Likelyhood of soundness?

J

joeanne

Well-Known Member
Joined
25 May 2008
Messages
5,322
Location
Cornwall
Visit site
Friends horse broke down 3 years ago. She came up lame and vet diagnosed a check ligament injury for which she had IGF and was turned away for six months.
Horse has now broken down again. This time she has done both hind suspensory ligaments, and is off Monday to Newbury for surgery.
Whats the likelyhood she will be ok after surgery and subsequent box rest, and is the previous injury likely to make a bad situation worse?
Or is field soundness the best she can hope for?
 
In your friends shoes I would be thinking long and hard about this one.

Who's the operation for friend or horse??

I know I'm pretty cut and dried when it comes to things like this, and it sounds heartless - but surgery would not be an option for me. And the horse would either be retired or shot.

What odds have the surgeons given?? Because I would have thought that they would be less than 20% to return to soundness and work, without breaking down again within a year of recovery (if recovers).
 
This is a standard op, and I just had it done last year to my 12 yr old gelding, who has come back fine.

Ask the vet to give you his honest opinion - in my experience they won't mince words.

My vet said the op ( I assume you mean a neurectomy) had a 75% success rate and horses came back to compete.

In terms of cost mine was covered by insurance, but initial diagnosis ( nerve blocks, etc) around £500, operation all in around £2000, and 2 post op visits at about £200 each. He did also have hock injections towards the end of the recovery period at around £900.
Good luck whatever you decide to do.
 
Are horses supposed to compete after a neurectomy? at all? under FEI rules? is it acceptable?
 
My vet is the vet to an international and extremely well known eventer and said that horses can come back to a full competition career after a neurectomy. Beyond that i do not know. I do not compete internationallly.

As I said OP shoud talk to the vet.
 
would depend on whether it was just unlucky or caused by conformation.

If the latter I would retire or PTS as returning to soundness would always be short lived
 
Surgery is about the only hope of soundness. Conservative treatment at suspensories runs at a 15-20% return to soundness, whereas surgery at about 60-80%. For a surgical treatment of lameness this is a good number.
 
Alsiola is the surgery a neurectomy?

Like others, I would feel uncomfortable about having a neurectomy for something which is essentially a fraying rope that will continue to fray until it, presumably, loses its mechanical function. I guess if the horse won't be in pain and its the only way to keep it alive without it being in pain it might be something I would consider, though.
 
Friend is a bit of an airhead so details are fairly sketchy. I am assuming its a neurectomy. Its absolutely a conformation issue, and quite frankly if the mare were mine, i'd have her PTS. She is not a particularly nice animal in nature or to ride (jogs constantly and is adept at reversing at speed).
Trouble is she is quite attatched to the damn thing as her mother bought it for her.
Interesting what you say AmyMay as she stuffed her fronts up 3 years ago, so now she will have all 4 legs excluded from any insurance policy.
I know its her call, but I dont want her to go down the route of forking out for an op that won't work long term, to find she still has a knackered horse at the end of it.
 
To those who have commented, have you rehabbed suspensory injuries and know what you are talking about?? So often I find people comment but have no direct experience!
I have rehabbed suspensories and know others who have done so successfully, even continuing to do endurance, thats without operations. Shockwave and controlled exercise is the key.
 
xxMozlarxx said:
To those who have commented, have you rehabbed suspensory injuries and know what you are talking about?? So often I find people comment but have no direct experience!
I have rehabbed suspensories and know others who have done so successfully, even continuing to do endurance, thats without operations. Shockwave and controlled exercise is the key.
Click to expand...

Was that in the hind legs? My understanding is that suspensory desmitis in the hinds has a really bad prognosis, but I have never had one myself, just heard about several on this forum and one in person.

OP the one I know of also had the jogging and reversing at speed and it was a symptom of the problem. The mare might not do it if she was denerved. I'm not a fan though, I think I'd have it put down probably. I just can't get my head around denerving a soft tissue injury that will (surely?) continue to degenerate.
 
xxMozlarxx said:
To those who have commented, have you rehabbed suspensory injuries and know what you are talking about?? So often I find people comment but have no direct experience!
I have rehabbed suspensories and know others who have done so successfully, even continuing to do endurance, thats without operations. Shockwave and controlled exercise is the key.
Click to expand...
Fair enough comment, but it looks like this animal is pretty much a lost cause, [easy to say when I am not involved emotionally] and to my mind it is nearing the end of the road, the animal is in pain, and will probably never be any use, think that these vets sometimes need to be clear [maybe they have been], and unfortunately there are owners who look for the high tech solution as a cure all, it is not always so.
 
cptrayes said:
Alsiola is the surgery a neurectomy?

Like others, I would feel uncomfortable about having a neurectomy for something which is essentially a fraying rope that will continue to fray until it, presumably, loses its mechanical function. I guess if the horse won't be in pain and its the only way to keep it alive without it being in pain it might be something I would consider, though.
Click to expand...

