Suspensory desmitis

[Sparkly]

My horse is having lameness investigations at hospital at the moment and they have phoned to say they are 99% certain it is suspensory desmitis (hindlimb)

They propose to do a few more tests to confirm and then suggest treatment with shockwave therapy and then surgery (to both hocks as subtle signs bilaterally)

Anyone had these treatments?

 

[Lynz25]

My horse had the operation back in August 2006. Decided on surgery as 80% success rate compared to 40% for shockwave. Seems to be doing well on it. Went back for rescan in March just slightly lame but thought that was from pelvis. Got to go back after a months canter work so should know if I can start jumping again within the next 4-6 weeks. He should already be further on in his rehab but we have no school and the fields go sooo wet over winter. Also then had foot abcess which put hings back for 3 weeks

 

[star]

i wouldn't go for the surgery unless everything else failed or the damage was so severe there was no chance conservative therapy would work. A general anaesthetic in a healthy horse carries a 1 in 100 risk if death and for me, i'd rather try conservative treatment first - each to their own though. My horse had mild proximal suspensory desmitis in his right hind 5yrs ago - he was 1/10 lame in a straight line and crippled after flexion. he had 3 shockwave sessions and some box rest with gradually icnreasing exercise over 6 months. after 6 months he did his first prelim, then sponsored ride then gradually worked back up to Medium dressage and 3ft SJ/XC with no lameness problems related to the suspensory ever since. Conservative therapy certainly can work with these cases and I wouldn't be in a hurry to jumping into surgery with its inherent risk as well as the risks of failure of the op - the nerve can grow back or the op itself can just not work. I did my final year dissertation at vet school on this topic, so looked at hundreds of cases and their treatments and outcomes, so have a fair bit of experience with it.

Incidently I'm not anti-surgery - I did have my horse operated on last year for a completely separate lameness problem which luckily he survived, but unluckily he went lame again a month ago and is now very unlikely ever to come sound again. It was worth it for the 6months more fun we had though.

 

[Sparkly]

Thanks guys - I appreciate surgery is a big risk for an otherwise healthy animal!

Definately going down the conservative route to start with - at the moment he is 5/10 lame on a straight line, unable to canter and bunny hops after flexion, so he is quite bad...

Vet has recommended shockwave and 3 months paddock rest

Does it make any difference where the problem is? His is high up in the right hock

 

[aran]

hope he does well with shockwave
just one thing if you are insured - remember you only have the year from the first diagnosis then you will get an exclusion put on legs (or such like) so try and ensure that you do all you can to resolve it. I only say this as a friends horse was on conservative therapies and after the year was still lame but she couldn't afford the £3k operation fees - its a shame as the surgery is supposed to be quite successful - although not something to rush into.

 

[Silgram]

My horse had suspensory desmitis in his near fore a couple of years ago. Opted for conservative mangment and he was turned out in a limited space (about 20X20m) which was increased gradually on a weekly basis for three months. He was also walked in hand threee times a week during this period. He was then brought back to work very slowly and returned to eventing 10 months after the original diagnosis. Has been fine since.

 

[GreedyGuts]

The 1 on 100 risk of anaesthetic death is highly variable between hospitals depending on the anaesthetic protocols used, experience of the anaesthetists etc., and also takes into account horses that are admitted for emergency surgery, such as very sick colics, which clearly have a much higher inherent risk of dying because they are already so compromised.

In cases of elective surgery, particularly orthopaedic cases where the horse is otherwise completely healthy and is fully prepared for surgery it is much lower, and I wouldn't be put off surgery on the basis of this if it was the best chance my horses had. It's probably worth giving conservative therapy a go though.

 

[Sparkly]

Spoken to vet again, thinks worth trying the conservative stuff, but horse is so hopping lame to be prepared that surgery may be the only way to make him come completely sound again

 

[star]

[ QUOTE ]
Vet has recommended shockwave and 3 months paddock rest

Does it make any difference where the problem is? His is high up in the right hock

[/ QUOTE ]

any reason why paddock rest? normal protocol is strict box rest with in-hand walking.

high up in hock area is proximal suspensory desmitis - this is the type that normally responds to shockwave and carries a better prognosis than body and branch desmitis. i would say that often the severe ones dont respond to shockwave though and would probably only give it a few months to see if there's a response before opting for surgery before insurance runs out.

surgery is just such a big thing - it took me ages to come to the decision to go down this route for my horse last year for his other lig problem. luckily he survived but the vet said he had a really rocky recovery. my friend's horse had the same surgery and he broke his leg in recovery and had to be pts. it really brought it home to me how lucky i am my horse survived and what a big deal surgery is.

