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Suspensory Desmitis

SIGNALMENT

Polish Warm Blood, 10 year old stallion, Jumper

HISTORY

Recently acquired horse showed for two months, but was always weak behind. He became acutely lame in the right hind and was previously diagnosed to have an affected suspensory region. Previous ultrasound and radiographic findings reveal proximal suspensory desmitis and subchondral sclerosis in the proximal suspensory region. Shockwave treamtents and stall rest proved ineffective and the horse came to New Bolton Center for further evaluation and treament recommendations

PRESENTATION

Upon admission, the horse was in general good health. On physical examination, morderate bilateral femoropatellar effusion was noted. The horse was negative to hoof tester application in both front feet. In the right hind limb, a firm bony enlargement was identified over the proximal middle aspect of hte lateral spint bone. The horse was not sore upon papation of this area.

Lameness examination revealed a 2o of 5 o right hind lameness, which was apparent in a straight line and on circling to the right or left. There was no improvement with plantar digital analgesia. There was moderate (50%) improvement with lateral abaxial analgesia, and with lateral planta (high suspensory) analgesia. There was inconsistent mild (20%) improvement with intra-articular RH fetlock injection.

DIAGNOSTICS

   
   

Ultrasonography

Nuclear Medicine

Radiology

Magnetic Resonance Imaging

     
         

DIAGNOSIS AND PROGNOSIS

Based on this comprehensive evaluation the horse was diagnosed with proximal suspensory desmitis with associated subchondral bone stress, and acute lateral oblique sesamoidean desmitis. The long-term prognosis was fair, following a minimum of six months to a year of rehabilitation and physical therapy for the injuries.

TREATMENT

Under ultrasonographic guidance the horse recieved two injections into both the soft tissue structures of liquid bone marrow harvested from its sternum. This procedure was carried out under general anesthesia. Phenylbutazone was prescribed for anti-inflammatory therapy during the first week. The physical therapy after discharge included confinement for four weeks. This was followed by increased intervals of walking up to 45 minutes for the next four weeks. Increased exercise and riding was to follow for the next two months.

 

 
         
 
Copyright © 2006 - University of Pennsylvania School of Veterinary Medicine, All rights reserved.
Faculty: Dr. Alexia McKnight
Student:Charles Bradley 2009