Severed Extensor Tendon in Rear Leg
   

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Severed Extensor Tendon in Rear Leg

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    04-12-2011, 07:43 PM
  #1
Foal
Severed Extensor Tendon in Rear Leg

Hello all~
I have a 4 year old double registered pinto/paint that I recently purchased. He is just like a little boy and gets into everything. Two weeks ago, my mother went out to feed the horses and "Dakota" was standing out in the pasture, refusing to come to get his daily grain. My step-dad ran out to make sure he was ok. He had gone thru the fence and severed the extensor tendon in his rear leg (horizontally).

We immediately made a vet call. It was extremely difficult getting Dakota to the barn, as his leg was unable to come forward because of the severed tendon.

Our usual vet was unable to come out so they sent another vet. He said that we should euthanize him as he would never be able to regain that tendon use. I was hysterical. He told me to get a second opinion so we loaded him in the trailer and drove to an Equine Clinic about 45 minutes away. They called me a few hours later and said that they would suture the tendons and he would be in a cast for 6 weeks.

We picked him up 2 days later. The cast lasted about a day and a half and then his ankle was mobile again. I called the clinic and they sent out a vet to re-cast him. While the original cast was off and they were re-building it, Dakota flipped out and landed right on the front of his hoof, making his leg flop forward like the first day. The skin sutures tore out and he was bleeding all over the place. They were unable to tell me whether or not the tendon sutures stayed intact and they just recasted him and left. I was left in the dark as to whether or not this was a wasted attempt or not.

Another day later, the cast was separated from his hoof and his ankle was able to move again.

I called my regular vet and she did some research. She was able to find a Kimzey Splint for the rear leg that would be able to keep his hoof up. I immediately purchased it from California and she came the next day to remove the cast, wrap his leg in bandages and put the splint on.

He seems to be doing well and appears to be happy. Bored, but happy.

I guess my question is....has anyone ever had a horse sever a tendon like this and fully recover?? He has so much potential and he is so young. I'd like to think he will recover so we can ride together again. HELP!!

Thank you so much,
Rebecca

PS: Below is a picture of the Kimzey Splint. I don't understand why the clinic that performed the surgery didn't have these available for people like me to rent? It is such a great idea to keep that hoof forward! Has anyone else used this splint??

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    04-12-2011, 07:52 PM
  #2
Showing
Wow, what a situation - I'm so sorry. Tendon injuries are horrible, and with the extent of the damage, I personally wouldn't expect him to be able to walk normally. I knew a mare that severed a flexor tendon and had to pick up her hind leg by her stifle and flip the rest of her leg forwards - nice mare, seemed happy, but completely unsound. Denny severed part of his tendon - I think 25% (maybe up to 50%, but no more..) and we were very worried about necrosis and soundness after he healed up - he did heal (helluva scar) and is sound, but I know even with a partial tear, it was a worry.
What was the vet's prognosis? With a completely severed tendon, I'm not sure I'd expect him to be riding sound.. but I'm no vet.
Good luck, please keep us updated. I would love to see pics of your sweet boy.
Oh, and regarding that splint.... I'm not shocked that it isn't kept on-hand, it seems quite specialized. Great idea for those types of injuries though :)
     
    04-12-2011, 08:13 PM
  #3
Started
I have no experience with this type of injury, I just wanted to post and say how sorry I am for your horse, I hope he is able to recover from this
     
    04-12-2011, 09:28 PM
  #4
Super Moderator
My mare severed 2 tendons in her back leg. One was at about 80% and the other was 100%. At the time she had actually severed the artery and a vein in her other leg as well and I was actually more concerned about that leg because of all the massive amounts of blood pumping out of her. I had no idea a severed artery isn't THAT big a deal! The vet had to lay her down to suture the artery because it was right at the fetlock and he couldn't get to it. When he went to look at the other leg he just sat back and said we should consider putting her down.

I wanted all the options so he said he could clean her up and stitch her up and then hope infection didn't set in. He also said she would positively be lame forever or we could load her up and take her to the equine hospital. We loaded her up and hauled her 2 hours to the hospital where they put her back together again. I think the surgery took about 3 or 4 hours.

They had her in a full cast for about 2 days and the they cut it in half. What they did was put gauze pads against the sutures and then placed the cast over that. We used the sticky ace type bandaging to hold the cast in place and then we used vet wrap over that. The other leg we did a standing wrap to avoid laminitis in the good leg.

