Suspensory lig damage what after shock wave?

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Horses24-7

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Hi all

My horse went lame on both hinds and nerve blocks showed improvements when hocks blocked and when sus ligs blocked (a day apart) neither made him sound so vet concluded that's its a combination of the 2 :( after X-rays showing slight arthritic changes in hocks and scan showing pattern changes on his sus ligs.

Had steroid inj in hocks and last week finished his course of shock wave treatments. Had bar shoes fitted to hinds
 
Cont... (silly phone ;) )

Box rest with an hours turnout in tiny paddock each day, hacking in walk every 2 days, seen physio and on cosequin! Oh and has magnetic boots on every day! Not much then! ;)

When farrier came out we trotted him up last week for him to see movement etc and to me he looked no better. Does anyone know if he should be showing any improvement at this stage?

He's back in a week on tue for reassess and rescans and when I asked my vets she just shrugged me off without answering !

I asked her what the next step would be if no improvement and she said we could consider the denerve op- am I being thick bit surely this would t work as he didn't come 100% when the lig was blocked so surely it would only have the same effect?

So what else could I try? Or would it be a matter of turn out to grass for 6+ months and try again in the future?

Have about £1200 worth of insurance money left...

Any opinions greatly received as I have come to discover my vet has no bedside manner and doesn't seem concerned!!
 
My friends horse has psd and the vet didnt rate the shockwave therapy, in his opinion he didnt feel it made much difference to any case he'd seen. Where on the suspensory is the damage ??
Have they mentioned steroids into the ligament, at the site of the damage ?
That was the next stage given to my friend, with box rest and if no improvement, the denerving op, which only knocks out the sensation to that area, but the nerves can grow back after a few years, and surgery only usually done once.
I cant tell from the vid what his hind limb conformation is like, but upright hinds seem to be pre disposed to psd.
If your vets being evasive, tell them that you need more information, its a real pain if they dont communicate, theyre paid enough to give good clear verbal pathways for treatment depending on responses from the horse.
The stats given to my friend for her horse with psd were approx 30% recovery from steroids, rest and shockwave if you want it.
With approx 70 odd percent recovery from surgery. ( not accurate but in the ball park stats )
These stats are for psd, have you been told that is his diagnosis with arthritic changes in his hocks ? The joint which is affected within the hock, can also make a difference as to how well the horse can be maintained after steroid injections into the joint.
When my horses joints were jabbed i was told to work him hard, but this was a good few years ago,things may have changed, unfortunately due to your horses suspensory damage, thats not an option at this time.
If it were me, id be phoning or emailing and asking for my vet to call me back and talk me through the progression of the treatments and likely outcomes with an overall prognosis.
Good luck, your vet must take time out to go through this with you.
 
So how long have you been riding him now? Mine had the 3 shockwave treatments, but only had PSD in one leg. TBH he was lame for a while after still as the leg/back was weak from having some time off work (I field rested him for a while whilst I got married etc, as he wasn't that lame, and I thought field rest would work, if not it didn't make it worse pre-diagnosis)

Even now, mine is uneven behind and bridle lame some days, as he has learnt to move in a certain way and this is now how he moves unless I correct it. More often than not PSD causes numerous other issues with backs (esp sacro-iliac) so I would be starting having a chiro/physio visit every 3 months too, I paid for this, but if you get your vet to recommend you can claim for it. I have also had mine seen by an osteo (gavin scofield) who has made a huge change to my horses posture and the way he moves, need at least another session with him to help my horse re-muscle himself properly.

I too used magnetic hock wraps, and a magnetic rug to help with back issues, and i've no idea if they helped, but they certainly didn't make it worse. I also bought some RRA (rustox, ruta grav and arnica) spray from Crossgates to help with the ligament repair, again no idea if this actually worked, but it wasn't costly and I was trying everything. They didn't recommend surgery for mine, and I'm not sure if I would have had it anyway due to the mildness of his PSD.
 
Thank you for your replies. To be completely go eat I'm not even 100% sure where abouts on the lig the damage is? I haven't even seen the vet face to face or gone through the scans/X-rays with her?

My guy feeling is that theres a 3rd factor causing the 2 problems highlighted I.e sacroiliac problems? Bit bet hasn't even spoke of this- my thought I that he needs the hocks and lig blocked together to ensure that that's the only problem- as they were done 24 hours apart.

I've been hacking him in walk max 30mins since he came back from the vets as his first shockwave
 
3fd51084.jpg


This is a side shot to give you an idea of conformation
 
You really need to go and speak to the vet face to face, I got to be there when mine was ultrasounded so I saw it for myself.

Definitely get a chiro or similar out, do it now before asking for vets if you can, I felt it was important to sort when I started the walk work as I wanted to get his gait/posture correct from the start as I worried if he still had the sacro and gait uneveness then the PSD would just recur.
 
going through exactly the same thing!! except i did not actually have my mare scanned so thats my next step, as i have now seen two different vets both have come up with different ideas, i will get my third vet in this week as im just not convinved its my horses suspensorys as blocking them only made a mild improvement, they will be scanned and i can make my mind up xrays showed very small changes,, in a 13 yr old horse i though they were better them expected IMO!!
sending vibes and please let me no how u get on, just to add my mare is only very slightly lame but serious lack of perfomace, i have never had any heat except for just inside the hock, and it only her near hind, no heat or swelling or noticable lameness, just 1/10!
 
