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Digital Flexor Tendon

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GWR
Reg. Jan 2006
Posted 2014-03-26 10:59 PM
Subject: Digital Flexor Tendon


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 Anyone have good luck with ultra sounding the digital flexor tendon between the heel and fetlock to diagnose a strain or tear? Can't really afford an MRI, but we have narrowed it down to lameness above the heel and below the fetlock. And x-rays look good. It's in the right front. 
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TurnLane
Reg. May 2007
Posted 2014-03-27 9:16 AM
Subject: RE: Digital Flexor Tendon



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Dang, that stinks. I know it is expensive but I will say that I have spent 2 years and many smaller vet bills only to have wasted that time and money. I recommend MRI if there is anything you can do. 
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TurnLane
Reg. May 2007
Posted 2014-03-27 9:18 AM
Subject: RE: Digital Flexor Tendon



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Also like to say that there is most often another issue causing DFT issues-not always but it could be secondary lameness that you can see and MRI would remove all doubt.  
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cheryl makofka
Reg. Jan 2011
Posted 2014-03-27 9:27 AM
Subject: RE: Digital Flexor Tendon


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Yep, started with X-ray then went to ultrasound
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barrelracingchick16
Reg. Aug 2004
Posted 2014-03-27 9:37 AM
Subject: RE: Digital Flexor Tendon



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     Another thing to consider in that area would be the sesamoidean ligaments.--should be able to see this on ultrasound as well.  
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flyhperformancehorse
Reg. Mar 2007
Posted 2014-03-27 9:49 AM
Subject: RE: Digital Flexor Tendon


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 What about a thermal imaging?? We did an MRI on a gelding who had a torn obliquie ligament in the left hind feltock... nothing we could do but 6 months stall rest. I deteremined in the future, I would skip the MRI, if xrays all showed good, then I would just stick the horse on stall rest for 4-6 months and then revaluate. Cost $2500 for the vet to say, well I figured that is what is was, but atleast it is confirmed now and it doesn't matter if it was torn, stetched, pulled, whatever, the treatment is the same. I was like ugh!
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luv2trainhorses
Reg. Jan 2009
Posted 2014-03-27 11:14 AM
Subject: RE: Digital Flexor Tendon



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Yes, we did an x ray and then ultrasound. My horse had a sesmoidian tear and was not lame at all but had a little swelling when I had him checked. Good thing I did as if I would have ignored it and tore it more it could have easily ended his career. Well worth having an ultrasound done as it showed everything I needed to know.
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GWR
Reg. Jan 2006
Posted 2014-03-27 2:25 PM
Subject: RE: Digital Flexor Tendon


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Thanks everyone for sharing your experiences.  This is a head horse that his performance has gone down hill over the last year or so.  Bad owner, I am, for not checking him sooner because he proved that on two grams a bute a day he worked like himself.  Finally took him last week to a very reptuable lameness vet and he blocked his right front heel and he didn't go sound.  Then blocked just above that and he went sound, but then lame in the left hind.   He's got a little issue in his left stifle and we injected.  The vet said he didn't think it'd be worth my money to have an MRI of the right front and said I needed to change the way he was shod.  So we changed his shoeing, injected the stifle, and put him on previcox for 20 days.  Went and roped last night with nothing but the previcox (started him on that on Saturday) and he didn't work so hot.  The thing is I'm 13 weeks pregnant and only have about 2-3 weeks left that I'm going to rope, so maybe it's better like one poster said to just give him the 4-6 months off and then see where we're at.  He is 12 and is a very nice horse, so I sure don't want to do anything that would be career ending.  Everyone kept telling me, "Oh well if he is better on 2 grams of bute then it can't be anything too serious."  The hard part with that is I know the horse has a very high pain tolerance...figured this out because he coliced and had to have surgery...long story to explain why we know his pain tolerance.   

So another question...when you give the 4-6 months stall rest do you do hand walking or what?  And then what was your program conditioning them after they're done with stall rest? 

