Proximal Suspensory Damage - advice and experiences please!!

[LBlockwell]

Okay, so in April, my 18 year old Thoroughbred became lame! She went to Newmarket and they came back with Laminitis in the Fronts, had tests for Cushings etc, came back all clear! So had to assume it's grass related! However, she was doing better on the longer, lusher grass, so that makes no sense. Anyway, she then went lame in her hinds, had a bone scan which came back with osteoarthritis in her lower neck, pain in lumbar facet joints, lower thoratic pain, Sacroiliac Issues, slight kissing spines, slight arthritis in hocks and Proximal Suspensory Ligament damage! She has been on Bute but that has now finished and she seems much better!
The vet gave the options of 3 months rest, shockwave therapy of surgery!
However because she's looking better she has said I can do light hacks! Should I be doing this if there is suspensory damage? I took her for a hack 2 days ago, trotted her up yesterday and she still looks good!

Has anyone had experience with this? What treatments worked? Long term Bute?
I'm just so undecided! Do I put her through surgery?
Any help would be greatly appreciated!!

 

[annunziata]

my horse has just done his DDFT they do say once they come sound to do inhand work and see how it goes, I have opted to turn him away for 12 months ish and see with scans in between if he is improving. He has been off since July so we are 1 month in his re scan is booked for the 16th of august. The vets want to operate on him but I am just soo undecided on it all so I have pulled his shoes and turned him out. I imagine the rehab is very simular to mine I had a friend who rode her horse after it being turned out for 3 months only hacked in walk in straight lines

 

[Birker2020]

Okay, so in April, my 18 year old Thoroughbred became lame! She went to Newmarket and they came back with Laminitis in the Fronts, had tests for Cushings etc, came back all clear! So had to assume it's grass related! However, she was doing better on the longer, lusher grass, so that makes no sense. Anyway, she then went lame in her hinds, had a bone scan which came back with osteoarthritis in her lower neck, pain in lumbar facet joints, lower thoratic pain, Sacroiliac Issues, slight kissing spines, slight arthritis in hocks and Proximal Suspensory Ligament damage! She has been on Bute but that has now finished and she seems much better!
The vet gave the options of 3 months rest, shockwave therapy of surgery!
However because she's looking better she has said I can do light hacks! Should I be doing this if there is suspensory damage? I took her for a hack 2 days ago, trotted her up yesterday and she still looks good!

Has anyone had experience with this? What treatments worked? Long term Bute?
I'm just so undecided! Do I put her through surgery?
Any help would be greatly appreciated!!

I'd ask your vet about the Tildren route for the arthritic problems for a start. It sounds from your description that this list of problems has resulted from one area in her body and she has been over compensating in other areas, thus causing problems in those areas. The back problems will most likely be attributed to the spavin and the overloading off the hind quarters onto the front end may be causing other problems.

From an article in 2013 - One study reported 90% of horses with acute proximal suspensory injury returning to work after box rest and controlled exercise and a recent paper described a surgical treatment for forelimb PSD in which a section of the deep branch of the lateral palmar nerve (DBLPaN) is removed. In the small scale study, all four horses with chronic fore limb PSD regained soundness within 6 weeks of the surgery and remained sound for at least 12 months.

First port of call would be a physio to make her more comfortable and suggest some gentle stretching exercises to free up the neck then a remedial farrier to offer some support to the spavin with lateral extensions to change the way the foot is loaded (spavin horses will walk in such a way to attempt to take the weight of the front of the joint which hurts), heel elevations and rounding the toes off to increase the breakover.

Long term bute at low dosage would probably work well and when/if you can ride her in the school again, working her on a good surface i.e. not too deep or too firm a surface.