suspensory branch injuries

[Posa]

Does anyone have any experience of suspensory branch injuries?
My boy has damaged his in both front legs. I can find lots of info on suspensory injuries but not that much on injuries to the branches.
He is on box rest and has just had his second shockwave treatment.

 

[applecart14]

Does anyone have any experience of suspensory branch injuries?
My boy has damaged his in both front legs. I can find lots of info on suspensory injuries but not that much on injuries to the branches.
He is on box rest and has just had his second shockwave treatment.

my horse has done three on three different legs. Shockwave was useless but PRP was very effective as was early intervention with lots ice

 

[ester]

Yes one leg I can't remember if lateral or medial off the top of my head! Horse had prp treatment was somewhat delayed due to lack of lameness. 6 months box rest and text book rehab after that horse now hacks in all paces but can't do circles, tried and she gets small compensatory lameness so just hacks now.

 

[Goldenstar]

Fatty did the lateral branch on his NS not long after I got him .
Sadly he done the same to OF two weeks ago .
We are starting twelve weeks box rest and will be doing controlled exercise we are turning him out in a tiny square ATM this will make it easier to do the controlled exercise bit later .
We are using bonner banages for cold and compression therapy this is cheap and very very important in this type of injury .
We are also putting in a equine criss cross system as soon as I get it sorted .
My experiance if the horse is sound in walk from the start they do well this will be hard for you to asses because your horse is bilaterally lame .
How did the injure himself ? Fatty got into some very deep mud both times this has happened to him .
You need to keep your horse as slim as possible we have taken away Fatties rugs during the day to try to help with this .
I am hiring a therapeutic ultra sound machine and will use that rather than shock wave which I think is very expensive for what it achieves .
The NS one has done very very well he's done I think it's seven season hunting since it was injured .
You must make sure on going that the shoes are really good and very very well balanced .

 

[Posa]

Thank you! Its nice to know I'm not alone.
I'm still not entirely sure how he did it, we are guessing it was in the field.
Its the medial branches in both legs, one worse than the either. There's not been any heat or swelling and we only really picked the lameness up on the lunge.
The vet is being very guarded about his chances of returning to work but its a wait and see game I think, she's going to scan again in a month and has said if that looks good I can start hand walking for 5 minutes a day.
He's been a star so far and is coping well..
She has mentioned PRP so that's on the cards.. see how the shockwave goes first.

 

[ester]

Fwiw having had shockwave and therapeutic ultrasound myself they both work on me anyway the sw is better

 

[applecart14]

Fwiw having had shockwave and therapeutic ultrasound myself they both work on me anyway the sw is better

My reply earlier was brief because the speaker on my training course was about to start. Long wave ultrasound was used on my horse after shockwave and three subsequent ultrasound scans showed no improvement. In the end he had PRP and recovered well but then a traumatic accident where his bad leg became trapped in the framework around a wheelbarrow wheel caused a massive set back resulting in huge scar tissue developing around the original injury. Calcification developed around the branch which limited his competition use for around nine months but slow rehab and progressive increase in workload as well as a different riding technique meant that the hop he had developed after the wheelbarrow accident became minimal. Unfortunately it has raised its head again a few months ago resulting in a total ban on jumping. However horse did very well with move to another yard resulting in vast diffrrnce in turnout and was able to cope. However more recently horse has been showing dramatic but very inconsistent lameness in wheelbarrow leg resulting in hacking only whilst waiting vet assessment in feb. It looks increasingly likely that the scar tissue and calcification will result in total ban in schooling and will no doubt eventually impact hacking too. Hope this explanation not been too boring. OP you need to ice ice ice as vets have said this has been a Godsend in Baileys recovery as have the 'icevibe' boots. Vets have said its an incredibly common injury.

 

[Goldenstar]

Fwiw having had shockwave and therapeutic ultrasound myself they both work on me anyway the sw is better

Perhaps I should try to do both .

