WWYD - Lameness and PSD

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27 July 2013
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Evening,

Just looking for some opinions from people not emotionally attached. For a bit of background I have a lovely 16hh ISH 11 year old by Ghareeb who I have owned for 3 years. Pretty much for the whole of the 3 years except the very beginning (she had a five stage vetting) she has had soundness issues with her front feet. I had a couple of different vets who had different diagnoses from navicular to thin soles. She had her navicular bursa injected which seemed to work for a couple of months. We then went though a year of working with the farrier and slowly adapting her foot balance and a coffin joint injection and front shoes with pads and impression material and I had a sound horse!! I then had 9 months possibly slightly more of being able to ride and get her out. Last summer was fab; xc schooling, dressage, lessons, hacking just enjoying having a lovely horse to take out. She is the easiest horse to do and take out and a horse I really get on with. However towards the end of the summer I was having some issues with jumping, having always been pretty bold jumping she started stopping

At the end of last summer she did a ODE she went beautifully and came 3rd. A couple of weeks later while xc schooling she went to jump a couple of smaller jumps but`stopped half way over the jump, she did this twice and I stopped and came home. Vet came out the following day and was happy she was sound but said she was very tight and gave her some oral muscle relaxants for 10 days. These made no difference and when the vet next came out she was bilaterally lame behind, worse on the soft. Her suspensories were scanned and she had enlarged branches at the upper and lower branches as well as a couple of holes in the lower branches.The left leg was slightly worse. She is not insured and therefore an op wasn't really an option. The vet also said that as she has slightly dropped fetlocks then the operation is less likely to be successful. He suggested 4 months off then 2 months of 30 min road walks.

Vet came out again after the 6 months and he was disappointed with how she looked and suggested she needs more time so would give her another 6 months. I had her hind shoes removed and shes been out. However with the hard ground she is slightly sore behind. I watched her trot across the field the other day and she in my eyes doesn't really look any better and possibly a bit off in front too.

So the dilemma is I'm not sure where to go; I could give her more time (I can put shoes back on behind) or it has crossed my mind whether PTS is a kinder thing to do as she has such a list of problems and I don't have an endless money supply to put in to fixing it. Another though is (a selfish one possibly) that if she does ever come right I have made a decision that she I would only hack and do light schooling. However I would really like to compete (only riding club level but a bit of jumping, dressage, fun rides ect) I wouldn't be happy pushing her to do this.

So what would you do? Does anyone have any success stories of PSD without surgery? Any other suggestions

Thank you for reading if you make it to the end
 
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I'm sure a lot of people will say PTS based on the prognosis, time you've put into her already, what you want to do ridden wise, cost & long term outcome if the surgery doesn't work. Is she comfortable as she is? I'm sat here with a pony who is only in work 6 months of the year due to pollen issues & I'm a big sap, so as long as he's comfortable out in the field, that's fine by me. That would be the point at which I thought otherwise, if he was uncomfortable full time.
 

SEL

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It took my friend's mare 12 months off (6 months box rest) before her hind suspensories scanned well enough for her to start ridden work - but she's still at gentle walk stage.

Mine is 6 months off in the field and still struggling. I'm expecting rest of the year off and hacking only if she comes sound .

PTS is not the wrong answer if you can't support an expensive field pet...
 

blitznbobs

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I’d pts... you’ve spent a lot of time already , the prognosis is poor for this condition, but field ornament I suppose is an option.
 
