suspensory ligaments

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little MJ

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My horse has been diagnosed with a progressive degenerative injury to his hind suspensory ligaments. We have tried box rest, shock wave therapy and turning him away but there has been no improvement. He is currently 2/10 ths lame but is worse when. Worked. Should I have him denerved? He would no longer feel the pain but his would not treat the primary injury and there are no guarantees it will make him sound.
Has anyone else had this done?
Was the outcome good?
Or an I going to far ...... Should i call it a day? :confused:
Please help!
 
unfortunately my own horse has just be diagnosed with this. so I may be facing the same decision in the not so distant future

We too are trying shock wave first

However I have already made the decision to go ahead with the surgery should it be needed

I looked a lots of vet papers on the subject before I cam to the decision

things that helped me decided were

70-80% success rate

he really is a special horse of a life time
he doesn't have overly straight hocks. also his heels are slightly low so once corrected this should help

If either horse is insured or you could afford it fairly easily I would go for it
 
I think the points that soulfull has raised above are important. I have a horse with suspensory damage who was never a candidate for surgery due to fairly straight hocks and a list of other issues.

Chronic suspensory strains are often the product of compensating from other injuries / areas of pain. Most common I think are sacro iliac and front foot pain.

If your vets think they know how the psd originated and thought that your horse was a candidate for surgery and you had either the money or insurance to pay for it then I would go for it. The success rate for return to athletic work with the more conventional methods with hind suspensorys is poor :(
 
Just re read your post again, how long did you box rest / turn away for? Did u re hab with plenty of walking, limiting the circles? Ligaments take a long time to mend.

I would be worried if the lameness has been there for all that time about other compensationary issues.
 
Hi thanks for your help so far.
He has quite straight hocks, they have found ocd changes in his hocks and he has a sore back/ sacroilliac problem these were caused by an accident. The vets think the problem he how has with his back has emphasis the problem with his suspensory ligaments. ie he has had the chronic suspensory ligaments injury for some time.
He has done 12 weeks box rest with increasing walking program untill he was to dangerous to walk in hand but couldn't be ridden due to his back. Then he was turned away sedated at first so he wouldn't hoon around for 6 weeks but he then got really bad mud rash!
When nerve blocked in the ares of his suspensory ligaments he is sound.

I'm waiting to find out if the insurance will pay for the operation.
I know I will struggle with the walking after the op as he is very, very exuberant. He had a tendons problem a number of years ago and I vowed then never to but me or him through that again! But my only other option is pts as he doesn't like staying in the field or staying in his stable and he lives to work! Also he get allergys in summer and mud rashin winter!
:(
 
Rehab specialist. Google Rockley Farm and contact Nic Barker for advice. She won't mind talking to you and she'll tell you straight if she thinks she can help.

You can search for threads about the place on here and the different horses of HHO members who have been there.
 
Just Googled it. He has really good feet! And my farrier is a corrective farrier. He is always shod every 6 weeks. He doesn't have low heals or long toes.
Have I missed something?
 
I have just read the web site again and i really don't understand how they can help. It only talks about problems with the hoof not to do with the suspensory ligaments that runs from the hock the fetlock!
Although I do know a friend who could use there help.
 
both my current horse and horse before that have done/did their suspensory ligaments. both of them had shockwave and both had surgery. D, my previous horse, had a particularly degenerative condition. He briefly came sound after shockwave but as soon as we introduced trot work he went lame again. upon rescanning, the ligaments hadn't healed at all and were infact worse than when originally scanned. i went ahead with the op, he had about 4 weeks box rest/walking in hand and then i had to turn out as he was going loopy. he had two months out in the field doing nothing before starting slow build up work. all seemed good - he was sound and happy (though not schooling to the same level as pre-injury [he'd been working towards advanced medium]), but about 6 months post-op he went lame again. upon rescanning, my vet was completely shocked and said he had never seen a ligament so close to rupturing that hadn't actually ruptured and he was sure that the slightly wrong hoolie in the field and it would go. i made the absolutely heartbreaking decision to have him put down.

after d, i swore i wouldnt put another horse through the denerving - until nico also did his (less than a year after i bought him). but the distinct difference this time is that the ligament had healed after the shockwave, but the vets felt there was residual nerve damage causing the pain (if you read last weeks h&h, bruce the vet talking about denerving was the surgeon who did the op) and they were as confident as they could be that the ligament wouldnt break down.

obviously i can't make your mind up for you re:surgery, but when you said your horse had a degenerative condition, it sent alarm bells ringing, and in that situation, i probably wouldnt. but if there are signs of ligament healing, i be far more inclined to go for it.

