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Discussion on Medial Patellar Ligament Splitting and rehab

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Margy
Member
Username: Annaspop

Post Number: 6
Registered: 9-2002
Posted on Friday, Sep 8, 2006 - 10:06 am:   Edit PostPrint Post

I had MPLS done on my pony's stifles. The vet is recommending a very conservative rehab. It started with 5 days stall rest w/ 15 min. of hand walking (2x daily) starting a couple days after surgery. After 10 days he's up to 30 min. 30 days after surgery he will be allowed 30-45 min turnouts 2x daily.
Nancy was rigorous trotting for 30 to 45 minutes per day for the 1st week.
Any thoughts?
Margy
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 16555
Registered: 1-1997
Posted on Friday, Sep 8, 2006 - 7:10 pm:   Edit PostPrint Post

Margy I don't understand your post, what does the next to last line mean?
DrO
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Margy
Member
Username: Annaspop

Post Number: 7
Registered: 9-2002
Posted on Friday, Sep 8, 2006 - 9:47 pm:   Edit PostPrint Post

Sorry Dr. O. Expressing myself in writing is not always easy for me.
I was referring to Nancy Sullivan's post "Discussion on Upward fixation of the patella"
I find it confusing that her vet would prescribe so much exercise and mine so little. I would feel more comfortable discussing this with my vet, if I had a better understanding of the differences.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 16557
Registered: 1-1997
Posted on Saturday, Sep 9, 2006 - 7:56 am:   Edit PostPrint Post

Got it. The blue background topic in the article on upward fixation details an experiment on ligament splitting involving larger numbers of horses, the post surgical exercise regimen, the rationale, and the outcome. Notice how this contrasts with the recommendations of transection of the ligament and the reasons there.

Any particular horse may have circumstances that cause a change in recommendations. Did your vet suggest why your horse is on prolonged rest or does it do all his ligament splittings this way.
DrO
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Margy
Member
Username: Annaspop

Post Number: 8
Registered: 9-2002
Posted on Friday, Sep 15, 2006 - 11:53 pm:   Edit PostPrint Post

Interesting, the recommendations the vet gave me where very similar to what is said here for the transections. She did state that the ligament had been weakened by the splitting and was concerned that it might tear if stressed too much.

I get the feeling that she hasn't done many, and maybe not on her own. Realize that she is the only vet, that I know, that had any interest in doing the surgery.



Bobby T.'s history-

At about 6 he was brought into this area by a trainer that decided that he had dressage potential. She put draw reins on him and "dressaged him". After she stifled him, he was turned out for a few years until the woman I got him from bought him for her young son. She told me that he is unsuitable for young children. I wanted him to be a companion for a horse that I have since sold. He’s very good with other horses in pasture and OK with being an only horse. He was very untrusting for 6 months or so. He acted like no one had treated him with patience and respect. And very ear shy, especially his left one. He is much better now.

He's 12 now. Almost cow hocked not strait behind.

Before surgery he would stick and only occasionally locked up after standing. He improved with exercise, but would still lock up some. He had no suspension to his trot, although he can trot 12 MPH when he wants.



I’m not able to put enough miles on him to get him in top shape, and even then he would properly still stick.



I decided that even if the surgery didn't help or caused other problems, I'm happy keeping him as a pet. I enjoy his personality and his POA attitude.

And with enough improvement I could use him to practice my lessons and maybe make him available to some kids in pony club or 4-H.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 16636
Registered: 1-1997
Posted on Sunday, Sep 17, 2006 - 7:33 pm:   Edit PostPrint Post

That was what I was thinking too Margy. If the splitting does not help, I would have it transected. I did dozens of these over the years and though a low grade permanent lameness often resulted, it was never so much that the horse could not be shown, and often was such the owner could not see it even when pointed out. The more intense rest may well prevent this. Diplomatically, you should point out the Proceedings reference to her and get her comment, she may even know of more recent work to suggest otherwise but start a dialogue since the authors of the study thought early work important.
DrO
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Margy
Member
Username: Annaspop

Post Number: 9
Registered: 9-2002
Posted on Sunday, Sep 17, 2006 - 8:15 pm:   Edit PostPrint Post

Do you know of anyone that is doing research in regard to the rehab? Like stall rest and hand walking vs vigorous exercise. I don't seem to have a talent for the diplomatic approach. Is there some available information in print that I could bring to her and ask her opinion as a starting point?
Margy
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 16641
Registered: 1-1997
Posted on Monday, Sep 18, 2006 - 7:20 am:   Edit PostPrint Post

I would start with the summary of the Proceedings in our article on UFP. I do not know of any studies that contrast different recovery techniques.
DrO
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Margy
Member
Username: Annaspop

Post Number: 10
Registered: 9-2002
Posted on Tuesday, Sep 19, 2006 - 11:02 pm:   Edit PostPrint Post

After it is transected, can a horse doze standing or does he have to lay down to sleep?
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 16674
Registered: 1-1997
Posted on Wednesday, Sep 20, 2006 - 8:55 am:   Edit PostPrint Post

With just one cut he will be able to doze standing.
DrO
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