 
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ACEINTHEHOLE
Reg. Apr 2005
Posted 2014-03-27 2:36 PM
Subject: RE: Digital Flexor Tendon



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GWR - 2014-03-27 2:25 PM Thanks everyone for sharing your experiences.  This is a head horse that his performance has gone down hill over the last year or so.  Bad owner, I am, for not checking him sooner because he proved that on two grams a bute a day he worked like himself.  Finally took him last week to a very reptuable lameness vet and he blocked his right front heel and he didn't go sound.  Then blocked just above that and he went sound, but then lame in the left hind.   He's got a little issue in his left stifle and we injected.  The vet said he didn't think it'd be worth my money to have an MRI of the right front and said I needed to change the way he was shod.  So we changed his shoeing, injected the stifle, and put him on previcox for 20 days.  Went and roped last night with nothing but the previcox (started him on that on Saturday) and he didn't work so hot.  The thing is I'm 13 weeks pregnant and only have about 2-3 weeks left that I'm going to rope, so maybe it's better like one poster said to just give him the 4-6 months off and then see where we're at.  He is 12 and is a very nice horse, so I sure don't want to do anything that would be career ending.  Everyone kept telling me, "Oh well if he is better on 2 grams of bute then it can't be anything too serious."  The hard part with that is I know the horse has a very high pain tolerance...figured this out because he coliced and had to have surgery...long story to explain why we know his pain tolerance.   



So another question...when you give the 4-6 months stall rest do you do hand walking or what?  And then what was your program conditioning them after they're done with stall rest? 


 

You need to figure out what it is and how bad.  4-6 months stall rest might not be enough, and if you start to ride again, you can possibly do more damage.  I would start with the U/S and posbbily x-rays and see if you can figure it out or if you need more diagnostics done and go from there. 
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GWR
Reg. Jan 2006
Posted 2014-03-27 2:44 PM
Subject: RE: Digital Flexor Tendon


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ACEINTHEHOLE - 2014-03-27 12:36 PM
GWR - 2014-03-27 2:25 PM Thanks everyone for sharing your experiences.  This is a head horse that his performance has gone down hill over the last year or so.  Bad owner, I am, for not checking him sooner because he proved that on two grams a bute a day he worked like himself.  Finally took him last week to a very reptuable lameness vet and he blocked his right front heel and he didn't go sound.  Then blocked just above that and he went sound, but then lame in the left hind.   He's got a little issue in his left stifle and we injected.  The vet said he didn't think it'd be worth my money to have an MRI of the right front and said I needed to change the way he was shod.  So we changed his shoeing, injected the stifle, and put him on previcox for 20 days.  Went and roped last night with nothing but the previcox (started him on that on Saturday) and he didn't work so hot.  The thing is I'm 13 weeks pregnant and only have about 2-3 weeks left that I'm going to rope, so maybe it's better like one poster said to just give him the 4-6 months off and then see where we're at.  He is 12 and is a very nice horse, so I sure don't want to do anything that would be career ending.  Everyone kept telling me, "Oh well if he is better on 2 grams of bute then it can't be anything too serious."  The hard part with that is I know the horse has a very high pain tolerance...figured this out because he coliced and had to have surgery...long story to explain why we know his pain tolerance.   



So another question...when you give the 4-6 months stall rest do you do hand walking or what?  And then what was your program conditioning them after they're done with stall rest? 


 
You need to figure out what it is and how bad.  4-6 months stall rest might not be enough, and if you start to ride again, you can possibly do more damage.  I would start with the U/S and posbbily x-rays and see if you can figure it out or if you need more diagnostics done and go from there. 