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My experience with my lovely boy 9 years ago was that I gave him the full treatment after being diagnosed with R hind suspensory, he came back sound but couldn't do any intense work. Luckily I moved to my own yard at home and got another horse. My old boy hasn't been ridden for about 5 years now.
I would be considering PTS in your situation, hind suspensories have a poor prognosis I think. Good luck whatever you decide.
 

milliepops

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I’d pts... you’ve spent a lot of time already , the prognosis is poor for this condition, but field ornament I suppose is an option.
I'm afraid to say this is my feeling too. I know a friend whose horse had dropped suspensories and it just got worse over time even though she was a retired horse, it was sad to watch. As yours has already had a lot of rest etc and is still appearing to be quite sore I think I'd be preparing to let her go :(
 

supsup

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Hind limb PSD rarely is an isolated thing. It often goes together with back/hock problems, and it's not often clear what the primary cause is, and what develops as a secondary problem. Given that your horse has struggled with front-end lameness as well and appears to have poor hind limb conformation (dropped fetlocks), I also think that chances of a full recovery are likely not great. I would say though that 6 months rest isn't that long in the grand scheme of things.
My gelding did have a (mild) PSD prognosis (1/10th lame after flexion, one leg only, together with unspecified sore back) and has come right over time (took 18-24 months) through a combination of rest and slow work (longlining/hacking in walk). He had about 2-3 months off initially on field rest, followed by another 3 months slow work, after which is was still not quite right. Followed 6 more months turned away completely (grazing the common) after which he appeared sound and without the sore back, then another 6 months of slow work gradually building up. After that, he's been back to normal work levels, though in his case that was mostly hacking to start with. I have not done any regular school work since as I was advised to avoid deep surfaces (and school on hacks/in an open field on large circles instead).
 

Pinkvboots

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I think I would seriously consider pts had it just been the front feet issue I think you would have a good chance of recovery, add in the psd behind and the fact the fetlocks have dropped it's just too much going sorry:(
 

scats

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I have a mare who was diagnosed with PSD last year and a whole host of other issues as a result- SI, back problems, hock problems... she was an absolute mess and could barely tolerate being touched. I opted not to do surgery. I took her shoes off and left her alone for 10 months. She was looking better than ever by this point so I started gradually reintroducing work. We are about 12 weeks in now and a visit from our vet chiro the other day confirmed her to be sound and her back and SI issues are no longer there. The horse herself looks completely different.

However, I don’t have any future aspirations for her. I thought she’d have to be retired, so being able to do a bit of light work at home is more than I ever thought possible. It is currently very light work. She does one or two days ridden- for twenty minutes- walk and a bit of trot, a lunging day (although I lunge the whole school, not on a circle) and some light hacking around the Farm tracks. I plan to carry on with this for the next 12 months if I’m honest and I have no intentions of cantering her for the foreseeable.
 

ForbiddenHorse

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So sorry to read this, it doesn't sound great specially considering her heels have dropped and she has more than one hole and enlarged areas elsewhere. A friend had exact the same happen to her horse of a lifetime last year, a suspensory injury and heels dropped. The vet said they couldn't do anything and he was PTS.

PSD is a common and mind boggling area, they now think it could be related to riding on surfaces especially deep ones. My gelding done his left suspensory and after a long time deciding what to do, he had surgery in February at only 7. Hes sound now and coming back into work, he feels ace but I know the nerves will grow over time and have accepted he probably won't make his mid teens so will enjoy what we can. (I understand you can't do surgery, just sharing my side)

I will add though, a friend at the moment has a gelding who is 15, he tore a hind suspensory 6 months ago and has had nearly 6 months box rest with in hand walking very strictly and plasma treatment or something along those lines. He has coped amazingly well, had it re scanned a week ago and to the vets amazement, its fully healed, complete difference. Hes coming back into work now so time will tell.

If she was mine, uninsured as well which makes a big difference.. if shes painfree in the field, i'd give her a few months over the summer at field rest and then PTS before winter. I done this with my mare who was PTS at only 9.. it just made me feel a bit better knowing she had a few months at field rest before I said goodbye as it was such a tough decision.
Sorry to say but PSD usually comes hand in hand with other issues, so if she hasn't had x-rays she could have hock arthritis or another underlying problem too.

xx
 
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SEL

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I have a mare who was diagnosed with PSD last year and a whole host of other issues as a result- SI, back problems, hock problems... she was an absolute mess and could barely tolerate being touched. I opted not to do surgery. I took her shoes off and left her alone for 10 months. She was looking better than ever by this point so I started gradually reintroducing work. We are about 12 weeks in now and a visit from our vet chiro the other day confirmed her to be sound and her back and SI issues are no longer there. The horse herself looks completely different.

