Medial suspensory branch injury

Tazzydog

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Hi, My 14 year old mare has recently been diagnosed with a small hole and some fuzzyness by ultrasound on her medial suspensory branch about a cm up from where it connects to the sesimoid bones. she is 2 tenths lame and the area of injury was sore when pressed in that area about a week ago, but did not feel discomfort a week later when checked by my vet. The area of injury is thickened and is about twice the size of the same area on her other front leg. The injury was cold hosed for about 3 weeks with danilon given. She is on box rest with some in hand grazing twice a day close to the stable. The vet has said the time for cold hosing and danilon to be effective has passed and to stop them both. I have been offered PRP treatment, but my vet does not think there is much evidence that it works but will do it if I want. The advice is box rest for 2 to 3 months then a gradual introduction to limited turn out if healing well with the possibility of ridden work in 4-6 months. The injury occurred due to her running about in a wet field that suddenly dried up when the weather improved. The worst of the ruts were fenced off as I was concerned about the field, but there was nowhere else to turn out at the time. Has anyone had experience this type of injury and if so did you try PRP or stem cell treatment. A friend has successfully used shock wave therapy on the same injury and so I will be discussing this with the vet on Monday.
 

ycbm

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A mare of mine did it, roughly the same place. I turned her away for six months, no box rest, she was brought back into work by someone else as a showjumper and it never bothered her again.
 

Pinkvboots

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My horse had a hole in is suspensory I was offered prp and he had 5 months box rest, vet was quite shocked as the hole had completely disappeared and he was sound, I would have the prp it's not expensive and it's an easy procedure and can really be effective on a lot of injuries.
 

hopscotch bandit

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Hi, My 14 year old mare has recently been diagnosed with a small hole and some fuzzyness by ultrasound on her medial suspensory branch about a cm up from where it connects to the sesimoid bones. she is 2 tenths lame and the area of injury was sore when pressed in that area about a week ago, but did not feel discomfort a week later when checked by my vet. The area of injury is thickened and is about twice the size of the same area on her other front leg. The injury was cold hosed for about 3 weeks with danilon given. She is on box rest with some in hand grazing twice a day close to the stable. The vet has said the time for cold hosing and danilon to be effective has passed and to stop them both. I have been offered PRP treatment, but my vet does not think there is much evidence that it works but will do it if I want. The advice is box rest for 2 to 3 months then a gradual introduction to limited turn out if healing well with the possibility of ridden work in 4-6 months. The injury occurred due to her running about in a wet field that suddenly dried up when the weather improved. The worst of the ruts were fenced off as I was concerned about the field, but there was nowhere else to turn out at the time. Has anyone had experience this type of injury and if so did you try PRP or stem cell treatment. A friend has successfully used shock wave therapy on the same injury and so I will be discussing this with the vet on Monday.
Yes my friends horse had PRP after having a suspensory branch injury on his near fore. He went back to normal competition (unaff SJ) around 8 months later. However the horse had a terrible accident around 14 months later where the leg which had received PRP got stuck beween the frame and wheel of a wheelbarrow very nearly breaking his leg and caused a life changing injury to that leg.

At the site of the suspensory branch injury the horse had calcification but it wasn't clear whether this was caused by the PRP or the trauma of the wheelbarrow. The vet said the adhesion couldn't be removed as it was connected to the ligament and it wasn't possible to be removed.

However i have read and also been told by an equine professional that PRP can cause adhesions and is a treatment that is less favoured by veterians for this reason.
 

Tazzydog

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Thank you all for your replies. Useful information. I shall ask my vet about PRP and adhesion. The vets are being very cautious regarding recovery and return to work so it is good to see that horses have gone on to be riden again, but if all she does is be able to go out every day and cope with turnout I will be happy.
 

ester

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We did PRP although someone else did check the scans to see if viable as there wasn't a 'hole' as such.
About 6/7 years ago now. Horse now in her 20s and still hacking. Didn't stand up to any arena work afterwards though, she'd get niggly again.

We didn't catch it as early as we should she had recently had lymphangitis and as sound, over phone more antibs were prescribed for said fat leg (I was in a different county so of minimal help). She was only actually lame if you rode her in an arena and trotted up the next day (and we didn't have an arena).

I only mention that as I do wonder if her outcome might have been more favourable if scanned quicker (though it wasn't that long overall, just not as quick as it could have been).
 

Tazzydog

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It is a difficult injury to identify. Minimal lameness, field sound on soft ground and in my horses case no swelling. I can see what I think is the thickened area of the ligament now her leg has been clipped to the skin for the ultrasound but I would not have found it before. I can imagine that many people would think it was just a tweak that would come right with some time off.
 

hopscotch bandit

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Lameness can be very subtle and sometimes barely present which can cause people to think the horse can be worked therefore causing more damage. The horse will often be lame when the affected leg is on the outside of a circle as it will be pushing off with that leg especially if the injury is a lateral injury.

The horse may be more predisposed to other legs being affected. It can often be due a medio/lateral imbalance of the foot or a degenerative condition.

As with any tendon or ligament injury cold therapy treatment, bandaging, initial box rest, anti inflammatories and possible remedial shoeing are undertaken. I believe that recent research indicates that horses respond better with a controlled exercise regime after a short period of box rest.
 
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AandK

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My now 23yo had a chronic type injury to his suspensory branch back in 2008. He had a total of 5 months box rest with controlled exercise, 10 min month 1, 20min month 2 etc, add a bit of trot in month 4. Once he was back out in the field, I then turned him away for 3 months. He made a full return to work, and was out eventing approx 13 months after diagnosis of the injury. He also had shockwave and a course of adequan, vet gave a guarded prognosis initially.
 
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