My lovely event horsie Finnly PSD?

[paddywak]

Finns Injury and Rehab

Diagnosis---
Initial Visit 14th Jan 2008
Poor Performance Analysis….. Full body Palpation – slight sensitivity behind saddle and over hind quarters, insignificant
Trot-up - Sound
Flexion Tests - Negative
Lunge hard +soft - Sound
Ridden examination- Noted unusual irregularity in rhythm and spookiness although sound, lacking impulsion with hampered anterior motion, favouring right rein and diagonal. Shifting rider to outside on left rein, tense and unsettled. Repetitive spooking, and extreme hollowing – out of character.

Advise- 1 week on Danilon (suxibuzone) 2 sachets twice daily for 2 days, 2 sachets twice a day for 5 days. Suggest initial rest period turned out with ridden work on days 6 and 7.
Reported significant improvement in behavior and general outlook on life, Advise admission to Veterinary clinic for further diagnostics.

Admission to vet clinic

Mon 28th Jan 2008 (Adam Jackson) Trot-up - Sound
Flexion Tests - Negative
Lunge hard +soft - Appear 1/10 unsound on right rein on left fore leg. Significant enough to nerve block. Perform Palmer digital nerve block left fore limb. ----- Still unsound.
Attempt to complete 4 point Palmer Metacarpal Nerve block, including IV sedative and appliction of humane twitch. Horse very uncooperative decsion to re- attempt nerve blocks following day.

Tuesday 29th Jan 2008 (Adam Jackson)
Re- Attempt 2nd nerve block. Horse very uncooperative. Suggest either 2 weeks turnout on bute and re-evaluate or contiune nerve blocks under full sedation with alternative drug. Suggest examination by Dietrich Von Scheinitz

Wednesday 30th Jan (Dietrch Von Scheinitz) Complete 2nd Nerve block --- Sound
Radiography – Entire lower limb –no sign of any bony activity or arthritic changes.
Thermo-Analysis- Hot spot below knee in suspensory/check ligament region.
Ultrasonography- Apprent Proximal Suspensory Desmitus. Low/moderate suspensory disease small amount of scar tissue between suspensory and check ligaments. Generalised loss of fibrous condition of top 1-2 inches
Shockwave Therapy-1500 shocks

Advise 2 follow-up shockwave therapy sessions at 2 weeks intervals.
Advise box rest with controlled walk exercise on horsewalker starting with 10 mins once a day for initial 2 week period, building up to 10 mins twice a day by end of first month.
Re-Asses and scan after final shockwave. If sound and showing significant improvement on scans a further 2 months of box rest with no turnout increasing walker exercise to 30 mins twice a day by end of 2 month period. Re-evaluate before starting ridden walk work. Re-introduce workload over 6 month period.

Alternatice Options

In circumstances with no improvement in soundness with scan results continually showing little to no improvement.
May be a candidate for PRP therapy, injection of Insulin rich growth platelets into damaged area.
Retirement
Work on low level of Bute to control pain to enable animal to continue with competitive career.




What do you all think about the treatent regiume? does anyone have any experience of injuries like this?
Am getting John Kilingbeck to look at his scans etc as well on friday as some think this much exercise restriction and box rest may not be the way forward?
Any help/info /personal eperiences would be greatx x

 

[star]

if it's PSD, which is sounds like then that is definitely the correct way to go about the rehab - they need strict box rest with either in-hand walking or horsewalker exercise for the first couple of months, followed by ridden walking, gradually returning to full work, all the while on strict box rest - any uncontrolled exercise risks a flare-up and a return to square one.

i would just add that if they dont come sound with shockwave, then the next option is usually de-nerving surgery.

 

[Minnies_Mum]

Sorry, what's PSD?

 

[Eaglestone]

"Proximal suspensory desmitis (PSD) is diagnosed with increasing frequency in horses and radial pressure wave therapy (RPWT) is a widely used therapy for painful orthopaedic conditions in man and dogs. There are, however, few published data as to the outcome of its use in PSD."

 

[carthorse]

Sounds like you are having the very best of treatment for your lovely horse .I hope it works out.

 

[Orangehorse]

I didn't understand the diagnosis. Where is the injury? In his leg or his foot?

 

[_jetset_]

If it is PSD then you are doing the right thing.

My mare has a PSD injury in her left hind... we did 6 weeks of complete box rest with 4 sessions of shockwave once a week. Then started walking in hand for 15 mins twice a week for four weeks. Took her for a scan, and there was an improvement, so ridden work commenced. That is where we are at now, up to 30 mins ridden work and the next scan in March.

 

[star]

[ QUOTE ]
I didn't understand the diagnosis. Where is the injury? In his leg or his foot?

[/ QUOTE ]

Thermo-Analysis- Hot spot below knee in suspensory/check ligament region.
Ultrasonography- Apprent Proximal Suspensory Desmitus. Low/moderate suspensory disease small amount of scar tissue between suspensory and check ligaments. Generalised loss of fibrous condition of top 1-2 inches

It says it here - PSD - that means damage to the top part of the suspensory ligament, just below the knee. The report doesn't mention a foot problem.