What to do next? Old injury

noblesteed

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I have a 19 yo 15.2 Andalusian x gelding with a range of medical problems. He has had episodes of laminitis on and off over the past 5 years so is kept in starvation paddock or muzzled and monitored very carefully. He's Currently absolutely fine. He also has arthritis in both hocks which were treated with steroid injections - I won't have any more of these as it caused laminitis. No cushings or PPID. 3 years ago he had his annular ligament removed in right hind and scar tissue taken out of the same tendon sheath after an injury. He came back sound after rehabilitation.
He is semi retired only hacking, no schooling or jumping. Our routine was about 3 rides a week of 4-5 miles with short canters.
Last summer his forefeet became very painful and despite very expensive remedial shoeing he refused to go forward when ridden. Vets wanted x rays etc but as he was no longer insured I had his shoes taken off and turned him away. In January this year he came sound so we have gone through a full barefoot transition - barefoot diet, hoof boots, trimming etc. I found that with him barefoot I can spot any slight lami changes immediately and treat quickly. He had a mild bout in April and was fine after 3 weeks. Over the past month we have been back to hacking 4-5 miles in hoof boots, lots of trot and began introducing canter. We also reached 2 miles barefoot on roads with plenty of trot. I was absolutely delighted to have my happy forward-going horse back! On his last health check the vet was really happy and said he was ever so slightly lame on that dodgy hindleg but to keep riding and give him half a Bute if he was stiff in his hocks.

Sadly a couple of weeks ago his right hind tendon sheath (where he had his operation) has started to swell :( He's walking forward well but slightly lame when ridden in trot on that leg. He doesn't want to canter up his field and sensitive on small circles. He's had Bute and cold treatment but no relief.

I am gutted. He isn't insured and I wouldn't put him through another operation anyway. Has anyone got any tips other than to turn him away again? He gets stiff with arthritis if not exercised and he needs Bute over winter to keep him mobile, and I have to watch him like a hawk for lami. He's been so happy to get his work back up to what it was and I really don't want to stop riding him as he gets depressed and naughty.

Any ideas for old tendon injuries?
 

fairhill

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If he’s sound in walk then I would keep him ridden in walk only. Straight lines as much as possible. Keep him on the bute.
You have my sympathy, it’s hard work managing a horse with multiple issues.
 

hopscotch bandit

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Have you involved the vet this time around? Do they know what has caused the lameness? If this is as a result of scar tissue then there's not really much you can do except as the previous poster said, just keep hacking on straight lines in walk. Icing is not going to do much good if it is old scar tissue that has adhered to the sheath or ligament. Scar tissue can also contract and deform surrounding tissue so if they couldn't get it all out it may have just got larger and is now interfering with the movement of the ligament.

Are you certain that the lameness he is showing is related to pain and not a mechanical lameness i.e. resulting from scar tissue interfering with the movement of the ligament during trot? This scenario happened to a best friends horse and the vet felt it was mechanical lameness resulting from calcification/scar tissue around a suspensory branch as nerve blocks made no difference. She was told she couldn't have the operation to remove the scar tissue as it was attached to the branch and there was no way of separating it cleanly She wouldn't have anyway as he was too old. In walk and trot on straight lines he was great but on a right circle it threw up a very weird 'hopping' movement which was worse when she sent the horse forwards. When it was suggested to her to try schooling the horse again as part of a rehab plan last year she had a few attempts at schooling and he was sound for a few sessions but then all of a sudden in the school one day he went suddenly acutely lame (7/8ths lame) yet seconds later if the horse was trotted under saddle or in hand he would be sound either on the other rein in the school or on the concrete yard outside (this was done for way of explanation for his condition with the vet not so she could continue to school) It's thought that this sudden 'lameness' was showing as intermittent mechanical lameness due to the scar tissue catching the branch in a certain environment, ie. on a soft surface when the foot was placed at a certain angle. She has had to resort to only hacking in straight lines and fun rides which she doesn't mind.

If he is sound in walk I'd not stop hacking, especially as this will help with the spavin issues. Regarding the spavin you could always look at Tildren or even chemical arthrodesis which doesn't involve the use of steroids, therefore you have no risk of laminitis if this were an issue in the future. THe latter is cheaper and long term.

If the vet is in agreement I'd consider putting him on bute long term throughout the year particularly if it is thought to be a mechanical lameness then this will help his hocks also.
 
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noblesteed

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Thank you for your replies. Yes he had scar tissue left over inside his tendon sheath - at the time of his op the vet was 50-50 on whether he would make a recovery.
This could have changed over the years I suppose. I am also slightly suspicious about his barefoot trim as his hoof angle is less upright than it was with shoes on.
After a week off his swelling has come down so I will just leave a couple more weeks and try slow and steady walking out.
The vet is happy for him to have a daily Bute - I started him on half a day and he's never needed any more.

Poor guy is looking a bit fed up today but possibly he's sick of the heat!
 
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