(on a side note, nico is currently at rockley with nic barker due to secondary front foot lameness and she says she regularly sees horses with both hind suspensory and front foot pain. suspensory damage is often caused by poor foot balance, so its not too surprising you get them connected)

best of luck whatever you decide - its a hard decision but you can only do as much as you can, and what you think it right. you know your horse - let him guide you.
 
Thank-you for your help. I've found it very helpful. The vets at leahurst seem to think it will never get any better..... Which is why I was wondering if it is something I should put him through knowing one day I could be riding him, or be out in the field and it snap! A few people at the stables see him jumping around or troting ( when I can't stop him) and say he's got nothing wrong but I can see he is lame and isn't his normal loopy self ie he won't buck ( which he loves doing).
I feel like I would be letting him down if i pts'd. I've come to the decision that if the insurance will pay I will have it done if not I won't.
It is such a difficult decision to make!
 
the good point about the surgery is that he would then at least be field sound - and if it does rupture, especially post-denerving, my vet assured me that they still couldnt feel it and that it wasn't an emergency like a fracture was.

D was mechanically lame in the end - he couldnt feel it but he was sore in other areas as he was compensating.

if the insurance will pay for it (and i dont see why they wouldnt if they are paying for the other treatments), then its probably worth going ahead, but bare in mind what you want to do with him long term. the op may only give you another 6 months, particularly if you want to bring him into work. if you were to retire him, then you might get a bit longer but at least he would be comfortable.
 
There is another avenue of information here http://www.dsldequine.info/
Also bear in mind, something as simple as an abcess could end his career. A friend had had her horse DN due to navicular and it didn't feel the abcess so it wasn't detected until there was some swelling. By that time the coffin bone had become infected and despite the vet operating to try to pare the bone away, and then several weeks of box rest later, it still couldn't be saved and had to be pts. The bruise had been caused by treading on a stone or something hard from hoolying around the field, it couldn't feel when it trod on the hard object.
Please look at the website, there is some treatment which has helped many many horses live out a relatively pain free retirement, if you could contemplate that scenario?
 
Thanks once again for your help.
The insurance are dragging there feet as we originally thought he was still lame due to an accident he had. But found this problem. We treated it but it was only when he went to leahurst we found out it was never going to get better.
I had noticed while he was turned away he had worn the outside of both his hind feet down when he wasn't shod the farrier corrected this and put shoes back on to help the outside of his feet grow.
The other thing that bothers me is ...I don't think it would suit him being retired. If he's out in winter he gets severe mud rash with lyphngitis and in summer he has allergys that make his eyes really itchy even with a mask and meds his eyes swell up. He jumps the gate and brings him self in quite a bit as well. But he box walkes in his stable.... He just loves being worked and this seems to be the only thing that keeps him sane!
 
muff747 said:
There is another avenue of information here http://www.dsldequine.info/
Also bear in mind, something as simple as an abcess could end his career. A friend had had her horse DN due to navicular and it didn't feel the abcess so it wasn't detected until there was some swelling. By that time the coffin bone had become infected and despite the vet operating to try to pare the bone away, and then several weeks of box rest later, it still couldn't be saved and had to be pts. The bruise had been caused by treading on a stone or something hard from hoolying around the field, it couldn't feel when it trod on the hard object.
Please look at the website, there is some treatment which has helped many many horses live out a relatively pain free retirement, if you could contemplate that scenario?
Click to expand...

looks like an interesting website... will have to have a ponder.

obviously you have to be careful with a denerved horse but when you denerve the hind suspensories (can't denerve fronts), because the nerve only goes to the ligament, the horse doesnt lose sensation in any other areas, unlike when you denerve the front feet. so its unlikely you'd have problems such as abcessess/bruising not being detected because the denerving is so specific. the most likely problem you will have that cant be felt is that the ligament degenerates to the point of rupture
 
little MJ said:
Thanks once again for your help.
The insurance are dragging there feet as we originally thought he was still lame due to an accident he had. But found this problem. We treated it but it was only when he went to leahurst we found out it was never going to get better.
I had noticed while he was turned away he had worn the outside of both his hind feet down when he wasn't shod the farrier corrected this and put shoes back on to help the outside of his feet grow.
The other thing that bothers me is ...I don't think it would suit him being retired. If he's out in winter he gets severe mud rash with lyphngitis and in summer he has allergys that make his eyes really itchy even with a mask and meds his eyes swell up. He jumps the gate and brings him self in quite a bit as well. But he box walkes in his stable.... He just loves being worked and this seems to be the only thing that keeps him sane!
Click to expand...

