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Discussion Starter · #1 ·
I recently found out bad news about one of my horse's who has been having on/off hind end issues :frown_color:. I was able to get a lameness specialist in and my horse was diagnosed with suspensory ligament desmitis in both hinds. Basically, the body of the ligament and branches are inflamed, but no big tears, as I understand. Out of the two, the LH is the worst and the RH isn't bad at all. The vet suggested shockwave therapy (+ 2 weeks stall rest and daily walks), which we did when he came down on the LH. He'd also like to do a bit of acupuncture since my horse has become sore in the hind end due to compensation. Has anyone had any experience using this as a treatment for suspensory ligament injuries? The treatment itself is quite expensive, but I don't mind doing It as long as It works.

I also called around and found a vet in my area who also does shock wave. She charges $170 per session, whereas the specialist charges $300 per session. The specialist also travels from 4+ hours away, so I can't imagine the travel fee (when I get the bill) will be that nice to me. The specialist wants to do 3 sessions on the left hind and 1-2 sessions on the right hind, so I could save quite a bit of money by having the other vet do these, especially since I'm close enough to trailer over. However, I don't want to offend the specialist and would still like him to be the attending veterinarian. How should I bring this up with him?

Overall, I'm pretty upset about this. I've already spent a lot of money with other vets trying to diagnose this and x-rays + 2 ultrasounds that were apparently clean, but we didn't have access to someone more experienced until recently. I've also heard bad things about ligament injuries and I'm really worried this treatment won't work, even though the vet thinks It will.
 

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Hi, yes, I have experience with this with a similar injury. My horse had inflammation of the suspension branch below the pastern, where it splits into two. Only one of the two branches was swollen, but it was not torn off. We did many ultrasounds to check it out over time to watch it.

We did shock wave with stall rest for 30 days hand walking with basically no difference. We sent him off to pasture for a year to recoup, he got better but never had a full recovery. I rode him on and off after that, I would have to ice him after jumping (infrequently) and we also tried magnets to increase circulation. Nothing really helped him except time. He did some trail riding for a few years just walking and developed enough scar tissue over time to make his leg more stable with constant low grade exercise. He still had good and bad days after that. The vet thought we would need to give bute for the rest of his life, but instead we managed him with supportive shoes, and gave bute as needed. Eventually we put him on previcox, which I wish had been recommended to us sooner, but that was years ago when it was still only available in equioxx... We also used surpass for him to reduce the drug load in his belly.

For the prices you are looking at, you might be better off buying the machine and doing it yourself, I've done it for one horse we had who had some tearing at the track. She recovered well, but was quite young.

This type of injury is so tricky... like you said, hard to see and diagnose. The ultrasounds can show one thing and your horse another. I just had to learn to read my horse to see how he was doing each day.
 

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Discussion Starter · #3 ·
Thanks Filou for the response 🙂 It’s so helpful to hear about your experience! I’m a bit of a mess right now and feel pretty helpless about the whole situation. I should mention that the 170 and 300 is in Canadian dollar, so I’m not sure If that makes any difference or not? Given a choice, I’d definitely opt for the cheaper vet, but I’m really not sure how to bring that up to the specialist.

I’m looking at other things I can do to aid healing and was curious about supplements. Did you use anything besides previcox?

I’m still learning about this condition and It seems like, in reality, It is going to take a very long time to heal. I’m fine with giving my horse the time off that he needs and definitely don’t want to take any shortcuts in that route. The specialist seems to think shockwave will work, but my horse’s fetlocks have slightly dropped, so from what I understand, this is more chronic than a tear? He said the entire body + branches were all inflamed. I asked If he thinks my horse will eventually be able to resume Dressage work and he thought so, but from what I’ve been reading, I’m having a lot of doubts.

On top of that, I’m not in the greatest situation to rehab this kind of injury. I board at a barn and It was supposed to be 24/7 turnout, so now I’m paying for shavings and driving out 30min to clean out the stall 2X a day. Luckily, the barn owner has been really understanding and is helping me out a bit. Another boarder is coming back in June and has pretty aggressive horse’s. There is only one paddock, so my horse has to be with them. I don’t want to risk turning my horse out with them at all, so I’ve been thinking of other solutions like making a small paddock where he can see them, but not run around or turning him out in the arena. We also live in a wet environment and get a lot of muck through the spring/summer and lots of snow/freezing rain in the winter. That just sounds like a recipe for reoccurrence. I’m probably getting overly worked up about it, but It’s just making the situation even more stressful when I think of all the $$$ and opposing factors to deal with.
 

