Peroneus Tertius rupture in an old horse

Helene_scott93

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Hi,

My 22 year old TB injured himself before Christmas, the on call vet wasn’t originally sure what the injury was, there was no heat & no swelling but she put a compression bandage on and told me to keep him on box rest.

Fast forward to 2nd jan and I got my own vet out to come and have a look. He diagnosed it as a Peroneus Tertius rupture, the words he used were ‘not good’ and ‘this is a serious injury’.

The prognosis I was given was pretty dire, he told me there was a slim to no chance of him being ridden again, slim to no chance of him being able to be turned out as normal due to there being no support in that back leg it would be easier to injure himself further if he was running around and being stupid. He said it could take 12 months plus to heal, which at his age is a long time.

I trust my vet implicitly, and I believe every word he says. So I was just after what other people’s experience with this injury is? Especially in older horses? I would like to hear the good, the bad and the ugly.

Baring in mind my horse was in full time work (5 days a week) prior to the injury and he is 100% healthy in every other way, bar his heart murmur.

Thanks!
 

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Sussexbythesea

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I’ve no experience but a quick Google brought up an article that gives a good prognosis after a few months box rest.

“Conservative treatment with 3–4 mo of stall rest followed by slow and careful reintroduction to exercise usually results in complete resolution of signs and return to athletic soundness”

I’d be getting a second opinion and I trust no-one that much.

https://www.msdvetmanual.com/muscul...e-of-the-fibularis-peroneus-tertius-in-horses
 

Chippers1

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Yes my pony did this two months after I bought him! He was only 9 then though. I was told by my vet that it was one of the better tendon injuries to have as treatment is cheap (box rest!! not even any bute) And most return to normal work.
Mine was solid box rest for 6 weeks, then for the next 6 weeks I was allowed to walk him for 5 minutes, building up 5 minutes a week until getting up to 30 minutes by week 12. He was also allowed to have turn out in a tiny paddock after the first 4 weeks. After the first 6 weeks the vet couldn't tell which leg was the injured one! Luckily he was calm in his stable but did try and run round the little paddock and he was also really naughty to lead for the walking so had to just walk up and down the yard, if his feet touched grass he'd leap off 😅

After the 3 months I was allowed to start bringing him back into work and turn him out fully (he normally lives out 24/7) but into a smaller field than he was normally in. Unfortunately after riding a bit more than I should've (my fault entirely) he was slightly lame on it again so I turned him out for a month and after that bought him back into work and he was fine.

I now compete, jump, gallop around, everything! In total it was 4 months of rest but in the grand scheme of tendon injuries that is nothing. I reckon you should get a second opinion or just stick him on box rest and see.
 

Helene_scott93

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it was because he has seen this injury 3 times and it didn’t work out for any of the horses. And due to his age, recovery is less likely.

He didn’t want to get my hopes up, which I am forever grateful for. I have read a multitude of papers about this injury, but they don’t highlight the ages of the horses who recovered fully. I haven’t been in this position before, so I am curious what the healing process is like for older horses. Is the injury more likely to encourage arthritis? Even if they don’t already have it.
 

Helene_scott93

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Yes my pony did this two months after I bought him! He was only 9 then though. I was told by my vet that it was one of the better tendon injuries to have as treatment is cheap (box rest!! not even any bute) And most return to normal work.
Mine was solid box rest for 6 weeks, then for the next 6 weeks I was allowed to walk him for 5 minutes, building up 5 minutes a week until getting up to 30 minutes by week 12. He was also allowed to have turn out in a tiny paddock after the first 4 weeks. After the first 6 weeks the vet couldn't tell which leg was the injured one! Luckily he was calm in his stable but did try and run round the little paddock and he was also really naughty to lead for the walking so had to just walk up and down the yard, if his feet touched grass he'd leap off 😅

After the 3 months I was allowed to start bringing him back into work and turn him out fully (he normally lives out 24/7) but into a smaller field than he was normally in. Unfortunately after riding a bit more than I should've (my fault entirely) he was slightly lame on it again so I turned him out for a month and after that bought him back into work and he was fine.

I now compete, jump, gallop around, everything! In total it was 4 months of rest but in the grand scheme of tendon injuries that is nothing. I reckon you should get a second opinion or just stick him on box rest and see.

Was the box rest purely box rest or did you hand graze?
 

Helene_scott93

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I’ve no experience but a quick Google brought up an article that gives a good prognosis after a few months box rest.

“Conservative treatment with 3–4 mo of stall rest followed by slow and careful reintroduction to exercise usually results in complete resolution of signs and return to athletic soundness”

I’d be getting a second opinion and I trust no-one that much.

https://www.msdvetmanual.com/muscul...e-of-the-fibularis-peroneus-tertius-in-horses

I have googled too, and there’s a mixed bag of opinions/findings. I just wanted to know what tendon healing was like in older horses.
 

Chippers1

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It was purely box rest for a few weeks, I took him out to muck out but only to the yard. I think it was around 3/4 weeks in that he was allowed in a small paddock for the day.
 

ycbm

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it was because he has seen this injury 3 times and it didn’t work out for any of the horses. And due to his age, recovery is less likely.

He didn’t want to get my hopes up, which I am forever grateful for. I have read a multitude of papers about this injury, but they don’t highlight the ages of the horses who recovered fully. I haven’t been in this position before, so I am curious what the healing process is like for older horses. Is the injury more likely to encourage arthritis? Even if they don’t already have it.


He sounds like a good guy. Is the damage near a joint? I wouldn't expect arthritis complications if it isn't. 22 isn't ancient, I would hope for a good outcome. A friend has recently had a 24 year old recover easily from a check ligament strain.
 

Helene_scott93

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He sounds like a good guy. Is the damage near a joint? I wouldn't expect arthritis complications if it isn't. 22 isn't ancient, I would hope for a good outcome. A friend has recently had a 24 year old recover easily from a check ligament strain.

He is an incredible vet. And we aren’t sure, there was no heat and no swelling anywhere. Now there’s just clear signs of a PT rupture (the odd gait and ability to flex the leg in a manner he shouldn’t.) he is in no pain. I just want to do what’s best to give him the best chance of recovery. I haven’t had a horse with a tendon injury before so any tips on a better chance of recovery would be amazing!
 

Chippers1

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No cold hosing, there was no heat or swelling. It was diagnosed because of the weird gait seen with this i.e. not being able to flex the leg and also being able to lift it straight up at an angle it shouldn't!
He wasn't in pain either so it's just a case of waiting until the tendon knits together again.
I don't think it would cause arthritis as it's not really near a joint. I would think the prognosis would be pretty good, it's not a long recovery like some tendons.
 

Helene_scott93

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No cold hosing, there was no heat or swelling. It was diagnosed because of the weird gait seen with this i.e. not being able to flex the leg and also being able to lift it straight up at an angle it shouldn't!
He wasn't in pain either so it's just a case of waiting until the tendon knits together again.
I don't think it would cause arthritis as it's not really near a joint. I would think the prognosis would be pretty good, it's not a long recovery like some tendons.

Sorry for my stupid questions, I just want to find out what worked/didn’t work so that I can encorporate it into my horse’s recovery and give him a better chance.
 

Chippers1

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Not stupid at all :) I couldn't find much info about it when mine did his but I was glad it wasn't as bad as some tendon injuries.
 
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