 

[ester]

I'm trying to remember if I've had them on the same bits or not! The ultrasound is certainly a much more pleasant sensation! Shockwave is quite intense!

 

[Goldenstar]

I am getting differing advice one is that therapeutic ultrasound is the best option the other is that shock wave is ,shockwave is just very intense ultrasound .
However Fatty will need sedating each time and a call out for a vet and a nurse and it's expensive .
I have never been terribly convinced with shockwave when I have used it in the past I am confused ATM not sure what to do.
I have a little time we need to get the acute swelling and heat away before we can do shockwave .

 

[applecart14]

I am getting differing advice one is that therapeutic ultrasound is the best option the other is that shock wave is ,shockwave is just very intense ultrasound .
However Fatty will need sedating each time and a call out for a vet and a nurse and it's expensive .
I have never been terribly convinced with shockwave when I have used it in the past I am confused ATM not sure what to do.
I have a little time we need to get the acute swelling and heat away before we can do shockwave .

My physio used long wave ultrasound my horse. This and the PRP became the turning point.

 

[ycbm]

I had a mare do an inside branch on a front leg with significant heat/swelling but only mild lameness. I've no idea how she did it. I turned her away for six months. She was never unsound again that I know of (she was sold) and went on to show jump.

 

[popsdosh]

I had a mare do an inside branch on a front leg with significant heat/swelling but only mild lameness. I've no idea how she did it. I turned her away for six months. She was never unsound again that I know of (she was sold) and went on to show jump.

Thats the only treatment we ever use on this sort of injury the best any veterinary intervention can do is speed it up a little they either come right or they dont. Standing in a box only causes scar tissue to form its better they keep moving around.

 

[Goldenstar]

My physio used long wave ultrasound my horse. This and the PRP became the turning point.

It's too minor an injury for PRP in Fattys case .

 

[Red-1]

Mine had one in 2015. He had PRP and Shockwave. The leg has come right, but he sagged with muscle loss with the rest, and now has mild wobblers.

So, not a lame stride for over a year, but not in work as he is not quite right in his wobbliness. If it gets worse he will be PTS.

Personally I feel it was straight line walking and time that cured the suspensory. The initial scans were not good after rest and treatment, but after another six months of walking straight lines the scans came back completely clear.

 

[ester]

Thats the only treatment we ever use on this sort of injury the best any veterinary intervention can do is speed it up a little they either come right or they dont. Standing in a box only causes scar tissue to form its better they keep moving around.

Shockwave/US isn't to speed it up it is to break down scar tissue?

 

[applecart14]

Shockwave/US isn't to speed it up it is to break down scar tissue?

I forgot to add that all my horses sb injuries were slight sprains that never progressed due to early intervention with vet and physio input careful rehabbing and my horse never had a days box rest due to arthritis and colic therefore needing usual turnout routine.

 

[Goldenstar]

Shockwave/US isn't to speed it up it is to break down scar tissue?

Yes that's the idea it breaks the lesions in a controlled way .
Suspensory injuries need to be protected from the side to side loading the horse does hence why vets don't like the horse to be free in the early stages of recovery .
In past we box rested horses for up to six months for severe suspensory injuries they now get them much quicker to controlled walking on a flat hard surface .
Fatty is not lame in walk so we are doing a bit walking exercise each day that way I hope we can keep him calm we we need him out and about more .
I am leading from any other horse our horses are used to this so he's much more settled leading off his friend .
OP keep icing then ice some more it makes a huge difference .
A very specialist vet told me once that vet can do all sorts of clever stuff for this type of injury but he still thought the dedication that the horses cares put into icing was one of the major factors in recovery .

 

[popsdosh]

Shockwave/US isn't to speed it up it is to break down scar tissue?

Its a bit of both to be honest as it encourages blood supply as well as remodel scar tissue nothing the horse doesnt do on its own if left mobile on the limb and exercised.

