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Discussion on UltraSound

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Kathie
Member
Username: kbr1

Post Number: 27
Registered: 10-2006
Posted on Sunday, Jul 8, 2007 - 12:33 pm:   Edit PostPrint Post

My horse injured herself out in the pasture in Feb of this year, the vet was called, he took x-rays, said she had a bowed tendon and put her on stall rest. She has been on stall rest ever since with some hand walking thrown in. I was unable to locate a vet with a portable ultrasound machine until just recently. He came out, looked at her leg and said there was no point in doing an ultrasound. That after 5 months her injury has healed as much as it is going to and I should put her let her out on a very small turnout area and see what happens. I have found someone that will take my horse to an equine clinic for me, so I can have an ultrasound done. I have read all the information I can about this type of injury. And my question is - is an ultrasound still warranted after all this time? I know we nothing to compare it to but won't it help to know what I am dealing with at this point? Any help or suggestions would be appreciated.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 18810
Registered: 1-1997
Posted on Monday, Jul 9, 2007 - 6:58 am:   Edit PostPrint Post

A single ultrasound will give you an important pieces of information that you currently don't have: how serious is the injury and from this a prognosis for future soundness. Sequential ultrasounds will help confirm when healing has stopped. Depending on the severity of the injury and your horses innate healing ability, it may not be true that after 5 months all the healing is done. For more on this and recommended rehabbing injured tendons see the article associated with this forum.
DrO
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Kathie
Member
Username: kbr1

Post Number: 28
Registered: 10-2006
Posted on Monday, Jul 9, 2007 - 8:32 am:   Edit PostPrint Post

Dr. O,
Thank you very much. I feel much better now. I will let you know what happens.
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Kathie
Member
Username: kbr1

Post Number: 29
Registered: 10-2006
Posted on Sunday, Jul 29, 2007 - 12:25 pm:   Edit PostPrint Post

Dr. O just thought I would let you know I finally got my horse to a equine clinic. here is what her write up says: RF - Flexor tendon sheath effusing with synoviits(sp). DDF strain proximal to fetlock, DDF medial marginal tear at level of P1B extending to P2A along medial lobe margin. Inter sesmoidean stain with periosteal reach on (sp) along lateral PSB cortex. Ddx- DDF tear RF.
The vet has recommended special shoes (she had them on before). and Stall rest with hand walking for 3 more months. Then move to walk riding for ten minutes a day increasing 5 minutes every two days if no lameness appears to be present. I am also applying 'succeed' - I think is the name twice a day. When I asked the vet for a best case out come - he said light riding, worst case - permanant lameness. Does this sound correct to you based on the information I provided, I really liked the vets that looked at her (they ended up with three) but I kind of felt like they were trying to be very positive, am I just being paranoid? Also, they offered to do some theraputic ultrasound but couldn't really say if they thought it would do any good, and it was pretty expensive and again I would have to get her there, but a lady I know told me she got one of those home use theraputic ultrasound (I guess made for people) and used it on her horse with some decent results, I would consider buying one if there was any chance it would be of help.
Thanks.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 18939
Registered: 1-1997
Posted on Monday, Jul 30, 2007 - 8:08 am:   Edit PostPrint Post

Not exactly right to me Kathie. In this region, where the tendon runs through the flexor sheath, ultrasound alone often falls short as a diagnostic tool alone. In the past few years the importance of evaluating this area with the use of a tenoscope for accurate diagnosis and optimal treatment has greatly improved the prognosis. This is not simply to improve the diagnosis but often lesions are found that when cleaned up surgically using the tenoscope the horses chances of recovery improve. Texas A&M has an excellent lameness service so I am interested in knowing what they did not feel this necessary in this case. For more on this procedure see the Tenoscopy subtopic in the article Diseases of Horses » Lameness » Diseases of the Lower Limb » Flexor Tendinitis.

Otherwise I see no clear reason not to take their comments at face value and discourage the investment in an expensive therapeutic ultrsound with unknown ability to help your horse.
DrO
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Kathie
Member
Username: kbr1

Post Number: 30
Registered: 10-2006
Posted on Monday, Jul 30, 2007 - 9:53 am:   Edit PostPrint Post

Dr. O, I am not sure why the tenoscope was not used, I wasn't aware of it. Could it have been because her injury is old (5 months)? I am in Virginia, not Texas. She is slightly lame at this point, and they did a test where they flexed her hoof in for 60 seconds and that came back positive. I am putting surpsass on her twice a day not 'succeed'. She is a young horse (7) so I would like to give her the best chance for recovery.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 18944
Registered: 1-1997
Posted on Monday, Jul 30, 2007 - 1:32 pm:   Edit PostPrint Post

Rereading your post I don't know where I got A&M. The tenoscopy procedure is pretty new but initial results pretty impressive for both acute and chronic problems with the DDF in the sheath. Ask them what they think about this as a best next step.
DrO
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Kathie
Member
Username: kbr1

Post Number: 31
Registered: 10-2006
Posted on Monday, Jul 30, 2007 - 5:12 pm:   Edit PostPrint Post

Dr O , we all have those moments. I will get with them tomorrow and see what they think about it. Thanks for your help and I will keep you updated.
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