastically!! Really worth looking into, slightly more costly but not out of this world. Mine wore them for a year and I then took them off and left them off

2. Shockwave therapy can greatly aid healing. Each session is only around £40.00 and is quick and straightforward. Bailey has three doeses each 2 weeks apart.

3. Magentic therapy (bell/ overreach boots) Bailey wore them every night until he was sound as they increased blood flow to foot and therfore aid healing.

Finally 4. A straight MSM supplement (Naf or Equine America) which is to aid healing and repair of ligaments/ tendons and soft tissue.

I have still fighting collateral ligament damage but the first time round my vet was absolutely speachless!!! He didnt eblieve he would improve in a year let alone be totally sound in just 4 months. You can do it!! Go with your gut and od whats right for your horse. I have kept a full dairy of Baileys treatment cine March 2009 so feel free to PM me for any further advice....

Good luck x x

 

[cptrayes]

Or take off the shoes?

rockleyfarm.blogspot.com

plenty of horses cured of collateral ligament damage in a just a few months in their rehab program. No bored ponies on box rest either.

 

[sarahhowen]

Connamaraponies, I feel your pain!

My WB Gelding has now been lame for 8 weeks and after lots of diagnostic work the vets are now estimating that it is soft tissue in the hoof and either the DDFT or the Collateral Ligaments of the coffin joint, both showed clear on an US but obviously due to the tendons going down into the hoof they can only scan the top and suspect the damage is lower down - We are now just waiting for our referral back from Leahurst for a MRI to find out for definite what is happening and how to treat it!!

My Vet has told me worse case were looking at about 9 months until were back in full work, does your vet have access to Stem Cell therapy and Shockwave as these have both beed recommended as a course of treatment depending on location??

Other treatment I have been told we are likely to face are Heart bars to protect the heels and prevent any further strains happening and medicating the joint to see if that improves things.

Unique, Im about to look into magnetice Over reach boots - would you recommend any particular brand??

 

[BlackRider]

My chap damaged his check ligament 7 years ago, I was told to box rest for 6 weeks, then rescan.

He wouldn't tolerate box rest, so he just went out for an hour a day in the field, i left him for 12 weeks before rescanning, and he was fine.

 

[cptrayes]

Connamaraponies, I feel your pain!

My WB Gelding has now been lame for 8 weeks and after lots of diagnostic work the vets are now estimating that it is soft tissue in the hoof and either the DDFT or the Collateral Ligaments of the coffin joint, both showed clear on an US but obviously due to the tendons going down into the hoof they can only scan the top and suspect the damage is lower down - We are now just waiting for our referral back from Leahurst for a MRI to find out for definite what is happening and how to treat it!!

My Vet has told me worse case were looking at about 9 months until were back in full work, does your vet have access to Stem Cell therapy and Shockwave as these have both beed recommended as a course of treatment depending on location??

Other treatment I have been told we are likely to face are Heart bars to protect the heels and prevent any further strains happening and medicating the joint to see if that improves things.

Unique, Im about to look into magnetice Over reach boots - would you recommend any particular brand??

please, please do yourself a favour and look into barefoot rehabs. Rockley Farm blog is the best resource, you do not have to send your horse there.

A friend of mine had an extremely poor prognosis given to her by Leahurst last year and her horse was walk trot and canter sound within eight weeks at Rockley. OK, he was quick, but most of them are in full work again within a few months and there is no box rest, medications, heart bar shoes, shockwaves or anthing else, just letting the hooves heal themselves.

Where has your vet got worst case 9 months to return to work from? with collateral ligament damage the statistics are that 80% of horses treated with conventional treatment of remedial shoes and medication never return to full work.

Honest, I am not a crackpot. If this thread was titled "ligament damage inside the foot" you would be being overwhelmed with stories of how people have horses who were due to be put down or out to pasture which are now in full work after barefoot rehabs. I owned one myself and in his new home he was jumping a metre the other day.

 

[sarahhowen]

The vet has given me that estimation as a conservative estimate after having the hoof in hand so to speak, im not against the concept of taking him barefoot but I dont believe that he is a particularly good candidate for this given he has got terrible feet to begin with.

I have dont a lot of research on injuries/ damage to the collateral ligaments and I am trying to stay positive, I have asked the vet to be realistic with me as to prognosis as I dont particularly want to put him through unnecessary stress of box rest if the chances are that he will never be ridden sound again, if thats the case, we'll look to manage the pain, pull the shoes and give him the chance of being turned away.

BUT at the moment I am trying to stay positive until we get the MRI, there has been a few symptoms that are not atypical with collateral/DDFT damage in the hoof that even has the vet stumped!

