Suspensory Ligament Damage / De-Nerved

[lisa_dundee]

This is a bit of a long story but please any advice would be much appreciated. I sold My horse of a lifetime 5 years ago who I had from being a foal and showed at county level qualifying for the RIHS he was 6 when I sold him. Over the past 5 years I have always kept in touch with his new owner and he was competing med / advanced dressage. However when asking for the more demanding movements such as canter pirouettes he struggled and became unsound in his offside hind.
He was taken to Nantwich Vets & through investigation was found to have a small tear in his suspensory ligament... In April 2014 he had PRP treatment to fill the tear which was successful (scans show this).
A 6 month recovery plan began with scans at various intervals, all was successful until canter work began which caused the leg to swell and be painful so work stopped and a 2nd opinion was sought from vet Tom Morton to rescan in November 2014.
He advised leg was 80% operational & although some of the new tissue had only weakly bonded he felt that the pain & lameness was due to scar tissue and nerve endings attached to the ligament and recommended follow on operation De- Nerving which was carried out on both hind legs January 2015 by Nantwich vets.

The recovery programme commenced again until canter work 5 week ago and was lame working on soft ménage surface and heat in the hock joint.

At this point I was contacted and asked if the horse could be gifted back to me as a hack and maybe in the future get him back in the show ring or possibly jumping again.

I have my own land and stables and I wouldn't hesitate to have this horse back even if he had 3 legs and he will never part company with me until the day he dies, however I want to try and do the absolute best I can by him.

It has been recommended he has a gamma radiation scan on his back legs £1500 to see if there is a problem with the sacroiliac joint or try steroid injections in to his hocks and sacroiliac joint. His owner has decided against this and he is coming home to me this coming Sunday.

I have ordered him a glucosamine joint supplement and I have been reading about ice vibe boots and magnetic boots.

I personally would not have had him de-nerved and would like anyone's experience in relationship to the same issues.

I would love to get this horse back in a county ring, however if he is a light hack / field ornament for the rest of his days then that's fine too.

 

[lisa_dundee]

Surely someone must have experience in this type of injury??

 

[be positive]

I have no direct experience but plenty of horses do come back to full work from suspensory issues, many event horses continue after denerving, although technically they should not, I guess it was done due to insurance pressures, the clock is ticking and I think he has probably been rushed through with the op in order to get it done within the 12 months.
My friends dressage horse has been undergoing on off treatment/ work/ rest/ work for a lower suspensory injury with much the same results, once he starts to get into more serious work it blows up again, he is an advanced horse and it seems that the hind legs just cannot take the work required, he is now turned away for the summer, out 24/7 as a last attempt to get him right, insurance ran out a while ago and they cannot keep chucking more money at a horse that probably wont ever return to full work and nothing seemed to really work any way.

I believe that with all the treatments available now along with the 12 month limit that giving a horse a proper rest is the last resort, years ago it would have been the only option, 12 months at grass may be just what your horse needs. Showing is far less stressful on the limbs than dressage so he may well come back sound enough to do that job, being so well established you could probably do all your prep out hacking avoiding the need to work in circles apart from when he goes to shows as it seems the schooling is what he is failing to cope with.

 

[ester]

Was he deemed sound after the denerving? Obviously the nerves can also grow back but I think since Jan would be a bit quick.

We've been dealing with a suspensory branch injury treated with PRP and rest in my Mum's mare since Dec 2013. She has been riding her since last September and vet is happy with her but she is still only hacking, she might go back to some school work eventually but as we don't have one so work in the field it isn't that pressing and I'm not sure she'd be quite right enough to do it.

I'd be tempted to take his shoes off, and put him in the field for a good while.

 

[lisa_dundee]

Yes I feel a bit the same but luckily I have the land and all the time in the world so I can turn him to grass for 12 months and see how that helps x

 

[lisa_dundee]

I think he was deemed sound after de Nerving yes

 

[ester]

I mostly ask just because I think suspensory/SI/hock issues can be hugely linked, same with us really because you start to use yourself differently. Even though technically sound currently Cally is certainly requiring physio treatment a lot more than she ever would previously- which is why she is only hacking still really. - Vet has agreed that though bad leg seems fine she doesn't move like she used to.

 

[applecart14]

I mostly ask just because I think suspensory/SI/hock issues can be hugely linked, same with us really because you start to use yourself differently. Even though technically sound currently Cally is certainly requiring physio treatment a lot more than she ever would previously- which is why she is only hacking still really. - Vet has agreed that though bad leg seems fine she doesn't move like she used to.

Without getting into an argument with anyone about my own horses problems, when this was raised to me as a question on this forum about my Bailey I asked a vet from the same practice as my usual vet about the correlation between hock fusion and suspensory injury and was told the two were not linked. My own vet came out yesterday for a reassessment of Bailey and I've been given the ok to proceed to canter work with jumping in six weeks. He confirmed the previous vets answer saying that the two were not linked. However I know there is a strong link between KS and hind suspensory problems are linked.

 

[ester]

we were talking about hock treatment though, not the issue with them. I was also thinking more hocks + SI issue in this instance. Essentially if your back legs aren't right anywhere the chances of making your hips sore is quite high- it does me, though vice versa often too!

