Tendon Injury - operate or not?

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Firebreathingdragon

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I am hoping you can save my sanity!

Six weeks ago I found my lovely girl stood on three legs in the field (still eating, well she is a section D!). A quick look told me I had a major problem - a nasty cut on the outside of the hind fetlock, and a huge amount of swelling extending to half way up the cannon bone. She was about 7/10th lame at this point.

Cold hosing did nothing to reduce the swelling. I bandaged the leg and put her in the stable, and the lameness did ease so that by the time the vet arrived a good hour later she was about 3-4/10th lame. Scans at the time showed no major injury so box rest and bute were prescribed and a re-exam 10 days later.

The re-exam showed her still 1-2/10th lame, but the gait was altered - toe turning out slightly in walk and a little worse in trot. the wound was fully healed but the swelling hadnt really reduced.

A week later my girl went to horse hospital for more scans and xrays. The scan showed damage to the outside edge of the DFT caused by the force of the kick. Devastated!

My vet advised the best possible course of action was to operate asap - within 2wks, and platelet therapy. (incidentally Cedric Chan who is doing the op cannot fit us in for another 5 wks, which is 9wk post incident - relevant?) She has said that, with the op and the perfect rehabilitation of 1mth box rest followed by 9mth quiet walking inhand building from a minute to an hour over this time, whch will give her a 75% chance of a full recovery... and herein lies my nightmare

My girl is a hot headed welsh D who struggles to handle being in for more than a couple of days. She cannot do quiet anything, let alone walking inhand after three days, let alone 9mth, She is a danger to herself and everyone around her. She literally explodes in the air doing a fantastic lippizaner impression. She is not nasty, but dangerous nontheless.

My question (Finally, I know!) is does anyone have any decent research on the stats for/against surgery? Optimum time for operating? benefits of platelet therapy and of course what the chances are without treatment ie turning away. My vet is quite cagey and seems to think its the operation with no alternative (my synical side this £££'s - sorry not all vets are like that), but I am looking at the whole horse, and she seems to only be interested in the one inch of damaged tendon. When I try to discuss her temperament and how we manage her rehabilitiation, she smiles enigmatically, and basically says thats my problem!

My girl is fantastically bred (3 brothers in top 9 at HOYS this year, and more qualified, being by Menai Cosmos) and has a good competition record herself, so if she couldnt return to work she does realistically have a future as a brood mare. Ultimately, she is my pride and joy and I want what is best for her all round. I am a bit of a control freak and I really need more info.

Please help!
 
I'm sorry, what a tough decision to have to make :( How old is she?

I can't tell you much about success rates of surgery, but if she really won't cope with extended box rest and will be a danger to herself and her handlers, I'd also consider turning away for a year and then reassessing as an option. Time and Dr Green can be a good healer.


Vibes that you can come to a decision that will suit you and your girl x
 
Sorry to hear about your girls injury.

Sounds like you may benefit from seeking at least a 2nd or 3rd opinion. It is so unfortunate that vets won't take into consideration the whole picture, and just leave you to deal with a box confined horse :(

Whilst great advances have been made in equine surgery and medicine, some of the simpler methods (turn away) seem to get over looked these days, whilst the scanners, mri's are trotted out....at huge expense....only to be told the results are inconclusive
 
My mare has just had a tenoscopy due to lesion on sdft. However during op, they then found that the manicular flexoria was torn but this hadn't shown up during scans. Mine is coping brilliantly with box rest and is allowed in hand grazing and starts controlled walking tomo. I'm glad she had op as without it the torn manicar flexoria wouldn't have been diagnosed. Surgery was apparently my only option so I went with it and luckily am insured. How about getting a second oppinion? Where are you based? 5 weeks wait is a long time! Mine was booked in for 6 days after insurance company gave approval.
 
If she really won't box rest and do the in-hand walk re-hab then there is no point putting her through the surgery. If she was mine, I would turn her away until May, re-assess and if she is still not coming good I would put her in foal.
 
surprisingly horses are not stupid when that leg is sore and healing that horse will not act like a ballet dancer, however when it starts to get better she might, if she is in a decent sized stable with only hay as feed no mixes and fed often rather than 3 meals a day she should cope well enough, for the first 2 weeks she might be aggitated but after that they realise they are not going out and settle.

i can't get over the number of threads on here about horses not coping with box rest, racehorses spend a lot of their early years on box rest due to the type of work they do and they continue to be fed racehorse mix and they are perfectly sane, so are we then saying that 2 year old TB's are better behaved than other horses, I hope not.
 
To be honest if she is that lame , turning away is not an option. Speak to the surgeon about sedation possibilities for when you start walk work.
 
Surgery is probably a bit late now to be honest and of all of the tendon injuries I have dealt with we have only had 4 done with stem cell/platelet treatment. 1 worked fantastically well, 2 were so so and the other one didn't work in the slightest.

Personally I wouldn't op. If your horse doesn't cope with box-rest then would they cope with a double stable sized padock?

Though I do agree with Putasocinit - Racehorses are fed vast amounts of "psycho food" and cope perfectly well. I think it is more down to the owners dealing with the animal that can't cope with the box rest. You expect the horse to explode and it probably will. You dander along like normal and they generally don't do anything.
 
