Suspensory Branch Injury

Dufus

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Hi, my horse was kicked in September and sustained a fracture to her splint bone and injury to the lower suspensory and outer suspensory branch , she is still lame and still on box rest although walking in hand 10 mins per day.

She was scanned 21/12/18 and it's still showing an enlarged suspensory.

I'm tempted to turn her away for 6-12 months and see if it heals with time however she does have recurring swelling of the suspensory so I'm unsure if the vet will agree to turning her away.

Does anyone else have a similar experience and what did you do? How long did it take for your horse to come sound if they came sound at all? As long as she is field sound and can live the rest of her life as a field ornament I will be happy as right now the likelihood of being ridden again seems impossible.

Thank you
 

Shooting Star

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Not quite the same as yours but similar. Mine had a hind suspensory branch injury which we box rested until I was forced to turn out due to cellulitis at I think about the 6 week point (vet & I both scratching head on where that come from on box rest).

Initially did a few weeks in a small paddock, removed shoes and then I moved yards and properly turned away 24/7, he came good quite quickly in terms of visible lameness probably 2-3 months but I gave him a full year off. He has been problem free from that injury ever since - I suspect in part due to going barefoot as it quickly became apparent that the shoeing had probably a contributory factor in the original issue.

Same horse also fractured splint bone on a different leg a few years before (did that a few weeks after starting turnout from box rest for another injury by doing handbrake turns in the sick paddock 😏).
That one also healed fine and although the suspensory scanned clear at the time it is definitely marginally thickened so must also have been injured. Again though we’ve had no Issues relating to the it either since it healed 🙂
 

Dufus

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Not quite the same as yours but similar. Mine had a hind suspensory branch injury which we box rested until I was forced to turn out due to cellulitis at I think about the 6 week point (vet & I both scratching head on where that come from on box rest).

Initially did a few weeks in a small paddock, removed shoes and then I moved yards and properly turned away 24/7, he came good quite quickly in terms of visible lameness probably 2-3 months but I gave him a full year off. He has been problem free from that injury ever since - I suspect in part due to going barefoot as it quickly became apparent that the shoeing had probably a contributory factor in the original issue.

Same horse also fractured splint bone on a different leg a few years before (did that a few weeks after starting turnout from box rest for another injury by doing handbrake turns in the sick paddock 😏).
That one also healed fine and although the suspensory scanned clear at the time it is definitely marginally thickened so must also have been injured. Again though we’ve had no Issues relating to the it either since it healed 🙂

Thank you for your reply and sorry for my late one but it's been a manic week and going back and forth with vet and decisions but I'm going to turn her away and give her 12 months off and keep everything crossed she heals. I'm worried to death about it as never turned a horse away to the elements before and not ticked them up cosy in their stable in winter but I know she's a horse and a fluffy fat one at that and probably doesn't worry about the rain and wind like I do but I just hope it works and means no more prodding and poking for her and box rest and everything else and she gets to just be a horse 😊
 

Shooting Star

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Thank you for your reply and sorry for my late one but it's been a manic week and going back and forth with vet and decisions but I'm going to turn her away and give her 12 months off and keep everything crossed she heals. I'm worried to death about it as never turned a horse away to the elements before and not ticked them up cosy in their stable in winter but I know she's a horse and a fluffy fat one at that and probably doesn't worry about the rain and wind like I do but I just hope it works and means no more prodding and poking for her and box rest and everything else and she gets to just be a horse 😊

Good luck and hope she heals well for you - if you turn out in a herd be prepared to have to deal with a horse that believes it’s been returned to the wild when it’s time to start working again though 😆. I worried the same as you but really shouldn’t have, I’ve never seen my horse so happy and decided to keep on 24/7 turnout and without shoe even after the injury had healed.
 

Dufus

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Good luck and hope she heals well for you - if you turn out in a herd be prepared to have to deal with a horse that believes it’s been returned to the wild when it’s time to start working again though 😆. I worried the same as you but really shouldn’t have, I’ve never seen my horse so happy and decided to keep on 24/7 turnout and without shoe even after the injury had healed.


Thank you, I've literally posted a thread and then seen your reply about how worried I am and will she survive! Lol. I do feel that it's the best thing for her to make a recovery and have some down time however I'm sure it's right for me and my worrying lol
 
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I’ve had two similar cases - although the one was Just the lateral suspensory branch and the other was the “main” suspensory and sesamoid bone. I’ve attached a reply of mine on this topic to a previous thread. What I did was originally seen as pretty unconventional - but there are more and more success stories of horses that have been written off by other vets yet have come right in a very short space of time with this protocol. Hope it helps xx


We had a top top top Grand Prix show jumper in our yard that did such a severe suspensory injury that he fractured its sesamoid bone from the force of the injury. The owners have lost a horse due to a suspensory injury before so they flew over a vet from Ireland (to South Africa) who is supposedly a very progressive vet when it comes to soft tissue injuries.

