Rehabbing a fractured pelvis

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Rococoms
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Rehabbing a fractured pelvis

Postby Rococoms » Thu Nov 23, 2006 9:30 pm

Welcome to my litany of woe ;-) Long story short, I recently brought home a 2 year old TB filly who fractured her pelvis in June training to race. She spent a month in the hospital immediatley after the injury being treated for complete cauda equina (she couldn't pass feces or urinate on her due to nerve damage for about 3 weeks), and was on a line and kept from laying down for a month. Initally after that was doing great, then began to develop severe muscle atrophy on the affected side. 3 months into her stall rest, and when it became clear that she wouldn't be racing anytime soon, or be able to go through auction soon, she became a giveaway, and thus came to me.

Her inital discharge from the hospital only identified her injury as a luxated sacrum, and reccomended 3- 6 months stall rest. No bone scan or radiographs were taken, but ultrasound and rectal exam confirmed pelvis fx. Her tail remains paralyzed, but she passes feces and urine with no trouble. I got her at 4 months post injury, and over the last two months, have begun very small amounts of handwalking (ie started at 1 minute, was up to 5 mintues). All was going rather well, and even the atrophy was becoming slightly less defined. Hardest part has been keeping all four feet on the ground while walking, since she would much rather buck, rear,leap etc than walk nicely.

But, the last 10 days or so, she seems to have become more agitated about her hind end again, especially when we walk, so I stopped walking her on my vets reccomendation. Today, we were grazing just outside of her stall when she took a step, and it seemed like it stung- started kicking out with that leg and got very upset. She got over it in a few mintues, but it certainly shook me up.

Of course, now I'm terrified that we shouldn't have walked, and I re-broke her, and now these several incidencies over the last week have been the new (or old) injury being tweaked and loosened. Other possibility is that because of the severe nerve damage she has in the area, and some of the therapies we've been doing have been to restore the area, maybe the discomfort is actually nerve tinglings?

Has anyone been through this at all? Any thoughts? I was going to take her back to the hospital, but since they never bone scaned her before, they said it would be not useful to do so now. I was even going to haul her up to Davis to get a complete work up, but their feeling was that no matter what we spent trying to image and work it up further, the end result would still be stall rest, so why not save the money and just sit tight. But I don't sit tight well. So, ideas anyone?

FYI, this filly is in a 12X20 barn stall, geting multivitamin supplements, joint supplement, Ameredon's Rapid Response F (used topically EOD as well), Ameredon's UnTyeMe, and has a blanket with magnets on the affected side that we've just gotten for her. She's had the chiropractor out twice for her, as well as muscle manipulation of the hind end daily.

I have photos I'll try to figure out how to post of the hind end atrophy. Thanks in advance for any help!

Evenheaven
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Postby Evenheaven » Fri Nov 24, 2006 9:49 am

I had a 2 y.o. gelding fracture his pelvis after a surgical geld at the university from when he woke up from surgery (apparently he didn't get up well). We nursed him for 4 months after the initial fracture and things were going well - as described in your situation. Unfortunatley, he took a turn for the worse - when hand walking (which was difficult because he wanted to run/buck/rear, etc) I noticed a similar situation where it seemed like something "stung" him which wasn't possible for the time of year. Needless to say, he developed internal bleeding and I had no choice but to put him down. I hate to share this with you because it was so hard for us, but while reading your situation, I felt like I was reliving ours from a couple of years ago. Good luck!
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clh
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Postby clh » Fri Nov 24, 2006 8:40 pm

I wish I too had better news for you. We had one mare that fx her pelvis while at a boarding farm foaling. Put the foal on a nurse mare and brought the mare home to our farm on stall rest. Couldn't x-ray because the clinic said she would injure herself more coming out of the anesthesia. She would occasionally weight bear, but would pile up her straw in the stall and actually rest her hind leg on it. Kept her legs wrapped and kept her on meds for pain control. Cut her fresh alf. every day from the field, two to three times a day. She dropped weight dramatically the first two months of her injury and then slowly started putting it back on. She foaled in March. By August we thought she might be improving but by September she was taking a turn for the worse and would actually try and kick at me when I went in the stall to clean, feed, wrap her legs. Decided to put her down. Walked her out to put her down and she walked like a dream so we decided we'd wait a little longer. Started hand walking her and letting her graze, hand walking a little bit at a time - she then got worse again and we decided we needed to put her down which we did. Had a necropsy and her fracture was at the pelvic/hip joint junction. They said it never would have healed. It was very traumatic for me - even while she was plotting to kick the tar out of me I wanted her to recover. In the end we were just glad she got out of her stall once in a while for the last few weeks of her life. Am not sure I would try rehabbing that kind of fracture again although we were told if it was just a fractured pelvis it would heal on stall rest in five to six months. We were fortunate she didn't have any other health problems (legs, etc...) although I swear if anyone had seen her the first few months they would have sworn she was a being starved. Good luck! It is difficult.
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Prairie
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Postby Prairie » Sat Nov 25, 2006 11:40 pm

A mare at our barn had fractured her pelvis several years ago. On the advice of the vet, she was stall-bound for many months. She survived and healed. Her hip area looks quite lopsided as a result of muscle atrophy, but her owner has saddle-trained her and is able to walk, trot and canter on her--her owner is very careful not to overdo it, though. The vet has cautioned that the mare should not be bred due to her injury.

The mare's injury is apparent, she can't be bred or shown as a result of the injury, but other than those issues, she lives her life as a normal, healthy and happy horse. Her owner adores her and enjoys her immensely.