# Collateral Ligament injury - need some advise please!!!



## Celtichorse

Has anyone here successfully rehabbed a horse with a ligament injury and if so - what did you do? Any input would be great! 

The vet diagnosed my mare (via ultrasound) and prescribed an asymmetrical shoe along with pads, hand walking for 15 min. and working my way up to 30 min. after about 3 weeks. Then riding at the walk in straight lines for 15 min. and working my way up. No real stall rest (due to her temperament) cold hosing and liniment.


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## Lisa in WA

Celtichorse said:


> Has anyone here successfully rehabbed a horse with a ligament injury and if so - what did you do? Any input would be great!
> 
> The vet diagnosed my mare (via ultrasound) and prescribed an asymmetrical shoe along with pads, hand walking for 15 min. and working my way up to 30 min. after about 3 weeks. Then riding at the walk in straight lines for 15 min. and working my way up. No real stall rest (due to her temperament) cold hosing and liniment.


i've had tendon injuries (bow) but not ligament. So she's to be turned out? Or you mean in the stall besides the hand walking?


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## Celtichorse

The vet didn't think she needs to be on stall rest and to be honest she is a total nutjob when she is confined for more than 24 hours - bucking, rearing, pawing in a 12x12 stall - which is totally counterproductive. She is much, much calmer when she is with her buddy in turnout. But I know from past experiences with a friend's horse that these kind of injuries require long term stall rest, so I was surprised when that wasn't part of her rehab program. I do wonder how this will affect her and if it will make her recovery take even longer.....


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## wr

I have dealt with ligament issues but I was told that you have to keep them stalled to restrict movement so they can heal and it seems counter productive to go through all the trouble of hand walking and doing the straight lines, if I horse can move freely the rest of the time.

Is this a pleasure horse or are you planning used for competition? I've seen some restored to sound enough to be used for light pleasure but I can't think of any that recovered and competed.


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## Celtichorse

She was supposed to be used for trail trial and competitive trail.... but I doubt she will hold up to that after this injury. We live in very hilly terrain and trail riding may not be ok for her anymore either. I'm considering putting her in a paddock to restrict movement and maybe that will do the trick. I can keep her buddy in the paddock next to her and maybe that will keep her calmer.... I've tried "Calm and cool" and stuff like that on her before and it didn't work very well - the vet had to tranq her twice for the exam - to give you an idea. 
My friend had a horse with a suspensory injury - now the horse is doing 3 Level dressage and progressing.... BUT she used shock wave therapy and injections to help things along. I don't really have that option, so I'm trying to do the best I can with the "conventional" rehab program and hope for a good outcome.


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## wr

Is there underlying issues causing that level of anxiety?


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## Celtichorse

No underlying causes that I know of. She gets plain old grass hay, no grain and she is calm when she gets worked regularly - she has a lot of energy and loves to GO. I would describe her as a "busy body" - not really anxious.


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## Irish Pixie

I can't really add much to what has already been said except follow your Vet's advice and I'm sorry this happened.


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## sidepasser

I would do what the vet advises, but did the mare tear her ligament or is it merely strained?


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## Lisa in WA

One thing the vet did have me do with the bowed tendon (besides stall rest and the regular stuff) was to swab DMSO on it to reduce the inflammation.


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## Grumpy old man

Put her on a bute ( Phenylbutazone ) diet for a few weeks and let her heal it's a pain/ anti inflammatory and will calm her down and allow healing . I have used this for many many years on the farm Horses and it works great . and they work for a living !


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## Lisa in WA

Grumpy old man said:


> Put her on a bute ( Phenylbutazone ) diet for a few weeks and let her heal it's a pain/ anti inflammatory and will calm her down and allow healing . I have used this for many many years on the farm Horses and it works great . and they work for a living !


If the horse isn't on stall rest and is given bute there is a good chance she won't feel the pain of the injury and will continue to use the injured limb and make it worse.


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## Grumpy old man

LisaInN.Idaho said:


> If the horse isn't on stall rest and is given bute there is a good chance she won't feel the pain of the injury and will continue to use the injured limb and make it worse.


