PALD + Annular Ligament Desmotomy

[thatsnotmyname]

I have decided to post some information regarding the diagnosis, surgery, outcomes etc as there are a few historic threads with little to no follow up on the outcome of the procedure.

I will caveat this by saying that horse had no other lameness issues before this, has had no treatment for any other hind end issues. Each outcome and scenario is obviously subjective to the previous history of the horse.
Will try keep it brief!

Has had puffy/very slight windgalls behind since after Christmas.
Seemed ‘off’ and sometimes slightly unlevel behind in March. Nothing obvious but sometimes just didn't feel right.
May - Windgalls now presented more obviously and asymmetric.
Way of going improved with work and went out competing with good results, no significant drop in performance.
Vet had no concerns re windgalls and trotting up sound.

Early June, Horse came in with one swollen leg and markedly lame behind.

Ultrasound revealed thickening of the palmar annular ligament and also a tear in annular ligament. No damage to manica, DDFT, tendons shown on ultrasound but couldn't say for sure there was no damage until they had got in there to have a look. Think it had got so tight and thickened then torn in field as the swelling had come up literally overnight.

Referred for annular ligament desmotomy.

Vet hospital scanned other back leg and found significant thickening of the other ligament and recommended that they operate on both.

Operation keyhole and successful, debrided the tear, cut both ligaments and found no further damage to other internal structures meaning the diagnosis is a primary palmar annular ligament desmitis.

Total box rest for 2 weeks - changing bandages. Stitches out end of week 2.
Began hand walking for 5 minutes per day from end of week 2.
10 minutes total at week 3 split into 2 outings adding on 10 mins total each week. Ice boots applied after each walking session to help with heat and swelling. Has bandages on 24/7 to prevent stocking up as recommended by vet.
Week 5 still walking but trotted up sound.
End of July is Week 6 - Vet will come to review and inject arthramid into tendon sheath, this is part of the whole procedure that they do with all horses that come to them for this.
Will decide on turnout (into pen) and how to progress further with rehab.

On the day he went lame and going from the initial scan, vet and vet surgeon seemed optimistic horse would be back out at the eventing by the end of the season. They said with a primary desimitis, after surgery a high percentage go on to make a full return to work, which would be eventing/hunting.

I have hundreds of photos. Feel free to PM me if you have questions.
Fingers crossed eh x

 

[acw295]

I lost my old mare recently doe to her annular ligament- she had the first one successfully operated on and made a full recovery, never had any further issues with it. She unfortunately developed the same issue in the opposite leg as a mich older horse. Couldn’t have surgery and eventually had to be pts.

I was warned the other leg often goes the same way so I’d be vigilant for that. I’d have had surgery a second time if she were young enough though as it was very effective and straightforward.

 

[thatsnotmyname]

I lost my old mare recently doe to her annular ligament- she had the first one successfully operated on and made a full recovery, never had any further issues with it. She unfortunately developed the same issue in the opposite leg as a mich older horse. Couldn’t have surgery and eventually had to be pts.

I was warned the other leg often goes the same way so I’d be vigilant for that. I’d have had surgery a second time if she were young enough though as it was very effective and straightforward.

Chose to op both at same time for this reason!

 

[Kirstd33]

My gelding had the exact same op early May on both hinds however when they went in they found further damage to the manica flexorior in his left (which was worse) so removed that at the same time. Protocol has been pretty much the same apart from coblet has been allowed out in a small paddock overnight since about week 4. He doesn’t hoon around thankfully. We walked 2 x daily from 5 mins increased by 5 mins each week up to 30 and as of 3 weeks ago the vet told me to get on board and I can combine his exercise to one walking only hack for up to 1 hr day. I probably ride 3x week and still walk in hand the remaining time. Vet has been pleased so far and due again next week to trot up again and advise next stage rehab.
HOWEVER i still feel coblet is resting his left leg far more and can seem uncomfortable after his exercise and I’m still giving him half a bute when he is, how do you think yours seems in himself? Coblet has lost a lot of weight and we also have concerns whether he’s developed ulcers as a result. Again talking to get about that next week.

 

[thatsnotmyname]

My gelding had the exact same op early May on both hinds however when they went in they found further damage to the manica flexorior in his left (which was worse) so removed that at the same time. Protocol has been pretty much the same apart from coblet has been allowed out in a small paddock overnight since about week 4. He doesn’t hoon around thankfully. We walked 2 x daily from 5 mins increased by 5 mins each week up to 30 and as of 3 weeks ago the vet told me to get on board and I can combine his exercise to one walking only hack for up to 1 hr day. I probably ride 3x week and still walk in hand the remaining time. Vet has been pleased so far and due again next week to trot up again and advise next stage rehab.
HOWEVER i still feel coblet is resting his left leg far more and can seem uncomfortable after his exercise and I’m still giving him half a bute when he is, how do you think yours seems in himself? Coblet has lost a lot of weight and we also have concerns whether he’s developed ulcers as a result. Again talking to get about that next week.

Mine is still in box and on 30 mins walking per day (15x 2)
I do think sometimes a bit sore/puffy after some walks so I reduce workload very slightly. Either less time, or less of a marching walk.

I’ve been using ice boots after every walk which I think has helped.

Has only trotted up briefly once and was sound but will update as workload increases.

My horse was resting the leg which eventually tore all of the time and also standing in the banks of a deep to relieve the pressure.
No longer resting leg or stood in banks.
If was or did start doing this I’d personally bute and reduce workload slightly. But my horse hasn’t had other damage. Vet said if manica damaged, rehab is longer but once it’s removed they can’t break it again!!

Mine is fat tbh. generally a very laid back person so they are just enjoying being in with unlimited forage. Horsey was really tight fit before, run as light as they would ever get

Perhaps stick on an acid buffering supplement in feed (Protexin acid ease is good)

I am happy to send pics if you want reference pics, you’re a bit further on than me. I’m not back on board yet.