Tell me about your suspensory injury stories

[Ellie2893]

Following on from my previous undiagnosed hindlimb lameness post, the vets located the issue after full x-rays of all four legs and nerve blocks. For context, pony was 1/10th very intermittently lame on his left hind leg, blocked positive to the suspensory.

I was expecting further scans (ultrasound or MRI) to confirm the level of damage and what we were actually dealing with but the vet seemed confident that the issue was 'inflammation' only, treated with injections into both hind legs as well as a full body anti-inflammatory to be given every 7 days for 4 weeks.

I was advised to keep him in for the initial 24 hours and then he was allowed to go back into the field (he's pretty sensible so fear of damaging himself in the field was quite low) and I was told to ride him 4-5 times in the first week, road hacking and in walk only. Second week (that's now) he can be hacked with some small trot periods 3-4 time and he is to go into the arena twice where he can have 5-10 mins combined of trot/canter work before he is reassessed next Tuesday. He's been hacking wonderfully and the walk, which was the indicator something was wrong, sounds really even again but the trot I can hear a toe drag (not sure if this was there before but now I'm looking out for it!)

I'm naturally terrified, I've only ever heard horror stories of suspensory injuries and all google is coming up with (dangerous to even search I know!) is the degenerative PSD symptoms and prognosis. I'd love to hear some stories positive or not so, of horses that have had similar injuries to the one my boy is facing right now.

So my questions are:
a. Should I be pushing for more clarity on what the injury actually is or should I trust the vets opinion that the lameness is so mild he can't see it being any tears/legions/holes etc?
b. What is the prognosis for injuries like this? Vet seems confident he can 'go back to the level he was competing at before if not higher' but I've not heard a lot of these success stories!
c. What additional treatments do you use to help treat/prevent further injury? We regularly have INDIBA on an older SI injury so that will be being used alongside his rehab.

Sorry for the epic and thank you in advance

 

[ihatework]

What area of the hind suspensory?

 

[Ellie2893]

What area of the hind suspensory?

That's the part I couldn't tell you...

 

[ihatework]

That’s probably what you need to find out, as treatment options differ depending on where the injury is.

Either way, I’d be wanting imaging as degree of lameness does not always equate to level of damage

 

[Birker2020]

If its a suspensory branch injury it's not so problematic as a suspensory injury. I'd speak to the vet and get more details.

 

[Tiddlypom]

There should have been at least an ultrasound scan done, it could have been done at the same time as the other diagnostics. It's cheap enough, too. First scan be checked with later ones to check healing.

Prognosis depends very much on the degree of damage. My late dressage horse trotted up sound in a straight line when his hind suspensory ligament had a hole running along most of the length of it, and his fetlock joint was collapsing.

 

[SO1]

That does not sound like standard suspensory injury rehab.

I presume they injected with steroids to reduce the inflammation? If there is a lot of inflammation it is difficult to see on the scan what the damage is so vet might want to get the inflammation down first before scanning but that is usually combined with box rest to prevent further injury.

When my pony had a hind suspensory branch injury it was a sprain so not a tear and he was on box rest for 15 weeks with controlled walking starting from 5 minutes and then at week thirteen started trot work and then was allowed small paddock turn out from week 15. 6 months of rehab before being allowed out in group big paddock again. Normally suspensory injuries have at least 6 weeks of walking and box rest. He was scanned as he is insured and then scanned again before turnout and then again once he was turned out in herd turnout.

 

[ycbm]

This sounds very odd Ellie. They x rayed all four legs when the horse was lame in one and it was known which one from the start? Then having blocked the lame leg and found out where it was lame, they didn't find out exactly why it was lame before deciding on treatment, when all that required was an ultrasound scan?

I wouldn't be at all happy with any of that, I'm afraid. I can't really answer any of the questions you ask, (exalt yes, I'd want a scan) because you don't know what the injury is, but hopefully it really is minor and will be fixed soon.
.

