Should Horse be more mobile by now after injury

[Ossy2]

Just wondering if anyone has dealt with similar or any advice on how best to go forward really. About 2 months ago my horse had an accident in the horse box which resulted in big cut to lower leg needing flushing out under GA at horspital. Cut missed major structures so was the infection and healing process to deal with. Horse had been bandaged till about a week ago, which essentially immobilised the leg to allow healing, vet now happy it’s healed over enough for the bandage to come off although there is some swelling around the fed lock joint. But here’s the issue on taking the bandage off, horse is still hopping round on bad leg, vet says there is no reason she should still be that lame and doesn’t think she will regain full mobility again. Not entirely clear her reason behind that conclusion just that maybe the initial infection effected the tendons.
Going to get a second opinion as if that’s the case then that’s the case she can be retired but I just want to understand the reason behind not being able to make full recovery.

 

[CanteringCarrot]

I agree with getting a second opinion. Even if it aligns with the opinion of your first vet. The peace of mind and knowing you looked into it well enough is worth it, IMO.

 

[bonny]

Has the horse been box rested all the time ?

 

[Ossy2]

Has the horse been box rested all the time ?

Yes 100% completely box rested as well under vet advice to keep leg clean as possible and as immobile as possible so the stitches didn’t pop. That parts gone well apparently. Has had swaps taken to test for residual infection which were clear and scans of leg taken in horspital didn’t show any internal damage but came very close to.

 

[Gloi]

I don't see why she should still be so lame with no reason and would be wanting to have that reason investigated probably with further scans now the wound is healed.

 

[ihatework]

If the horse has been fully bandaged and immobilised then it will take a bit of time once they are allowed to start rehab.

That said I find your vets response unhelpful (or perhaps it’s how you interpreted their response?) and I would be getting a second opinion and be scanning the injury to see what you are dealing with re scar tissue.

 

[Ossy2]

If the horse has been fully bandaged and immobilised then it will take a bit of time once they are allowed to start rehab.

That said I find your vets response unhelpful (or perhaps it’s how you interpreted their response?) and I would be getting a second opinion and be scanning the injury to see what you are dealing with re scar tissue.

Thanks yes I agree vet response unhelpful and that is what she said, rather my interpretation, shouldn’t be that lame still legs gone hard don’t think full Mobility will be regained but will prescribe some more bute again and see if that helps get her using it a bit more again. No offer of rescans or X-rays ect, hence wanting a second opinion. Scar tissue is a good point.

 

[Arzada]

I would expect post injury rehab to include regular physio. Not quite so well used in equines is myofascial release.

MFR with a brilliant bodyworker enabled my eventual full recovery from serious injury. I saw her from 11 months post injury for about 4 years. Her work, unsticking the injury affected parts of me, meant that my body recovered sufficiently to start Clinical Pilates and increasingly to do more and more.

I would recommend an MFR equine specialist, if you can find one, to help with the scar tissue and the wider damage to affected fascia.

 

[Birker2020]

Just wondering if anyone has dealt with similar or any advice on how best to go forward really. About 2 months ago my horse had an accident in the horse box which resulted in big cut to lower leg needing flushing out under GA at horspital. Cut missed major structures so was the infection and healing process to deal with. Horse had been bandaged till about a week ago, which essentially immobilised the leg to allow healing, vet now happy it’s healed over enough for the bandage to come off although there is some swelling around the fed lock joint. But here’s the issue on taking the bandage off, horse is still hopping round on bad leg, vet says there is no reason she should still be that lame and doesn’t think she will regain full mobility again. Not entirely clear her reason behind that conclusion just that maybe the initial infection effected the tendons.
Going to get a second opinion as if that’s the case then that’s the case she can be retired but I just want to understand the reason behind not being able to make full recovery.

Could it be scar tissue that is causing her to be lame? https://www.horseandhound.co.uk/plus/serious-scar-tissue-horses-hh-vip-626136

 

[SEL]

I think its a bit like when humans have had bed rest and all the muscles start to contract. Usually physio would be recommended to try and loosen everything up before a horse is completely written off.

 

[Elf On A Shelf]

2 months in bandage on box rest!?!?!?!?!

How extensive was the injury? Did it affect the joints or was it just over the straight parts of the leg?

We have never had anything in a big, immobilising bandage for more than 3 weeks. And with the exception of 10 days in a cast the bandage was taken off every day to allow a small amount of movement and for it to be cleaned and assessed.

 

[Ossy2]

2 months in bandage on box rest!?!?!?!?!

