Slightly tricky injury to the suspensory branch- stem cell, shock wave etc?

[Michen]

Very short story but.. my youngster has a very slight injury to his suspensory branch- on the "surface" of it. Looks to be the result of a trauma. Unfortunately despite a months box rest with controlled walking, it is no better but not worse either (despite having broken free twice and had a couple of heart stopping gallops with tight turns). He is also lame with it (mildly, mostly under saddle).

For various reasons, the main one being his ability to get loose regardless of contraption, he is going out in a paddock 24/7 with an elderly horse for a couple of months to see if we can get some healing.

I am completely out of insurance money so every scan etc if out of my own pocket. My vet said he is unconvinced re "most" therapies being useful for this sort of thing but if we were to try anything it would be Stem cell therapy (likely preference- £1500) or shockwave.

I'd be really interested to hear of any experiences with the above. The horse is due to go on full loan to my friend when recovered, or be sold if she no longer wants him, and I had every intention of letting nature takes its course with regards to healing rather than likely throwing good money after bad but I just can't not give him the same level of care that I would to my other horse- I'd feel terrible if in a couple of months it was the same and I hadn't tried something.

Experiences gratefully received

 

[SO1]

I think the key with a lot of these treatments is that you have to start very soon after the injury is done for it to be really effective and be able to do the controlled walking and exercise. If you spend a lot of money on these things and then your horse whilst in the paddocks does a sharp turn or slips or has a mad moment whilst still in the healing process then all that money and treatment could be for nothing.

My pony strained his hind suspensory branch last year and had the box rest and controlled walking for 13 weeks before small paddock turnout. (He actually went in the middle of the horse walker for the start of his small paddock turnout as there was a lot of long grass in there and it was impossible for him to get any speed up and it had a sand base under the grass so a good surface). My vets suggested laser which would have been nearly 3k and I decided not to spend that money and did the more conventional old fashioned way and he made a good recovery. I am lucky enough to livery on a rehab yard so we have lots of kit like cold water ice spa which he had at the start of his injury.

A friend spent money on shockwave for an annular ligament issue and it did not work and she ended up having it operated on, and another friend had PRP which did work though they did the conventional box rest/controlled walking as well.

 

[HappyHollyDays]

When B tweaked a front suspensory skidding in the snow I sent him away to a local cold salt water therapy unit for three weeks and had the vet go there and administer the shockwave treatment every 10 days or so. He went in the freezing cold water up over his knees every day, was on box rest the whole time until the last week when he was put on the walker for 10 minutes each way. He has ‘touch wood’ never had a days lameness from it since. He sustained the injury in the February and didn’t go to rehab until May and once home we hacked in straight lines for a few months with lots of hills thrown in to build muscle.

 

[conniegirl]

Cobbus injured his suspensory branches on both hind legs. He had shockwave and rest and now 2 years on you would never know he had damaged then.
His shockwave was done during the initial 12 week box rest and continued during his hand walking.
Cost £150 a time (including sedation) and my vet (major equine vet hospital) recommended it over stem cell. Cob had 6 sessions of shockwave

ETA - cob was 18 yrs old at the time and my vet did warn that at his age healing would be slow and treatments may not work as well.

 

[Michen]

I think the key with a lot of these treatments is that you have to start very soon after the injury is done for it to be really effective and be able to do the controlled walking and exercise. If you spend a lot of money on these things and then your horse whilst in the paddocks does a sharp turn or slips or has a mad moment whilst still in the healing process then all that money and treatment could be for nothing.

My pony strained his hind suspensory branch last year and had the box rest and controlled walking for 13 weeks before small paddock turnout. (He actually went in the middle of the horse walker for the start of his small paddock turnout as there was a lot of long grass in there and it was impossible for him to get any speed up and it had a sand base under the grass so a good surface). My vets suggested laser which would have been nearly 3k and I decided not to spend that money and did the more conventional old fashioned way and he made a good recovery. I am lucky enough to livery on a rehab yard so we have lots of kit like cold water ice spa which he had at the start of his injury.

