# Collateral ligament strain of coffin joint SUCCESS STORIES?



## L11GHH (22 August 2015)

So after 4 months of being fobbed off with laminitis by the vet I demanded a referral for an MRI for my intermittently lame horse. This mare is my world, I have put my heart & soul in to her, blood, sweat & tears & we had worked out socks off to get where we are. My dream for this year was compete in our first BE together. I was never convinced of the laminits diagnosis & sure enough the results of the MRI have shown:

 "Focal desmitis of the axial mid to distal aspect of the medial collateral ligament of the DIP joint RF"
"Mild synovitis within the DIP joint RF"

"To summarise, strain of the medial collateral ligament of the right fore foot. This is likely a traumatic injury sustained in the field rather than a repetitive strain injury associated with chronic imbalance.
Treatment  involves rest over a 6 month period in combination with remedial farriery. Peri-lesional medication and/or intra-articular medication with platelet rich plasma (PRP) is likely to improve healing, reduce inflammation and increase the prognosis for return to exercise."

Obviously I will be doing everything in my power to bring her right, her shoe is on its way & I will be ringing the vet to arrange PRP on Monday. The vet said that she has a 50/50% chance of making a full recovery. Basically she either does or she doesn't. I just can't get my head around the fact that she may never be ridden again if the injury doesn't heal. I'm totally devastated, can't stop blubbing & I'm desperate to hear some sucess storeis from people who have gone through the same thing :-(


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## ycbm (22 August 2015)

I am sick to the back teeth of vets giving these poor prognoses for these horses and continuing to recommend remedial shoeing which has a very poor success rate. Look at rockleyfarm.blogspot.com for plenty of examples of horses returning to full work after your horse's injury, without any rest period. or medication,  but the right work, and no shoes.

There is no guarantee, but about four times as many come sound, and many of those have already been through, and failed, the shoes/medication route.


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## googol (22 August 2015)

Following. Sorry no advice to give


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## pairciban (22 August 2015)

This is what my horses MRI summary said.

Asymmetric proximal ossification of the lateral cartilage of the foot LF > RF 
"Inflammatory" signal within the mid portion of this ossified cartilage LF 
Desmitis of the lateral collateral ligament of the DIP joint LF 
Minor modeling of P3 at the insertion of the above LF 

I was told to shoe with heart bars and i could have laser treatment or PRP.  My horse has been competing for the last 18 months without shoes and past experiences with heart bars, they are not top of my list!  I was told 6 -9 months box rest and he should be fine.  My vet said that out of all the bits to damage the bit he did has the best prognosis.  We are about 8 weeks after MRI now and I am having a real job finding a farrier that will trim him to the x-rays and scans.  He is on box and box sized paddock during the day rest.  I have said to myself that I will rest him until spring and then see where we are.


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## aussierider (23 August 2015)

My mare had a 'moderate to severe' tear to the medial collateral ligament and some legions on the DDFT. She wasnt properly diagnosed for 6 months during which time she didnt improve  at all despite box rest. The vet that did the MRI said he would give her an 80% chance of not healing if she had injured it earlier that week. He said given it happened 6 months ago he thought she would pretty much be cactus. 

I found a really wonderful barefoot trimmer and once he started working on her she gradually improved. She is now sound and in work. I dont even worry about her anymore. She had a full year off and then another year where i started riding but was very cautious with her.


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## Mooseontheloose (23 August 2015)

Our mare was diagnosed with similar, aged fifteen after a fairly serious jumping career. Made to measure heart bars, to support foot,  six months rest and then bringing back into work and three years later is happily competing, obviously at a lower level due to age but very happy. 
Personally I wouldn't touch a barefoot trimmer with a ten foot barge pole but each to their own.


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## Exploding Chestnuts (23 August 2015)

Mooseontheloose said:



			Our mare was diagnosed with similar, aged fifteen after a fairly serious jumping career. Made to measure heart bars, to support foot,  six months rest and then bringing back into work and three years later is happily competing, obviously at a lower level due to age but very happy. 
Personally I wouldn't touch a barefoot trimmer with a ten foot barge pole but each to their own.
		