We changed the casted bandage daily and the standing wrap every other day. We had some pretty scary moments with the bandage changes also, I think it's because when you pull the wrap off the blood flows down and it's like that sudden pounding pain they get that gets them flailing around like "kung-fu pony", which is what we called her those months!

She was on stall rest for like 6 weeks. We could only hand walk her for 5 minutes and I believe that was after weeks of stall rest. They told us that the chances of her coming out of this injury sound were about 70%. When we took her to the vet for her check-up about 3 months after the injury she was fairly gimpy and he told us that was the best she'd ever be. Not true! After about a year she was mechanically lame. She just has a slightly stiff movement but she has been cleared to walk trot canter and even jump! She does have her days, especially in the cold but it's been about 4 years since her injury and we really haven't had any issues with her.

Good luck and don't give up. I know someone that is going through a tendon puncture right now, it was a tiny puncture but infection set in. They've had a lot of ups and downs and everytime they think it's time to throw in the towel the vet sees improvement so... Just keep your chin up.
     
    04-12-2011, 11:56 PM
  #5
Super Moderator
I had a very nice gray 4 year old gelding sired by Shawnee Bug (great Barrel Horse sire) that I bought off of the track. He kicked across a gate that had and angle iron brace. Some how he sliced through his hind extensor tendon and severed it completely.

Like yours, his hind foot just knuckled over and he could only set it down on the front of the pastern. I wrapped it and got him to the barn and called my farrier. [I had treated one once before that was going to be put down by a Vet and so I know what to do -- but that one was older and was badly infected when I got it. He made a school horse but was never 100% again.]

I had the farrier make a shoe with a piece of strap iron welded to the front of it. The strap iron was bent (while hot) to conform to the front of his hind leg with his hoof on the ground. Then, all I had to do every 2 or 3 days was unwrap the leg, dress the wound, and then wrap the piece of iron into a second wrap over the leg. I kept the leg wrapped like that for about 3 months -- that was several weeks after the wound had actually healed. I wanted to re-set the shoe, but we decided it would be too risky to give the hoof a chance to knuckle over, so we left it on for 3 months.

Every time I unwrapped and re-dressed the leg, my husband held up the front leg on the same side so he could not tear up the scar tissue that was going to hold the tendon. That was enough to keep him standing good.

We reset him one time and kept it wrapped 6 or 7 weeks longer. He was walking on it OK after that but was pretty stiff. We put him in a paddock and finally turned him out. He had very little scarring, but I think that was mostly because we healed up the cut so nicely without any proud flesh or infection.

It was about 6 or 7 months after the injury that I started longeing him. He seemed OK so I started riding him. He was making a very nice hunt seat horse when a lady from El Paso Texas came and bought another horse I had going over fences very nicely. She fell in love with the Shawnee Bug gelding so I sold him for $1000.00 with the full disclosure of how bad his injury had been. We both knew he would be worth a lot of money if he made the team. So I sold him with a contract and kept his papers. She could pay the balance any time and I would send his papers. She called only a couple of months later for his papers. She was jumping him and was going to show him in AQHA Hunter Over Fences classes. I checked later and he had quite a few AQHA Points. He was 100% sound and got back his gorgeous way of going.

I hope your works out as well. Since the extensor tendon is not a 'weight baring' tendon, so it not as serious as you think if you can just immobilize it and heal up the wound. Good luck with him.
     
    04-13-2011, 09:08 AM
  #6
Foal
Wow! Thank you so much for all the responses!

My vet remains positive but she has never seen an injury like this before so we are all learning together. She also put gauze pads against the wound, wrapped it with sticky ace bandage and put the splint on. She said she wants the splint on for 10 days...then she will stop by to unwrap, check the wound and rewrap.

I try to remain positive but I have my moments when I seriously doubt I will ever ride him again. This is week 3. If he hadn't fallen onto his hoof when the clinic vet came out to recast him, I would be much more positive about the sutures staying put but since he DID fall onto the front part of his hoof and the skin sutures came unstitched...I just don't know about those tendon sutures. My local vet poked around a bit when she was putting the splint on and she said she couldn't touch bone (like we could the 1st day), but she wasn't sure whether or not the sutures stayed on the tendons. She really couldn't tell.