How extensive was the injury? Did it affect the joints or was it just over the straight parts of the leg?

We have never had anything in a big, immobilising bandage for more than 3 weeks. And with the exception of 10 days in a cast the bandage was taken off every day to allow a small amount of movement and for it to be cleaned and assessed.

Yip, basically from fetlock down at front was degloved but then the one that had to be stitched was essentially where you’d get an overreach injury looked like one too but went literally all the way in so the tendon was visible but wasnt damaged per say. This then got infected which is why she had to go in to get flushed and restitched. The bandage did get changed every 5 days, we did it ourselves sometimes then vet came out to check on a couple of changes, healing was slower than the vet wanted initially and with risk of infection and stitches popping she was kept in that set up until the other week when vet said happy for it come off. But she seemed to expect to take the bandage off and my horse to suddenly start walking round whereas she literally still hobbles like the bandage is on, surely she just needs time to re-adjust but like you I’ve never had one bandaged for so long and not really getting answers from my vet.

 

[Arzada]

But she seemed to expect to take the bandage off and my horse to suddenly start walking round whereas she literally still hobbles like the bandage is on, surely she just needs time to re-adjust but like you I’ve never had one bandaged for so long and not really getting answers from my vet.

Doctors look for movement as soon as safely possible because of the effects of immobilisation. Just one article. It's surprising that your vet hasn't factored this in.
'Human skeletal muscle loss is a common consequence of physical inactivity, immobilization, aging and disease [1–5]. Two to three weeks of immobilization causes a loss of muscle mass of 5–10%, accompanied by a decrease in strength of 10–20% [6–8], and, accordingly, individuals with injuries that require immobilization of a limb experience a rapid loss of muscle mass and strength. The recovery from such an injury can be complicated by the lag time for strength recovery ...'
https://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-5-166

 

[Melody Grey]

No experience of the issue, but I’d be worried there is more extensive damage than previously thought/ excessive scar tissue etc.

has the leg been scanned and x rayed? How much investigative work went on at the time of injury?

 

[Melody Grey]

Curveball here- there’s no chance the leg has been damaged much higher up in the travel accident is there and something else is causing the lameness? ....or the bandage has been too tight causing nerve damage? ....sorry, clutching at straws!!

 

[PinkvSantaboots]

Doctors look for movement as soon as safely possible because of the effects of immobilisation. Just one article. It's surprising that your vet hasn't factored this in.
'Human skeletal muscle loss is a common consequence of physical inactivity, immobilization, aging and disease [1–5]. Two to three weeks of immobilization causes a loss of muscle mass of 5–10%, accompanied by a decrease in strength of 10–20% [6–8], and, accordingly, individuals with injuries that require immobilization of a limb experience a rapid loss of muscle mass and strength. The recovery from such an injury can be complicated by the lag time for strength recovery ...'
https://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-5-166

I think this is probably what has happened and I would get a second opinion with a very good physio as the horse has probably almost forgotten how to use that leg properly.

I was immobile for 2 weeks and my leg literally wasted away and was so weak it used to shake just trying to put weight on it.

 

[BronsonNutter]

Doctors look for movement as soon as safely possible because of the effects of immobilisation. Just one article. It's surprising that your vet hasn't factored this in.

Whilst I agree moving some injuries is a good idea, I wouldn't in a bandaged horse following a serious degloving injury. Immobilisation is necessary to allow these to heal, any movement of the degloved areas will only increase healing time, and moving a horse about lots in a bandage is likely to result in bandage sores. The amount of muscle mass lost in a horse will be less significant than in a person as there is very little muscle in the horse's distal limb.

Are there any sores or swollen bits on your horse's limb OP? Or any serous ooze anywhere? Your horse should definitely not be hopping lame at this point post-injury, if none of the 'important bits' were injured initially. I have seen a few that have been hopping with bandage sores, hopefully it is something simple for you like that! Or was any bone exposed at the time of injury; sometimes if there has been damage to the outer layer of the bone it can take 2-3w to show. Best of luck with the second opinion.

 

[Arzada]

Whilst I agree moving some injuries is a good idea, I wouldn't in a bandaged horse following a serious degloving injury. Immobilisation is necessary to allow these to heal, any movement of the degloved areas will only increase healing time, and moving a horse about lots in a bandage is likely to result in bandage sores. The amount of muscle mass lost in a horse will be less significant than in a person as there is very little muscle in the horse's distal limb.

I wasn't suggesting that the horse was kept moving. The vet hasn't factored in loss of muscle mass and strength to recovery so there isn't a rehab plan.

