Page 331 - The Veterinary Care of the Horse

Scintigraphy

Scintigraphy does not reliably detect proximal suspensory desmitis. However, it can be
VetBooks.ir helpful in the diagnosis of proximal suspensory desmitis when it is accompanied by an

avulsion fracture or if other diagnostic techniques have been inconclusive.

Magnetic resonance imaging (MRI) and computed tomography (CT)

MRI or CT are occasionally helpful in cases where the horse responds to nerve blocks but no
changes are visible on ultrasound.

TREATMENT

Treatment consists of the following:

• Box rest initially with support bandaging

• Controlled exercise for 3–6 months.

• Correction of any foot imbalance.
• Regular monitoring of healing by ultrasound examinations until the ligament has healed.

In some horses the affected area never returns to a normal appearance. Rest and

controlled exercise in these cases is continued until the ligament appears the same in
sequential examinations.
• Non-steroidal anti-inflammatory drugs, e.g. phenylbutazone, as necessary.

Other treatments that may be used include:
• Stem cell therapy

• Platelet rich plasma

• Gene therapy (see page 197)

• Topical dimethyl sulphoxide (DMSO)

• Shock wave therapy. This is normally reserved for horses with chronic lesions not
responding to conservative therapy

PROGNOSIS

This depends on the severity of the injury and how quickly it is diagnosed and treated
appropriately. More damage can be done if the horse is kept in work. On the whole the

prognosis is good: 85–90% of horses with acute injuries respond well to conservative
management.