My baby has a hole in her tendon

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Llwyncwn

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Cass was scanned tonight and they have found a small hole in her suspensory near the anular ligament, hence the huge wind gall and her leaning on my right hand.

Please can anyone put my mind at rest ... vets want to GA and cut her anular ligament which is very inflamed (4.9mm), and use stem cells. I dont have a problem with this, but I have nearly lost her twice in her 11 years and the GA is giving me the heaby jeebies.

The options are :

1. Box rest for 3-6 months and hope it gets better.

2. Stem cells and anti inflams in the tendon sheath - may not work.

3. GA, cut anular ligament, stem cell injection.

Seems the little hole has been there for a while which is why she had trouble getting that leg under her and why she was leaning on my right hand all the time.

Can anyone help on this operation, the options, and in particular the GA?

All help welcome.

Hx
 
I can't help much re: the stem cell etc, but I have been through the whole tendon troubles thing and if you need any general advice/to talk, feel free to PM me
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I hope whatever you decide, it turns out well.
 
Im so pleased you have answered! Couldnt find your name in online users. Any advice Sil would be greatly appreciated. Have you had a GA and a cut anular ligament?
 
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Am I the resident tendon guru??!
Before I can make any comment I need to know exactly where the hole has been found. If it is in the suspensory ligament then it is a bit different to it being in the superficial or deep flexor tendons. Plus if it's a ligament I will have to do some reading up
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My horse's injury is too far down in the hoof to be able to do anything about it. My vet offered me the option of surgery to cut any adhesions and smooth off the degenerated cartilage (that was her other issue alongside the tendon) but I didn't go for that as it just wasn't worth the risk of putting her under GA and opening up the hoof capsule. So I have done nothing! It worked though as she was damned well sound last week, and seeing her move I am not sure I have ever seen her truly sound until then!
Anyway let me know the exact diagnosis and I will see if I can help
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There has been some success with stem cell treatment in suspensory ligament injuries (a very well known dressage horse was treated and is back competing at a high level again). Stem cell implantation alone can be done under sedation and with ultrasound. Bear in mind you are still looking at long periods of box rest and time off even with stem cell therapy, the theory being that the quality of the repair will be better with stem cells than scar tissue.

Good luck.
xx
 
I do not have enough vet knowledge to help but send lots of hugs and healing vibes. My lovely old dressage horse had tendon trouble but rest cured it. My friends horse has ligament problems and has had lots of treatment but has not come right and is now having time turned out. She has looked into treatment from America but at the moment it is not recommended for him.
Would you consider putting her in foal or is she in pain. I have had a few horse have GA and not had much problem but I know the risks.
I wish I knew the answer , what are the chances of full recovery of the leg ,has he said?
 
Bl**dy hell H! No wonder she's been off and on lame and unhappy on that leg! Does Philippa know how it would have happened and if it's a long standing injury? I know nothing about this but my limited understanding is that stem cell repairs are very new science, very expensive new science, the outcomes aren't guaranteed and, as Dr S says, Cassie would still need tons of rest. Also, where do they harvest the stem cells from? Would it be a bone marrow extraction under GA? Poor Cassie! Is it time for a referral to a specialist centre???
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I can't help re stem cell therapy but my pony had surgery to cut her annular ligament last year.

She was 18 at the time she underwent surgery and I was worried sick about her having a GA. She originally went for surgery to have some adhesions removed from a tendon but they did suspect there was a problem with the ligament as well.

She had been lame on and off for months and we had tried box rest etc but nothing changed so surgery was then deemed to be the only other option.

She had to be walked out in hand very soon after surgery and then brought back into ridden work quite quickly and a year on she is sound and back in full work. If faced with the same situation again I would choose surgery.

Good luck with whatever you choose.
 
Is the hole in the ligament or the tendon?

Has the vet given you a success rate for all three options?

My mare had a GA for the operation on her hind suspensorys. She did not have a hole in hers, but I did a lot of reading up on the suspensory ligaments and it seems that stem cell treatment is proving successful on lesions within the ligament.

I have now been through two GAs with her in less than four months
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And although it is very scary, they are in the best hands. The only thing I can recommend is to have your horse operated on (if you choose this option) by an expert, even if it means a long travel. My surgeon was outstanding, but I was also willing to travel down to Sue Dyson if I had not been with Peter who is an expert too.
 
Thanks everyone for your replies, its comforting to know you have somewhere to turn when your head is in a hole!