Cptrayes, do you mind me asking where you got the statistic of " 80% of horses treated with conventional treatment of remedial shoes and medication never return to full work."

I have been doing a LOT of research and I have not seen statistics that high especially given we do not know the severity of the damage at the moment?? I'm just keen to learn as much as I can about this so I know the right questions to ask when he has his assessment/ mri at Leahurst!

 

[cptrayes]

Terrible feet aren't a barrier to going barefoot, they are some of the best candidtates because the quality of the foot improves so much. Please take a look at the blog address and you'll see what I mean. My own rehab had feet so soft I could bend them with my fingers and soles 3.5mm thick on his xrays.

I'll find the reference to the research, it is a proper study that was done into recovery rates and for collateral ligament damage the recovery rate with remedial shoeing and meds was no more than 20%

Rockley's recovery rate with horses who have already failed with meds and shoeing is around 80%. Having been 24 hours from being put to sleep my rehab was competing dressage at 11 weeks and jumping on a farm ride at 13 weeks. He had been lame for over a year. He is far from abnormal.

Just off to search for the research reference.

 

[cptrayes]

Here's a start point. It was 27% not 20% sorry, but barefoot rehabs are coming in at 3 times that figure even among horses who have already failed other methods. I'm also intrigued by other people's defininitions of "full work". Usually, those with horses cured of hoof lameness seem to qualify their "full work" by saying things like "obviously I take it easy on hard ground" which is not full work in my definition.


http://www.horseandhound.co.uk/forums/showthread.php?t=521621

 

[criso]

The study I had actually gave an even poorer prognosis, about 11% from memory for collateral ligament damage. Other structures in the foot had a slightly higher recovery rate, I think about 20% for ddft and dsil.
I'm on the blackberry but I'll dig out the study which someone emailed to me when I get home.
My horse had damaged all of those and didn't respond to anything we tried. He's an ex racer and had some of the worse feet you've ever seen, luckily I tried Rockley as a last resort.

 

[criso]

This was the study that I referred to. Someone kindly emailed me it so I could see the breakdown

In terms of horses that returned to work

DSIL has 26.6 %
DDFT 21.8 %
Collateral ligament was split into 2 groups
Mild damage 0% returned to work
Moderate to Severe 16.6%

The 11% I mentioned is an average taking into account the number of horses in each group.

When Frankie had his MRI it was before this study and my vet quoted me another earlier one which had better percentages but did not include such a large number of horses or follow them over such a long period of time.

http://onlinelibrary.wiley.com/doi/10.1111/j.2042-3306.2010.00081.x/abstract

 

[sarahhowen]

Criso, can you qualify those stats??

You say that:

"Collateral ligament was split into 2 groups
Mild damage 0% returned to work
Moderate to Severe 16.6%"

What is the correct % for mild damage of the CL returning to work and was that study based on any particular CL?

 

[AmyMay]

The key to any successful recovery from ligament or tendon damage is the appropriate initial treatment and then rest.

OP have a chat with your vet about whether you can now turn your pony out to field rest for the next few months.

 

[criso]

Criso, can you qualify those stats??

You say that:

"Collateral ligament was split into 2 groups
Mild damage 0% returned to work
Moderate to Severe 16.6%"

What is the correct % for mild damage of the CL returning to work and was that study based on any particular CL?

I have it at home and I can put the exact definition they used later but they are talking about the collateral ligament in the feet.


Now you need to remember you are not talking about huge numbers. Of the 55 horses in the study maybe only a fifth had collateral ligament damage but that applies to all the studies. Some used as few as 20 horses overall.

However that is the correct percentage - 0%, not a single horse with mild damage returned to work.


The abstract gives 32% overall which you can see on the link and there are some types of pathologies that have a much more positive outcome (including some types of bone changes) up to 50% success rate.

The reason I focused on those 3 was that a) we were specifically discussing at the colleratal ligament and b) they are the 3 areas that with my horse showed problems on an MRI so for selfish reasons I focused on those.

 

[criso]

So the exact wording is

Collateral sesamoidean ligament:
Altered signal intensity with mild enlargement and asymmetry 0%
Altered signal intensity with moderate to severe enlargement and asymmetry. Adhesions to
navicular bursa or adjacent structures 16.6%

Hope that clarifies.

 

[chestnutrawr]

my friends tb did this and even though he was sound the vets said to carry on resting and doing in hand walks because there still may be a slight bit of damage there and they wanted to be sure he was fully recovered first

 

[sarahhowen]

I think Chestnutrawr hit the nail on the head here, OP sorry the threat got slightly hijacked but if you trust your vet to really need to go with his/ her recommendations, he afterall has seen the horse and done the diagnostics to detirmine what is wrong.

If you do not have confidence in your own vet then maybe its time for a second opinion??