AAEP Veterinarians Discuss Suspensory Ligament Injuries

Attendees discussed diagnostic and treatment options, among other topics.
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More than 250 equine veterinarians attended the Suspensory Ligament Care and Treatment table topic at the 2013 American Association of Equine Practitioners convention, held Dec. 7-11 in Nashville, Tenn. Discussion covered types of suspensory injuries (forelimb or hind limb? Branch, body, or origin?) with particular focus on different diagnostic approaches and associated considerations.

W. Rich Redding, DVM, MS, Dipl. ACVS, led the discussion on the value of using MRI to accurately assess proximal suspensory injuries with particular reference to hind suspensories. Other emerging diagnostic imaging modalities include elastography (an imaging modality that maps the elastic properties of soft tissue) and Doppler ultrasound. The attendees agreed that diagnostic analgesia to confirm a horse’s source of unsoundness is the first line approach, as ultrasound imaging/radiology might not always be useful with pathologic lesions that are not readily apparent.

There was also extensive discussion regarding the difference between acute and chronic suspensory unsoundnesses in their diagnosis/management/treatment, with a consensus that most require a minimum 90-day recovery and that the chronic or recurrent cases are often more difficult to give an accurate prognosis for. In addition, attendees agreed that the discipline that the affected horse was engaged in appears to impact his ability to recover from and remain sound after a suspensory injury. Neurofasciotomy of hind origin suspensory pain, while still a new approach for long-term management, has shown promise in sport horse and some Thoroughbred practices utilizing this procedure.

Final discussions revolved around rehabilitation approaches: aquatread, swimming, extracorporeal shock wave therapy, laser therapy, and exercise approaches. The veterinarians reported multiple strategies to be successful with appropriate case selection

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