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A friend's calf roping horse, Ronnie, injured both rear suspensories on bad ground at a local rodeo a few years ago. All shockwave therapy seemed to accomplish was a lot of time in the trailer and an empty wallet. An old-school vet recommended the old-school therapy-- pull the shoes and turn him out on good ground with a gentle companion for a year and he'd either get better or he wouldn't. Aside from farrier work to keep the feet in balance, and some extra feed in the winter, he left the horse pretty much alone. His gelding did heal pretty well. He will never be a rope horse again, but he does just fine for trail riding on the weekend, or for guests or kids to ride around. He runs and stops hard at turnout, but they keep his riding to walk/trot only if possible, especially with a heavier rider. So far so good. Hoof care is important-- if Ronnie's heels get too high or low, he tends to get sore behind.



I would think the prognosis for a horse with congenital issues (did your vet rule out DSLD?) or soreness all around would be worse than a horse with known injury, but I'm not a vet. I might be inclined to get a second opinion in your situation. Shockwave therapy certainly can't hurt, but the jury is out on whether it actually helps, or if time is still the only real healer.
 

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Most therapies, (shock wave, magnets, dry needling, ultrasound, etc.) is designed to increase circulation. Even massage paired with some liniments.

Which works best is up for grabs. Some people swear by one, others another.

I tend to use low-tech solutions and get good results. Rest. Address any inflammation (without but). Massage, at times.

Glad your horse doesn't have tears. I'm also not surprised he had issues in the other leg. Some horses compensate more for injury than others.

PS - the ultrasound I referred to is the therapeutic variety, not the diagnostic imaging version.
 

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Discussion Starter · #6 ·
I am worried the shock wave won’t work. I’ve heard conflicting opinions about It. I also Don’t want to be out $1000 + on something that doesn’t help. I was planning on going back to school in the fall as well, so this really came at a bad time. Better to find out than later though, I suppose.

I do have to clarify some things with the vet. He seemed very positive about the whole process, but did throw out the term desmitis or degeneration out. At the time, I didn’t think too much of It since the vet didn’t seem too bothered. However, after reading up on the separate terms and DSLD, I’m really scared. My horse was at a barn 2 years ago with very deep footing in the arena. Another horse also came out of that barn with suspensory ligament issues. DSLD seems to have a genetic proponent? Or is that just a term to describe the ligament stretching enough that the fetlock drops? The vet seems to think that shockwave may tighten up the ligament enough to lift the fetlock back up a bit.

The specialist will be back in two weeks to check the leg again for progress.
 

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I will come back and post later, but if he has dropped pasterns, I would consult with the vet and farrier about putting a shoes with trailers on to support the legs, and put bell boots on. The horse may manage to get them off a few times before he adapts to the trailer sticking off the back of the shoe, so expect to need them re-tacked on a few times at first.
 

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Is it possible for you to put up a round pen, maybe 50-60ft inside of the pasture where your horse can stay? (Maybe you an offer to buy the fencing for a kickback in board, then let them keep it, just an idea) I think some walking is good, but you don't want them to have enough space to get too riled up. I think stall rest makes it hard to hand walk them without the crazys, you get the issue with shavings, at least in a pen they can walk themselves. I would see about putting in some sand. Not deep enough to hurt his legs further but enough to be comfortable.

My horse did really well in light sand footing. I also hacked him (walk, trot, canter, and galloping) out on an asphalt bike path daily after his injury when he was retired from jumping, and he went on 5 mile trail rides a few times a week up and down some big hills on disintegrated granite trails. He was barefoot at that point and sound most days, I really believe the asphalt helped his legs. It was a balancing act between exercise, rest, getting too fat to the point it hurt his legs, and letting him be able to eat.

For me, if I had another horse who ended up having tendon inflammation I would stick them out in the round pen for 6 months, do a check in ultrasound, leave out for another 6 months, and ultrasound again. After that if things look clear, bring back into work very slowly. Depending on my budget I may do ultrasounds a few more times as the horse is coming back into work to make sure nothing is becoming inflamed again. If it did become inflamed again I would have to decide if it could be managed or not, and if it's worth the drugs to continue riding. Like I said some days he was fine, so we kept going and played it by ear. I personally wouldn't do the shock wave stuff unless the horse was 8 or younger and was still growing and through it's youth could heal well enough to keep going. That's just based on my personal experience that I don't want to go through hoping it will work again.

