Suspensory Desmitis and surgery

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emfen1305

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After a niggling feeling that Toby has not been right for a while and checking all of the usual things, I changed vets to get a fresh pair of eyes to look at him and she diagnosed him lame right hind which I agreed with. He went in today for nerve blocks and showed improvement in his block to the suspensory by going dog lame on his left leg! She did an ultrasound on both hinds and showed disruption and inflammation in his suspensories, albeit not the worst she has ever seen! She said that surgery has the best outcome so I am just doing a bit of research and wanted to hear other people's experiences of it and what to expect? Is there anything else to look out for as well as the PSD? He has hock arthritis but mild changes and today's xray and block suggest that the pain causing the lameness isn't originating from his hocks. The vet thinks there may also be an issue with his SI joint, did anybody else find this too? Sorry for the million questions, I am a little worried about the surgery but due to his age the vet thinks the prognosis will be good! I am now keeping everything crossed the insurance will agree to pay! Thanks in advance!
 
My horse had SLD on offside fore. Was treated with PRP (platelet rich plasma) in May 17 and shockwave therapy. He was boxrested for 8 weeks followed by an in hand walking programme 5/10/15 mins daily over a number of weeks (not easy as he was mental). He is now totally sound. He is 19.
 
1. Go find the 'psd discussion group' on Facebook. Lots of lovely people with all sorts of experience on there. You might get more replies than on here.

I had the N&F op in June 2016. George was 7 at the time. There is almost always a secondary cause so yours could well be SI, but I don't have any experience with that. We think Georges was caused prior to me getting him 9 months before the op but he wasn't in full work so wasn't noticed. Caused by poor arena surfaces, poor/lack of shoeing and poor conformation.
It was a very long and slow rehab for us. He wasn't fit going into surgery and by my own naivety/poor advice I don't think I helped with him loosing a lot of condition. But we made it through, now about to enter our first novice dressage and treat him like a normal horse. Although I am paranoid about deep surfaces!

Previous YO had it done and is competing 90/100cm BSJA with no problems.

Not everyone has a success story and some go for different treatments. The actual non-riding part was only two months before I could get back on again. This was really important for him mentally. I don't think he would have coped with having a whole year off in the field as some opt for. We probably would have had to re-back him...not something I thought I could do!

Good luck, there's lots of help and advice out there. Some people a pretty anti-surgery but keep an open mind and get a good vet willing to help you through rehab!
 
Casey76 said:
Anti surgery... yes. I think denerving a horse is horrific.
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On the other hand there is not a yard under an hours drive from me that could offer 24/7 turn out to turn him away. Which probably wouldn't have worked as his case was quite chronic.
Box rest for a very prolong period I think is also horrific and detrimental to many aspects of the horses health mentally and physically. This combined with therapies such as shockwave was not seen as a good treatment for my case.

It's not an option for everyone which is why I suggested having an open mind to all treatments. However there wasn't a viable alternative for me apart from sell a lame naughty horse or pts.
 
madamebonnie said:
1. Go find the 'psd discussion group' on Facebook. Lots of lovely people with all sorts of experience on there. You might get more replies than on here.

I had the N&F op in June 2016. George was 7 at the time. There is almost always a secondary cause so yours could well be SI, but I don't have any experience with that. We think Georges was caused prior to me getting him 9 months before the op but he wasn't in full work so wasn't noticed. Caused by poor arena surfaces, poor/lack of shoeing and poor conformation.
It was a very long and slow rehab for us. He wasn't fit going into surgery and by my own naivety/poor advice I don't think I helped with him loosing a lot of condition. But we made it through, now about to enter our first novice dressage and treat him like a normal horse. Although I am paranoid about deep surfaces!

Previous YO had it done and is competing 90/100cm BSJA with no problems.

Not everyone has a success story and some go for different treatments. The actual non-riding part was only two months before I could get back on again. This was really important for him mentally. I don't think he would have coped with having a whole year off in the field as some opt for. We probably would have had to re-back him...not something I thought I could do!

Good luck, there's lots of help and advice out there. Some people a pretty anti-surgery but keep an open mind and get a good vet willing to help you through rehab!
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Thank you - I have joined the group :) My vet seems to think that the very little energy being generated from his hind end is being blocked in his SI joint - he does present all of the symptoms for SI joint problems too however these symptoms are also indicative of just about everything else going! Toby is straight hocked which my vet thinks is a factor in the arthritis and the PSD. Like yours, Toby wasn't in work when I got him and his issues started manifesting themselves around a year and a half go, about 6 months after I got him and started asking more of him so I suspect he's had his various problems much longer than I've had him. Toby is fairly fit and vet is keen for me to keep hacking him until the surgery and then she said she would expect him to be back in hacking work 8 weeks post op however the not riding really doesn't bother me at the mo as just want him better!!

