# Swelling along tendon? Please, please read. =|



## Mercedes (Jun 29, 2009)

Pictures?


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## riccil0ve (Mar 28, 2009)

Pictures wouldn't show anything, it's only slightly squishy now, and she's got lots of fur on her legs... or did you want them to see what area it is I'm talking about?


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## Mercedes (Jun 29, 2009)

riccil0ve said:


> Pictures wouldn't show anything, it's only slightly squishy now, and she's got lots of fur on her legs... or did you want them to see what area it is I'm talking about?


I want to see her body, her forelimb conformation, her feet, and the area that you are talking about.

There's a few possible things it can be, but since I can't be there to see it firsthand and palpate it, you gotta help us out and give us something more to go on.

If that's just not possible, then this is my best advice. Stop working her, turn her out and leave her off for the period of time she had the swelling. So, if it's been swelling off and on for two weeks and now it's gone, then she needs two additional weeks off without any swelling. If it takes four weeks for the swelling to go away, then you give her an additional four weeks off after that for a total of eight weeks.

Doing that will ENSURE that the soft tissue injury is healed regardless of what it was. Because even though you can't see outward inflammation, there will be internal cellular inflammation.


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## riccil0ve (Mar 28, 2009)

I'm not sure what kind of pictures are best, but I took these yesterday. The affected leg is the right one. Do you see that little brown spot on the inside of her right leg? It's right along there, running down in front of the tendon.










You can kind of see the swelling in this one. Kind of, lol.










This is the most recent full-body shot I have of her, taken on Tuesday or Wednesday.










And the best conformation shot from last summer.


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## riccil0ve (Mar 28, 2009)

Argh, forgot this one. The inside of her left leg. And to point again the place I'm talking about, it's that groove. =]


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## Mercedes (Jun 29, 2009)

She's very straight through those front legs. Give her the time off that I suggested originally.


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## Ryle (Jul 13, 2007)

If this has continued and continues, then schedule a specific lameness exam with your vet. Often-times if you don't set the appointment about a specific problem the vet will assume it's not your top priority and don't go too in-depth unless you really stress that you want to find an answer. Or because it's something really mild and has only been there a few days they don't get too excited until the problem doesn't resolve or gets worse.

An ultrasound exam will likely be recommended since it's not resolved so that the vet can determine if there is damage to the tendon that requires special rest and rehab.


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## riccil0ve (Mar 28, 2009)

Ok... but what do you think it could be? There's lots of scary words they throw in with tendon injuries, but as I said, this is over my head, and I really don't KNOW any of it. I know there's lots of things it could be, and that without being there you really can't know, but if I know the possibilities, I can look it up and talk to the vet and really figure out what's going on.

Anyone else?? Please?!

Edit: Thanks Ryle. I brought it up at their floating appointment because he was out there. At that point, it had only been a few days. And I brought it up again at my chiro appointment because she was out there. I'm too poor to call a vet out any time she comes up limping, but it's usually an abcess or being sore from a long, hard ride so it's things I can handle. This is different though. I am supposed to have a follow-up appointment with her chiropractor in another week or two, and I'm going to base the exam on her leg and then do chiro if I can afford it. The chiro she can do without, it's not top priority.

At this point, would you suggest cold-hosing, aspirin, bute, anything?


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## Ryle (Jul 13, 2007)

At this point, I would say to cold hose and rest her. If you stall her, note if the swelling increases or decreases. Note if the swelling increases or decreases when she is out moving around. 

Is the chiro a licensed vet? If not, you need to get one out and it would be a good idea to have one that has a special interest in lameness.

Here is a handy reference website: William R. Pritchard Veterinary Medical Teaching Hospital


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## MyBoyPuck (Mar 27, 2009)

Yeah, I hear you on the "tendon" danger word thing. It sure is an area that sparks fear in both the owner and the wallet. The only thing I can add is that, regardless of what it is, I wouldn't want any prolonged swelling in that area, since it can only serve to stress or even stretch out a nearby tendon or ligament. Until it's gone completely, or it's otherwised diagonsed, either cold hose or ice wrap it twice a day. Also, since she's not showing any lameness, I would continue to at least walk her as much as possible. Definitely don't stick her in a stall or tiny pen. Movement and circulation are your friends.