regarding the wear on his feet - was he actually more lame as a result of that, or did it help matters? just because he is wearing that side down isnt necessary a bad thing if thats helping to balance the strain in the ligament further up. by stopping him doing that, you may actually be making the situation worse. the rockley blog on foot balance etc is a wonderful resource for these things.

my boy used to get lovely mud fever too. i found a combination of mud boots, lots and lots of sudocream and waterproofing agents (eg pig oil) really useful.

if he is a horse that needs to be worked, then oping is worth a go, but i wouldn't be hopeful of a long successful career post-op unfortunately :(
 
He did seem worse once the farrier had corrected his feet but if we had left them he wouldn't have had a foot left! Now they have grown I'm going to have his shoes taken off and see.
 
Yes I found when I booted my boy when he was apparently "footy", his SL swelled up because of the extra weight on his legs so I would have thought metal shoes would do same. Some farriers want to "correct" what their idea of what a foot should look like with metal shoes but I think the horse wears the foot to how it feels most comfortable.
There are alternatives to turn out in a boggy field, maybe you could find somewhere that has a barn with a yard area. My gelding suffered with MF quite badly at one time. Again I found different yards affected his MF differently, especially if cows had been on the land previously. It definitely was worse than land that had never had cows on it:confused: My remedy is trim all feathers off and put lots of udder cream on in the morning before turnout and then rinse off all mud when bringing in and towel dry. Some of the greasy creams tend to not rinse off and mud sticks to it so you can't towel dry. I also have neoprene turnout boots which help to keep the cream in the affected areas.
Good luck with your decision, I feel your heartache;)
 
Thanks for your help. I've had him on many yards, but he always gets bad mudrash even in the slightest mud. I've tried boots and creams but nothing works. His resent mudrash took 6 weeks to get under control with creams from vet ab's and shampoos! We did shave his legs even though he has a fine coat. I don't think there are any yards that have barns/ yards that I could let him out in but it is a good Idea and i will look in to it.
As for the shoes he was at the red line on his feet so the farrier was worried he would get an infection etc if we didn't allow his feet to grow.
 
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little MJ said:
Thanks for your help. I've had him on many yards, but he always gets bad mudrash even in the slightest mud. I've tried boots and creams but nothing works. His resent mudrash took 6 weeks to get under control with creams from vet ab's and shampoos! We did shave his legs even though he has a fine coat. I don't think there are any yards that have barns/ yards that I could let him out in but it is a good Idea and i will look in to it.
As for the shoes he was at the red line on his feet so the farrier was worried he would get an infection etc if we didn't allow his feet to grow.
Click to expand...

The only other thing I can add is the persistent mud fever and the inability to lay down more hoof than wear, is indicative of inadequate nutrition - namely minerals for a start.
I'm not suggesting you are not feeding a good diet - but please be aware that feed companies equate their mineral balance in feeds in a ratio to avoid deficiency....that isn't the same as providing enough for good health and individual horse' needs.

It is widely accepted that what we feed horses heavily influences their skin health - which includes hooves. Horses CAN lay down enough hoof to cover wear (think of the barefoot endurance horses doing 80 + miles in a day). They can still cope even when it is excessive wear from a pathology but ONLY when they are provided with the correct building blocks to do so. And by correct I mean, correct for the horse's individual requirements not just correct for the feed company's nutritionist:)

Excessive wear is considered by most to be a symptom of an unstable limb and something that should be corrected.
I believe excessive wear is the hoof's dynamic attempt to stabilise the unstable limb and something that should be respected during trimming.
As you noted that your horse was more uncomfortable post shoeing - that seems to make sense.

Good luck with your horse. I hope it all works out ok.
 
Hes fed formula 4 feet at the recommend amount for his size he also gets adlib haylege when he's in or grass if he's out. he has good hoof growth normally and never throws a shoe. He had been stressed in the field and had lost weight at this time. He is prone to infections in his hind legs due to lyphangitis damaging his lymphatic system in his leg. He has sensitive skin and if turned out in rain will get rain rash too. May be its got something to do with being chestnut!
 
once out of insurance i would turn away/out with friends for 3 months and then do 12 weeks pavement pounding! in increasing walk and trot til doing 1 to 2 hours walk and trot on the road. very old school. in the interim keep his feet well balanced and shod.
 
Thanks of course you can. Will this still work with it being a degeneration of suspensory ligaments and not just a simple injury? I was under the impression that the condition only progressively gets worse?
 
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