Tendon/ligament injury - Dpony

[needastrongone]

Hi there, would appreciate some advice.

Found Dpony a week last Monday completely unable to weight bear in his field. Clearly in considerable pain.

Emergency Vet called naturally, sedation and a thorough examination in the field before moving him to his stable via the trailer. Sedation allowed a touch of weight bearing, which the vet was pleased about.

Diagnosis was tendon/ligament related. Complete box rest for 5 days. Then walking 5 times a day on hard surfaces. Sadly, he developed colic on the Friday (stress, change in diet, routine etc) so Vet was back out then!

First 24/48 hours showed massive improvements. There has never been any swelling or heat strangely and he walks fine on hard surface but his leg 'gives out' every so often on soft surfaces even after nearly 10 days.

We've had a tough week or so getting DD and myself to farm that many times a day, but love our pony and will do whatever it takes.

Yesterday, we rigged up a paddock in a very quiet field and let him graze there with a companion while we mucked out, a total of maybe an hour, injury no worse for this. The usual paddock is where he can see his own field and (more importantly), the mares, which, frankly, sends him loopy usually I plan to have him in this quiet field where he can't get too excited until he's absolutely fully sound.

Vet now wants us to move towards gentle turnout, which I completely understand, I would want to move about and shake off any stiffness if I had a strain and I am not sure the rest is having any further benefit. Plus, I want him out as much as possible over winter anyway, I don't want to baby him. I am just scared of going backwards with him!!! We are going on a long planned holiday next week and, while we have very good friends who will help, I can't realistically expect this level of commitment if he re-injures himself.

We have a physio calling back but not sure when they will treat him as he's quite sought after round here.

Just looking to vent a bit really, I am a worrier but want to do the right thing too.

[needastrongone]

ps - frosty - he did great for 48 hours, further our previous 'conversation', then he's stuck at this stage!

[frostyfingers]

Tricky - they always manage to do things when you're about to go away. Have a chat with your vet about possible problems and with your friends and ask how much they could help if necessary. My insurance covered b&b for dhorse after his op, would yours do that, does your vet have somewhere he could go if it was really that bad? Could you/would you think about sedation for a short period to keep him chilled out? Random questions but may give you some ideas.

FWIW I sprained my foot a month ago - it swelled up massively and was agony for about 3 days, that has gone and the pain is intermittent, I'd probably be about 3/10ths lame if I were trotted up! Maybe this is what's happening to dpony - the worst has gone, and he just needs time to finish mending.

[Booboostoo]

I am not a vet but this is a weird diagnosis from your vet. Non-weight bearing injuries are not usually tendons/ligaments. Tendons/ligaments injuries cause mild (although of course still serious) lameness.

Tendon/ligament injuries usually have swelling that goes down after the first 48 hours (with rest and cold hosing) and they do NOT lead to the leg 'giving out'.

Also, how could the vet say it was tendon or ligament, doesn't he have an opinion on which one it is? Didn't he scan the area and tell you the severity of the tear and exactly where it is? Not to mention that ligament injuries show up on the soft (surface) but tend to be sound on the hard, while tendons are lame on the hard and tend to be sound on the soft.

What is the physio supposed to do for a ligament or tendon injury so early on in the recovery?

Sorry to worry but it all sounds weird. Is your vet an equine vet? You may need a second opinion.

[needastrongone]

Booboostoo - I have had the same niggling feeling all week to be honest so I did call the vet again today and insisted that the main guy come out.

I am so glad I did, as he is seriously concerned about Dpony and the significant lameness he still has, plus he feels all four feet are showing signs of pain, early lami etc. He's lost a significant amount of weight too.

We are booked in on Monday for full scans, X-rays, nerve blocks etc to root out the issue and he's been placed on full box rest again.

We are new to owning a pony, it's been a rollercoaster of a 6 months and I honestly wish we hadn't done it!

Frosty - I think if he's on full box rest then we will have cover, but will have to wait to see what Monday brings anyway.

[needastrongone]

And vet's hunch is feet in any event.

[Floralnomad]

Good luck with it , I hope it isn't laminitis as that's a terrible illness .

[Booboostoo]

I am sorry it might be lami, but it is a better 'fit' and at least your vet is onto the problem now.

Are the pulses elevated? How does the pony react to hoof testers? If you suspect lami you won't do any harm by putting the pony on a very deep bed to cushion the feet and giving him wet hay. Has the vet started him on Equipalazone and ACP?

[Booboostoo]

Sorry just to add...it could still just be an abscess so don't panic quite yet. Sometimes the most spectacular lamenesses have the easiest solutions.

[frostyfingers]

A farrier's opinion may also be worth asking for - I quite often ask them first if I think something is foot related. Had he been recently shod? Sometimes a pricked foot can lead to an abcess as Boo mentions.

