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Discussion on Swelling in ankle and pastern

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Nancy Sullivan
Username: Sully

Post Number: 20
Registered: 6-2004
Posted on Saturday, Dec 18, 2004 - 4:47 pm:   Edit PostPrint Post

Dr O
My horse caught her front leg inbetween a post and gate 2 months ago. She was stuck for about 5 minutes and struggled hard until she freed herself. She was caught just above the hoof. The veterinary came within 20 minutes and stiched an area mid canon that had been cut. She had swelling from there down to her hoof. We kept her bandaged for the next 12 days, changing every 3 days. Within that 12 day period, she started sloughing skin(like a rope burn) on each side of her pastern where her foot had been caught. After the stiches were removed, we continued to bandage the wounds on the pastern. We have sweated her leg to reduce the swelling and this helped some, but 2 months after she still has swelling in the fetlock and pastern area. Just over a month into treatment, we x-rayed this area and 2 bone chips were noticed. These pictures were sent to Ames Iowa to see if surgery was indicated to remove them. They talked with my veteriary and decided that they had been there before the accident. They had no sharp edges and were rounded is the reasoning. I am worried that the swelling is still present and after consoltation with my clinics senior veterinary, they instructed me to continue wrapping the leg. 10 days using dsmo then 10 days of just wrap alone and see if the swelling goes down and stays down. She has shown little lameness until she is flexed and then they put her at 2-3 for lamesness. The senior veterniary says at 3 months after accident, they will ultra sound and xray her again. Now they are suspecting upper ring bone or something about a ligament or tendon that runs behind the fetlock not moving properly. Finally my question. Would it be in my horses best interest to take her to a veterinary college that has an mri to get a better look at this leg before more time elapes? Could the trama have moved these bone chips so they now are in the joint capsule of the fetlock and causing problems? If it was your horse, what would you be doing?
Thank You Dr O and anyone else that has an answer.
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Robert N. Oglesby DVM
Username: Dro

Post Number: 11696
Registered: 1-1997
Posted on Sunday, Dec 19, 2004 - 12:10 pm:   Edit PostPrint Post

Without looking at the horse and the radiographs I cannot really give specific advice Nancy. However I can say injuries of these types often have remarkable swelling permanantly afterward do to damage to the soft tissues particularly the flexor tendon, surely the tendon your veterinarian is refering to. They are concerned about adhesions forming between the tendon and the adjacent structures. The plan by your veterinarians seems reasonable. If you are worried about the lack of a specific diagnosis, MRI will certainly give more information on the nature of the injury, I just don't see what changes in treatment it is likely to yield. Rest, proper wound care, daily hand walking, antiinflammatories, and pressure wraps would all be logical.
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