Recurring Tendon Injury - Long!!!

Dolphin

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I would appreciate any thoughts on the following which I will keep as short as poss.

My mare injured her inferior check ligament approx 3.5 years ago. As she does not box rest well (runs round and round box) she was turned out for 6 months and was then successfully bought back into work (although I took it very very slowly - 18 months in total).

She was then kicked in the field right on top of the scar tissue, which my vet thinks weakened it, and managed to sustain the same injury a couple of days later whilst turned out. This time round she had 9 months of field rest, and I commenced ridden work 10 days ago (albeit it just 5 minutes in walk!) after a good scan and on the advice of my vet.

Last week, I got her in for her walk and she had "done" her tendon again. My vet came and the scan showed that she has ripped the ball of scar tissue away from the rest of the tendon, i.e. she has not damaged any healthy tendon, just scar tissue. However, she is sound on it!!!! The vet thinks this is because the only injured tissue is scar tissue which does not have many blood vessels etc running through it. As this is the third time she has done it now, the vet gave me 3 options:

1) Turn away for another 9 months although she said this is exactly what I have just done, and it hasn't helped a bit in that I am back to square one.

2) Have a op to remove the inelastic scar tissue completely. She would need 8 weeks box rest after and my vet said her leg would be "extremely vulnerable" during these 8 weeks. Due to my mare not being able to cope well with box rest, we have ruled this out.

3) Give it all a month to settle down again, and then ONLY if she is still sound, commence my ridden walking work very very cautiously. The idea behind this is that gentle exercise during the healing process as opposed to after the healing process may promote the injury to heal in a more elastic way than it has previously.

My vet has gently swayed me towards option 3 but I would really appreciate any opinions/advice as this really is the last chance for her. I did ask which option would be better for her long term health as opposed to being able trying to get her back into work but my vet said whichever option I took was irrelevant - my mare should be able to live a happy life retired and turned out if need be whichever route I took.

Sorry this is so long!
 

Halfstep

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Ligaments heal badly, that's the problem. They lay down fibres of scar tissue and are very weak. This is why box rest and controlled exercise is the ideal for ligament injuries, as it helps the scar tissue to form evenly.

I would say option 3 is your only option. I would be extremely careful to walk her only on hard, even ground for a LONG time when bringing her back into work. The operation would be an option for a horse who accepts box rest, but as your horse does not, it is right to discount it.

Good luck.
 

TayloredEq

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My friends mare was on box rest a few years ago for a total of 4 months. she did not take well to box rest but there was no other option. As a result she was given regular amounts of ACP and her box rest was then managed fine.

Secondly have you discussed the option of using a hydrotherapy spa with your vet?

Good Luck with your decision
 

Dolphin

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I'm glad someone else agrees with option 3. And yes, I would anticipate that the walking would go on for 9 months i.e. the same amount of time as if she was field rested. That's no problem, this has been going on for 3.5 years now so I am in it for the long haul!

Hydrotherapy was not discussed - possibly because my insurance company have long ago exluded not just the injured leg but all of my mare's legs, and my vet has been very aware of how much this is costing me(!), and also maybe because of our location on the outskirts of London.
 

hellybelly6

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Yes option 3
My horse split his DDFT and had box rest and exercise in hand gradually building up to turnout for 1/2 days.

Tendons need regular gentle exercise to help the new tendon fibres line up with the existing fibres and the best way is with regular gentle exercise, otherwise there is the risk of adhesions. I would imagine it is similar for ligaments.

Good luck, I know how you must be feeling having a horse with a tendon injury who is back to the vet school tomorrow.

x
 
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