It isn't just an affected limb which loses muscle mass and strength from lack of movement but the rest of the body too. The horse was on box rest for 2 months.

 

[BronsonNutter]

I wasn't suggesting that the horse was kept moving. More that the vet hasn't factored in loss of muscle mass and strength to a recovery plan. There isn't a rehab plan.

It isn't just an affected limb which loses muscle mass and strength from lack of movement but the rest of the body too. The horse was on box rest for 2 months.

I still wouldn't class it as normal for the horse to be 'hopping lame' due to box rest and lost muscle though. A bit stiff taking time to loosen off, yes, and certainly not ready to go out and win a dressage test, that would be normal following 2 months stuck inside. Something else is going on to make this horse very lame which needs working out before any form of rehab plan is made, because that could significantly effect the plan.

 

[Ossy2]

I thought I’d come on and update those who replied but also thought it useful for anyone searching for similar in the future.
So we had a second opinion, we had x-rays and scans and the second vet confirmed no obvious signs of any significant damage to the internal structure eg ripped tendons. Significant scarring and residual swelling noted, no obvious cause of swelling other than scarring and residual from the initial injury.
So we slowly started on rehab program to get movement back into the fetlock joint, started with just simple walks around yard increasing number a time of these, then started to introduce a little jog to those walks, then moved into walking in the area too to mix of the surfaces, we then added a little lunging just in a head collar, increasing the amount of trot as we went. We found that on the lunge because there was little flexibility in the fetlock she found it easier to canter to trot so we let this happen and slowly the swelling started going down and she began to offer a little more trot instead of canter. Over Xmas she started to get an hours turnout again which was such a relief and next week we start a little long reining and if all goes well I may get back on at the start of February.
She still has some swelling around the fetlock and there isn’t full mobility in it yet so is still around 1/10th lame but has improved from pretty much none weight bearing at the start. Whether we will ever get full mobility back 100% I don’t know yet but I’m happy the horse now at least has a quality of life again.

 

[View]

Thank you for coming back with an update. Is ride and lead a possibility for getting more movement in without a rider?

 

[ihatework]

That’s sounding positive. It will take time. Did the vet mention laser at all?
Where abouts are you as I have a friend that does veterinary laser

 

[Ossy2]

Thank you for coming back with an update. Is ride and lead a possibility for getting more movement in without a rider?

Thanks for the suggestion the reason for the long reining mainly is that when free on the lunge she tends to compensate by essentially swinging her bad leg out to the side to avoid keeping it underneath her and it having to flex more so long reining is to help keep her straighter between the hand and leg so we can encourage her to move straighter and subsequently the joint flex’s more and that continues the improvement, this will then set her up to do similar ridden but that will only happen when progress on long reins is good. I don’t think I’d get that level of control of her leg on ride and lead.

That’s sounding positive. It will take time. Did the vet mention laser at all?
Where abouts are you as I have a friend that does veterinary laser

Thank you, yes she’s only just 6 now so happy to give her all the time she needs and I’m lucky I have another to compete this season. Thank you for the suggestion, we are Cheshire/Lancashire border location. We are using a infra red laser, not sure if that’s similar to what you refer too? And also now she’ll put all the hoof down on floor she’s going on a theraplate regularly. Essentially anything that says it will help bloodflow ect we are trying lol

 

[ihatework]

Too far from me but sounds like you are doing all the right things ?

 

[Birker2020]

? And also now she’ll put all the hoof down on floor she’s going on a theraplate regularly. Essentially anything that says it will help bloodflow ect we are trying lol

Ice vibe boots might be the solution as the massage therapy will improve circulation to allow oxygen to reach the tired and damaged tissue. The massaging affect stimulates repair and improves bloodflow.

You can use them without the cold packs just on their own.

 

[Toby_Zaphod]

Never be worried about seeking a second opinion on an injury. We use 2 different vets depending on the injury, illness our horses have. For general illnesses we use one vets & for 'lack of performance' type issues, lameness mainly we use another vets. The second vets specialise in lameness/lass of performance, most of their vets have done extra studies, a year longer at college, and they are so damn good. I would like to use them all the time but they are quite a distance away from us.

 

[Hallo2012]

deffo second opinion but a friends horse degloved hind cannon area and after bandage came off it took a couple of months to be moving normally/level due to muscle wastage and scar tissue.

 

[Cragrat]

That's great to hear OP.

I bet you are glad you went for the second opinion!

Hopefully with time she will come 100% - as you say, being 6, time is on her side, and she is lucky to have you on her side too.