Acute Lameness

[drewsbadboy]

My six year old gelding came in from the pasture today severly lame in his right front. He has swelling around the fetlock, which I immediately cold hosed for 20 minutes. I called my vet and he feels that he will be ok until Monday, when he will come out and take x rays. I've got him in a stall with deep bedding, given him some bute and wrapped both front legs (I put extra wraps on the injured leg to immobilize the ankle). I know that it can be a variety of injuries, but I'm thinking it is suspensory related or a problem with the sesamoids). Does anyone else have any experiences with injuries like this? I'm concerned because his leg really hurts, I've done all my vet's suggestions and he will be out to examine him first thing Monday morning. He's not acting like a severely injured horse (except for not bearing much weight on the affected leg) in the sense that he is not sweating, his respiration is not elevated, gum color is good, eyes are bright and he has a great appetite. Any experiences or suggestions would be greatly appreciated. Thanks in advance.

[TrueColours]

Did you by any chance take a picture of it before you wrapped it?

Did the vet recommend bute or banamine or Naquasone? What about DMSO painted on it?

IMO - while the immobilization and stall rest is good, I'd want to also address the pain and swelling aspect as well

If he was mine, I'd want to cold hose or ice every hour and definately not leave him bandaged without addressing the swelling for the next 48 hours until the vet arrives. Plus I'd put him on Naquasone and Banamine right away as well

Can you address those options with your vet before his arrival?

[drewsbadboy]

Thanks so much for the quick response. I did give him some Banamine and I did the wrapping per my vet's orders. I've just never had an injury quite like this before. I've cold hosed him several times and then reapplied the bandages. Does this sound typical of a suspensory type injury to you?

[Strategic Maneuver]

If you suspect a suspensory injury, be careful with your double wrap. Did you by any chance check his coronet band for any softness or tenderness? An abcess blowing out the top can cause swelling in the fetlock at times. Good luck.

[TrueColours]

Is there any way of taking a picture that you can post for us?

I am wracking my brain and I cannot think of anytime I have seen a true suspensory injury, where it was isolated and only in the fetlock area. That just doesnt make any sense at all to me

is it on the front or sides of the fetlock in the joint area? Or in back and above the fetlock where the suspensories and tendons are located?

Is the swelling equal all the way around or more isolated on the inside or outside, or front or back? Is there pain on palpation?

Do you have some DMSO you can paint on there? And what about Naquasone? Do you have any? The Naquasone will pull all of the fluid from the affected area and the swelling will noticeably subside

Let us know on the swelling aspect

[Strategic Maneuver]

If you suspect a suspensory injury, be careful with your double wrap. Did you by any chance check his coronet band for any softness or tenderness? An abcess blowing out the top can cause swelling in the fetlock at times. Good luck.

Total brain fart, please disregard, you are talking fetlock and I'm picturing pastern. Stupid.

[drewsbadboy]

Here's a picture. You can see the swelling in the back of the ankle around the sesamoid area. My vet (who is excellent with leg injuries) feels comfortable with seeing him Monday...however, if he takes any turn for the worse I will insist that a vet sees my horse before that. And there is heat behind the ankle and slightly above it (which is why I'm suspecting suspensory and/or sesamoid damage...does that seem logical to you guys?)

[img][img]http://i713.photobucket.com/albums/ww134/drewsbadboy/Irish-injury007.jpg[/img][/img]

[drewsbadboy]

Vet was here this morning. I was just too worried to wait until Monday. Xrays have been taken and we will know something this afternoon. He definitely has injured both his suspensory and the tendons in this leg, so stall rest, bute, cold hosing and leg wraps are his future for now. My vet feels that it is not life threatening in his case, just career threatening. (Which is fine with me, I can deal with having an extra big pet )
I will let you all know what the xrays show later today. Thanks for all of the help.

[TrueColours]

Oh what a bummer! Did he ultrasound as well or just x ray?

Did he feel that he pulled or strained the tendons and/or ligaments down at the bottom where they attach around the fetlock joint? I wonder if he hyper extended that area, or whacked it with another leg

Was a bone bruise a possibility or did he feel it was definately tendon and/or ligament related?

Poor guy - please do let us know what the vet tells you

[Diane]

So frustrating when you pay for a sunday farm call and you have to wait for best answer. As TC asks, vet didn't ultrasound? Last time we had a tendon without tearing but just enlargement of sheath/capsule (?) the treatment included putting a wedge pad with heel support. You might want to put a call in to your farrier today to alert him you might need a visit Monday-Tuesday if your vet suggests shoeing modification. My farrier likes it when I call him because the vet suggests something. He usually comes readily but a heads up to adjust a busy schedule is generally appreciated.

[cewright]

Not being a vet and not having the horse in front of me, I am questioning the advice you have received. First your vet tells you it does not sound like the injury is that bad and it can "wait 'til Monday". You get worried and pay for a Sunday call and now the injury is maybe career threatening. I am also surprised you need to wait for the results of the radiographic exam. Many vets today use digital equipment. Many also feel ultrasound is more appropriate for soft tissue issues. If it was my horse I would quickly seek out an experienced equine lameness vet and get a second opinion.

JMO - Chuck

[drewsbadboy]

Not being a vet and not having the horse in front of me, I am questioning the advice you have received. First your vet tells you it does not sound like the injury is that bad and it can "wait 'til Monday". You get worried and pay for a Sunday call and now the injury is maybe career threatening. I am also surprised you need to wait for the results of the radiographic exam. Many vets today use digital equipment. Many also feel ultrasound is more appropriate for soft tissue issues. If it was my horse I would quickly seek out an experienced equine lameness vet and get a second opinion.

JMO - Chuck

Thanks so much! This vet is very good with leg injuries and the reason for the xrays was because sesamoid fractures are obviously a big concern. And any suspensory injury is potentially career threatening for a hunter/jumper (or any horse for that matter). I realize that they can be rehabilitated and return to their former sport, but the fact is that it's impossible to tell until the horse has had time for the injury to heal. Upon palpation he could tell that the tendon is injured as well as the suspensory. The plan is to see what the xrays show, rest him and ultrasound at a later date. Not all vets use the digital xrays...so I have to wait a little bit (sigh). However, I feel much better spending some money and having a professional (whom I trust) let me know that my horse is not catastrophically injured.

[drewsbadboy]

Just got a call from the vet...no fractures!!! Yeah!!! Now we're just going to do stall rest, wraps, bute (only a few days for the bute), and cold water therapy. He will be checking him in a few weeks to see his progress. I'm relieved that it's not as bad as it could have been; thanks so much everyone for the thoughts, advice and opinions. They are all appreciated! Best wishes to all and I'll keep you guys posted on his progress.

[TrueColours]

If I had a choice between a fracture and a pulled tendon or suspensory, I would pick the fracture every time to be honest, because generally once they heal, if you give them enough time to do so and calcify, they generally wont cause any more problems ...

Tendon and/or suspensory issues - whole 'nuther ballgame ... they can take forever to heal and because the scar tissue that will form doesnt have the same elasticity as the original tendon or ligament did, it will always and forevermore be the "weakest link" for that animal

That is why - IMO - an ultrasound is imperative to see what you are dealing with. A tear or inflammation or ??? Right now you are flying completely blind. I am amazed for a vet that you mentioned was an excellent leg man, that isnt the first thing that he did

I'd have another chat with him to be very honest ...

[drewsbadboy]

Thanks so much! I will ask him again.