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Discussion on Cunean tenectomy may help?

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Cathy Miller
Member
Username: Buddil

Post Number: 58
Registered: 11-2001
Posted on Friday, Aug 12, 2005 - 4:12 pm:   Edit PostPrint Post

Dr. O, I have a gelding that has a bone spur on the lower joint area. Joint injections give little, if any relief. I am seeking information on doing a cunean tenectomy to see if this would help, but vets in my area are not very up on this procedure. I am going to contact the University of Madison, Wisc. to see if they will perform this procedure. However, before I do I really would like your opinion based on the xrays if this is even worth looking into. I do realize you cannot see the horse but maybe the xrays will give you some idea. I hope I upload these right! Thanks in advance, Cathy
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Cathy Miller
Member
Username: Buddil

Post Number: 59
Registered: 11-2001
Posted on Friday, Aug 12, 2005 - 4:16 pm:   Edit PostPrint Post

Well, guess they didn't come through. Can I email these to you? Thanks, Cathy
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13522
Registered: 1-1997
Posted on Saturday, Aug 13, 2005 - 3:51 pm:   Edit PostPrint Post

You could email them Cathy but they don't change my recommendation. The decision to do this surgery should be based on whether the pain blocks out with a tarso-metatarsal block or a cunean bursa block. Radiographic changes like you describe above are often not associated with pain. If it does localize to this area I would first follow the recommendations in the article on arthritis and if that fails consider this option. For more on these see References » Equine Illustrations » Leg Anatomy and Conformation » Hock: anatomy and intrarticular injections.
DrO
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Cathy Miller
Member
Username: Buddil

Post Number: 60
Registered: 11-2001
Posted on Saturday, Aug 13, 2005 - 8:53 pm:   Edit PostPrint Post

Thanks so much! We are going to go ahead with blocking the hocks next week and also blocking the bursa. I have found a highly recommended surgeon at Wisconsin Equine in Oconomawa that is very familiar with this procedure and he also recommended doing the surgical arthrodesis with the 3 hole drilling. He feels he would be a very good candidate for this procedure and has had very good outcomes from the ones he has done.

Cathy
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Cathy Miller
Member
Username: Buddil

Post Number: 61
Registered: 11-2001
Posted on Wednesday, Sep 21, 2005 - 5:32 am:   Edit PostPrint Post

Wanted to update you on my gelding. Cunean Tenectomy was performed 8/23 and revealed excessive scarring on both tendons, especially the left with the bone spur. Bursa was fine. Surgeon removed all scar tissue on the left, which was about 1" worth and about 1/2" worth on the right. Tendons so tight they snapped when clipped. He has been back to work now for 2 weeks and is sound behind. This is a horse that has not been sound in years, even with hock injections. He has arthritis in both hocks, lower joint only with the left having spurring and extreme joint space reduction. I am very pleased with this procedure, was an easy surgery for him and am curious why it has fallen out of fashion?
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13749
Registered: 1-1997
Posted on Wednesday, Sep 21, 2005 - 7:12 am:   Edit PostPrint Post

I guess as science based equine medicine grew stronger it was hard to explain why this procedure might work. That along with the fairly high failure rate of the procedure, when used for poorly localized lameness of the hind legs, caused it to fall our of favor. The trick could be to pick your cases carefully where pain can be referred to just this area.
DrO
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Cathy Miller
Member
Username: Buddil

Post Number: 62
Registered: 11-2001
Posted on Wednesday, Sep 21, 2005 - 2:15 pm:   Edit PostPrint Post

That does make sense to me. I would imagine that a scarred up tendon pressing against a spurring hock would cause a great deal of uncomfortableness for the animal. In my case it caused him to improperly use the total leg, which led to torn suspensory and back and stifle soreness. I would imagine it is hard to tell if a CT would work. Is it possible to block the cunean tendon and maybe that would be something that would show this type of surgery would alleviate pain? I am just amazed at the outcome of this surgery, but my gelding must have been as you say a "carefully picked case". Thanks again!
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Cathy Miller
Member
Username: Buddil

Post Number: 69
Registered: 11-2001
Posted on Saturday, Aug 26, 2006 - 9:39 am:   Edit PostPrint Post

Just an update on my gelding that had the Cunean Tenectomy. He did very well with this, however the torn suspensory along with an old sesmoid fracture that aggrivated the old torn suspensory has led him to retirement with some trail riding. The CT really helped his range of motion, however. I feel it did help with his hocks and fusion. Hocks have had a considerable amount of fusion since the CT.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 16465
Registered: 1-1997
Posted on Saturday, Aug 26, 2006 - 12:33 pm:   Edit PostPrint Post

Thanks for the update and sorry to hear about the other complications. At least he will be more comfortable in retirement.
DrO
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