From:
Laurie
Dear Jessica, I hope you can help me once again. I read your letters every week and always find something useful, but now I have to ask a very basic stupid question and I hope you will answer it.
Last week I was jumping my horse "Teddy" and he suddenly began to limp. I jumped off and looked if there was a stone in his shoe, and there wasn't. So I called the vet and he came out and said that Teddy has a bowed tendon. If I look carefully and compare his two front legs (the backs of them) I can see that there's a difference. The one with the bowed tendon is more bulging out and hot and sort of soft, and the other leg is more straight and not soft at all. The vet looked at his leg with ultrasound and said it was a "superficial lesion" but then he told me to keep him in his stall and cut his feed back and keep putting ice on his leg. He showed me how to wrap it also. But I was embarrassed to ask him what exactly is a bowed tendon and why I need to do all this, and keep Teddy in his stall, if it's just superficial. And he wants me to do this for several months, then he'll check Teddy again with the ultrasound. Does this sound reasonable to you, for a superficial problem? And what is a bowed tendon anyway? He also said that he'd rather not give Teddy any pain medications, which seems cruel. And he said that I'd need to keep an eye on the other leg. I'm certainly not going to be jumping Teddy when he's on stall rest, so was he trying to be funny? I don't think he should joke about something like this.
Thanks
Laurie
p.s. Teddy is eleven years old
Hi Laurie! I'm glad you called your vet right away, and it sounds to me as though he's managing the situation very well. The answer to your question is a little complicated, but here goes:
A bowed tendon makes the back of the leg look a little bit curved (the "bow"). The heat and mushy feeling, like the bow itself, are the results of an injury to the tendon. Tendons connect muscles to bone, and when tendons are pulled hard or suddenly, as they might be when landing after a jump, the fibres that make up the tendon can be stretched or torn. When those fibres are torn, fluids (blood and lymph) leak into the tendon and make it puffy and swollen and mushy and hot.
It's painful for the horse, and the pain helps to remind him to stand quietly and not jump around. Pain medication can make the horse feel better, but that's not necessarily a good thing, because if he feels better, he'll want to be more active, and being active can damage the tendon even more.
Pain and swelling are nature's way of saying "SLOW DOWN, STOP, TAKE IT EASY." There's another downside to pain medications: they can slow the healing process. So I'd have to agree with your vet's stand on this.
Bowed tendons are notoriously slow to heal, and they NEVER heal 100%. They can end a horse's athletic career -- take this one seriously! They need to be diagnosed with ultrasound -- which your vet has already done -- and then they need to be treated, some with rest and ice, some with medications, some with surgery. If your horse's injury responds well to rest and ice, you're lucky. And no matter how it's being treated, it will have to be checked and re-checked with ultrasound at regular intervals, so that your vet can see how it's healing.
Talk to your vet again, and don't be embarrassed to ask him questions. He won't mind: he'd probably LIKE you to ask questions. He knows what he knows, but he doesn't have any way of knowing what, or how much, YOU know. You have to ask questions. Don't worry about sounding stupid: you won't. Your vet is SUPPOSED to know more than you do about these matters -- you're consulting a professional, and that's the intelligent thing to do. When you don't understand something that the vet tells you, ask what it means, otherwise you may make a wrong assumption. For instance, the word "superficial" doesn't mean "trivial", it just means that the torn fibres are on the outside of the tendon rather than deep inside it (that would be called a "core" lesion rather than a "superficial" one). A superficial lesion has a much better chance of healing well, provided that you follow your vet's instructions carefully, and take all the time that the horse needs. It may take anywhere from several months to six months to an entire year of stall rest and ice, then stall rest, controlled, in-hand walking, and ice, before the injured leg is healed.
As for watching the other leg -- your vet wasn't being funny, he was serious. Horses carry most of their weight on their front legs, and when a horse has an injury to one front leg, he'll tend to carry less weight on the hurt leg and MORE weight on the uninjured leg. This puts a lot of stress and strain on the uninjured leg, and it's not at all uncommon for a horse with an injured left front leg (for example) to strain its good right front leg just because that one has to carry so much extra weight while the horse is recovering. So DO watch that other leg, and be aware of any signs of strain, such as heat and/or puffiness. If your vet shows you how to wrap your horse's legs, he'll almost certainly want you to wrap BOTH front legs, not just the injured one.
Take good care of Teddy, and let me know what the vet says after the next ultrasound!
Jessica
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