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I have a 9 year old Event horse that has a hole in the left

 
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Customer Question

I have a 9 year old Event horse that has a hole in the left front suspensory at attachment. also mid-body old adhesions and old hole that never completely healed. What are the best options to rehab this horse? I have heard of shockwave, shockwave with SDFT (?) and platelet plasma injections. Just want to know which direction will be best. he is off for the rest of the season. I have him in a large box stall with an ice bandage. Thank you.

Submitted: 309 days and 11 hours ago.
Category: Horse Veterinary
Value: $18
Status: CLOSED

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Expert:  Dr. Gabby replied309 days and 10 hours ago.

Hello. Thank you for asking your question. My name isXXXXX will try to help.

My own horse had a 16 cm x 1 cm tear at the insertion of the suspensory on the L front as well. I had a surgical specialist do a procedure where they make tiny incisions in the fascia that covers that area. This increases blood supply to the area. The told me she may never be sound again and 4 years later, we are showing FEI dressage. So I would recommend the fasciotomy. 6 months of rehab and then back to normal work.

I tried shock wave. It is a temporary fix. It helps short term with the pain. It does not seem to help speed up the healing.

Platelet rich plasma is also effective because it increase the blood flow to the area which speeds up healing.

The shock wave can help break up adhesions though. But you could get those reduced if you had the fasciotomy done.

I also used a cold laser, on the leg, every day. This increases blood flow to the area and help with collagen repair. You can rent one online.

I have not seen very good success with stem cells which is where they harvest tissue from the hip, and then plant it into the affected area.

So do not give up hope, my horse had one of the worst injuries and she has been sound for three years.

You will have to be very careful when you rehab.

I would go to a surgical specialty clinic or a veterinary school.

 

Journal of the American Veterinary Medical Association
Volume 229 | Issue 3 (August 2006)
Outcome of desmoplasty and fasciotomy for desmitis involving the origin of the suspensory ligament in horses: 27 cases (1995-2004)
J Am Vet Med Assoc. August 2006;229(3):407-12.
Christina A Hewes1, Nathaniel A White
Marion DuPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Leesburg, VA 20177, USA.

Abstract
OBJECTIVE: To determine outcome of percutaneous ultrasound-guided desmoplasty with simultaneous fasciotomy for proximal suspensory desmitis (ie, desmitis of the origin of the suspensory ligament) in horses that have not responded to stall rest. DESIGN: Retrospective case series. ANIMALS: 27 horses. PROCEDURES: Medical records of horses with proximal suspensory desmitis treated by means of desmoplasty with fasciotomy were reviewed. Follow-up information was obtained through telephone conversations with owners and trainers of the horses or by examination of horses at the hospital. RESULTS: 23 of the 27 (85%) horses, including 3 of 4 horses with forelimb lesions and 20 of 23 horses with hind limb lesions, were able to return to full work after surgery and rehabilitation. All horses had ultrasonographic evidence of healing of suspensory ligament lesions. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that desmoplasty with fasciotomy is a viable treatment option in horses with proximal suspensory desmitis that have not responded to stall rest.

Short term analgesic effect of extracorporeal shock wave therapy in horses with proximal palmar metacarpal/plantar metatarsal pain.
Vet J. January 2009;179(1):50-9.
Isabel Imboden1; Nina M Waldern; Thomas Wiestner; Thomas Wiestner; Christoph J Lischer; Gottlieb Ueltschi; Michael A Weishaupt; Michael A Weishaupt
1Equine Hospital, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland.

Article Abstract

Extracorporeal shock wave therapy (ESWT) is an accepted form of treatment for chronic cases of proximal suspensory desmitis (PSD). Subjective evaluation of horses shortly after being treated with ESWT has led clinicians to comment on an immediate reduction in lameness. This study aimed to evaluate the analgesic effect of ESWT on 16 horses with PSD or PSD-like pain in a fore- or hindlimb. To objectively assess lameness, gait analysis was performed on an instrumented treadmill before and 6, 24, 48 and 72h after ESWT of the origin of the suspensory ligament and the results compared to the effects of local anaesthesia. Stride frequency, stance duration, vertical impulse and peak vertical force were determined. Thermographic imaging and evaluation of skin sensitivity of the treated area were carried out before and after ESWT in the same interval as gait analysis. The results showed that there were no significant improvements in the investigated parameters at any time after ESWT; however, in horses with affected forelimbs the contralateral weightbearing asymmetry decreased significantly 72h after ESWT. Neither skin sensitivity nor thermographic imaging revealed changes that could be attributed to ESWT

If you have additional questions, please click "reply." Thanks

Dr. Gabby41134.8645142708

Expert TypeHorse Veterinarian
Category: Horse Veterinary
Pos. Feedback: 97.6 %
Accepts: 283
Answered: 8/13/2012

Experience: DVM for 14 years, Equine chiropractor, Riding 34 years

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Expert:  Dr. Gabby replied307 days and 7 hours ago.

Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Gabby

Customer replied302 days and 11 hours ago.

I am having trouble finding the right cold laser to purchase. I looked on-line for rentals and think it may be in my best interest to purchase one. She is on week 3 of stall rest. She is wrapping her at night with poultice and we cold-hose her 2x/day for 20 minutes.I will also inquire about the fasciotomy you had recommended. Thank you for your help!!!!! Fondly, Susan Ahern

 
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