He bought his "UTC Scanner" (which is a 3D colour scanner that is like a mix between an ultrasound scanner and MRI - just much more affordable). We had previously planned to box rest the horse for a few months but when he arrived 2 weeks after the injury he insisted the opposite. Although this is very unconventional - the reasoning makes sense to me.

Rest= scar tissue
Scar tissue = weakness
Weakness = reinjury.

His UTC scan showed that although the lesion was severe- not too much scar tissue had developed. He explained to us that when a horse injures soft tissue (ie a suspensory) the scar tissue that forms is not suspensory tissue (only way for body to generate more suspensory tissue is proper stem cells. Therefore, one has to "teach" the tissue to behave like suspensory tissue by starting early exercise with the horse. This all sounded great but was very impractical at the time as the horse is impossible in hand and one wrong step could injury the suspensory even further.

Resultantly, he rented us an Equinetendon Rehabilitation device (like a boot but fitted in 3 parts) which controlled the degree to which the fetlock could extend- thereby controlling how much strain was put on the horses suspensory. This allowed us to control the amount of support offered to the fetlock/suspensory throughout the rehab through 4 different settings. This also met that when the boot was set on the CORRECT setting for particular stage of healing the horse was in - is is practically impossible for the horse to injure himself further when in the device. This allowed us to safely turn the horse out from the get-go as he hates being in the stable.

For our horses rehab - he insisted we started walking the horse (UNDER SADDLE) for 10min three times a day on setting 3 -the second "strictest" setting of this rehabilitation device/boot. Two weeks later we started trotting the horse for 2 min a day building up to 20 min of trotting a day over the following 2.5 months. All this work was done on firm ground in straight lines. Next we introduced cantering work. Throughout this process the vet was flown over from Ireland to rescan the horse. Because the scanner can differentiate between healthy tissue and scar tissue - we could spot (quite accurately) if the horse was not coping with the work level (a normal ultrasound scanner cannot give you this info).

Almost exactly 5 months after the horse sustained the injury the horse started doing small jumping (+-90cm) in the rehab device on setting 1 (this offers little support- but ensures the fetlock never extends past peakload where the horse is at risk of reinjuring the suspensory/tendon).

Fast forward 2 months (7 months after injury) and the horse was back jumping in the 1.45m classes! A further month later and he jumped around a 155m World Cup qualifier.

I would categorically like to state that this is NOT the route we would have conventionally followed - but after seeing the success of the vets protocol in some top Gr 1 racehorses with diabolical injuries we figured we had nothing to lose. Im not exactly sure where you are based - but I cannot recommend this vet and his protocol enough!

It saved our boy!!


I hope this gives you some hope regarding what you are going through. There really is so much one can do these days and breakthroughs like the technology above really are giving many horses second chances.
 

Dufus

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Thank you that's really interesting, so was his line of thinking that if the leg is just left without any intervention and without using it the scar tissue would be worse? And therefor the risk of reinjury alot higher? I'm so pleased he came sound for you 😊 and especially at that level, I will be happy if we can just back lol. The device sounds amazing, is that something that was custom made for him?
 

Pinkvboots

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Mine was slightly different one of my horses had a hole in the upper part of his suspensory on his hind leg, he had prp treatment on it and 5 months box rest it was 're scanned at the end of the 5 months and the hole had healed and he was sound, that was 4 years ago and his still ok I have just been very careful with him, no jumping no fast work on deep dodgy ground and I still do ridden showing with him.
 
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Hiya!

Yeah that’s exactly it! They’ve actually managed to prove that rest is DETRIMENTAL to tendons! Basically because you have an excessive build up of scar tissue etc. which is always going to undermine the strength of the tendon. The vet mentioned thats why some horses redo the same injury so shortly after coming back into full Work.

The device was made by a formula 1 engineer (who is also a horseman). As far as I know they come in 3 sizes. We had someone come fit it for us. To the best of my knowledge you can only rent them because the cost something ridiculous (like over £2.5k to make). We did the sums though and overall we saved money if one looks at the price we would’ve paid to have the horse standing in the stall doing nothing.

The only thing I will say is that because it’s carbon fiber and because it has quite a few parts - it can be a bit laborious to use when you’re getting used to it . But at the end of the day we found it really helped the horse and that’s what’s most important.