I am choosing surgery as the vet suggests it has the best prognosis and has been very successful in all of the cases she has treated. I don't think I could opt for long periods of time off with Toby, either box rest or field! He would live out but there is nowhere close by that I can do this so retirement/rest livery would be our only option and at £80 a week minimum that is just not feasible! I will continue with my research and keep my fingers crossed the insurance will pay! I am pleased yours has been a successful story and hope it continues to be :)
 
Mine had PSD in both hinds, along with SI pain. All areas were injected, then we had a programme of shockwave therapy. I was advised that turning away had minimal affect, shockwave saw some cases having a 40% chance of returning to a full workload, and that surgery was 80%. My boy wasn't a candidate for surgery, so we went with the paddock rest and shockwave. Unfortunately, he had to be pts, as the PSD was diagnosed while undergoing investigations for sleep deprivation. We couldn't get to the bottom of this after seven months, so vets advised pts was kindest option, so I can't advise whether PSD improved or not, as I never was able to ride him again. I wish you all the best with your lad.
 
Leo Walker said:
Where are you getting that figure from?? Its a £100 a month near me and I'm not in a cheap area of the country!
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There are three retirement/grass liveries that i've enquired about (within half an hour drive) and the cheapest actually charges £60 a week but you have to pay for extras (the others are inclusive of a couple of things). There are a couple of places there are just grass but it is literally just a field and still works out cheaper to keep him where I am! There isn't an abundance of land or grazing around me so i guess that's why its expensive!
 
little.soldier said:
Mine had PSD in both hinds, along with SI pain. All areas were injected, then we had a programme of shockwave therapy. I was advised that turning away had minimal affect, shockwave saw some cases having a 40% chance of returning to a full workload, and that surgery was 80%. My boy wasn't a candidate for surgery, so we went with the paddock rest and shockwave. Unfortunately, he had to be pts, as the PSD was diagnosed while undergoing investigations for sleep deprivation. We couldn't get to the bottom of this after seven months, so vets advised pts was kindest option, so I can't advise whether PSD improved or not, as I never was able to ride him again. I wish you all the best with your lad.
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Sorry to hear about your horse :( thank you for taking the time to reply! My vet is confident that surgery will work for us alongside further investigations into his SI joint and potentially Kissing Spine so hopefully the insurance will give us the thumbs up! My vet didn't seem over fond on turning away either, not at the moment anyway as we don't know the full story!
 
My 6 year old was diagnosed with PSD in both hinds & mild SI changes in Aug 2016. Vet advised the op as being best chance of recovery. So had it done, 6 weeks box rest etc then turned away for six months. Brought back into work as advised and he had SI injection. He came back sound enough to do a few things this summer but then went lame again this autumn and vets said he had reached the end of what could be reasonably done. Combined with a couple of other issues I took the decision to have him PTS on Thursday. Completely heartbroken as he was only 7 and I loved him to bits.

As the saying goes better a week too soon than a day too late- I wish I hadn’t put him through it all and could turn back the clock. If I had another diagnosed with the same I would turn away for six months/1 year and if he didn’t come back sound I would PTS.

It’s so hard to decide what to do for the best, I really feel for you. What maybe worth doing is getting a vet called Rob Jackson to look at the horse for a second opinion before deciding. He is highly recommended on the Facebook page for PSD.
 
emfen1305 said:
Sorry to hear about your horse :( thank you for taking the time to reply! My vet is confident that surgery will work for us alongside further investigations into his SI joint and potentially Kissing Spine so hopefully the insurance will give us the thumbs up! My vet didn't seem over fond on turning away either, not at the moment anyway as we don't know the full story!
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I would be unhappy that your vet is recommending this surgery without first exploring the possibility of kissing spines. I think is a different picture altogether if the PSD and SI was caused by congenital kissing spines.

And I'm afraid I've heard of too many horses denerved for PSD who subsequently break down again to go for that operation myself. I would be going for the turn away option, if the back is OK, even if it means sending him quite far away to get a reasonable price.
 
Led said:
My horse had SLD on offside fore. Was treated with PRP (platelet rich plasma) in May 17 and shockwave therapy. He was boxrested for 8 weeks followed by an in hand walking programme 5/10/15 mins daily over a number of weeks (not easy as he was mental). He is now totally sound. He is 19.
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I'm glad your horse is OK. There is a much better chance of a foreleg coming right than high suspensory strain (PSD) in a hind leg.
 
madamebonnie said:
On the other hand there is not a yard under an hours drive from me that could offer 24/7 turn out to turn him away. Which probably wouldn't have worked as his case was quite chronic.
Box rest for a very prolong period I think is also horrific and detrimental to many aspects of the horses health mentally and physically. This combined with therapies such as shockwave was not seen as a good treatment for my case.