Sounds like therapy to me , A relaxed horse is not out trotting around the field and un medicated this horse sounds like a major accident waiting to happen ! Slow purposeful walking IS what the vet suggested ! By Not using the limb she would be more inclined to contracture of the ligaments which would just hinder the recovery further and SOMETIMES an old farmer may have a good idea ! That horse will NEVER be sound enough for serious competition again .Sorry and assuming that she would be is just a bad idea right up to the time she is compleatly lame in the middle of a competition .Is it really worth it ?sounds like it might be time for brood mare duty !


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## Lisa in WA

Grumpy old man said:


> Sounds like therapy to me , A relaxed horse is not out trotting around the field and un medicated this horse sounds like a major accident waiting to happen ! Slow purposeful walking IS what the vet suggested ! By Not using the limb she would be more inclined to contracture of the ligaments which would just hinder the recovery further and SOMETIMES an old farmer may have a good idea ! That horse will NEVER be sound enough for serious competition again .Sorry and assuming that she would be is just a bad idea right up to the time she is compleatly lame in the middle of a competition .Is it really worth it ?




Er.....my horses kick and buck and rear and gallop when turned out. Not all the time but they do it. That kind of behavior can easily cause more problems. WHy are you supposing the horse won't be trotting,etc on bute?
Not saying old farmers never have good ideas...maybe the vet did put the horse on bute. I wouldn't do it though unless the vet gave me the okay.


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## Grumpy old man

have you ever used it ? Not personally but on a horse ?


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## Lisa in WA

Grumpy old man said:


> have you ever used it ? Not personally but on a horse ?


Are you serious? What horseman/woman hasn't? Are you under the impression that bute is some kind of new wonder product?
Are you thinking that Bute is a sedative too?


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## Grumpy old man

LisaInN.Idaho said:


> Are you serious? What horseman/woman hasn't? Are you under the impression that bute is some kind of new wonder product?


I would think the "grumpy old man " title might give some insight , The point is it's NOT some NEW wonder drug and I have been working horses for many many years ! Just like performance cars performance horses are prone to serious breakdowns /injuries and any owner should be prepared for these outcomes . When you take an animal and make them PERFORM at high levels these things happen . Consider the horse not the blue ribbon . And yes I'm serious !


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## Irish Pixie

Lisa is right, Bute is a painkiller and an anti inflammatory, if a horse can't feel pain it could do things it shouldn't and exacerbate the injury. This would be more easily done in turn out than stalled where movement is restricted. 

In this case, with this horse, the Vet may have prescribed Bute but the rule of thumb is Bute and stall rest.


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## Celtichorse

Thank you for all the advise. I will keep her in a paddock, use liniment and DMSO and start hand walking her as soon as my farrier gets the new shoes and pads on her (tomorrow). The ligament didn't tear, but the ultrasound showed some remodeling and fibrosis of the ligament (normal for the healing process, but that's what causes the ligament to become less elastic and more prone to re-injury and the fibrosis could calcify if the ligament is not being used). She is sound at the walk and grade 2 lame at the trot on a circle and grade 1 lame on a straight line. The vet told me that as soon as she is ok at the trot on a straight line I can start riding her (in straight lines on even ground at the walk). He doesn't recommend to use bute because he was worried she would re-injure herself. He suggested topical treatment for the inflammation (that is rather moderate). Thanks again for your input!!! It's much appreciated.


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## Irish Pixie

I've had good luck with Sore No More gel, but I recently used some Absorbine (it was what I had) on my TB mare and while on my hand the swelling and pain was better than it had been in quite awhile. Stinks to high heaven tho.


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## GrannyCarol

BTW, for a little thread drift... I found that for a horse with chronic pain, where you do want to manage the pain, that B-L pellets work almost as well as bute and without the side affects. 

Sounds like the owner and the vet have this under control with a plan though that covers the horse from re-injury from general horse silliness and still works the ligament to keep it free.


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## Lisa in WA

GrannyCarol said:


> BTW, for a little thread drift... I found that for a horse with chronic pain, where you do want to manage the pain, that B-L pellets work almost as well as bute and without the side affects.
> 
> Sounds like the owner and the vet have this under control with a plan though that covers the horse from re-injury from general horse silliness and still works the ligament to keep it free.


I like to hit it with a good dose of bute first to really slam down the inflammation and then follow up with BL. The biggest issues with bute come with longer term use.