[needastrongone]

The farrier came out the week before he became so lame, he isn't shod and never had been. I specifically asked about his feet condition and as usual, the answer was 'lovely'. I actually pay extra than some of the other guys at the farm for this farrier as he has such a good reputation, I feel sure he would have spotted something?

Boo - I might have got my terminology wrong if it makes a difference, vet said 'borderline' lami? His pulses WERE elevated in all his feet, vet checked all other major joints for pain and didn't find a reaction, no heat or swelling, but 5/6 lame in his front left leg, which he couldn't explain without tests and pain in his feet. He did say possibly the stress of being boxed can increase the risk of lami, although he did ask when the farrier last called and if he had recently changed fields (he changed sections of one large field but it's all the same grass, there are no particularly lusher sections)

I just want him well, DD is making such a huge personal effort to look after him that many folk are offering their support and help, which is encouraging for when we go away. She gets up at 6am with me and we go sort him, then she mucks him and the companions stable too, plus we were walking him up the lane 5 times a day!

Ref stable - thickly layered and banked.

We've started hiding small bits of carrot in his hay net and puttinh apple in his water to relieve the boredom, vet has given us calmex, but says actually, the first two weeks often are the worst for the pony.

[needastrongone]

Oh - he's 5/6 lame if that makes sense in front left, even with 10 days rest.

[Booboostoo]

If it is lami don't give him any carrots or apples, it will only make him worse (or any hard feed at all, just wet hay) - he should also be on Bute and ACP (which is a vasodilator and helps in lami cases. Calmex seems to be a herbal remedy so probably on the useless side for acute lami. Sorry to be so rude but your vet still sounds odd, bute and ACP are standard treatment for lami.

There is some really good information on laminitis here:
www.laminitis.org/


Barefoot horses can still get abscesses and it may be (pure speculation here) that he has an abscess in one hoof, the pain from which has triggered stress laminitis.

If it is laminitis he should be tested for Cushings.

[needastrongone]

Hi, just wanted to post an update.

The vet is an equine specialist with 25 years experience and we have known for 5 years via other parts of our life. I trust him. I was very cross about the first vet from the practise that they sent, but given out vet was on holiday, I had little choice. Have made my feelings clear!

Anyway, no signs of laminitis at all today, probably was the change in weight bearing and the small amount of grass he was having with limited turnout. Whatever the reason, no lami signs at all. I asked about the apple thing; giving a few bits of apple to a pony that has no history at all of lami is fine. In any event, whatever the cause, he's fine in this regard now with no bute or wet hay etc.

Sadly, the vet had him all day and nerve blocked all the way up his leg, starting from his foot and working up and couldn't identify the problem. He x-rayed all legs, checking in the main for spiral fracture. Apparently, our pony has, quite astonishingly, no wear and tear at all on any if his joints even at 12 and who has worked quite a lot.

So, next week, our pony goes nuclear scintigraphy, they make him radioactive essentially but can then scan all parts on him, it allows them to identify areas of the body that have increased blood flow, which would indicate injury. Then from there, they can devise a treatment plan or operate as appropriate. Can only do one a week as the staff can only be exposed to certain levels of radiation.

It's nothing we have done or not done, not the pony racing or any lack of care, just terribly unfortunate.

Thanks all for your concern.

[frostyfingers]

Well that's sort of good news but a bit of a puzzle to put it mildly. I hope pony going nuclear isn't as dramatic as it sounds but gives you some sort of answer.

[needastrongone]

I googled it, it's very high tech! He has to stay there for 48 hours with minimal handling but completely safe.

However, given the vet had nerve blocked him as much as he could without going up into the shoulder, which apparently would be reckless, and nothing touching the lameness and no X-ray results, then we have little choice!

Ho hum.

[Booboostoo]

A scintigraphy is a brilliant diagnostic tool. Generally it is used after other options have been exhausted but if your vet feels it is necessary it will certainly give you some answers.

Laminitis is very unlikely to go from non-weight-bearing to absolutely fine with no bute/acp and so quickly.

Hope you get an answer and a treatment!

[needastrongone]

Thank you. Do you think the fact that he was only ever borderline made a difference? Vet mentioned that horses carry 60% of their load on the front and him shifting his load to compensate might have caused this but he says a lot of technical stuff and I find it hard to take it all in!

In any event, it's not there now and there's no 'damage' if that's the correct word to any of the structure in his feet.

We are thankfully insured but have a £3k limit (plus an extra £1k for vet recommended treatments), insurance have indicated there would be no reason not to pay, given no previous medical history, but I suspect a bill ourselves. Damn, feel a bit stupid not getting more cover but he's never ever had anything wrong with him, I have his medical history.