It's not an option for everyone which is why I suggested having an open mind to all treatments. However there wasn't a viable alternative for me apart from sell a lame naughty horse or pts.
Click to expand...

There’s nothing horrific about box rest if the horse has been trained to have an a good relationship with stabling and you the owner do it well .
 
Ok I can only give you my experience and what I have learnt along the way . Our pony was diagnosed with PSD in both hinds not that long after we bought her we didn't go for the op as it was only mild so she had shock wave and came sound enough to still compete although we didn't jump her . We are now 4 years later facing up to the fact that we may have to have her PTS as she is struggling and her suspensories have thickened she has been hacking for the last 18mths. She is slightly straight in her hind leg but the vet didn't think that was the cause we never got to the bottom of what of it was. I should add her hocks were fine . I would be careful if there are multiple problems as they seem to snowball I do think they need to keep moving long periods of box rest don't seem to be good . I am fortunate that I have my own land if it is your one and only horse be realistic the horse may come back into work but only as a hack it is not a curable condition .It is heartbreaking and vets are very good at positivity but it is you that has to do the day to day looking after them .
 
As others have said, PSD is usually secondary to something else, finding it can be the problem. I have an ISH who had N & F for hind PSD (before I got him). He made a good recovery, but has never been 'right' somehow. Now being treated for SI pain.
I believe his was aggravated by poor hoof balance. He arrived with both hinds in negative palmer angles - despite remedial shoeing. He is much improved since taking the shoes off.
Good luck.
 
ycbm said:
I would be unhappy that your vet is recommending this surgery without first exploring the possibility of kissing spines. I think is a different picture altogether if the PSD and SI was caused by congenital kissing spines.

And I'm afraid I've heard of too many horses denerved for PSD who subsequently break down again to go for that operation myself. I would be going for the turn away option, if the back is OK, even if it means sending him quite far away to get a reasonable price.
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Sorry i didn't explain very well, we are looking at all that might be wrong with him first before doing the surgery so we can make a plan of what to treat and when. If turnout turns out(!) to be best for him then I will do that but if not then will be treating primary causes alongside surgery.
 
Thornsett1 said:
Ok I can only give you my experience and what I have learnt along the way . Our pony was diagnosed with PSD in both hinds not that long after we bought her we didn't go for the op as it was only mild so she had shock wave and came sound enough to still compete although we didn't jump her . We are now 4 years later facing up to the fact that we may have to have her PTS as she is struggling and her suspensories have thickened she has been hacking for the last 18mths. She is slightly straight in her hind leg but the vet didn't think that was the cause we never got to the bottom of what of it was. I should add her hocks were fine . I would be careful if there are multiple problems as they seem to snowball I do think they need to keep moving long periods of box rest don't seem to be good . I am fortunate that I have my own land if it is your one and only horse be realistic the horse may come back into work but only as a hack it is not a curable condition .It is heartbreaking and vets are very good at positivity but it is you that has to do the day to day looking after them .
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Sorry to hear about your pony! I have heard mixed reviews on them coming back into work, a friend had the surgery (the PSD was primary in her case) and horse came back into full work including jumping but I appreciate every case is different. For me, i have to do all I can to fix him and if he doesn't come right then at least I know I have done my best. I don't have my own land so turning him out and having another would not be affordable for me so will do my best for him and if that's not enough I'll have to explore options!
 
Regandal said:
As others have said, PSD is usually secondary to something else, finding it can be the problem. I have an ISH who had N & F for hind PSD (before I got him). He made a good recovery, but has never been 'right' somehow. Now being treated for SI pain.
I believe his was aggravated by poor hoof balance. He arrived with both hinds in negative palmer angles - despite remedial shoeing. He is much improved since taking the shoes off.
Good luck.
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How did you identify and treat the SI pain if you don't mind me asking? Toby has long toes is quite narrow both hinds, heels are lower than i'd like but trimmer is not too concerned and says we will just keep on top of them. She is coming Friday so i'll tell her about the diagnosis and see how much the feet might be impacting!
 
emfen1305 said:
How did you identify and treat the SI pain if you don't mind me asking? Toby has long toes is quite narrow both hinds, heels are lower than i'd like but trimmer is not too concerned and says we will just keep on top of them. She is coming Friday so i'll tell her about the diagnosis and see how much the feet might be impacting!
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He was seen by a vet, who didn't there was anything amiss. Got a chiro out to him, I could see the difference in his back once he'd treated him. We do specific exercises, in-hand work, massage and he is on boswellia. I am loathe to have him injected, he is good on this regime. Plus his feet are so much better now, his heels are further back and much bigger, which takes pressure off the back of the leg.
 
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