 

[Sparkly]

Orthopaedic vet at Bristol Uni said he normally has these horses on paddock rest....
Horse is coming home tomorrow, he thinks a course of shockwave and rest and is fairly confident he will be sound in 2 months. If he isn't then will be re-assessed with thoughts of surgery (like you said, insurance is only for 12months)

So he will be paddocked on his own as he is generally quite quiet anyhow - and yay!!

MY HORSEY IS COMING HOME!!!

 

[BenjaminBunny]

My neddy was diagnosed with the same thing nearly a year ago - after 6 weeks of box rest and 4 sessions of shock wave we gradually built up the work over a few months with scans inbetween to check the progress - he got signed off in feb and is being built up slowly more cos he's got no muscles/top line

but all is going well

it's hard work but shockwave certainly worked for him and his was high near his hocks

 

[MurphysMinder]

Glad he is coming home, fingers crossed the conservative treatment works for him. I'm curious, what happened to your earlier post about Bristol students, did it offend the powers that be?!

 

[Sparkly]

MurphysMinder - I had it removed as I know there are a lot of vets/ students use this site and maybe it would have been defematory (sp?)

 

[star]

[ QUOTE ]
Orthopaedic vet at Bristol Uni said he normally has these horses on paddock rest....
Horse is coming home tomorrow, he thinks a course of shockwave and rest and is fairly confident he will be sound in 2 months. If he isn't then will be re-assessed with thoughts of surgery (like you said, insurance is only for 12months)

So he will be paddocked on his own as he is generally quite quiet anyhow - and yay!!

MY HORSEY IS COMING HOME!!!

[/ QUOTE ]

all the ones i studied in my dissertation were put on strict box rest, but that was at the RVC, althuogh my horse was diagnosed in Newbury and I have lots of friends horses who were all on box rest too. Mind you I mostly ignored them and my horse was in a fenced off bit of paddock twice the size of a stable for most of his rest time. He hates box rest!

 

[custard]

I'm getting really depressed reading all this. Had a chat with the vet today when he came for 1st SWT. Said a lesion in the suspensory was quite unusual & would have been done at some speed and hell of a wrench, how does this differ from desmitis?

He doesnt seem overly worried and said the outcome very much depends on how much improvement there's been between 1st and 2nd scan

 

[sadowner]

Hi, my horse had the op (neurectomy and fasciotomy) last august after all failed over the previous 10 months. He was never given box rest, he was in a small paddock and was ridden in walk everyday leading up to trot. Also having shockwave treatment. The vet said he was he was sound after 3 months (i could tell by riding he wasnt) so in the end i took him for a second opinion. He was 3/5 lame in both hind legs due to a hardening at the top of his suspensories and they said to do op.. Unfortunately, after op he was still lame after 2 months so he is now on a years full rest out 24/7 and hopefully he will come back into work after that. I just thought Id mention this as who knows if he had had box rest he might have recovered sooner.

 

[star]

[ QUOTE ]
I'm getting really depressed reading all this. Had a chat with the vet today when he came for 1st SWT. Said a lesion in the suspensory was quite unusual & would have been done at some speed and hell of a wrench, how does this differ from desmitis?

He doesnt seem overly worried and said the outcome very much depends on how much improvement there's been between 1st and 2nd scan

[/ QUOTE ]

desmitis just means inflammation of the ligament - a lesion is a hole where fibres have completely ruptured. desmitis is just swollen fibres - as no rupture it should carry a better prognosis, but often doesn't as the inflammation just doesn't settle down. most actual lesions will heal with enough time - sometimes 12-18months. desmitis if it's going to heal will do so in more like 3 months, but often is just stubborn and refuses to go away.