Windgall or suspensory ligament damage - fore? Anatomy Q also

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BeckyD

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Back at the end of March Ronnie developed heat and swelling on his off fore, above fetlock in the front one of the two "grooves" running from fetlock to knee. He was box rested, cold treatment, and it seemed to go down, he was never lame. Vet came out, said couldn't see anything wrong, but box rest for a week or ultrasound scan. I chose the scan route as I wasn't convinced about the week's box rest (the swelling went down with exercise and he wasn't lame so how would I know if he was "better"?). Scan showed no damage to tendons or suspensory. Vet said "keep an eye on it but seems to be just a knock".

After hard (fast) work (not jumping, strangely), this swelling returns - usually the next day. No lameness, just swelling. Swelling goes with exercise - even 2 mins on the walker seems to remove it.

Tuesday night this week Ronnie had been going silly in the field, and when I got to stables both front legs were swollen above fetlock, veins up on his lower legs, cuts all down the inside of his legs, and he was (very very slightly) lame on off fore. Cold treated it, bandaged it and called vet. Vet says it could be suspensory after all. Box rest then reassess (i.e. as before) with probable re-scan.

My quandary is I'm not sure exactly WHAT is the suspensory - is it the middle sticky-out bit of the lower leg? i.e. front to back: Cannon bone, gap, suspensory, gap/deep digital flexor tendon, superficial flexor tendon.

I'm fairly sure the near fore swellings are windgalls (ground was hard and uneven on Tuesday when he was galloping like a lunatic). Could off fore be windgall as well? It's a different shape/feel to the near fore but in the same place.

Should I just get another scan done - but what if, again, it doesn't show anything?! Vet wasn't remotely helpful really
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ARGHHHH. Can anyone point me in the direction of detailed anatomy of lower front leg?
 
If the suspensory is damaged then the scan will show it fairly clearly (all presuming your vet is any good at reading the scan pics though). There will be swelling and probably pain if you poke about at it (gently!!) Be aware though that if your horse does a suspensory on one leg it is quite easy for them do it bi-laterally (both legs) as they try and ease the pressure on the initially affected leg. I have personal experience of this and frankly I would be getting the leg scanned asap and if you're not happy with the vet then find a different one!
 
Sory to say this sounds very similar to my mare. My vet thought suspensory at first too, but the scan showed nothing much, except a bit of fluid around the annular ligament area. so we box rested her for 8 weeks and she went back for another scan. At this scan, the swelling had reduced and showed an injury to the annular ligament and also the deep digital flexor tendon.

My mare has now been on paddock rest for 5 months and isn't due to be re-scanned till August!

Sorry to sound negative, but IF it is annular ligament which often shows as windgall type lumps on the fetlock area, the sooner it is treated the quicker the recovery time I believe.
 
Windgalls are sacks of fluid that come up to protect a problem injury, very often the suspesory ligament can be strained too much due to low or flat pedal bones in the feet (these should be at roughly a 5° angle in the foot) which in turn lower the heels causing the suspensory ligament to be put under excess strain and for this reason windgalls will appear for protection. My Husband (Vet) is just treating one of my livery owners horses with this same problem. The horse has gone lame in the last week but before moving to our yard the owner tells us that she has had windgalls for 6yrs and her previous Vet just prescribed box rest. My husband x-rayed the feet and fetlock joints (the latter to make sure there was no OCD in the joints) the x-rays showed that the pedal bones were totally horizontal with no angle to them at all, when you looked at her feet generally they looked in very good shape but the x-ray showed differently. We put her straight on Cortaflex HA with a course of Bute and called the farrier in to put the horse on Wedged shoes (this raises the heel slightly allowing the pedal bone to angle) they must NOT be left on more than ONE shoeing as they can create other problems. The farrier was then able to cut back the hoof toe dramatically to the x-rays so that he could see how close he could cut back to the pedal area. two weeks on she is sound and schooling well but with caution for a little while until the foot shape changes with good shoeing. The windgalls will never go but will/should go down dramatically and remain soft and squidgy to squeeze. If they are hard then they are working over time to protect the problem causing them. Hope this helps!
 
Thank you - that helps more than you can imagine. You may have seen my other post about my horse's feet, which farrier has allowed to grow very long in the toe and flat at the heel. Coincidence that this should happen at the same time? Not by the sounds of it. I've got a new farrier coming out in 2 weeks' time to see my horse's feet.

All swellings have now gone, he's been on box rest since Wednesday. He's still unsound though, not right on that off fore. I've spoken to vet and she's going to arrange a rescan for next week. I think this is going to be a foot and leg problem all in one.

Thank you for your reply, and good luck to your livery horse, sounds like she's on the mend. I've been thinking about a joint supplement.
 
Ok thanks, I'll mention this tot he vet next week. I'd rather be forewarned for worst case scenario. I don't even know where the annular ligament is so I'll have to go and get my vet book!
 
Nope nor did I before all this - didn't even know my horse had one....!
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Its the ligament which circles around the back of the pastern area and supports all the other downward ligaments/tendons.

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the x-rays showed that the pedal bones were totally horizontal with no angle to them at all, when you looked at her feet generally they looked in very good shape but the x-ray showed differently

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That's interesting to me too, as my mare also had surpisingly flat pedal bones - not negative, just flat - so all connected obviously, although the ligament injury could clearly be seen as some kind of impact injury.

Anyway, hope your horse doesn't have a serious problem BeckyD and makes a swifty recovery.
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I would certainly insist on foot x-rays for your farrier to trim the feet back so he has guidence as to the angle of the pedal bone. It is something that needs trimming by a remedial farrier so make sure your new guy is capable of doing this for you! Cortaflex is the only product that is properly SCIENTIFICALLY proven which is why my husband recommends it. Its £52 in powder form but last 2 months so not too bad really. A lot of the other brands use molecules that are too large so the gut can't absort which then just gets passed out in the dung. Good luck & glad I could help you.
 
Vet (different vet) didn't scan in the end as he thinks Ronnie's not got a suspensory inujury (just a sprain or concussive type injury). But, vet thinks Ronnie's at risk of suspensory injury if we don't get his feet sorted out, as his left foot in particular is putting excessive strain on the suspensory. So, farrier is coming next Friday and I'll go through all this with him. Until Ronnie's feet are sorted out better I'm to do only non-concussive work with him. I will examine my bank balance and see if I can fit Cortaflex in to my budget. I'm a massive fan of Cortaflex as it kept my old arthritic horse sound for years, and every time I took her off it (because I ran out or was trying to save pennies), she went lame.

Thanks again for your help! I'm keeping the Xrays as a back-up plan for if farrier has difficulty...
 
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