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I am of the opinion that heartbars are not going to do what they say, in fact the idea of "support" is contrary to what is required, which is to ask the foot to support itself, to adapt, to model and to strengthen itself.

I had a similar injury to my own knee, it was very painfull,  at first I wore walking boots when on any unlevel ground, but this did not work, and the tear was repeatedly re-torn, I started walkiing in the house with no slippers and outside with my short [and oldest] Ariats with thin soles. The proprioreceptors in my feet automatically responed to the ground and even now, some two years later, when barefoot in the house, I can feel the strength of my own natural support system in response to changes in the flooring. 

I got the idea after having taken my boy barefoot, for thirty years all my horses had been shod by world class farriers, but no more. I would use a good farrier over a trimmer simply due to their experience and their training, but none of them ever said "these feet need shoes", most of them said "they need no balancing", and grumpy said "you have gone over to the dark side" lol!

If I were OP, I would buy the book First Feet [ignore seaweed], get the horse on a hi fibre NO sugar [<5%] diet and minerals with lo iron and high [10gms] magnesium. 25gms salt [no pink salt], and 25gms micronised linseed.
The minerals seem expensive, maybe £1.00 per day, but by stopping feeding branded horse feeds and using straights this will level out.
The Rockley farm blog is huge, but over time by reading the essentials and following a few case studies you will gain confidence in their system.

It is possible to get vet referrals on some insurances, but by the sound of things you may have to find a more receptive vet. Though you may be able to work on him as he has proved fallible.  Nic [Rockley] will be willing to advise on all matters, prognosis, referrals and so on, but the best thing might be to get a reasonable understanding of things before you speak to her on the phone.

It may be possible to work on the horse at home, but the injury seems complex and in my opinion your best scenario is to have re-hab in a specialist facility.


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## L11GHH (23 August 2015)

Thank you all for your replies. With regards to the shoe, they have recommended a 'Michael Valiliant Aysmetric shoe' which is designed to support the medial collateral ligament. She has no previous issues with her feet & with it being a freak accident rather than conformational issues that have caused the strain I am happy to give it a go. They PRP sounds very promising & providing I can keep her from thrashing around (she is in a small flat box size paddock with shelter at night & box size field in the day) I'm trying to mix it up so she doesn't get bored as obviously she will have to come in when the weather/ground changes as she needs to be on a firm, flat surface I hope she has a good chance of recovery. I think I just heard the 50/50 prognosis, got fixated on it & it's taking a lot to get my head around it. He said the damage was relatively mild & was in the middle of the ligament which was not worst case scenario. 
All I can do is my best & stay positive but it's proving quite difficult at the moment. Thank you all again x


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## criso (23 August 2015)

L11GHH said:



			I think I just heard the 50/50 prognosis, got fixated on it & it's taking a lot to get my head around it. He said the damage was relatively mild & was in the middle of the ligament which was not worst case scenario.
		
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Not sure where the 50% came from.  I have seen the full details of this study and it gives a breakdown of each injury. Collateral ligament has a recovery rate of 10% and mild worse that severe.

http://www.ncbi.nlm.nih.gov/pubmed/21039796


I'm with Bonkers on this, my horse went to Rockley with collateral ligament issues (though he had other issues as well) after 18 months of the best farriers around.  Came back into full work including jumping and cross country until he had to be retired with a shoulder injury.

Try what your vets are suggesting but keep an  eye on the insurance so you might have a different option if it doesn't work.  I would also take photos to see what is happening.  I used to do it when they he was shod just before the new shoe goes on but after trimming so it was the same time in the cycle. Vet and Farrier thought they could see improvements (because they really hoped there was) but the photos showed a different tale.