However, I don’t have any future aspirations for her. I thought she’d have to be retired, so being able to do a bit of light work at home is more than I ever thought possible. It is currently very light work. She does one or two days ridden- for twenty minutes- walk and a bit of trot, a lunging day (although I lunge the whole school, not on a circle) and some light hacking around the Farm tracks. I plan to carry on with this for the next 12 months if I’m honest and I have no intentions of cantering her for the foreseeable.
Pleased to read this Scats! I can add PSSM into the mix, but your first sentence describes my mare. No one is quite sure what the primary issue is, but her back end is 'not right'. No rush from my perspective and she seems happy enough in the field, but it would be nice to think she'd be comfortable enough to a potter around the lanes at somepoint in the future.
 

flying_high

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My now sadly departed 17hh WB was diagnosed with hind PSD in 2011-2013 but went on to do two future BD winter regionals at Elementary. It wasn't an easy journey, but he didn't have surgery, and we did manage to get him using his body better, rehab from the PSD and the foot balance and the SI issues and have a lot more fun. Sadly his arthritis and high mileage eventually caught up with him in his early 20's.

I think IF you can work out and eliminate the cause of hind suspensory damage, and give time and structured rehab and body re-education, you can come back from it. But if it is conformational caused / you cant find the reason are damaging suspensories / or cannot eliminate the primary cause the prognosis is pretty low.
 

Ceriann

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My mare has an injury to left hind (medial branch suspensory) and some inflam of left fore suspensory (likely linked). She’s been investigated for everything - no primary conformational cause other than I was told her feet could have contributed - she has typical TB feet (thin soles, underrun heels, long toes) all improved with a good farrier but WIP. I’ve been told prognosis to return to normal work is poor by one vet but good by another (provided I’m prepared to do the long slow rehab). It’s a minefield and whilst mine isn’t psd I am taking the advice I’ve read to restrict free movement (stable or very small paddock) and control all exercise. Her shoes are all off as rehab for injury and barefoot is complimentary. I’ve been told to realistic expect a 6 month rehab and then v slow return to work. I’m lucky in many ways, she’s easy to handle etc and I keep her at home. I appreciate this is a very difficult process, made more difficult for you given the conformation issues. I’d have a very honest discussion with a vet you trust - from what I understand prognosis is often driven by an expectation horses will be put back to work too soon.
 

scats

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Pleased to read this Scats! I can add PSSM into the mix, but your first sentence describes my mare. No one is quite sure what the primary issue is, but her back end is 'not right'. No rush from my perspective and she seems happy enough in the field, but it would be nice to think she'd be comfortable enough to a potter around the lanes at somepoint in the future.
Thank you SEL. I can’t believe how far she has come. This time last year, she was written off by the vets and I was told that it was highly unlikely she would ever be suitable for ridden work. They were still quite convinced that a lot of it was a behavioural issue but I was adamant that if it was, it was purely because the mare was shouting for help and no-one had ever listened before.

It seems that all her issues were connected. Her PSD was relatively mild compared to some, but her back and SI problems were truly awful.
She looks different, she moves differently, she’s relaxed (verging on a bit lazy!), she no longer jogs everywhere. It’s a total joy to see. I went with my heart when I bought that horse, definitely not my head (!), but I felt the strongest feeling that she needed help and I was going to do whatever in my power to fix her. I feel that I’ve made her a much happier horse and that means more to me than anything. I’ve also never seen a horse who genuinely seems so grateful for everything I do. She is an absolute treasure to have around.
 
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