A friend spent money on shockwave for an annular ligament issue and it did not work and she ended up having it operated on, and another friend had PRP which did work though they did the conventional box rest/controlled walking as well.

Unfortunately the controlled walking is just not an option at this point. He's far less likely to do those antics turned out in a paddock with a quiet companion 24/7 eating, than what he's currently getting up to at the minute.

So will probably have to take my chances that it could be a waste of money but could not be. Given he's done all those moves and it's not worsened it, maybe I'll get lucky.

I wonder how many horses with similar issues get turned away for a lameness that's undiagnosed, and come right just fine? Who knows!

 

[fredflop]

Arc equine?

 

[ycbm]

Mine did a front one quite badly. I turned her out for six months, a dealer bought her from the field and a new owner contacted me a year later to say she was show jumping with no problems at all.

My impression is that branch injuries heal relatively easily and time is a better friend than any treatment.

But I'm old school and very out of date these days.
.

 

[Michen]

Mine did a front one quite badly. I turned her out for six months, a dealer bought her from the field and a new owner contacted me a year later to say she was show jumping with no problems at all.

My impression is that branch injuries heal relatively easily and time is a better friend than any treatment.

But I'm old school and very out of date these days.
.

That's good to hear, though I think hinds are trickier?

I suppose I'd just like to "do" something, to know I have done what I can to give him the best chance.

 

[Lucky Snowball]

My TB injured a hind suspensory branch. She would never settle in the box so she was secured in the field shelter. Surprisingly happy with this she stayed in for many weeks then had a stable sized extension which was gradually increased (electric) so she never got too excited. Vet was aiming for field sound as horse was in her late teens. She returned to full work and never looked back.

 

[spookypony]

My understanding is that the evidence for the efficacy of either stem cell or shock wave is very limited indeed: perhaps someone else knows otherwise? When the Spooky Pony did his check ligament, we (after a month of box rest) corraled him right beside his mares, in a corner of the field. We shifted the corral every 2-3 days, so he had plenty to graze, and he could talk to his friends over the electric tape. This worked for 2 months, and then he jumped over the tape and declared himself sound. Would a corral be an option for your horse?

 

[PurBee]

Not sure of the stats on better recovery for the treatments youre enquiring about, but wondered if you’d thought of laser/ multi-band light therapy treatments? It aids cellular regeneration, speeds up healing basically. Ive researched this for humans, specifically near-infrared light cellular healing and it’s a viable treatment path, it seems studies on horses have been done too:

Studies on equine ligament issues show it to increase healing compared to controls:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494822/

Near-Infrared light therapy helps recovery:

https://www.celticsmr.co.uk/news/ve...aser-treatment-of-tendon-injuries-for-horses/

You can purchase infrared tendon wraps - but you might find better prices looking at human athlete stores/websites for infrared leg wraps etc. as we know anything with equines in mind the price automatically doubles than any other industry!

Or you could consider employing a practitioner experienced with various lightwave therapies. Might be worth calling one for some advice, as you could have a few sessions by a trained professional who might also suggest you use some light pads daily/every other day inbetween sessions.

Its similar in a sense to shockwave therapy as sound waves can be transposed into light waves, i just havent read as much regarding shockwave therapy…but playing bear some mozart to chill him out might work a treat! ?
(saying that, animals seem to revel listening to classical music, there’s tonnes of youtube videos about it….music therapy has its place more for emotional states regulation)

 

[Sossigpoker]

My old horse had a huge tear in his front suspensory, about half way up. He had Shockwave every other week together with box rest. It healed very well and never caused a problem afterwards.