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## L11GHH (23 August 2015)

criso said:



			Not sure where the 50% came from.  I have seen the full details of this study and it gives a breakdown of each injury. Collateral ligament has a recovery rate of 10% and mild worse that severe.

http://www.ncbi.nlm.nih.gov/pubmed/21039796


I'm with Bonkers on this, my horse went to Rockley with collateral ligament issues (though he had other issues as well) after 18 months of the best farriers around.  Came back into full work including jumping and cross country until he had to be retired with a shoulder injury.

Try what your vets are suggesting but keep an  eye on the insurance so you might have a different option if it doesn't work.  I would also take photos to see what is happening.  I used to do it when they he was shod just before the new shoe goes on but after trimming so it was the same time in the cycle. Vet and Farrier thought they could see improvements (because they really hoped there was) but the photos showed a different tale.
		
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The 50% will be based on the results of HER MRI, not a general statistic. So I suppose it's good news in a way. Thank you for the info about Rockley, I've done lots of reading up about the place, very interesting & definitely worth thinking about if the next 6 months & recommendations from the vet don't go to plan. I've got EVERY THING CROSSED!!


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## ester (23 August 2015)

These are the shoes I guess. http://www.michel-vaillant.com/gb/shop/9/35/asymetrix-aluminium-shoe,1275.html

I have to say if mine were given that diagnosis I would be taking the shoes off OP, and allowing the feet to develop their own true support instead. My boys landing pattern on his lame foot suggested that he would likely have some chronic collateral ligament damage- didn't MRI as it wouldn't have changed treatment options for him. Well done for pushing for a scan on yours though . Our mare had PRP for a suspensory injury and is back in work, so actually I might have that and shoes off .


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## Mooseontheloose (23 August 2015)

You may consider heart bars unnecessary. All I can say is that I followed the advice from Newmarket Equine Hospital and we got a sound horse again. The farrier worked from the scans and xrays. (He is possibly one of the best known remedial farriers in the country) If a world class vet's practice suggests something I would not consider myself more of an expert and ignore their advice. That's why one goes to them.
I wouldn't say that is what the OP has to do, but she asked for success stories so I told her ours.


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## L11GHH (23 August 2015)

Mooseontheloose said:



			You may consider heart bars unnecessary. All I can say is that I followed the advice from Newmarket Equine Hospital and we got a sound horse again. The farrier worked from the scans and xrays. (He is possibly one of the best known remedial farriers in the country) If a world class vet's practice suggests something I would not consider myself more of an expert and ignore their advice. That's why one goes to them.
I wouldn't say that is what the OP has to do, but she asked for success stories so I told her ours.
		
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THANK YOU  I think sometimes people go off on a tangent with regards to what you're actually asking for. Although it's nice to hear other people's opinions on treatment I travelled her 5 hours to a specialist Equine Hospital for her MRI who were fantastic & I am more than happy with the treatment they have recommended, I just wanted some reassurance from others who have been through the same thing & come out the other side with a sound horse. Hopefully I'll be one of those!  x


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## ester (23 August 2015)

TBF you are hearing from people that have has similar diagnoses and come out with a sound horse , they are only trying to help. It's just that some of those were by alternative method after 'conventional' treatment didn't work and I think for most it is helpful to know there is another option if the conventional doesn't work. It is also perhaps useful to remember that insurance drives the conventional because there is a time limit on a claim and research into the alternative has been limited because there is no financial driver compared to drug etc treatments.


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## L11GHH (23 August 2015)

ester said:



			TBF you are hearing from people that have has similar diagnoses and come out with a sound horse , they are only trying to help. It's just that some of those were by alternative method after 'conventional' treatment didn't work and I think for most it is helpful to know there is another option if the conventional doesn't work. It is also perhaps useful to remember that insurance drives the conventional because there is a time limit on a claim and research into the alternative has been limited because there is no financial driver compared to drug etc treatments.
		
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I appreciate all the responses & I'm all for alternative treatment, I went down that route with my 20 yr old arthritic cob after the conventional methods did little to help & he is still competing to this day. 
I am happy to follow the recommendations of the specialist hospital on this one though as for now I feel it's my best shot. Again, thanks for the responses


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