Pulled Suspensory Ligament

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TJ2010

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My horse was up the vets on Monday and confirmed a pulled suspensory after ultra sound. It must have been done a good 3 weeks ago as when I first took him to the vets they didnt think it was that and sent him home with bute. Then I insisted he was back up for x rays etc and turned out it was his suspensory ligament.

I opted for surgery to remove the nerve.

Anyone else had this done? Recovery time? did they go back to normal work loads etc?

thanks
 
I think they cut the nerve rather than removing it?
My old pony had it done October 2008 at Oakham; he was there for 6 days, then box rest for 2 weeks; however he doesn't do in hand walking ( which at this point were were meant to do lol) so I opted to turn him away for a few months, then bought him back into work, taking around 4 months to get him back up to hacking 3 hours a day :)


Worked a treat for us, and even though I don't have him anymore I keep in touch with his new owners and he is a little monkey! fit as a fiddle and back to jumping, which I never did with him, good outcome for us :D
 
Sorry if I sound thick, but how on earth can you "cure" a damaged tendon/ligament by denerving? Surely all that means is, when the tendon is damaged again, the poor horse just doesn't feel it so isn't lame? A suspensory ligament needs box rest and steady rehab for a period of weeks or months, depending on how bad the original injury was.
 
Thank you AngieandBen that is good to hear.

Fatpiggy - I don't think the vets would suggest it if that was the case!

Anyone else had this done or similar??? Any HELPFUL responses?

And yes Fatpiggy my horse will be on box rest for 4 weeks and then turned out in a small paddock for 2 and then a check up at the vets and see how we are getting on and hopefully get back in the saddle to start building him up again.
 
Your horse will be haing a Fasciotomy and Neurectomy. The vet will split the fascia which will allow the suspensory to swell and then heal. The nerve is severed to encourage the horse to use its leg properly and enable the suspensory to heal properly. The nerve only feeds the part of the suspensory ligament that is affected by PSD. Your horse will still have feelings in its leg
 
unfortunately that doesn't work for proximal suspensory desmitis which is what the original poster is talking about. that would be correct treatment for a core lesion in the body of the suspensory ligament, but PSD just doesn't get better with that. It's either shockwave or surgery. The op cuts the little branch that supplies the top of the suspensory ligament and makes a hole in the soft tissue surrounding it to allow the swelling somewhere to go so it can then resolve. It does mean they cant feel the inflammation in the top of the ligament but they dont seem to have probs with going on to have ruptures or anything more significant so it doesn't appear to be a problem to cut the sensory nerve to this small part of the suspensory ligament.
 
Star, I think you are a vet so your advice would be good. I thought that proximal or high suspensory strain was improved by this surgery?? I understood that the vet should do a nerve block to the precise area and the resulting degree of soundness would be the same as you would get from the surgery, if that makes sense.

I have not been offered surgery and I wonder why not?
 
TJ2010 said:
Star - what doesn't work for my horse?

Sorry I do not quite understand what you have stated.
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sorry, was meant to quote fatpiggy in my post - for some reason it didn't work. what it should have said was that rest alone doesn't work for PSD. you either need shockwave or surgery. doesn't matter how long you rest them they almost always go lame again as soon as work is re-introduced.
 
cavalo branco said:
Star, I think you are a vet so your advice would be good. I thought that proximal or high suspensory strain was improved by this surgery?? I understood that the vet should do a nerve block to the precise area and the resulting degree of soundness would be the same as you would get from the surgery, if that makes sense.

I have not been offered surgery and I wonder why not?
Click to expand...


you are right about the surgery. i dont know without seeing your horse why you haven't been offered surgery but you should quiz your vet about it if your horse has already had shockwave and is still lame.
 
Thanks Star. Yes he has PSD and has had the surgery. Have been advised strict box rest now he is home for 2 weeks. Then 6 weeks of turn out in a paddock no bigger than 4 stables. Fingers crossed this works! Glad I did opt for surgery straight away!!!
 