It's a combined neurectomy and fasciectomy. Some research has shown that a proportion of the pain from suspensory ligament injuries is from the physical swelling of the ligament putting pressure on the nerve, causing neural degeneration and neuropathic pain. The neurectomy is aiming to remove the damaged nerve, and the fasciectomy is to release pressure being put upon it.
This seems to be one of the reasons why HL suspensories respond so poorly to conservative treatment - although the ligament injury itself is resolved, the pain coming from the nerve itself remains, and can only be treated by surgical removal.

On the subject of neurectomy vs. retirement vs. euthanasia, I look at it like this:

You are in hospital and a doctor has just diagnosed you with a painful condition, he gives you three options:
1) He can kill you now because it hurts
2) He can write you a doctor's note for early retirement. You will no longer have to work but will be in a moderate amount of pain on a daily basis.
3) He can perform a surgery that has a good chance of giving you complete resolution of pain. There is a small chance of it becoming very severe in the future, but he can always use option 1 on you the anyway.

As number 3 is the only one that would see me leave the hospital both alive and pain free, I think I'll be taking that one.
 
xxMozlarxx said:
To those who have commented, have you rehabbed suspensory injuries and know what you are talking about?? So often I find people comment but have no direct experience!
I have rehabbed suspensories and know others who have done so successfully, even continuing to do endurance, thats without operations. Shockwave and controlled exercise is the key.
Click to expand...

Shockwave and controlled exercise is the key to about 20% of SL injuries.
Surgery is the key to around 60% of SL injuries.
There is no key to the remaining 20%.
 
alsiola said:
Shockwave and controlled exercise is the key to about 20% of SL injuries.
Surgery is the key to around 60% of SL injuries.
There is no key to the remaining 20%.
Click to expand...

I would be interested in how those figures were researched, says who?? Bit of a blanket statement anyway as it depends whether front or hind and what part of the suspensory.
 
alsiola said:
It's a combined neurectomy and fasciectomy. Some research has shown that a proportion of the pain from suspensory ligament injuries is from the physical swelling of the ligament putting pressure on the nerve, causing neural degeneration and neuropathic pain. The neurectomy is aiming to remove the damaged nerve, and the fasciectomy is to release pressure being put upon it.
This seems to be one of the reasons why HL suspensories respond so poorly to conservative treatment - although the ligament injury itself is resolved, the pain coming from the nerve itself remains, and can only be treated by surgical removal.

On the subject of neurectomy vs. retirement vs. euthanasia, I look at it like this:

You are in hospital and a doctor has just diagnosed you with a painful condition, he gives you three options:
1) He can kill you now because it hurts
2) He can write you a doctor's note for early retirement. You will no longer have to work but will be in a moderate amount of pain on a daily basis.
3) He can perform a surgery that has a good chance of giving you complete resolution of pain. There is a small chance of it becoming very severe in the future, but he can always use option 1 on you the anyway.

As number 3 is the only one that would see me leave the hospital both alive and pain free, I think I'll be taking that one.
Click to expand...


Great information, thanks Alsiola. The discomfort I feel at neurectomies is the thought that damage is continuing to occur (as in neurectomy for navicular, for example). But in this case the damage can be stopped and the pain is mechanical pressure on a nerve, not the nerve signalling damage to the brain. I think I'd probably have the op if the horse was young-ish and had nothing much else wrong with it.
 
xxMozlarxx said:
I would be interested in how those figures were researched, says who?? Bit of a blanket statement anyway as it depends whether front or hind and what part of the suspensory.
Click to expand...

Those are figures for hindlimb proximal suspensory desmitis, based on research done by Sue Dyson at the Animal Health Trust and Andy Bathe at NEH.
 
xxMozlarxx said:
I would be interested in how those figures were researched, says who?? Bit of a blanket statement anyway as it depends whether front or hind and what part of the suspensory.
Click to expand...

I think that as much as research is vitally important - a certain amount of logic and common sense needs to be applied too.

Two buggered front lets, 2 buggered back legs, conformationally defective = extremely poor prognosis. It's a no brainer really.
 
MrsD123 said:
And . if there are two hind legs involved plus a poor conformation, what are the odds then? also the two front legs to consider.
Click to expand...

If the horse had no previous injury I would be less pessamistic. However as stated, the horse blew a check ligament which resulted in almost a year off work, a year in slow work, and now a year into "normal" work she has buggered the suspensories in the hinds.
The question is with EVERYTHING factored in (previous injury and poor confo) is she likely to be so much as a light hack?
As I said if she were mine, she would have gone to the hounds long ago, but I dont think my friend realises the implications of a)recovery and b) long term prognosis!
 
You must log in or register to reply here.
Top