REGULAR FEATURE
EW by Michelle Delco, DVM, DACVS T
Dr. Delco is originally from New York, and received her veterinary degree from Cornell University in 2002. After a one-year post- doctoral internship at Rood and Riddle Equine Hospital in Lexington, Kentucky, she completed an equine surgery residency at the University of California, Davis and obtained board certifi cation through the American College of Veterinary Surgeons. Dr. Delco then joined the faculty at Kansas State University as an assistant professor in equine surgery.
Although she greatly enjoys teaching, Dr. Delco left academic practice to join Pilchuck Veterinary Hospital in July 2008, and is excited to live and work in the Northwest. Her professional interests include orthopedic surgery, sport horse lameness diagnosis and treatment and minimally invasive surgery.
When not in the hospital, she spends her time gardening, singing and playing traditional American music and exploring the outdoors with her dog, Kirby. For more information or to schedule an appointment visit
www.pilchuckvet.com.
Equine Wellness
Tendon and Ligament Injuries From Prevention to Prognosis
endon and ligament injuries are common causes of equine lameness, responsible for up to 30 percent of lame-
ness in athletic horses by some estimates. With the changing of the seasons, following is some timely information on preventing tendon and ligament injuries, especially in those horses that may have had a quiet winter.
An Anatomy Review A ligament is a fi brous tissue that connects bone to bone; a tendon is a fi brous tissue that connects muscle to bone. Both are made of long, thin collagen fi bers, organized in bundles of thou- sands, like a rope. The tissue is extremely strong but also somewhat stretchy, which allows liga- ments and tendons to support the weight of the horse and to act as shock absorbers. Injury occurs when these tissues are overloaded — either due to an athletic injury (repetitive/additive strain), a single traumatic event or a combination of both. There are many different types of tendon-liga-
ment injuries. Common ones include superfi cial digital fl exor tendon (SDFT) — classic “bowed tendon;” suspensory ligament — “high suspen- sory” and suspensory branch injuries; collateral ligaments — almost every joint has collateral ligaments that lend side-to-side stability and common joints involved are the coffi n, fetlock and stifl e; deep digital fl exor tendon (DDFT) inju- ries can occur behind the cannon bone, at the pastern or low in the foot.
Diagnosing Tendon-Ligament Injuries Some of these injuries are relative easy to spot
(e.g., bowed tendon), as they have heat, swelling and sensitivity. However, a surprising number of soft-tissue injuries (especially ones within the hoof capsule) are tough to diagnose. They don’t show obvious heat or swelling, and the degree of lameness can be variable. For example, a common scenario with tendon-ligament injuries
26 May 2012 The Northwest Horse Source
is that lameness improves with rest, but recurs and/or worsens with exercise. Therefore, pursuing a workup with a
veterinarian who is experienced in lameness diagnosis is critical. This involves a thorough lameness evaluation, including an ultrasound, the imaging modality of choice to look at tendons and ligaments. Occasionally, graphs and MRI also are used.
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Prognosis Tendon-ligament injuries are worrisome in terms of healing and return to use. Unlike muscle, tendons and ligaments take a long time to condition… and a long time to heal. The tissue is poorly endowed with blood vessels, and the body’s ability to remove damaged collagen and replace it with new, functional tissue is limited. Ligaments and tendons tend to heal with inelastic scar tissue which is unable to hold up to strain and stretch, setting the horse up for re-injury when going back to work.
Treatment Call your horse’s veterinarian as soon as you suspect a problem. It is important to note that tendon-ligament injuries are not all created equal. A veterinarian must fi rst make an accurate diagnosis to recommend the appropriate treat- ment. Acute injuries with heat and/or swelling are usually treated with rest, cold therapy, wrap- ping and anti-infl ammatories.
Rest and Rehabilitation During the rest and rehabilitation phase, the concept is to control the load/strain on the healing tissue, and to never overload it past what the body can repair. We work to gradually build strength and regain elasticity. In general, when the intent is to return the horse to athletic function, free turnout is not recommended. One “run-buck-tear” around the pasture is all it takes
www.nwhorsesource.com
PHOTO COURTESY OF PILCHUCK VETERINARY HOSPITAL
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