 

[Slightlyconfused]

My big heffalump has done 3 out of four hind suspensory branches in the last 4 years. He is a 12hh pony in a 16:3 tank.
First time we did the shock wave, box rest, in hand walking for 12 weeks. Didn't work, he got hard to handle and sheath swelled up, the lameness only improved a bit.
So vet was OK with lobbing him out for 8 months in the feild with my other one and just ignoring him mainly apart from the normal daily checks and in at night in the winter.

Came back completely sound.

Each time he has done one he has had feild rest and that's it. He injures himself in the feild, he likes to pull moves his body cannot cope with.
He is now 18 and coming back into work after doing his third one and a year off. All times he has come back sound after the time off.

I am just waiting for him to do the fourth one and then he will have a matching set ?

 

[SEL]

I know a human who had shockwave for a ligament injury and said just 3 sessions made a real difference.

My vets recommended laser for my mare but I was out of insurance and she has too many other issues.

 

[mavandkaz]

You know my story and shams suspensory problems.
Both vets said not to bother with shockwave (implied it was more of an analgesic, and as he had no heat or swelling it wasn't worth it). First vet did suggest laser, and we did one treatment but as paying out of my own pocket wouldn't have been feesible to continue with it as needs to be done often, and with his being all 4 legs very time consuming. So opted for turning him away.

I'm still on some of the PSD Facebook groups and the latest thing seems to be INDIBA. Don't know much about it but is some sort of micro current therapy. I always get wary when you see people pushing a certain treatment, but could be worth a look.

 

[paddy555]

I wonder how many horses with similar issues get turned away for a lameness that's undiagnosed, and come right just fine? Who knows!

mine, I think it was last summer. Aged 15, went lame behind on one leg. Didn't know what it was but guessed it was probably going to be suspensory branch or similar.

Didn't get a diagnosis as I couldn't see the point. Whatever it was I would have done the same which was to turn the horse away but I am also very old school and I go for time and rest. The horse just lived his normal life minus any work. He came in during the daytime when necessary due to the flies and heat and lived out the rest.
After around 3 months he started to become sound and after 4 he was sound and I started leading him in hand very short distances gradually increased the distances and moved onto the long reins.

He resumed riding a long time ago and is perfectly sound and ridden daily.
For me it wasn't the money just the fact that I believed time was going to be the greatest healer and patience was required. If the vet advice was to keep the horse stabled and walk in hand for X minutes a day I wasn't prepared to do it with that horse. He would have been totally stressed by the end of day one being stabled and I would be dealing with ulcers and a PSSM horse who after a few days stabled would not have been able to move.

 

[Ceriann]

Mine did a front one quite badly. I turned her out for six months, a dealer bought her from the field and a new owner contacted me a year later to say she was show jumping with no problems at all.

My impression is that branch injuries heal relatively easily and time is a better friend than any treatment.

But I'm old school and very out of date these days.
.

This - time and restricted turnout (no room for zoomies). Mine recovered from a nasty hind medial branch injury. No therapy just restricted turnout for 6 months and very very slow intro back to work. I didn’t do any of the therapies - vet advised against it as a lot of money with no science to support the benefits for a branch injury. She’s completely sound and back in full work - it’s modified to mitigate risk but that’s choice. I think it’s too early with this sort of injury to consider what you are doing isn’t working.

 

[maya2008]

I wonder how many horses with similar issues get turned away for a lameness that's undiagnosed, and come right just fine? Who knows!

Mine, a fair few times over the years. Last winter the two youngsters kept bugging each other and playing in the mud - one went lame, had a few weeks off, got better, hurt self again. Then the second hurt himself too. So we moved them to a mud-free field and left them to heal. All good a while later.

My mare who tore her manica took 9 months to come completely right (she did have surgery to remove the mess she had inside her leg). Left her in the field after initial box rest, waited until it hadn’t swollen upon charging around for a month or two then got back on.

In 20 years, I have had three lamenesses investigated - one was canker, one arthritis, one the torn manica. I always have 4+ horses, and any other minor lamenesses have gone away on their own with time and rest.