 

[ester]

GS yes we did hand walk from day one of box rest. The mare had PRP but not shockwave, the PRP was a bit of a punt in her case but she was insured and figured nothing to lose essentially.
SW came up again with Frank's annulars but decided as not problematic to leave them alone and move him to the flat .
The SW I have had has been on old scar tissue on old injuries- one near an old break and the other the ligament to the side of my sacrum- that is essentially a chronic long term issue that was first identified 20 years ago when I was 14 as a result of my wonkiness/hypermobility/trying to hold myself together! I have no idea whether it looks any better as not scanned but the improvement in how they feel has been noticeable post treatment, over and above other treatments I have had.

 

[Goldenstar]

I think Fattys not a candidate for PRP because the damage is minor and there's no space to inject into the suspensory.
We have jabbed him with cartofen already .
He is sound today in trot ( just did a few steps) but that's on Danilon so doesn't mean much he was very sore on Tuesday after all the prodding and trotting up on Monday .

 

[ester]

I suspect that is the case, I know that our vet checked with the chap who would do the PRP as we didn't have a hole as such, obviously it was decided there was enough space. Fingers crossed for Fatty's improvement. Our main issue was not spotting it for what it was, she had a filled leg previously which resolved with antibs so led to a wrong assumption on that front when it was filled again as not lame, well only lame the day after schooling which as we didn't have a school and it was winter was tricky to ID. I wasn't at home so hadn't seen it myself, I think if I had I would have pushed to scan earlier, the vet was surprised at the damage given the outward signs so that was my valuable lesson that damage isn't always obvious - which is why F got scanned for an unusual (for him) windgally bit more rapidly.

 

[Posa]

Thanks everyone
Hope everyone's horses are ok

I will do an update in a few weeks after the scan

 

[applecart14]

Good luck Posa. They are definetely rehabbable but it can take six or more months to get back to fitness as previously if it is a small sprain.
I'd keep icing as much as you can and as often as you can. I carried on for at least three to four weeks each time although was told it probably wasn't necessary and also did a regular ice vibe treatment on a daily basis.

 

[Posa]

Some good news! He had his scans yesterday and they are looking really good.
We have been hand walking one a day for 5 minutes for the last two weeks and can now increase it to ten minute. Slowly increasing the hand walking over the next 6 weeks and then rescan. Very happy!

 

[Regandal]

Good news then. My old ID did a very minor strain to one of his branches, when he was younger. He was turned out in a very small paddock. He came sound.

 

[Posa]

Well another update. its been 6 months since the original injury. We have just finished 6/7 weeks of walk rehab and he's still lame on a circle. The scans look great but its not reflected in how he's moving.
We have another 6 weeks of walk work scheduled and then will scan again :-(

 

[hopscotch bandit]

Well another update. its been 6 months since the original injury. We have just finished 6/7 weeks of walk rehab and he's still lame on a circle. The scans look great but its not reflected in how he's moving.
We have another 6 weeks of walk work scheduled and then will scan again :-(

Is your horse lame on a circle when the affected leg is on the outside of the circle?this is because they push off with the injured leg if its on the outside and can give the appearance of the horse being lame on the other rein if that makes sense. I wonder if long wave ultrasound from an ACPAT physio would help.This is what my friend used on her horse and he came good. The vets opinion was that the huge amount of repeated icing with ice cups and ice vibe boots made a huge difference in the outcome as well.

 

[Posa]

Is your horse lame on a circle when the affected leg is on the outside of the circle?this is because they push off with the injured leg if its on the outside and can give the appearance of the horse being lame on the other rein if that makes sense. I wonder if long wave ultrasound from an ACPAT physio would help.This is what my friend used on her horse and he came good. The vets opinion was that the huge amount of repeated icing with ice cups and ice vibe boots made a huge difference in the outcome as well.

Unfortunately he damaged the branch on the inside of both legs so lame on both reins.
I will speak to the vet re the long wave ultrasound, thank you