What should I do for the other leg to discourage any lameness/founder, since all the weight is being put on that leg right now. I see that he is laying down during the day, which is good, but I still worry for the other leg.

My vet was able to contact a doctor at Cornell and he told her that most of the time, they don't even suture the tendon. They mostly tend to the skin wound and rely on swelling for the tendons to re-attach. Has anyone heard of this?

Also, what do I do for therapy after a few months. The clinic vet (who did the surgery) said absolutely NO therapy or walking for 6 months after the cast comes off. But isn't a horse like an athlete? Wouldn't you want them to start therapy so they can re-build tendon and muscle strenth? I would think you wouldn't want stiffness. I realize I have a LONG way to go with strict stable quarantine. Just trying to get some input for the road ahead.

Again, thank you SO much for all the responses!!
     
    04-13-2011, 09:18 AM
  #7
Started
The open wound will heal by "second intention" meaning it will heal and fill in slowly. The tendon might or might not stay with sutures, but again, scar tissue will adhere it at some point.
I would suggest total stall rest and once the cast is removed, then stall rest again. You are probably looking at 6 months or more stall rest and no exercise except at some point hand walking, but that will be along time down the road. As far as being an athelete, once he is healed, it will be bringing him back into shape slowly slowly slowly. Too bad you do not have a pool handy, those work so well for getting horses back into shape(dogs also) because they put no stress on the legs while swimming.
Put a full standing bandage on the other leg, that will help prevent laminitus, although there is a good possibility you might have to deal with that. Personally, if he is in the stall, I would put standing wraps on all his legs at this point. A horse will keep weight off the bad leg and put uneven weight on the good legs and can cause laminitus
This can heal, but will be a long, expensive period.
Good luck
     
    04-13-2011, 10:16 AM
  #8
Super Moderator
We did not suture the one that I treated. The unsuccessful one that I tried to rehab had been sutured twice before I got him. Both times they pulled out even with a cast and my Vet said that contributed greatly to his never gaining full soundness. The really good equine Vet that I had used for many year before I moved to OK told me that extensor tendons healed better and faster if you did not do further damage to them by trying to suture them.

If your horse stands on the foot -- which he should as the supporting (weight bearing tendons) are uninjured, his other foot and leg should be OK. A standing wrap would not be a problem as long as you know how to wrap it correctly. I have seen them do a lot of damage when the wrap is not done correctly for a long-term wrap.

I also would not give him Bute or any other anti-inflammatory drug. They slow healing and can hide pain that you should know about (like from a wrap that is too tight or ???)
     
    04-13-2011, 11:24 AM
  #9
Super Moderator
I still have the instructions that were sent home with Beauty on the excersize regimen. I'll try to pull them out tonight. If I remember right, it was about 6 weeks before we were allowed to walk her and then it was handwalking for 5 minutes at a time. Have you ever tried to handwalk a horse that has been crammed in a 12x12 stall for 6 weeks????!!!! LMAO... not pretty.

With Beauty we had to do the standing wrap on that other back leg the entire time but that was because I was terrified she would end up with laminitis. Her injury was to the back of the leg rather then the front so when she stepped down her felt lock touched the ground.

She actually spent 10 days at the equine hospital living like royalty before coming home....
     
    04-13-2011, 12:27 PM
  #10
Foal
(If your horse stands on the foot -- which he should as the supporting (weight bearing tendons) are uninjured, his other foot and leg should be OK. A standing wrap would not be a problem as long as you know how to wrap it correctly. I have seen them do a lot of damage when the wrap is not done correctly for a long-term wrap.)
What should I buy? (Quilted Leg Wraps & Standing Bandages?) And what is the improper way to wrap? Too tight? I honestly have never had to wrap any of my horses' legs. This is all new to me. I have always had easy keepers with 0 injuries.

He is on antibiotics and one bute a day (per my vet's instructions). He seems to put weight on it but yesterday I forgot to put bute in his grain and he wouldn't put any weight on that leg. Kinda scared me.

The vet also recommends that the splint stay on for a full 8 weeks. She said hopefully as time goes on, we will need less and less bandages but still use the splint. Also, do you think I should be unwrapping and cleaning that cut more often or should I just let it heal and follow my vets instructions of every 10 days??

Everyone has been so helpful and positive. I really appreciate all of your responses! Thank you!
     

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