Im waiting for date for prp and surgery to denerve for suspensory ligament injury.Ive dealt with severe tendon injury on tb about 4 yrs ago and did turnout but very restricted.My lad is on 24 hr turnout with a maze of small paddocks hes 5 yrs old fortunatley very sane unlike my previous horse and is being very sensible.I honestly think the turnout is whats keeping him sane. Hes able to walk from paddock to paddock but cant really run around as I have kept them small. The last two evenings I have walked him inhand to keep him sane and ticking over .Two other horses went mental in paddocks beside us and fortunatley he didnt over react.Obviously once hes had surgery prp and shockwave he will spend month possibly on box rest Ill do whatever vet advises.I think my way is good compromise:D
 
Mine tore his DDFT.
He is an epic box walker and verges on dangerous when not in proper work.

I did opt for surgery & we did his about 10wks after initial injury, as it was mis diagnosed.
I very much said to the vet, that if the tear was very bad to leave him and PTS. We had no idea at that stage what the tear was like, as no MRI had been done.

Anyway, he was operated on and returned home after a week.
He box walked really badly, I tried cross tying, but gave up as it was worse for him.
He escaped from the yard at full gallop about 10days after the surgery, just as I was trying to change his bandage. I called my vet in tears about how I wasn't coping.
We tried sedaline, but he got worse once it wore off.

He came over and gave him an injection of a slow release sedative. This lasted for about 2 -3wks and took the edge off him.
I walked him in had with a chifney, but it didn't stop all the larking about. I was eventually walking for 40mins twice a day (and I lost loads of weight and got really fit!)

Then I was allowed to ride, something which is much safer.
He's back in full work now and I treat him like a normal horse and dont limit his work anymore.

Good luck, it isn't always easy, but I'm glad I made the effort.
 
Can't really help with the surgery side of it but when my siser's tb was on box rest for weeks he was literally bouncing out over the door, we used regular doses of valarian which worked really well at helping to mildly sedate and calm him, and didn't have any side effects.
 
My heart goes out to you - a difficult decision I know, what to do for the best ...

My personal opinion is don't operate. I work in lameness rehabilitation and the mantra is 'rest the injury, not the horse', the ethos of the rehab is based on the horse's sanity as well as the injurious site. All obviously alongside your vet's advice.

Provided the horse is not pain-relieved to the point of no feeling, you'll find that (usually) horses are sensible enough to know to be cautious. If you can turn out in a reasonably restricted area with a safe, ploddy companion, and allow him the time it takes to heal, this will be ideal and provide him with as natural an environment for him as you can give him with movement and the ability to browse.

Good luck, and here's wishing him a good recovery.
 
I chose not to operate as pony was 14 and although i was told he wouldn't work again, he would be comfortable and i didn't want to risk it. I had got as far as taking him to the hospital but it didn't feel right. We kept him in and did a gradual exercise program. He shocked everyone by coming back to full work and winning the champ at hoys the following year! Touch wood, he has never had a problem with that tendons again. Ime most get used to box rest and with the right sedatives and handling can be managed. Follow your heart as its normally the right answer.
 
racehorses spend a lot of their early years on box rest due to the type of work they do and they continue to be fed racehorse mix and they are perfectly sane
Click to expand...

Just want to pick up on this. I have an elderly ex racehorse and she is still very traumatised from how she was kept while she was in training. You only have to bring her into the yard for her to start trembling, grinding her teeth and pooing constantly. If you put her in a stable (she goes in as she's very well behaved) she wont eat or drink at all. How long would it be before she coliced or suffered from dehydration?

She hurt a tendon a few months ago and with the Vets agreement she was put in a small electric fenced off area in the field. She has fully recovered from the injury.
 
Thanks everyone for your comments. My girl is 9. I know TB's cope realy well, i have a couple they they are sooo much easier than my sec D! She was hill bred and hardly handled until I bought her at three. It took over a year to get her walking in a half way sane manner through the stable door (gotta watch out for them monsters!). I know from a period of short box rest (another kick, 9 stitches) that despite my best endeavours, she is a honey in the stable, but once she gets a hint you are going to take her out, the wheels come off and her brain starts to pop. She isnt nasty, she literally cannot contain the bounce

I am still waiting for my vet to come back to me with more info/stats on the chances with/without surgery in an attempt to help my head rule my heart. I will let you all know how things progress. In the mean time, more info really appreciated
 
Fortunately there is a great product on the market called Zyklene. I would suggest using that for a few days to see if it has any bearing on your mares behaviour during box rest.
 
Quick update...

finally got all the feedback/info from my vet and the thing that struck me most was that the success of the operation/natural healing would be largely down to her genetic make-up and how much scar tissue she would throw down during recovery. Effectively, if she is the type to scar badly, this will be a problem whether we operate or not.

My vet also advised me that, if the tendon were to develop scarring, the main problem would be the annular ligament. Effectively, if this does become a problem, we can cut the ligament at a later date.

Both of these facts gave me the wobbles and I cancelled the operation. Why risk anaesthetic when there are uncontrollable influences and less intrusive options further down the line?

Anyway, on the planned day of the op my vet came out and we left the stable for the first time in a month. After an exciting walk and trot, with a couple of 'airs above the ground' my vet pronounced my girl 100% sound. Result! A follow up scan showed excellent progress.

We are now battling a daily walk out and in another week we can turn out in a small pen (having to look for another yard because mine wont accommodate - great!). If all goes well she can do ridden walk work a month after that. Just for ten minutes a day, but its got to be progress.

Anyway, we are months off being sure how good her recovery will be and, given her nature there is plenty of time for things to go wrong.

So a message to everyone - question everything your vet says, time and again. They are the professionals and undoubtedly know more than us mere mortals, but we know our horses, and horses are good at throwing us curve balls, defying logic and reason. Unless the decision is critical, take time to think it through and check out all your options. Then think again and ask more questions. Dont be afraid to make a nuisance of yourself - after all, you are the customer and vets are paid handsomely for their time!
 
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