I've had x-rays...now I just need to figure out how bad the soft tissue damage is.  This vet said he doesn't like to do ultra sounds on that area because it doesn't show very well.  So mainly I wanted to know who has had ultra sound done in that area and if they were actually able to diagnose something using ultra sound in that area rather than just jumping to have an MRI done.   
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Clancy0407
Reg. Sep 2006
Posted 2014-03-27 5:51 PM
Subject: RE: Digital Flexor Tendon



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I had one who ripped his DDFT. Took him to a very reputable lameness vet in the NW and we were able to find the tear/"rip" by ultrasound. It was right below his fetlock on the backside of his pastern on a back leg. His was so bad, we weren't sure if he would ever race again, but I faithfully did everything I was supposesd to do and didn't cut any corners. I invested in a Game Ready machine and he was on stall rest. First couple weeks he was on strict stall rest (his tendon sheath was also severely inflamed) with icing (I spent about 40 hours icing/soaking/cold hosing his leg in the first 2-3 weeks and that was after the correct diagnosis, not previous time spent doing so). After the first couple weeks, we gradually worked up to hand-walking an hour a day (that happened over several weeks) and I continued to use the Game Ready machine for about 30 min. everday after his hand-walking. After several months of hand-walking for an hour a day, we added in some trotting. I also used SmartPak's Smart Tendon supplement for the last couple months of his stall rest (not sure if it really played a part or just coincidence). He was on stall-rest for about a year and 2 years after the initial injury, he came back and won a state title for my sister and made some of his best runs ever...with NO bute or drugs. It was a long process but I'm glad I just took it slow. The vet also had us put him in 3 degree wedges on his back feet. Thankfully I also have an awesome farrier. Over the course of his year on stall rest, we gradually decreased the degree of wedges until he was back down to a regular shoe.

Sounds like yours is in a similar area (other than being on a front leg). My lameness vet was able to diagnose it just fine with an ultrasound. If you have any doubt, don't be afraid to get a second opinion. Mine actually injured himself out in the pasture when the ground was wet (early spring) and he slipped...Initially I couldn't figure out what was going on, his leg swelled massively...and quickly. The "everyday" vet came out, injected him with penicillin thinking it was an infection (he spiked a high fever the first few days as well). After a few days of him not making a huge difference, she finally decided to ultrasound him and said he had a tear (although when I asked her where, she couldn't tell me the exact location/which tendon, but she was looking at the suspensory area) and went ahead and did a shockwave treatment. My gut was telling me that there was something more that she wasn't getting...sure enough, took him to the lameness vet and they didn't find any tear up higher where she was "saying" it was...and they believe that the reason his tendon sheath was so severly inflamed (in addition to the DDFT tear), was because of the shockwave treatment she did. I think in this case, it was shockwave was not a good treatment, just caused more problems. I do believe it has its uses (as long as the person using it is knowledgable). Needless to say, I will NOT use the original vet again. Lesson Learned. It never hurts to follow your gut and/or get a 2nd opinion. This horse of mine also has high pain tolerance.

Good Luck!! Sounds like it will be good timing to do stall rest during your pregnancy!


Edited by Clancy0407 2014-03-27 5:56 PM
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GWR
Reg. Jan 2006
Posted 2014-03-27 7:53 PM
Subject: RE: Digital Flexor Tendon