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## Mercedes (Jun 29, 2009)

riccil0ve said:


> Ok... but what do you think it could be? k


A sprain/strain




> At this point, would you suggest cold-hosing, aspirin, bute, anything?


Turn out, no pain killer. Leave her be, keep an eye on it.


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## riccil0ve (Mar 28, 2009)

Yes, the chiropractor is a licensed vet at one of the best animal hospitals in my area. I'll base the appointment on her leg, and then if that doesn't cost a fortune, I'll get her adjusted too. 

And an update: I went out this morning and lunged her a touch, I'm really trying to see what helps and what makes it better. I took a few short videos too, but I don't have time to upload them now. The swelling had gone down a touch after some lunging, and then I cold-hosed her leg for 10 minutes, stopped and gave her a little bit of grain with some Equispirin. It took her 10 minutes to eat that, and then I cold-hosed for another 10. This evening, the swelling had gone way down, almost non-existant. I didn't think to cold-hose again tonight, but I did give her some more Equispirin. I don't like to give medication unless really necessary, so I'll probably stop and just cold-hose and see if that helps. She is outside 24/7 but she is with my little one and I can't keep them separated if my little one inspires Ricci to play.


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## riccil0ve (Mar 28, 2009)

Bumpity? =|


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## NorthernMama (Mar 12, 2008)

I agree with cold-hosing if it's warm and soft tissue. Handwalking only. No lunge work. Circles can be hard on tendons. Free turn-out is best. Though you may want to restrict her a little bit if she gets frisky with other horses and risks further injury. So a smaller paddock away from horses that get her excited. In my experience, stall rest only increases swelling and heat, also increases general stocking up. Plus the horse gets cabin fever -- bored, fidgety.

Allow LOTS of time for full recovery. When you think you've let it go long enough, you haven't. Wait another week or two depending... 

When you ride, start slow. Just walking for 2 weeks; then add 5 minutes of trotting for a week; then 15 minutes, and so on. You get the idea. 'Course I may be exaggerating the time needed, but I have no way to compare her injury to what my horse had.

I took in a horse with severly bowed tendons and she is now fine. We all had doubts that she would make it, but with the above recipe, we did OK.

Good luck.


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## Ryle (Jul 13, 2007)

Actually free turn out is NOT best for soft tissue injuries. Tendons do not heal well without serious restriction of motion because each step pulls on the already damaged areas and prevents them from being able to heal well. 

"Your initial goal is to reduce inflammation. Support bandages, twice daily cold water hosing or ice will help to reduce heat and swelling. Anti-inflammatories should be given under the direction of your veterinarian. *Your horse should be confined to a stall until ultrasound confirms the presence of an injury*. "--UC Davis website on tendon and ligament injuries in horses


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## ~*~anebel~*~ (Aug 21, 2008)

Ryle said:


> Actually free turn out is NOT best for soft tissue injuries. Tendons do not heal well without serious restriction of motion because each step pulls on the already damaged areas and prevents them from being able to heal well.
> 
> "Your initial goal is to reduce inflammation. Support bandages, twice daily cold water hosing or ice will help to reduce heat and swelling. Anti-inflammatories should be given under the direction of your veterinarian. *Your horse should be confined to a stall until ultrasound confirms the presence of an injury*. "--UC Davis website on tendon and ligament injuries in horses


Thank you!


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## Mercedes (Jun 29, 2009)

Ryle said:


> Actually free turn out is NOT best for soft tissue injuries. Tendons do not heal well without serious restriction of motion because each step pulls on the already damaged areas and prevents them from being able to heal well.
> 
> "Your initial goal is to reduce inflammation. Support bandages, twice daily cold water hosing or ice will help to reduce heat and swelling. Anti-inflammatories should be given under the direction of your veterinarian. *Your horse should be confined to a stall until ultrasound confirms the presence of an injury*. "--UC Davis website on tendon and ligament injuries in horses


I've rehabbed many horses with soft tissue injuries and turn out works beautifully. No drugs so the horse won't over do it. No buddies to chase them around. Paddock size should be such that the horse can move around, but not run. The ability to move keeps them from going stir crazy and ultimately injuring themselves further. The abliity to move allows for circulation of blood and lymphatic fluid to continue, which will promote healing.