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## Molly Mckee

If she is sore enough on the leg to favor it or not put a lot of weight on it, it would probably be better not to relieve the soreness. She will be less likely to cause more damage, as long as she is calm enough to remember it hurts!


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## where I want to

You might look into ultrasound therapy or laser therapy. I have used both although not for that injury and have been surprised at the effectiveness- To me it sounded like voodoo but it worked.


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## Lisa in WA

where I want to said:


> You might look into ultrasound therapy or laser therapy. I have used both although not for that injury and have been surprised at the effectiveness- To me it sounded like voodoo but it worked.


CelticHorse posted that ultrasound wasn't an option for her.


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## Celtichorse

The problem with shock wave and ultrasound therapy is that the vet with the equipment is well over an hour away from me and doesn't do housecalls..... My mare is not favoring the foot at all (even without bute or any other anti-inflammatories) which is good and bad - good, because that means she's getting better, bad because she is using the leg to turn on etc. So the new shoes are supposed to keep her from re-injury by keeping her foot more level and not causing any leverage in the injured side. Like I said the is sound at the walk but not the trot. I've tried to post pictures of the shoes, but for some reason it doesn't work....

I've got SoreNoMore, Absorbine, Vetrolin, DMSO, Surpass and a bunch of other liniments that I can try on her. The vet shaved her from the fetlock down for the diagnostic ultrasound, so it's easy to apply the meds. 

Thanks again for the input !!!!


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## where I want to

The time I used ultrasound, it was done by a human physical therapist who was a rider. She borrowed the equipment from her work place.


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## sidepasser

I caution you that when using DMSO, make sure the leg is very clean and does not have other linaments, etc. already on it. Use rubber gloves to apply and rub in thoroughly. Allow to dry.

DMSO is a carrier and can carry other substances through the skin. Hence the caution of making sure the leg is clean and free of other substances. I rehabbed a hunter mare who tore her suspensory and she came back sound.

My routine was get up at 4:00 am, administer reserpine in feed, drink coffee, unwrap bandages, cold hose leg for 30 minutes, apply ice boot for 10. Dry leg, use DMSO. Allow leg to air dry. Wrap with standing wrap. Put back in stall.

Do this 2 times per day with the exception of reserpine which was once per day. 

Did this for three months while she was on stall rest. Ultrasounds were once per week to grade progress.

After 90 days, hand walk with same routine above. Handwalk was started at 15 minutes per day, then up to an hour a day over a period of a month.

Limited turnout at month six. Limited by area and time out.

That went on for 3 months.

Then finally I could ride her. Straight lines only at the walk, 15 minutes to begin with. At month 12 I was at walk, trot and canter.

Cost - over 5,000. 

Horse was fixed though, sound and back to her old job. Hunters over fences, on the flat, trail riding, etc. Now she is fox hunting. Sound as she can be.

They can come back but it requires a ton of diligence and the willingness to go beyond what "normal" people would do. BTW - my mare had never been in a stall before I bought her, and she did this ligament thing the day after I wrote the check. Happened by bucking and having a "fun" time in the pasture. I saw her when she did it. Flipped her front shoe off in the process.


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## Lisa in WA

sidepasser said:


> I caution you that when using DMSO, make sure the leg is very clean and does not have other linaments, etc. already on it. Use rubber gloves to apply and rub in thoroughly. Allow to dry.



you'll want to dry the area welll before putting on the DMSO. Mixing DMSO with water causes heat and irritates some horses.


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## sidepasser

True Lisa, some horses will be irritated by the DMSO and lose their hair, etc. It can work as a blister agent on some horses so I started mine on a friday evening so I would be off work on the next two days to monitor.

Never had a problem with her.


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## Celtichorse

Thanks, Sidepasser for all the info about the rehab for your mare. I'm really glad to hear that she came out sound! I also appreciate the heads up about the DMSO. I've used it on my old gelding and he lost some hair, but I'm not sure if it was from the DMSO or the other liniments - he seemed to be allergic to just about anything.... so far I've used the Vetrolin linement on my mare and she tolerates it well. The farrier is coming out today to put the shoes and pads on - so we'll see what that does for her. 
So far she's ok in her paddock and I hope she stays sane without doing anything silly. 

I wish I could get a physical therapist with ultrasound or shock wave equipment to come out here, but that's an issue when you live in the middle of BFE - you're on your own. 

Thanks for all the help!


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