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Clancy0407 - 2014-03-27 3:51 PM I had one who ripped his DDFT. Took him to a very reputable lameness vet in the NW and we were able to find the tear/"rip" by ultrasound. It was right below his fetlock on the backside of his pastern on a back leg. His was so bad, we weren't sure if he would ever race again, but I faithfully did everything I was supposesd to do and didn't cut any corners. I invested in a Game Ready machine and he was on stall rest. First couple weeks he was on strict stall rest (his tendon sheath was also severely inflamed) with icing (I spent about 40 hours icing/soaking/cold hosing his leg in the first 2-3 weeks and that was after the correct diagnosis, not previous time spent doing so). After the first couple weeks, we gradually worked up to hand-walking an hour a day (that happened over several weeks) and I continued to use the Game Ready machine for about 30 min. everday after his hand-walking. After several months of hand-walking for an hour a day, we added in some trotting. I also used SmartPak's Smart Tendon supplement for the last couple months of his stall rest (not sure if it really played a part or just coincidence). He was on stall-rest for about a year and 2 years after the initial injury, he came back and won a state title for my sister and made some of his best runs ever...with NO bute or drugs. It was a long process but I'm glad I just took it slow. The vet also had us put him in 3 degree wedges on his back feet. Thankfully I also have an awesome farrier. Over the course of his year on stall rest, we gradually decreased the degree of wedges until he was back down to a regular shoe. Sounds like yours is in a similar area (other than being on a front leg). My lameness vet was able to diagnose it just fine with an ultrasound. If you have any doubt, don't be afraid to get a second opinion. Mine actually injured himself out in the pasture when the ground was wet (early spring) and he slipped...Initially I couldn't figure out what was going on, his leg swelled massively...and quickly. The "everyday" vet came out, injected him with penicillin thinking it was an infection (he spiked a high fever the first few days as well). After a few days of him not making a huge difference, she finally decided to ultrasound him and said he had a tear (although when I asked her where, she couldn't tell me the exact location/which tendon, but she was looking at the suspensory area) and went ahead and did a shockwave treatment. My gut was telling me that there was something more that she wasn't getting...sure enough, took him to the lameness vet and they didn't find any tear up higher where she was "saying" it was...and they believe that the reason his tendon sheath was so severly inflamed (in addition to the DDFT tear), was because of the shockwave treatment she did. I think in this case, it was shockwave was not a good treatment, just caused more problems. I do believe it has its uses (as long as the person using it is knowledgable). Needless to say, I will NOT use the original vet again. Lesson Learned. It never hurts to follow your gut and/or get a 2nd opinion. This horse of mine also has high pain tolerance. Good Luck!! Sounds like it will be good timing to do stall rest during your pregnancy!

Thanks for your help!! It's hard because he's never really showed lameness except drop in performance. I'm with you on not taking a horse for something like this to just a run of the mill vet. That's why I was so surprised this vet said an ultrasound in that area wasn't very good. Anyway, thanks for sharing your experience. Sounds like you did all the right things and put in a lot of hardworking to get your horse back. 
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casualdust07
Reg. Mar 2005
Posted 2014-03-27 10:44 PM
Subject: RE: Digital Flexor Tendon



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Yes you can see a lot of stuff with an ultrasound in that area!

I had a mare with a torn oblique distal sesamoidean ligament and she would be intermittently lame, performance dropped, but couldn't definitively diagnose anything. one ultrasound in that area and my problem was diagnosed. Why it took 5 vets, $5000, and 11 months to pull an ultrasound machine out I don't know!

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TurnLane
Reg. May 2007
Posted 2014-03-28 9:22 AM
Subject: RE: Digital Flexor Tendon



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GWR - 2014-03-27 2:25 PM Thanks everyone for sharing your experiences.  This is a head horse that his performance has gone down hill over the last year or so.  Bad owner, I am, for not checking him sooner because he proved that on two grams a bute a day he worked like himself.  Finally took him last week to a very reptuable lameness vet and he blocked his right front heel and he didn't go sound.  Then blocked just above that and he went sound, but then lame in the left hind.   He's got a little issue in his left stifle and we injected.  The vet said he didn't think it'd be worth my money to have an MRI of the right front and said I needed to change the way he was shod.  So we changed his shoeing, injected the stifle, and put him on previcox for 20 days.  Went and roped last night with nothing but the previcox (started him on that on Saturday) and he didn't work so hot.  The thing is I'm 13 weeks pregnant and only have about 2-3 weeks left that I'm going to rope, so maybe it's better like one poster said to just give him the 4-6 months off and then see where we're at.  He is 12 and is a very nice horse, so I sure don't want to do anything that would be career ending.  Everyone kept telling me, "Oh well if he is better on 2 grams of bute then it can't be anything too serious."  The hard part with that is I know the horse has a very high pain tolerance...figured this out because he coliced and had to have surgery...long story to explain why we know his pain tolerance.   



So another question...when you give the 4-6 months stall rest do you do hand walking or what?  And then what was your program conditioning them after they're done with stall rest? 