Cold water hosing is useless unless you plan on being there for hours on end, 10mins on, 10mins off, for hours and hours. If you need to control the initial acute stage of inflammation, then you inject an anti-inflammatory.

You can't wrap a bandage tight enough to give any significant support.

Only when you've had tendon splicing done, are dealing with a suspensory injury, or something along those lines is stall confinement a good choice. And even then, a double stall or small paddock works better once the initial acute stage is over.

Horses are designed to heal in movement, and it's only the most severe cases where stall confinement for extended periods of time is the best choice.

I do agree ultrasound is a good choice to determine extent of injury if you don't have the experience.

Considering the OP is out riding this horse every day, and the swelling is not getting worse, nor is the horse getting lamer...I don't see that the UC Davis 'wrap them in bubblewrap and put them in a padded stall' actually applies.

Now, had the horse torn a suspensory ligament, or sliced a tendon in half...then we'll talk about it.


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## riccil0ve (Mar 28, 2009)

Ok, now I'm just mostly confused. 

Firstly, to Mercedes. No, I am not riding every day. I'm sorry if I didn't make that clear enough. I have ridden her four times since this came up three weeks ago, and all the other "work" was a minute or two of lunging just to see how she is moving and if she's tender at all.

In the beginning, the swelling went down when she was put into a bit of work. When I mentioned this to the second vet [the chiropractor], she said it was probably circulatory, but that if it didn't go away it's something that needs to be looked at. The first vet checked her on a day she wasn't swollen at all, but her felt her legs and said her tendons felt fine.

To top off the oddness of the situation, she is not, nor was she ever, lame. There is not, nor was there ever, heat. It was just swollen.

I have come to the realization that working is no longer helpful. Whether it's harmful or not is anyone's guess. I put her on aspirin and cold-hosed and the swelling has gone down immensely. Today is her first day without aspirin but I will still cold-hose. Tomorrow, I will know if the aspirin is making a difference, or if cold-hosing alone is enough.

As far as her living situation, I can stall her if I have to, but I don't want to unless I REALLY have to. I'm not big on keeping horses in stalls, and she typically comes inside at night over the bad parts of winter, but she spends most of her time outside, and she's happier that way. Not to mention, her pasterns all swell when she is stalled [because she isn't moving]. The only way to separate my two girls is to stall one or the other, but as I said, I'd rather not.

I'll definitely be looking into getting the ultrasound done, but in the meantime, what on earth am I supposed to do with her?!? I'm not sure who's advice to be following here. So far, I'm on Mercedes side because I can follow the logic. If I don't know the how's and why's of a treatment, I'm not about to just give it a whirl. Furthermore, she's been out 24/7 with my little one the whole three weeks, and nothing has gotten worse.


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## Mercedes (Jun 29, 2009)

Yes, I understand your confusion, which mostly just stems from not knowing exactly what's wrong. Once you arm yourself with the information, then deciding what to do becomes immensely easier. I don't think an ultrasound is warranted for this, but talk to your vet, and if it'll ease your mind, then go for it.

I've seen just about every kind of injury a horse can get. Unless it's spurting blood, a bone is sticking out, the horse refuses to bear any weight, the horse is shockie et al...I'm just not getting excited.

I've tried every kind of approach to injury rehab, I've worked with equine specialists and other healthcare professionals, and have studied extensively (even own a couple of books written by UC Davis), and therefore do not come to my conclusions blindly.

There are few injuries to horses that require or benefit from the horse being locked up in a stall.


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## riccil0ve (Mar 28, 2009)

Thanks, Mercedes, that makes me feel loads better. I've never dealt with something like this. In about 10 years when I'm done with vet school, I'll probably know what's going on, but now? Totally clueless. My gut tells me she isn't dying, and honestly, the ultrasound boils down to how much it costs. Either way, she is going to the vet for her follow-up chiro. Now here's hoping she doesn't kill herself on the trailer ride there!


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## riccil0ve (Mar 28, 2009)

Okay, quick question. Hypothetically, if I were to not get her veterinary attention for her leg, and it was a strain/sprain as Mercedes thinks, would she heal any less... better? [Please excuse the poor word choice, my brain seems to have taken a leave of absence.] What complications could we possibly face if I just give her a lot of time off and cold-hose?


