The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
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49 February 2016 THE HORSE TheHorse.com therapy, and in many cases we may employ more intensive techniques such as ultrasound-guided injection of platelet-rich plasma or stem cells directly into the lesion, or surgery to release the SDF's accessory ligament in order to al- leviate some tension on the tendon. The most critical aspect of successful tendon rehabilitation is a sufficient rest period followed by a cautious and regimented return to performance on a gradually increasing plane of exercise. Ideally, your veterinarian will perform an ultrasound exam every four to six weeks, or at least before significant increases in athletic stress are planned, allowing he or she to track the tendon's progress and ensure that it is responding positively to therapy and exercise. It sounds like your horse was very well- managed and has recovered uneventfully from the acute SDF injury. The most important factors to consider now for maintaining long-term tendon health are: 1. The presence of other musculoskeletal injuries that could cause him to exert too much stress on the healed ten- don. The main considerations include opposite limb arthritis and foot pain. Many OTTBs are not blessed with great feet, so you have to make sure he is comfortable on both and not lean- ing away from a sore side. You have probably had flexion tests and X rays taken at some point, so you are aware of potential areas of joint pain that could also cause asymmetrical weight- bearing. This allows you to monitor for early signs of trouble and discuss appropriate management with your veterinarian. 2. Maintaining regular shoeing intervals with an appropriate toe length and foot balance is very important for healthy limb mechanics, as well as to help prevent foot soreness. Off-track Thoroughbreds are very prone to the long toe-underrun heel conformation, combined with thin soles and a pre- disposition to foot bruising. Most need the shoes for protection and regular farrier visits to maintain optimal foot balance and hoof health. 3. Choosing a style and level of competi- tion that is appropriate for each indi- vidual to prevent overstressing an old injury and potentially causing a new one. Although the tendon is technically healed, the type of collagen deposited in the tear is more like scar tissue with less elasticity and ability to withstand extreme strain than the original healthy tissue. If you hope to move up a level in workload or competition and are unsure if that tendon is up to the task, your veterinarian can perform serial manual and ultrasound exams during your months of preparatory training, as well as during the competi- tion season, to monitor the tendon's size and fiber pattern. This will provide feedback about how well it is adapting to increased strain. If there is any sign of inflammation or swelling, hopefully you will have caught it early enough to prevent a serious setback. While there is no way to guarantee that an old tendon injury won't flare up someday, these three factors are the key preventive measures to help ensure years of enjoyment with your horse. Melissa McKee, DVM McKee-Pownall Equine Services Ontario, Canada