 

[PinkvSantaboots]

I would want it scanned so you can see the degree of damage that does sound strange, my horse had a hole in the upper part of his hind suspensory and was 4 tenths lame he had prp and nearly 6 months box rest, he was scanned again and it had healed and trotted up sound and has been fine since that was in 2015.

 

[Ellie2893]

This sounds very odd Ellie. They x rayed all four legs when the horse was lame in one and it was known which one from the start? Then having blocked the lame leg and found out where it was lame, they didn't find out exactly why it was lame before deciding on treatment, when all that required was an ultrasound scan?

I wouldn't be at all happy with any of that, I'm afraid. I can't really answer any of the questions you ask, (exalt yes, I'd want a scan) because you don't know what the injury is, but hopefully it really is minor and will be fixed soon.
.

Probably not clear on my part, apologies.

The lameness was identified, I requested X-rays at first (he’s 15 so for me personally it was logical) but they came up clear. Vet then decided to block the next week which is when he blocked positive in the suspensory.
Since then the vet returned which is when I presumed they’d ultrasound and then treat but only treated.

I’m confused, concerned and really worried that the information I’ve been given is detrimental but frankly a bit embarrassed to keep calling and asking questions.

 

[Sail_away]

I have a horse with a mild RH suspensory issue but went through a very different process to you in terms of diagnostics. Ultrasound is pretty cheap so I think it would be worth asking your vet about - this was actually how mine was diagnosed as he is a bugger to nerve block. We were then offered a few options - MRI in the hope that it would find something surgically treatable, shockwave therapy or turn away. In our situation (he had other complicating issues) we turned away/retired. Injecting was never mentioned, but to be fair we never got very much into the treatment details.
In your case I would certainly push for clarity, even if it doesn’t change much I personally would benefit from the peace of mind given that I’d done the right thing.

 

[Tiddlypom]

I’m confused, concerned and really worried that the information I’ve been given is detrimental but frankly a bit embarrassed to keep calling and asking questions.

I really feel for you, this is not of your making. But don't back off from asking any questions that you have - you are a paying client.

It is why, though, I recommend that if possible that folk take their horses to horsepital for a lameness workup, rather than getting vets out to the yard who may or may not have the right equipment with them. This would all have been sorted as a one stop shop at my local vet horsepital - the workup, nerve blocks, x rays, ultrasound plus the joint medications in one day. It ends up a lot cheaper too, (depending on transport costs), as you are not paying for all those individual call outs.

Good luck, please keep us updated.

 

[Birker2020]

This would all have been sorted as a one stop shop at my local vet horsepital - the workup, nerve blocks, x rays, ultrasound plus the joint medications in one day. It ends up a lot cheaper too, (depending on transport costs), as you are not paying for all those individual call outs.

Good luck, please keep us updated.

Agree. My horse went in for coffin joint Arthramid treatment last Friday and whilst at the vets the vet rang me to say he'd scanned the navicular bursa and it was inflammed, did he have my permission to jab it with Artrhamid?. If I'd had him come out to the yard he would have either had to come back with a scanner or just took pot luck that his suspicions were right.

 

[Ellie2893]

Update

Vet has been back up today to reassess after the above treatment two weeks ago and the pony is absolutely sound and showing a significant improvement in the ridden work, especially in the canter.

I've booked him + a secondary vet to come and check again in four weeks time after full work has been reintroduced but for now a very positive outcome from what I feared was a very bad diagnosis.

Thank you all for your responses x

 

[Birker2020]

Update

Vet has been back up today to reassess after the above treatment two weeks ago and the pony is absolutely sound and showing a significant improvement in the ridden work, especially in the canter.

I've booked him + a secondary vet to come and check again in four weeks time after full work has been reintroduced but for now a very positive outcome from what I feared was a very bad diagnosis.

Thank you all for your responses x

That's good news, I wonder if their original diagnosis was wrong.

I was told my horse had a DDFT injury when thankfully she had a Check ligament injury instead (this was prior to scanning). So maybe they jumped the gun as did the attending emergency vet.