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## Ryle (Jul 13, 2007)

Yes, the leg can heal "less well" with inappropriate rehab and too much movement too fast. The tendon may not be as tough or have as much ability to stretch and snap back with improper rehab and thus end up more likely to be damaged again. Stall rest and a slow rehab program based upon the severity of the damage to the ligament/tendon is still recommended as an vital part of rehab even in the most recent veterinary literature and lectures. This is becaue each step puts enormous additional strain on the already damaged tissue. 

The equine vet I worked for had a special interest in lameness (why she switched over to lameness after getting board certified in equine surgery I don't know  ) and we treated many many competition and race horses with musculoskeletal injuries of the leg. I have seen the detrimental effects of allowing a horse to move too much too fast during rehab of a tendon or ligament injury--even from simply turning them out in a slightly larger paddock.


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## Mercedes (Jun 29, 2009)

riccil0ve said:


> Okay, quick question. Hypothetically, if I were to not get her veterinary attention for her leg, and it was a strain/sprain as Mercedes thinks, would she heal any less... better? [Please excuse the poor word choice, my brain seems to have taken a leave of absence.] What complications could we possibly face if I just give her a lot of time off and cold-hose?


A sprain or strain in an equine, is the same as a sprain or strain in a human. 

The difference is that you can't treat it quite the same. You can't tell the horse to lay down and elevate their leg. 

You can cold-hose, but again, that's mostly just to make you feel better. It doesn't have any lasting effect, unless you rinse and repeat for a few hours on end, plus you're past that acute stage where if you sat there for hours it would have the most effect.

In terms of time off for healing...I already gave you a very good rule of thumb for that to make sure that the internal structures (cells) are healed. You can then return to work with full confidence that it's healed completely.


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## Mercedes (Jun 29, 2009)

Ryle said:


> Yes, the leg can heal "less well" with inappropriate rehab and too much movement too fast. The tendon may not be as tough or have as much ability to stretch and snap back with improper rehab and thus end up more likely to be damaged again. Stall rest and a slow rehab program based upon the severity of the damage to the ligament/tendon is still recommended as an vital part of rehab even in the most recent veterinary literature and lectures. This is becaue each step puts enormous additional strain on the already damaged tissue.
> 
> The equine vet I worked for had a special interest in lameness (why she switched over to lameness after getting board certified in equine surgery I don't know  ) and we treated many many competition and race horses with musculoskeletal injuries of the leg. I have seen the detrimental effects of allowing a horse to move too much too fast during rehab of a tendon or ligament injury--even from simply turning them out in a slightly larger paddock.


We haven't even determined that it's a tendon problem or to what degree. There isn't enough swelling or obvious lameness to even determine it wasn't anything more than just a bang.

I believe you're putting unnecessary 'terror' out there. 

I have worked with lameness specialists as well...in conjuction with my own racehorses. I have had tendon slicing done in my barn by one of the vets who started doing it in racehorses...guess how long my horse spent in a stall? 10 days...with handwalking multiple times per day for those 10 days. 

Then 3 weeks in a paddock about 3x's the size of a stall so he could freely move, but not run, and then out he went into the big paddock for the last 6 months, where he was free to rip around as he pleased. Full recovery and you can't even tell which leg it was.

How much cold hosing? None. How much pain killer, anti-inflammatory? One shot, the day of the surgery. How much bandaging? A few days to allow for the skin to close from the needles to make sure he didn't get an infection.

The horse in question has nothing even remotely as severe going on.


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## NorthernMama (Mar 12, 2008)

I agree with Mercedes that this is not likely a severe injury and that Ryle is erring hugely on the side of over-caution, but she is a vet and that what most owners want their vets to do.

I do not agree with Ryle about stalling, unless as Mercedes indicates it is a severe injury. It'd have to be pretty severe for me to lock up my horses. In your particular case, you already know that stalling causes your horse to stock up so you want to avoid that unless absolutely necessary.

You say there isn't any heat there? But there is swelling? And she is not lame? This is not a the joint, but at the tendon area, right -- so it's not arthritis I would assume. Is there pain if you palpitate (sp?) the area? Does she flinch? I'm thinking this is an old injury that you didn't notice or happened before you came along and it is acting up. 