 

Stall rest is stall rest- ie- clean around them or tie them up and clean their stall. Consider it like bed rest. Then rehab is tricky-which is an advantage to knowing a diagnosis.
But there is a nice little rehab schedule that someone posted on another thread recently that is very similar to the one my vet gave me.  Like walk 5 min a day for a week, 7 min next week, ect for 60 to 90 days increasing slowly the gait and distance/time.
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Gunner11
Reg. Mar 2011
Posted 2014-03-28 9:35 AM
Subject: RE: Digital Flexor Tendon



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http://www.atlantaequine.com/pages/client_lib_tendonlig.html#backto...

Scroll down and click on the "Back to Work" schedule to see what they recommend. Lots of good info in this article!
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halter_ego
Reg. Feb 2007
Posted 2014-03-28 2:14 PM
Subject: RE: Digital Flexor Tendon



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Mine was just diagnosed with 3 DDF tendon strains.  One above the fetlock, one between the heels, and one on the very bottom of the foot.  We did not do a MRI, my vet was able to ultra sound and see the upper 2 very clearly.  He then injected a dye and took xrays, could see some that way, and also ultra sounded from the bottom of the foot and was able to get a good idea of what was going on there as well.  My suggestion is to find a VERY GOOD lameness vet, I am about 95% my general vet would not have been able to do what was done.  Good luck, they say these are long, long healing injuries.  I opted to go with stem cell, still in my 3rd month on walking only. 
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GWR
Reg. Jan 2006
Posted 2014-03-28 4:09 PM
Subject: RE: Digital Flexor Tendon


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halter_ego - 2014-03-28 12:14 PM Mine was just diagnosed with 3 DDF tendon strains.  One above the fetlock, one between the heels, and one on the very bottom of the foot.  We did not do a MRI, my vet was able to ultra sound and see the upper 2 very clearly.  He then injected a dye and took xrays, could see some that way, and also ultra sounded from the bottom of the foot and was able to get a good idea of what was going on there as well.  My suggestion is to find a VERY GOOD lameness vet, I am about 95% my general vet would not have been able to do what was done.  Good luck, they say these are long, long healing injuries.  I opted to go with stem cell, still in my 3rd month on walking only. 

 Thank you!! I'm glad to hear you were able to diagnose with an ultrasound. I think I may need a second opinion even though I feel this is a very good lameness guy. I don't want to say much about him because most in my area would figure out who he is and I don't want to bad mouth the guy. 
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Lmichaels
Reg. Feb 2007
Posted 2014-04-06 9:28 AM
Subject: RE: Digital Flexor Tendon



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My mare tore her joint capsule on her rear fetlock in April 2011 - xrayed and ultrasounded - it was a bad tear as you could see the tear in the xray - she was turned out til Jan 2012 and we started lightly riding her - in Feb 2012 she went back into rotation and I started running her again

With tears its not worth risking it - a min of 3-4 months rest is best and then re-evaluate from there

I would just turn the horse out til after your pregnancy and let time heal him - then go get a full work up when you are ready to start riding again 

2 things my vet told me
- keep your horse on a good feed thru/injectable supplement the entire time you are resting them as it will help repair the body

-keep shoeing her even if we arent riding her


 
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Paintbrlrcr
Reg. Sep 2003
Posted 2014-04-06 10:03 AM
Subject: RE: Digital Flexor Tendon


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My OTTB tore his tendon sheath in the left hind just above the feltlock.  He's been on stall rest for 3 months, we did surgery to repair the tear.  He was in a Kimzey brace for 2 months and he's currently in a 7 degree wedge. 

Stall rest means he can come out of his stall to rewrap the leg once a day and that's it.  We've been doing laser therapy which has seemed to help a lot and will probably start him on the theraplate soon.  Vet was able to diagnose with an ultrasound.
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myvwranch
Reg. Sep 2008
Posted 2014-04-06 8:44 PM
Subject: RE: Digital Flexor Tendon


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sounds like a plan to turn him out until you have the baby....

I have a mare front righrt foot lame. like no weight on it at all lame.. vet cant find anything with xrays or ultrasounds.. he suggested we get an mri... should I get a second opinion or just go for the mri ??? thnks you
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