 

[lisa_dundee]

I think they have missed something in the sacroiliac and stifles and using himself in a different way has caused damage to the suspensory ligament and hocks :-/

 

[Goldenstar]

Lucky horse getting 'home ' .
I would suck it and see do lots of hacking and gentle work and let him live as naturally as possible .
This issue is often linked to the hind toes getting too long so pay special care with his shoes .
Good luck with him.

 

[milos]

Six months to me is not long. I would be looking at a year to eighteen months. Rest rest n rest turnout in grass does the world of good mixed with patience. If your in no rush I would simply turn him out. Having done extensive box rest with a number of horses re tendon issues you often find that extended box rest in its self leads to other issues in my case both horses went on to get spavin which me and the vet put down to the box rest as not moving is not great! I found I got great results with bio flow magnetic boots on 12 hours a day and ally's use my ice vibe boots after work. Feed a good joint supplement. I would avoid arenas for a goo while. My horses both had a full year off work and turned out no stabling. I took six months of hacking before I looked in an arena. I only introduced canter work the last month of rehab and then only on good ground. None of the three injuries ever caused them bother again. I feel now days everyone rushes them back to work to quick. I also did cartophen injections and shock wave therapy. I would also be clear in your mind if you do get a successful rehab do you really want yo give the horse back??? Seems a bit unfair on you. If it is spavin in the hock straight line low level hacking it will probably fuse! I decided not to inject my 8 year olds hock as felt she was a bit young re risks and long term issues she fused nicely. Decided to inject my 17 year old as he was old

 

[lisa_dundee]

No he's not going to be returned, he will be with me until the day he dies, always regretted selling him in the first place even though it was a good home, he's only 11 now and I have noticed from the pictures of him his feet have got a bit long and narrower and my farrier always did them round and more upright. I have just bought some ice vibe boots this afternoon for him and I have found some bio flow boots in the tack room, I've ordered him a glucosamine supplement too, he will be living out over winter anyway and I agree he just needs more time x

 

[milos]

Rude away are doing 20% off if you spend over £120 so I've just ordered a second pair of ice vibes so I've got for all four legs ... Saves me time and horse can travel home from show so got them for aprox £140 including free postage if yours have cost more might be worth stopping order and getting from rideaway x

 

[lisa_dundee]

I've given £120 for a second hand pair but they are literally like new, only used a few times and still in all original packaging and everything, that sounds like a really good deal at ride away though for fronts as well x

 

[Zuzzie]

Agree with everyone that rest rest rest best course. Dont do steroid injections as in my experience they are short term results that dont last and I think weaken the structures. Its amazing what a difference time makes AND good foot balance. Your boy sounds gorgeous and I would be puttting out the flags for him welcoming him home. Good luck.

 

[lisa_dundee]

He's home tomorrow, so excited, I'm looking for a semiflex saddle for him if anyone knows where there is a brown 17" straight cut one

 

[lisa_dundee]

Quick update, I had him looked at by a thermal heat imaging lady and although she picked up slight heat changes in his hocks, the only actual problem she found on the whole of his body was heat around the saddle area where the saddle which had been used on him hasn't fit and had pinched either sides of his whithers too. Also his feet are terribly boxy which they never used to be. He has now enjoyed some time off in the field since he's been home and the Physio came out and said that providing I get a saddle that fits and try sort his feet out, she can't see any reason at all why I wouldn't be able to show and do some jumping on him in the future. But wel see when I bring him back in to work

 

[CBAnglo]

With the SI joint, vets are usually able to see if there is an issue on hard palpitation of the joint. Do you have a good McTimony chiropractor near you? If so, I would get them out to have a look. My ex-racer has all of the above; KS (3 processes removed), double neurectomy and Si joint injections x 2. He has had a hard life and at 17 is basically retired now; for years it was a case of careful management - lots of longreining long and low and over poles to keep topline together to help SI and KS; riding to open spine. He could not have more than one or two days off as he became disjointed in the canter. It was a nightmare to keep him going in winter when I didn't have time to hack except on weekends so I had to keep him going in the school but I didn't want him doing too many circles.

Visually you will also be able to tell from his hindquarters. They are normally underdeveloped and the horse tends to go on the forehand a lot as it cant truly bring its hind legs underneath it if the SI is damaged.

 

[Victoria25]

I only have limited knowledge on this as my mare damaged her suspensory branch back in Jan this year (which developed from an infection rather than impact) ad we’re now into month 6 of our rehab programme but fingers crossed all is going very well with each scan!

We had 10 weeks of box rest with cartrophen injections/fitted with eggbars on her x2 hind feet – which then went onto walking in hand for 10 mins each day increasing by 5 mins each week which took us until end of April. Then another month of going out during the day for another month (only dry weather though and v flat unbuggy tiny field) and now after another scan at the end of May the vet has given go ahead for her to start spending the nights out too now (again bringing her in when wet) and with a support boot on to help support the fetlock.

So touch wood, farrier due this weekend and I can now start riding again (just a 15 min walk round the block to start off with) and then increasing each week!
I bought her to only hack anyway so she’ll get ridden as and when we both feel like it so Im hoping she’ll make a full recovery by later next year with a possibility of a local show or two if we’re lucky!

Im sending good vibes in that a good year off will help him – he’s lucky to have you!!! x