Having just looked at the sideways on picture does he always stand with his fore feet that far under his body as this is usually a classic sign of lower back, lumbar pain or discomfort as thats the way they try to stretch it out. Also think its very important to fully discuss with vet all their findings and rehab programme
 
My horse suffered suspensory ligament desmitis & was operated on at Newmarket, she was still not right a year on and I was offered further treatment (like you, insurance cover running out!!). She was 14 at the time and I had just had the best year bsja jumping on her :( Your horse has suspensory ligament damage, not sure how that compares to desmitis as this is degenerative but all I can say is that I gave her 18 months off and she did come back sound, I did not want to risk jumping her again but 3yrs on she is happily hacking about... (happily out on loan to a friend) I think a lot injuries would be better managed with time off, a longer wait until you can ride again and it depends on what you want to do with your horse, wishing you all the best
 
My horse did his lateral branch of his suspensory ligament on his near fore and the problem was most likely causing because he was weight bearing and overcompensating on his n/f due to his off hind bone spavin.

He had three lots of shockwave which personally did b**ger all and then had PRP which is called protein rich plasma. They take blood out of the horses neck, put it in a centrifuge with some drugs and the plasma eventually separates from the blood. Because its rich in protein its injected back into the ligament to help with the building blocks to relay the fibres in the correct direction (think I've explained that right).

It took about an hour and a half, my horse was sedated at the equine hospital (vets place) and suffered no reaction. He had the injury in June last year (2011), and in Feb/March this year started doing very small grids which have over the last three months built up to showjumping courses of 2ft9. We are ready to go onto 3ft this weekend so I'm aiming to do a 2ft 9 course with a 3ft jump off part (single phase). The vet said do a particular height for a month and if all well move on. I have been getting the horse used to different surfaces such as fields/roads/verges/driveways/arenas and gradually been putting more pressure onto the limb, always looking out for signs of heat/swelling/unsoundness. He's recently been looked at by my physio and I have for the last week been trying to ride him more uphill. I want to compete unaffiliated eventing again, and would like to re-register BSJA one day. As for the eventing, I've been unable to do any jumping in fields due to the terrible weather, so even if the weather clears up and dries the horse will not be ready. My physio friend says to take him to the gallops and just do slow uphill canters until he is used to the surface and I think its a really good idea to get the leg adjusted as much as possilbe if that makes sense.

Hope this info helps you.
 
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Thanks for your thought will definately speak to vet about prp applecart- do you know how much it cost? Dont mind putting money to the insurance left, but want a proper/convincing diagnosis first!

Littlespritz
 
A friend's horse had an op on both hinds for PSD a few weeks ago and understand recovery rate is & 70% plus if they have good leg conformation. There was also an article in H&H 2 or 3 weeks ago about this condition.

If you aren't happy with information you are receiving from your vet then I'd ask for another opinion.

Good luck :)
 
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Tiffany said:
A friend's horse had an op on both hinds for PSD a few weeks ago and understand recovery rate is & 70% plus if they have good leg conformation. There was also an article in H&H 2 or 3 weeks ago about this condition.

If you aren't happy with information you are receiving from your vet then I'd ask for another opinion.

Good luck :)
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That was my horse in the article mentioned. He was diagnosed with PSD in both hind legs and a bone spavin on the NH (PSD was worse on this leg). We discussed the options on diagnosis and I will admit money did come into the decision to go straight to the op. Rossdales didn't rate shockwave for us, they quoted 40% effectiveness on hindlegs which makes sense given how deep the ligament is compared to the front leg. Also if I had gone down that route I would not have had enough insurance to pay for the op as well. That was before NFU gave us the run around on paying out grr.
His only real fault is being a bit long backed and had gone in with a suspected Sacro problem not Suspensory! We have had lots of chiro in addition to the op and he is a much better moving horse now hence his appearence in H and H for his win first time out BD!
I would ask about the Plasma thing though for your case given that it is damage not desmitis. If he did not come sound on nerve blocking I doubt the op with help much unless you can find out what else is going on.
 
Horses24-7 said:
Thanks for your thought will definately speak to vet about prp applecart- do you know how much it cost? Dont mind putting money to the insurance left, but want a proper/convincing diagnosis first!

Littlespritz
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Hi Horse 24/7. I think it was around £600 but I honestly can't remember. It seemed very effective, especially in the longer term.

If you go on You Tube and look up my user name Applecart14 you will see various videos relating to Bailey's progress following his initial sprain in June 2011. Its been a long hard road, but we got there in the end! You can see where he was overcompensating on that off fore due to the sprain of the ligament branch on the near fore, hence the hopping.

I would definetely recommend Zyklene also, and say whatever you do don't risk sedalin or any other medication when you eventually turn out. Zyklene is brilliant stuff.

Now he is back jumping 2ft 9 and I hope to introduce jump off three foot course this weekend but I take lots of precautions, like check the leg before and after riding, sometimes put ice boots on if it gets slightly warm (paranoid) and don't jump him to death at home, just seven or eight jumping efforts total over a single fence, or maybe three or four times over a course of three or four fences and that's it. He is bandaged for extra support.
 
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if it is suspensory ligament damage - another vote for PRP. My horse was diagnosed last July - and after a year long rehab program - we're also now back out jumping. He also had a lot of physio/chiro treatment to help keep him straight during the rehab, and I was very strict following the vets advice during his rehab program. PRP was about £700, but you also need to add in the costs for ultrasound exams at the time of treatment and during rehab. My vet was fantastic throughout his treatment and rehab, and always willing to discuss all treatment options and any worries I had, which was really important to me. Good luck
 
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