At this rate, I would price an ultrasound. This will give you more information for sure. Depending on the results, you may want an xray in case there is a splint in there somewhere. I know it's money, but it is probably the only way you will be able to resolve this -- with information. Unfortunately, if it is an old injury, it is much more difficult to help with healing. First things first though, you won't be content until you know "why" and "what".


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## ~*~anebel~*~ (Aug 21, 2008)

I still agree with Ryle. 
Maybe I am a bit different with my horses and baby them too much. But I would rather have a horse bandaged to hell, cold hosed twice a day and in a stall for a week for the vet to come out and say "it's fine" then have the horse turned out and have the vet come out to tell me I've turned my horse's leg to mush.
Better safe than sorry. If my horse came in with a swollen leg you bet I would have ice and cold water on it within 5 minutes and I would have my vet on the phone and on the way to my barn despite the cost. A new horse costs a lot more than a $200 vet trip.

Honestly riccil0ve - if there was more damage to be done, it's been done. You've been lunging, riding and turning the horse out with minimal treatment for weeks. At this point all the vet will be able to say if there has been a serious problem is "better luck next time". It sounds minor, but I would still have the vet out to see what kind of rehab they suggest. And honestly? Save your money on a chiropractic adjustment and utilize the vet for vet work. Focus on fixing the horse's leg before you're worried about how aligned her body is.


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## welshies rule (Feb 7, 2010)

you seem really worried and I mean no disrespect to the people on this forumn but all we and i include my self, can do is give u an opinion. we cant tell u exactly whats wrong so if your as worried as you sound just get the vet out.

I rode a horse who had a tendon injury and he pulled up dog lame as soon as it happened. my advice get the vet and stop terrifying yourself.

I dont mean to sound nasty. Just if I was that worried I would cal the vet


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## riccil0ve (Mar 28, 2009)

I'm just wondering if it is a strain or sprain, what is the vet going to do besides tell me it's a strain or a sprain? From my understanding, to heal a strain or sprain is lots and lots of rest. So if I follow Mecedes guidelines prior to start working her again, wouldn't that be ample time to heal?

And as someone already mentioned, if it was going to get worse, it would have gotten worse by now, and it has only gotten better. So seeing as she's been outside the WHOLE time, and it hasn't gotten worse, I don't see how stalling her would be better... but again, what do I know? I'm not a vet.

She isn't in any pain. She was never in any pain. Just swollen. I can touch it, poke it, pick up her other foot, massage it, and it doesn't hurt. My horse is a pretty big baby, and has gotten several abscesses in my time owning her, and she honestly walks around like she's dying, and "whimpering" pathetically at me. I know my horse very well, and I think she would let me know if she was in pain at any point in the last three weeks.

No, this is not an old injury coming back to life, because she's never had any injuries. ::knock on all the wood in the world:: I hate bringing this up, but the previous owner has had Ricci since she was a weanling, and she's never had any problems other than the occasional scratch, all on the hind legs, and possibly a few abscesses. I'll ask her tomorrow, but I trust the previous owner, and I know she wouldn't lie. Nor is it possible for me to have missed something. I spend several hours a day with them, every day, and I'm up there at least twice to feed, and sometimes a third. There's no way I would have missed an injury.

For the record, her chiro appointment is the last thing on my mind. I just brought it up because I'm supposed to have an upcoming one anyway, so instead of that, I'll just get her leg looked at. And then, if I haven't already spent a fortune, I'll get her adjusted. I don't need anyone to think my priorities are funked up, because they're not.

Tomorrow is "call-every-vet-in-the-state-of-Washington" day, to get prices and ideas and possibilities and information about recovery. I posted this thread hoping someone might have had the same situation, and could give me an idea what it was. I didn't want to call my vet and say, "her leg's swollen" without any other kind of information to go on, or even questions he would ask so I know how to answer.

And I have one question for the night. Is it possible there is a problem in her knee, and the fluid is draining down the back of her leg? Because, as I said, her tendon feels fine, they both feel similar, but I wouldn't know what would feel wrong unless it was really wrong. I only ask because, while feeling her legs this evening, I noticed the inside of that knee was a touch warm. It is very possible that is a result of her standing in the sun, most of her body was warm to the touch, but just a thought. I'll check it in the morning.


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