I do appreciate though that this approach is much easier when you have land, other horses to ride and a settled herd.

 

[Michen]

Just a quick message to thank you all for the info and comments, really helpful and interesting. He's been dropped off and was so happy to be out in a paddock with a new old mate- I feel pretty at peace with the decision not to put him on individual turnout on a postage stamp field somewhere. He can be out 24/7, has a shelter, a friend and not too much grass to be of much concern.

I've decided to go ahead with the Stem cell so vet is in the process of ordering that kit. I'll keep you updated, there does seem to be more success stories than I first thought. I know it's not ideal that we aren't combining it with a box rest approach but given how things have unfolded with him and the behaviour over the last week, plus the sheer relief I feel tbh, I think this is the right thing to do.

Will post again in 8 weeks once he's been rescanned (or may leave it 12, not in a particular rush tbh). At that point I'll decide whether to bring him back and get him moving or just keep him out until next year. I suspect the former as I do want to get his feet "moving" and rehabbed.

 

[Michen]

You know my story and shams suspensory problems.
Both vets said not to bother with shockwave (implied it was more of an analgesic, and as he had no heat or swelling it wasn't worth it). First vet did suggest laser, and we did one treatment but as paying out of my own pocket wouldn't have been feesible to continue with it as needs to be done often, and with his being all 4 legs very time consuming. So opted for turning him away.

I'm still on some of the PSD Facebook groups and the latest thing seems to be INDIBA. Don't know much about it but is some sort of micro current therapy. I always get wary when you see people pushing a certain treatment, but could be worth a look.

I think PSD is quite different to this which seems to be a trauma injury to the suspensory branch, or rather surface of. I could be wrong though and maybe treatment options are still similar.. but I'm hoping as this isn't a chronic break down type thing that it is as mild as my vet thinks, despite the disappointing healing so far..

 

[ester]

We did PRP into a messy looking bit (not a proper hole so I know our vet checked with the one who did it whether it was worth trying) + extended rest. She only came back into hacking work, she'd go a bit off the next day if she did any arena stuff. - was a lot older than bear though!
I can't remember which branch it was though.
Fingers crossed for him

 

[Michen]

We did PRP into a messy looking bit (not a proper hole so I know our vet checked with the one who did it whether it was worth trying) + extended rest. She only came back into hacking work, she'd go a bit off the next day if she did any arena stuff. - was a lot older than bear though!
I can't remember which branch it was though.
Fingers crossed for him

Yep my vet told me again why he thinks PRP isn't a good option, but had the most manic day at work and wasn't ingesting info properly- I think the risk of over activity or something? Basically that it wasn't big enough/messy enough etc.

 

[Ceriann]

All the very best for you both and hope it’s a success. There is no one size fits all and you have to do what works for yours - lots don’t cope with box rest or small turnout. Keep us posted.

 

[SO1]

I think this is the right thing to do in your circumstances. It seems like you have a very well paid job so can afford to do this and this is a young pony and you also don't want to keep the pony you want to loan or sell so you need to do all you can to enable you to do that, to try and prevent ending up with having a field ornament for next 25 years if he doesn't come sound.

My circumstances were different my pony was 18 when injured would never be sold and I didn't have the funds to take a risk on a treatment that was experimental - lazer. Luckily he came sound the conventional way but he was ok with box rest and the controlled exercise.

Just a quick message to thank you all for the info and comments, really helpful and interesting. He's been dropped off and was so happy to be out in a paddock with a new old mate- I feel pretty at peace with the decision not to put him on individual turnout on a postage stamp field somewhere. He can be out 24/7, has a shelter, a friend and not too much grass to be of much concern.

I've decided to go ahead with the Stem cell so vet is in the process of ordering that kit. I'll keep you updated, there does seem to be more success stories than I first thought. I know it's not ideal that we aren't combining it with a box rest approach but given how things have unfolded with him and the behaviour over the last week, plus the sheer relief I feel tbh, I think this is the right thing to do.