Hi TJ2010! I'm afraid that even after de-nerving the prognosis is not terribly good for returning to full work. My big boy has been off work periodically for the last 4 1/2 years with PSD. The first time he had box rest for 6 months with an hour's walk exercise per day. Granted he came back into more or less full work after that. He also had shock-wave treatment during this time. When he broke-down for the second time he was de-nerved at AHT under Sue Dyson and we did 7 months of walking and box rest. It was pointed out to me at the time that the nerves could regrow/reattach within 12-24 months so nothing was guaranteed. In fact he had 13 months of proper work before he became chronically lame again in January last year. I turned him away for 14 months and have brought him back into walk exercise in March this year. I don't believe he is sound - I dare not check to be honest! He trots when he wants to - not when I ask - and I don't intent to school or compete him again as I would not want to put pressure on his ligaments so that he 'broke' permanently. So on a pessimestic note - if your horse has bad lesions in the ligament and not just a slight strain then the prognosis for full return to work function is not too good even after de-nerving. But you might be lucky.....
 
charmeroo

I do not totally agree with saying that a horse can not get back to full work / compete when they have done a suspensory ligament injury.

My boy did a lower hind suspensory ligament injury last September and the vet was not very hopeful that he would ever compete again let alone become sound.

For 2 months he was in a playpen built around a corner stable (He does not do box rest) He had Shock wave plus injections plus a treatment that filters the plasma and then it is re-injected into the lesion. I also used several Homeopathic remedies. After the 2 months he started walking out and then I increased the work and he is now back in full work to do some endurance. My vet cannot believe how well the leg has healed.

Patience is what is needed but a horse can come back to compete again.

I also have a little Arab Mare that has done a suspensory ligament that had her best season last year winning 2 race rides and the veteran Marathon. The mare is 20 years old. She is 100%
 
Thanks guys. I am very hopeful for my boy.

He is young and healthy and thrives on work. He has had his op and his two weeks solid box rest. Had his shoes put back on today. Incision has completely healed over and he is now out in a small paddock for most of the day.

Of course there is always a chance that the horse wont come right but I will keep positive as there is more chance (%) of the horse being OK than not.

Was not told about the nerve re growing though.....
 
My horse was diagnosed with PSD in both hind legs in Sept08 he was on box rest and had shock wave therapy followed by months and months of walking. In August 09 the lameness became worse and he had a neurectomy and faciotomy in sept 09. He is pretty much sound and has been working harder since Jan and has held up to increased canter work and jumping. He is now waiting for a tie back operation which he is booked in for next week as since hind leg surgery he has become a roarer. Talk about bad luck! All in all the surgery on his hind legs appears to have been successful
 
Excuse my ignorance but what is a roarer? or do you mean rearer? What is the tie back op? Is it because he had the Nuerectomy and Facioctomy?

Glad you horse is back in work and doing well :-)

After the surgery what was the recovery plan?
 
Roaring is also referred to as Laryngeal Hemiplegia. It is the damage or disease of a nerve called the recurrent laryngeal nerve that supplies the muscles that control movement of the arytenoid cartilages when the horse breathes. This results in the partial or complete paralysis of one of the arytenoid catrilages, leading to an obstruction of the airflow when the horse takes a breath. It usually effects effects the left side. The exact cause of this condition is unknown, although larger horses appear to be more at risk.
Surgery for roaring involves placement of large structures to hold the cartilage open (called a tie back). My horse was scoped and was a grade 5 roarer (complete paralysis).
This is not related to the hind limb surgery but it is since he was operated on that there has been the problem. Has anyone else had any similar experience?

My horse is/was a show jumper given the positive outcome following the Neurectomy and faciotomy I made the decision to have him operated on again (not an easy decision).

With regards to recovery following the hind limb surgery, he had a period of complete box rest (I think 1 month) followed by controlled exercise (horse walker starting 5 mins x2 per day increasing to 30 mins x2 per day for 1 month then ridden work increasing duration and intensity.

How is your horse getting on following his surgery?
 
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