This is the only vid I can find, but there are definitely more out there.
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Maybe also look at Equinetendon.coms FB page ? They have quite a range of success stories with all different types of soft tissue injuries. Someone there may be able to point you in the best direction for your particular case.
 

Dufus

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when you say rest is detrimental do they mean complete rest as in box rest ( which she has already done 5 months) or rest from work and just field rest? i'm trying to find a happy medium for my horses mental well being and physical well being and feel like i'm failing at both!

that does look really interesting i will have a better look after work tonight.
 

Slightlyconfused

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Mt big boy, 769 kilos, did his rh suspensory branch injury back in june 2017.

He did the shockwave and box rest with just mild improvement not enough to carry on.
We turnt away for 8 months.
I had to ignore the hoolies, he thinks he is a 12hh sports pony not a 16:3 effalump 🙄, and just let him be a horse.
Had reveiw may 2018 and he was just about sound so we started hacking out.

Thankfully the ground was hard last summer so it was perfect for his rehab. Had his last reveiw sept 18 and he was completely sound.

We have only just started school work and by work i mean walking larger and a bit of trot on long sides the past six weeks.
He is walk, trot and canter out hacking.

Ive just taken everything slow.
 
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Not quite the same as yours but similar. Mine had a hind suspensory branch injury which we box rested until I was forced to turn out due to cellulitis at I think about the 6 week point (vet & I both scratching head on where that come from on box rest).

Initially did a few weeks in a small paddock, removed shoes and then I moved yards and properly turned away 24/7, he came good quite quickly in terms of visible lameness probably 2-3 months but I gave him a full year off. He has been problem free from that injury ever since - I suspect in part due to going barefoot as it quickly became apparent that the shoeing had probably a contributory factor in the original issue.

Same horse also fractured splint bone on a different leg a few years before (did that a few weeks after starting turnout from box rest for another injury by doing handbrake turns in the sick paddock 😏).
That one also healed fine and although the suspensory scanned clear at the time it is definitely marginally thickened so must also have been injured. Again though we’ve had no Issues relating to the it either since it healed 🙂
How old was your horse and what was their “job”
 

fredflop

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Can anyone tell me what treatment options are available for injured suspensories (apart from the machine above!)

My vet just wants to spend money on coming out every couple of weeks to “rescan”, which I’ve said no to, as I don’t believe it’s serving any purpose apart from wasting money
 

Red-1

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Can anyone tell me what treatment options are available for injured suspensories (apart from the machine above!)

My vet just wants to spend money on coming out every couple of weeks to “rescan”, which I’ve said no to, as I don’t believe it’s serving any purpose apart from wasting money

Mine lots and lots of ice at an early stage. We then had PRP and shockwave x 3. I did not box rest as I hate it; we had small paddock turnout and in hand walking in straight lines, starting with 100 yds and working up to 2 miles 3 or 4 times a week. I got him an Arc Equine, which he wore every night for weeks and weeks.

My vet did suggest the operation where the nerve is cut and the area cleaned up, he said the horse would be sound afterwards and the ligament would have more space to operate, but it would not actually mend anything. The horse would also be banned from affiliated competition afterwards (not that I would have disregarded the operation if he needed it, he was welcome to retire) but he went sound relatively quickly.

I only had it re scanned a few times, the last time showed it to be fully healed. Not a mark on there. Sadly we lost the horse to an unrelated issue (he became a wobbler) so never 'tested' it back to the full extent out eventing, but he did some canter work, 30 minutes schooling etc and remained fine. felt good as new.
 
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EstherYoung

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My old boy did his front splint bone/suspensory aged 8. As rehab we did a lot of long slow distance work, and as a result of that discovered Endurance Riding. He turned out to be rather good at it - we reached advanced level/100km and won a few bits and pieces. I lost him aged 26 to unrelated issues.

I remember reading in the bible aka veterinary notes for horse owners at the time that 'reinjury is not uncommon' for this type of injury but arguably the rehab work we did was the making of both of us.
 

AandK

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My horse had a hind suspensory branch injury in 2008 age 11. He was box rested with controlled exercise for 5 months (month one 10mins walking, month 2 20mins etc, adding small amounts of trot in month 4), he also had adequan injections and shockwave. Once he was back out in a full size field after 2 weeks (started with a small pen) I turned him away 24/7 for about 4 months and then started bringing him back into work. He has lived out since then. He did a one day event 13 months after diagnosis, and had no further issues with reinjury etc since (did an ODE Aug last year age 22)
 
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