Eventually he needed the shoes with trailers I mentioned above, but not for about 5 years after his initial injury. The dropped pasterns is scary, I've never though of that as something that could be remedied.

We gave my horse injections for his joints anyway and we gave him grand meadows which I liked him on. There's other stuff out there too, but after a long week at work it's not coming to me right now.

Maybe it will work out in some way for you where your horse can be resting in an affordable manor and you can focus on school, then you can see where things are at the end of that road.

Hopefully there's others out there who've been though this that can chime in too, as said above different things work for different animals/people.
 

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Discussion Starter · #9 ·
Is it possible for you to put up a round pen, maybe 50-60ft inside of the pasture where your horse can stay? (Maybe you an offer to buy the fencing for a kickback in board, then let them keep it, just an idea) I think some walking is good, but you don't want them to have enough space to get too riled up. I think stall rest makes it hard to hand walk them without the crazys, you get the issue with shavings, at least in a pen they can walk themselves. I would see about putting in some sand. Not deep enough to hurt his legs further but enough to be comfortable.

Unfortunately, no. In order to do that I'd have to buy a round pen and I just don't have the money for that right now, although It is a good idea! I only pay for the hay and they have talked about eventually getting out of horses, so I don't think they would reduce board. The inside of the pasture is also mucky, so I plan to keep him away from that for at least a year. Not worth the risk.

I have been thinking around those lines though. I may be able to set up a smaller fence line (electric type fence, but not plugged in) attached to the outside of the paddock. They normally have that area fenced in over the summer anyways. It would be on grass, which he really isn't supposed to have, but I could muzzle him and have him brought in at night.

My horse did really well in light sand footing. I also hacked him (walk, trot, canter, and galloping) out on an asphalt bike path daily after his injury when he was retired from jumping, and he went on 5 mile trail rides a few times a week up and down some big hills on disintegrated granite trails. He was barefoot at that point and sound most days, I really believe the asphalt helped his legs. It was a balancing act between exercise, rest, getting too fat to the point it hurt his legs, and letting him be able to eat.

Good to know! I was actually wondering if walking on asphalt would be a good idea. Do you think hand walking him on it now would be too premature? He is on week 1 of stall rest, after having shock wave done a few days ago.

For me, if I had another horse who ended up having tendon inflammation I would stick them out in the round pen for 6 months, do a check in ultrasound, leave out for another 6 months, and ultrasound again. After that if things look clear, bring back into work very slowly. Depending on my budget I may do ultrasounds a few more times as the horse is coming back into work to make sure nothing is becoming inflamed again. If it did become inflamed again I would have to decide if it could be managed or not, and if it's worth the drugs to continue riding. Like I said some days he was fine, so we kept going and played it by ear. I personally wouldn't do the shock wave stuff unless the horse was 8 or younger and was still growing and through it's youth could heal well enough to keep going. That's just based on my personal experience that I don't want to go through hoping it will work again.

hmm. Something for me to definitely think about. I understand what your saying about the shockwave. My fear I guess with not doing It is that his ligament will get worse. I feel I only have one chance to do this right.

Eventually he needed the shoes with trailers I mentioned above, but not for about 5 years after his initial injury. The dropped pasterns is scary, I've never though of that as something that could be remedied.

Yes, I'm a bit confused why the vet thought we could be back to doing second level dressage in a year or 2. Maybe he was trying to have a positive outlook on things? I'll have to clarify a few things as I want to know exactly the grade of suspensory issues my horse is having. This is all new to me, so I didn't fully understand the differences between desmitis vs tears when he was on site. I'll also ask him about the shoes with trailers.

We gave my horse injections for his joints anyway and we gave him grand meadows which I liked him on. There's other stuff out there too, but after a long week at work it's not coming to me right now.

Maybe it will work out in some way for you where your horse can be resting in an affordable manor and you can focus on school, then you can see where things are at the end of that road.

Hopefully there's others out there who've been though this that can chime in too, as said above different things work for different animals/people.
My responses are in red :)
 

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Discussion Starter · #10 ·
Also, a question for anyone who has done shockwave. Did you bandage in the stall between sessions or use back on track wraps? My vet said It wasn't necessary, but my horse is getting pretty stocked up in the hinds. I wasn't sure If it interfered with circulation coming in or not, but It's really going against my instinct to wrap.
 
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