It's Sod's law, never claimed on house insurance in 20 years!

[Floralnomad]

Your main issue with insurance will be exclusions in the future . Would it not be worth seeing how he goes for a couple of weeks on box rest before doing the scintigraphy.

[Lovesswimming]

Sorry to hear you're going through this and I hope they find the cause. Who are you insured with?
You will still have future exclusions even if you dont claim so you may as well put it through as most insurers ask for vets records and don't cover anything that has been previously treated or even the limb that has been previously treated! I've never claimed on any insurance but have claimed 4 times on horse insurance. If there is any mention of Lami on his record he will have an exclusion for it in 12 months time though sometimes vets can have argue your case for you and have the exclusion removed. I looked after a horse who was 9 10th lame in one front leg, she was put on a drug to help prevent Lami as you say at risk due to the weight shift. She was at the vets though.
I hope they find something and that he makes a good recovery

[Floralnomad]

Did the vet get to the bottom of the lameness needastrongone ?

[needastrongone]

Hi Floral, thanks for asking

The bone scan got to the bottom of the issue, he had small fracture in his elbow. They operated on Friday and put in a plate, after lengthy discussion re prognosis, cost etc.

The operation went well and he has size, age and build on his side (13.1 and very slight). The only caveat the surgeon had was how 'old' the break was, so the advice of the first vet was a real issue here and I will be having protracted discussion with our own vet (one of the partners) when he eventually calls back. I am angry that the time delay, mis-diagnosis and advice to begin small frequent walks and limited turnout, meaning the break was healing incorrectly or could have been made very much worse could have had serious implications for his potential recovery.

As it happened, the surgery went as well as it possibly could have and his post operative recovery has been fantastic. He could have come home today but sadly, we are trailer-less until Friday. He's happy and alert(read nosey) and standing well on the leg.

Long period of box rest and slowly bringing him back to work but hopefully, he should be good to ride in approx. 3 months. We will not rush as there are other ponies that DD can ride or even do a games season on if required.

Insurance will pay but we will be well out of pocket too, but I can't just give up on a pony can I, as some suggested at Pony Club, nice bunch eh?

[Floralnomad]

Oh dear that's awful , did they have any suggestions as to how it happened ie was he kicked ? not that it makes much difference just nice to know . You will get that kind of attitude from some sections of the horse owning community ,to lots of people they are not family pets . That said horses with fractures can be extremely problematic in recovery and its a difficult decision to make . Box rest ,in itself ,can lead to lots of problems and please be on the lookout for colic . Good luck with him and best wishes to your daughter .

[needastrongone]

No kick marks, swelling, heat at all. Vet's best guess is a fall in the field. I had worried that he had done it pony racing the day before, given he was just so 'pumped' the whole day and quite a handful (although very successful as it happens!) but vet and even vet surgeon assure me not, although I can't help wondering.

Yes, he's already had colic, or the early stages, but seems to have settled to his lot now and very chilled in the stable (vet said, in his experience, the first couple of weeks are the toughest). We have a myriad of things to do to keep him occupied.

The surgeon was surprisingly optimistic for his future and saw no reason why he couldn't return to full work (for us, hacking, jumping and games in the main), just may suffer with a tough of arthritis in older age. As previously stated, he's very slight, which seems to be a big benefit for this injury. We visited him both Saturday and Sunday (the clinic is well over an hours drive away, closer 90 minutes), I saw some horses with very similar injuries in 'slings' who had been there over 2 weeks, so I am pleased they deem him fit to go home after 5 days.

I don't get the 'commodity' thing, I love our pony and will do right by him, but understand we have the luxury of 'spare' ponies at the farm for our long term use (and good friends to offer such kindness).

[Floralnomad]

I don't get the 'commodity' thing either ,we don't sell anything and all my horses have had long and happy retirements before their eventual end . At one point we had 2 retired horses ,a retired Shetland and a horse on long term sick leave but that's how it goes. At the moment we have a retired 20 yr old Dartmoor pony on full livery . To us our horses and ponies are no different to the family dog . I'm pleased your vet is so optimistic and will keep my fingers crossed for you .

[needastrongone]

Thank you again.

The only possible reason for me taking a different view would have been if the prognosis for a 'useful' future was very slim. He's only 12, enjoys being ridden, taken to all the new stuff we have thrown at him with good spirit and willingness.

Had it been that we would be out of pocket to the tune of 000's (which we will be), with a relatively young pony that could not be worked again or suffer pain, then I might have considered that not in anybody's best interest (our pockets are not endlessly deep and pragmatism kicks in at some stage) but our odds seem relatively positive and I will take that chance.

He'll be with us for life though, even if loaned from the yard.

Bet you are glad you don't have that many equine family members now!