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Figures 5: A. Radiographs of a normal cannon bone on the left and abnormal on the right. B. Bone scan images of PSL desmitis with bony inflammation (black arrows).

under strict stall rest for two to four weeks and then transitioned into hand walking, ride walking and small paddock turn out over the following four to six weeks at the discretion of the surgeon. Horses receiving ESWT are confined to small paddock turn out with hand or ride walking for 10 weeks with three shockwave sessions three weeks apart at the beginning. Walking should be limited to 20-30 minutes, five to seven times per week. After the initial rehabilitation is complete, a complete lameness exam and ultrasound exam should be performed. Horses showing significant improvement can be transitioned into work. A detailed program of daily exercise is outlined for the rider, adding in an additional two minutes of trot work per week split up with walk breaks. Monthly rechecks should be performed to ensure the soundness of the horse. Horses failing to response to initial therapy can be treated with additional shockwave sessions, or sent for surgery if not previously elected. Adequate imaging and diagnostic blocks are required to properly diagnose PSL desmitis in the hind limb. Properly diagnosed and treated horses have a good prognosis for return to athletic performance. References/Suggested Reading 1.




Dyson S, Murray R. Management of hindlimb proximal suspensory desmopathy by neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy: 155 horses (2003-2008). Equine Vet J (2011) 44,361-367. Murray R, Dyson S, Tranquille C, Adams V. Association of type of sport and performance level with anatomical site of orthopaedic injury and injury diagnosis. Equine Vet J Suppl (2006) 36, 411-416. Hughes T, Eliashar E, Smith R. In vitro evaluation of a single injection technique for diagnostic analgesia of the proximal suspensory ligament of the equine pelvic limb. Vet Surg (2007) 36, 760-764. Contino E, King M, Valdés-Martínez A, McIlwraith C. In vivo diffusion characteristics following perineural injection of the



deep branch of the lateral plantar nerve with mepivicaine or iohexol in horses. Equine Vet J; (2014) epub ahead of print. 5. Hewes C, White N. Outcome of desmoplasty and fasciotomy for desmitis involving the origin of the suspensory ligament in horses: 27 cases (1995-2004). J Am Vet Med Assoc (2006) 229, 407-412. 6. Dyson S. Diagnosis and management of common suspensory lesions in the forelimbs and hindlimbs of sport horses. Clin Tech Equine Pract (2007) 6, 179-188. 7. Denoix JM, Farres D. Ultrasonographic imaging of the proximal third interosseous muscle in the pelvic limb using a plantaromedial approach. J of Eq Vet S (1995) 15, 246-350 8. Norvall A, et al. Diagnosis, treatment, and outcome of hindlimb proximal suspensory desmopathy in sport horses: 75 Cases (2008 –2014). Proc 61th Am Assoc Equine Pract (2015) 61, 358

Kent Allen , DVM, Cert. ISELP Dr. A. Kent Allen received his veterinary degree from the University of Missouri in 1979. His practice, Virginia Equine Imaging in Middleburg, Va., focuses on toplevel sports medicine, lameness and diagnostic imaging. Allen is Certified by the International Society of Equine Locomotor Pathology (ISELP) and serves as its Vice President and Executive Director. He serves as the volunteer Chairman of the United States Equestrian Federation (USEF) Veterinary and Drug and Medications Committees. He has served as USEF Team Veterinarian in multiple roles in multiple disciplines. He has served on the Board of Directors for USEF and United States Eventing Association (USEA). Allen is the National Head Veterinarian for the Federation Equestrian Internationale (FEI) for the United States and serves on the FEI Veterinary and List Committees. He has been the Foreign Veterinary Delegate (Veterinary Judge and Technical Delegate) in two Olympic Games, two Pan American Games and served as the Veterinary Services Manager at an Olympic and World Equestrian Games.


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Practitioner Issue 4, 2017  

A publication by the Florida Association of Equine Practitioners, an equine-exclusive division of the FVMA. Your Invitation to Attend the Oc...

Practitioner Issue 4, 2017  

A publication by the Florida Association of Equine Practitioners, an equine-exclusive division of the FVMA. Your Invitation to Attend the Oc...

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