I have been waiting for the vets to come back with some answers, but they are so busy atm. I would be interested to know how long the operation will take and will the anaesthetic be lighter than lets say a colic surgery?

Silmarillion - the hole is in the superficial flexor tendon slightly above the very swollen annular ligament. The swelling is 5.9mm (not 4.9 as said previously) from the ligament to the skin.

Hollymav - I would love to know about the operation and recovery and exactly what to expect.

Jet-set - Becky? Is this Grace who had the op's?

paddywhack - thank you very much for the link, I will mail it to my vets, but its very interesting reading.

Dr Spring - thank you for that. My vets have now carried out 7 stem cell implants, 6 of which were a complete success. The one horse who didnt respond 100% came sound but due to the amount of holes in her tendons due to racing injuries, couldnt be ridden again but stayed field sound. After stem cell implants it will be box rest - walk in hand for 30 days and then (if sound enough) to be walked under saddle for 30 days then a re-scan.

A local lady had the annular operation last year. Her horse has become sound enough to compete BSJA and one day events, but she is lame for 2/3 days afterwards. To me this wouldnt be acceptable
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Carthorse, Box of Frogs, Sarah - thanks for all your support. Vibes needed for me to make the 'right' decision for my girl.

Will get some pics in the morning of the tendon so you can all see for yourselves.

Thank you all so much.

Hx
 
Ok so it is a tendon hole and not ligament, but with significant ligament swelling. 5.9mm isn't huge, my horse managed to tear 2cm!! Is it 5.9mm depth? Or is it 5.9mm long tear?
It would quite neatly explain why she has been slightly lame, Maiden went HOPPING the day after she tore hers, then was just "slightly off" (about half a tenth lame) from then on. It took me a month to decide to get vet out, by which time the vital initial period had passed. Tendon injuries are very rarely more than about 2/10ths lame, and if they are (as in my case, she was 8-9/10ths) it is usually only temporary - which is why they are so awful as you keep riding and wondering why they aren't quite right. So although the damage must already have been done in your case (how long has she been "off" for?), my first question is what are you doing right at this minute in her management and treatment? Cold therapy is vital in the first two weeks at the very least, and is so often missed due to the horse only being very slightly lame. This is when the tendon goes through a period of rapid repair - imagine the tendon as being a structural wall within your house, if it started falling down you'd get some support up PDQ so the whole house didn't fall on you. After two to four weeks the benefits of cold therapy are debatable although IMO there's no harm in it, even if there is no benefit!
As for management, I assume she is now box rested? Again, box rest in the first month is thought to be beneficial, but after this period (with SDFT tears/strains) it is thought that controlled exercise is beneficial, to help the tendon fibres align properly during healing (they have an annoying habit of laying down higgeldy-piggeldy, cuasing the tendon repair to be weaker). Obviously if the injury has been there for some time, total box rest may not be necessary (it depends then on the individual horse and the thoughts of the vet - mine wanted Maiden out for a couple of hours every day in a stable-sized grass pen... actually, telling the truth, he didn't give a t*** and every time I saw him/spoke to him he couldn't remember what he had said the last time
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)
Thirdly, treatment. It sounds to me as though you have similar options to what I had at the time. Maiden tore her deep flexor tendon right down below the navicular bone (so inside the hoof capsule) and also had degeneration of the cartilage attaching the DDFT to the pedal bone (making it worse). This was a very serious tendon injury, Maiden doesn't do things by halves! I was given the options of 1) turn her away for a year, 2) Cartrophen injections to help the cartilage repair, and to hopefully stop adhesions forming, although it would be impossible to tell if it had worked or not and it was £60 a pop (four injections), or 3) an operation into the hoof capsule to smooth off the roughened cartilage manually, and to see how badly damaged the tendon was, although opening the hoof capsule is very risky. I went for option 2 because, with the advice of my fab new vet (the one who I initially called for the lameness told me to shoot her, I told him to s*d off because she was perfectly happy and she'd retire quite happily; I then transferred to a new vet practice and although my vet is reknowned for being a total pessimist, she was hopeful that we could do something to help!) who told me that surgery would probably not pay off in my case, I decided that I could spare the money (insurance paid anyway) for the injections and doing nothing wasn't an option. £240 was a lot of money for me to gamble, but although I will never know if it worked, she has come sound so obviously there aren't any serious adhesions or cartilage problems in there.
So really what I'm trying to say is that what you need to do is ask your vet as many questions as possible about both the surgery and the stem cell. IMO, but bear in mind that I know very little of your individual case, I would at least give the stem cell a go if you can. I know very little about operating on that region (Jet_Set would probably be better able to give you an idea about that
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) but from what I've read of stem cell, although it is an area that needs a lot more research, it has proved successful on a number of cases. At the end of the day even if it doesn't work, all you've lost is money. If I hadn't given Maiden a chance with the Cartrophen and she would have been permanently lame, I would never have forgiven myself for not trying.
I'd be very interested to see any pics you have
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Yes the A cell treatment my horse had worked and the annual ligament opp worked going under GA was fine as for being lame for 3 day is wroung she is stiff for one but this is due to it
one for being on both back legs
two she doesn't heal well
three she is an x racehorse and has had injuries in the past
and
four if the vet and i wernt happy that she was ok i would be the last person to push a horse to what she isn't capable of ok