Will post again in 8 weeks once he's been rescanned (or may leave it 12, not in a particular rush tbh). At that point I'll decide whether to bring him back and get him moving or just keep him out until next year. I suspect the former as I do want to get his feet "moving" and rehabbed.

 

[Illusion100]

ArcEquine

 

[Britestar]

You know my story and shams suspensory problems.
Both vets said not to bother with shockwave (implied it was more of an analgesic, and as he had no heat or swelling it wasn't worth it). First vet did suggest laser, and we did one treatment but as paying out of my own pocket wouldn't have been feesible to continue with it as needs to be done often, and with his being all 4 legs very time consuming. So opted for turning him away.

I'm still on some of the PSD Facebook groups and the latest thing seems to be INDIBA. Don't know much about it but is some sort of micro current therapy. I always get wary when you see people pushing a certain treatment, but could be worth a look.

My friends horse has a stifle injury, that required surgery.
He has had 3 indiba treatments as a 'supplementary' to his recovery programme. Whilst I was sceptical, even I notice a difference in him each time.
The last treatment was last week, and prior to that I had noted that whilst almost sound in trot in the field, he was still bunny hopping in canter. After the treatment this time he is taking proper steps behind in canter.
He's still not working, but now it has been suggested back to walking my be beneficial, a good 6 months sooner than expected.

 

[Michen]

I think this is the right thing to do in your circumstances. It seems like you have a very well paid job so can afford to do this and this is a young pony and you also don't want to keep the pony you want to loan or sell so you need to do all you can to enable you to do that, to try and prevent ending up with having a field ornament for next 25 years if he doesn't come sound.

My circumstances were different my pony was 18 when injured would never be sold and I didn't have the funds to take a risk on a treatment that was experimental - lazer. Luckily he came sound the conventional way but he was ok with box rest and the controlled exercise.

Eeek I have to say if he was permanently retired I'm afraid I'd PTS, but yes it's fine for the forseeable to double up on livery so that he can be wherever he needs to be and still keep his box where I am etc.

I'm sure he will be in much better nick in a couple of months

 

[Michen]

Well the vet from “lipogem” finally came today. It was very interesting to watch but also quite disgusting! They basically sucked out fat from his bum to then inject into the area. Sort of stem cell but already there rather than cultured (I did understand it at the time ?). Anyway it’s all very funky and not enough research behind it to know if it’s really a “thing” but it’s definitely worth a shot I think. Well I hope given what I’ve just spent on it!

He’s back home for a couple of days box rest before he goes back to his resting paddock down the road. He had a stable there is needed but I just want to see how he is over the next few days for myself

And even better, the injury was improved despite it being only 10 days since the last scan. So it’s improved more in 10 days field rest than it did in 4 weeks box rest. That also means we will likely never know if the treatment worked or it would have healed anyway but heck who cares ? I’m feeling hopeful I’ll be bringing him back in a couple of months to start ridden walk work.

Bog was sort of happy to see him ?

edited as I wrote a couple of weeks and meant months!!

 

[brighteyes]

My understanding is that the evidence for the efficacy of either stem cell or shock wave is very limited indeed: perhaps someone else knows otherwise? When the Spooky Pony did his check ligament, we (after a month of box rest) corraled him right beside his mares, in a corner of the field. We shifted the corral every 2-3 days, so he had plenty to graze, and he could talk to his friends over the electric tape. This worked for 2 months, and then he jumped over the tape and declared himself sound. Would a corral be an option for your horse?

Mine, too!

 

[Momo22]

My horse has a similar injury to his hind medial suspensory branch and we are having stem cells next week, we are already 17 weeks post injury so no idea really how effective they will be but he is insured and my vets think it is worth a go. He was on boxrest for 6 weeks with hand walking but the hand walking was getting dangerous so ended up putting him out in a small paddock which he is a lot happier in, he still has swelling at the site and is still lame in trot.