so i am happy with that being acceptable as the mare is happy with what it is doing and it was better than just being stuck in a field as my mare could never do thaat as it would drive her mad not doing anything
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My horse got kicked in the field 4 years ago and tore his DDSFT and SFT. Prior to this he was a county level Welsh Sec D doing ridden and workers.
I made the decision to have the tears debrided, the vet was very negative about him ever making a full recovery. I turned him away for 2 years and now he's fully back to hacking, jumping, showing etc ........... And winning.
Since the operation he has never been on bute or anything like that, he still sometimes gets heat in the leg but I just keep an eye on it.
I wish your horse well but time is the greatest healer once you decide if to go ahead with treatment.
 
hi, sorry if this is an old post...sorry to hear about your problems with your girlie. *hugs*


its just my boy has recently started leaning hugely on my left hand, and this is the side where he has a huge, windgall like lump on his fetlock! he's not lame, but reluctant to step under himself on a tight circle on that side, and there is heat to it. does anyone of that sound similar to you with your girl?

thanks in advance
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Hello WoodysMum and welcome to the forum
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I did read your post earlier and intended to reply tonight, but here goes ...

Last November we had upped our schooling and had introduced canter half-pass. On the third lesson I felt her 'go', similar to if you or I went over on our ankle, if that makes sense. She was field sound until I tacked her up the following day and realised there was a problem. Where there was a windgall before, there was now a wacking great lump the size of an egg on the side of her fetlock. No heat and only unlevel in trot. The vet said to rest her and "lots of horses get windgalls and it shouldnt affect her". I rested her for 3 months and asked same vet to come out and scan as I wasnt happy. Vet came and examined her and said he wasnt going to bother scanning as there was nothing going on inside, it was just a huge windgall and I was to bring her back into work, walking for 6 weeks and then introduce the school again. Things were going well until a lesson I had 2 weeks ago with a GP dressage trainer. Cass was leaning so hard on my right hand that I got a blister on my finger and we were working on her for about 15 minutes before she softened enough to start work. I'm the first person to tell my liveries to listen to their horses - should have took my own advice! She couldnt get off my right hand because her n/s hind had a hole in the superficial flexor tendon
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I got my equine clinic to scan her and they confirmed the hole, in fact I saw it for myself on the scanner.

I have wasted so much time and in my opinion I wouldnt hesitate to get your equine practice to scan your boy. Its better to be safe than sorry later. Hopefully in your case it will be something simple.

Is there any heat coming from the fetlock or surrounding area? Are the windgalls squidgy or hard? I would certainly cold hose him as much as possible, and as you sound concerned, I would get the vet.

Do let us know how you get on.

I will be posting pics of my mares legs tonight (if my OH will download them for me) and an update on what the vet has said.
 
thanks for taking the time to reply
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what a saga youve had with your diagnosis for your mare!

the lump is very squidgy on the side of his fetlock (like a big windgall), but there is heat at the back of the fetlock.

He is bi-laterally lame about 1 or 2/10 permanently, so any unlevelness is hard to spot since he is wonky anyway!

The other day he just would not get off my hand, he is normally nice and light in his contact but I got really frustrated since he would just not carry himself on the left rein.


I am cold-hosing it often and putting like ice on it overnight. I also thought about putting tubigrip with stable bandages over the top on his hinds to give it some support (whatever is going on in there!) but wasnt too sure.

Im not riding him while all this is going on, but its such a pain, as he was getting nice and fit!
 
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