RUNNING HEAD: Suspensory Ligament Injury
Equine Suspensory Ligament Injury Case Study
Gerri Pritt
Tarleton State University
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Suspensory Ligament Injury
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Juliana is a 12-year-old Quarter Horse mare who was adopted by Jon Sterling 2 years
ago. Today she presents to us with right foreleg lameness, the owner had noticed the lameness
earlier when he was bring her in from pasture. He told us that she is currently competing in
western pleasure at a local level. He also noted that before he purchased her, that she had some
soundness issues but has since been fine (Christensen, C., & Rockett, J., 2010, p. 157).
Physical Exam Findings:
General Appearance: BAR, 5/9 BCS
Temperature: 100.0 Rectal
Skin/coat: Normal
Eyes: Normal
Ears: Normal
Oral cavity: Normal
Musculoskeletal: 1/5 lameness to right foreleg, also noted slight shortening of stride and a small amount
of swelling caudal to cannon bone (Christensen et al., 2010, p. 157)
Cardiovascular: 32 bpm, no murmurs
Gastrointestinal: No palpable abnormalities, +2 motility
Respiratory: 18 Bpm, normal auscultation
Genitourinary: No abnormal findings
Nervous system: Normal
Lymph nodes: No palpable lymphadenopathy
Dr. Smith suspects a suspensory ligament issue and would like to perform an ultrasound to
confirm his suspicion. The client would like to know why he chose ultrasonography instead of
radiography to examine the leg (question #2). Although radiography can give us some detail as to what is
wrong with the leg, it is more beneficial to perform an ultrasound on the leg. Ultrasonography can give us
a more in depth look at the fibers of the ligament and surrounding tissue, whereas radiographs can be a
vague outline of the muscle. The client would also like to know if a Magnetic Resonance Imaging
(MRI) can be performed on a horse (question #3). Yes, in fact MRI’s are becoming more popular
in the equine industry and can “provide the best method of imaging the suspensory ligament and
the best means of making an accurate diagnosis and determining the exact nature and severity of
injury” (Scott, M., 2013, Nov 6).
Suspensory Ligament Injury
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I have prepped the patient for the ultrasound by clipping the hair in the required area of
the foreleg, then I have wiped said area with alcohol to remove any superficial fats (question #1)
(Brown, M., & Brown, L.C., 2014, p.136). Juliana is not cooperating with the ultrasound so I
apply a gentle hand twitch to distract her. The most common place for a hand twitch in the lateral
aspect of the neck (question #4) I placed my hand on the lateral aspect of the neck and pinched
the loose skin firmly. This had worked for a short period of time so the Dr. allowed me to use a
Kendal humane twitch. This twitch has 2 handles that clamp on the nose. Pressure is then
controlled by opening or closing the handles (question #4) (Holtgrew-Bohling, K., 2012, p.40).
When using a 7.5MHz probe, we get an increase in fine detail and better spatial resolution but
the penetration depth is decreased, as compared to a 5 MHz probe (question #5) (Brown et al
2014, p.140). During the exam, Dr. Smith noted an abnormal hypoechoic area in the suspensory
ligament. Hypoechoic means fewer echoes, therefore the image is darker than surrounding
structures (question # 6) (Bassert, J.M., & McCurnin, D. M., 2010, p. 579). When looking at the
screen, I notice an acoustic shadowing with the cannon bone (question #7), it is a lack of echoes
beyond a reflecting object. Now that we have completed our exam, it is time to clean up the
mess. I will first start with wiping down Juliana’s leg with a dry washcloth, then I proceed to
clean the transducer with a new clean, dry soft washcloth to remove all remaining acoustic gel
(question #8) (Brown et al 2014, p. 143).
In the little amount of time I have worked with horses, I would conclude that it is possible
this tear had occurred many years ago and is now making an apppearence. According to Dr.
Scott of HorseJournals.com, it is possible the tear could have been present the whole time, but it
was not until now the clinical signs are showing up (Scott, M., 2013, Nov 6). It is possible
Juliana hyperextended her foreleg when running a race or in the pasture but with the history of
Suspensory Ligament Injury
unsoundness, it is possible for the tear to have occurred years ago and is now becoming noticed.
Dr. Smith has prescribed 1 gram of Phenylbutazone PO BID. This means he would like Juliana
to take 1 gram of Phenylbutazone by mouth twice daily, every 12 hours, for pain and
inflammation.
With time Juliana will be back to her normal self and will run with the others, but for
now she should be resting while the tear heals.
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Suspensory Ligament Injury
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References
Christensen, C., & Rockett, J. (2010). Case Study in Veterinary Technology: Ascenario-based
critical thinking approach. Heyburn, ID: Rockett House Publishing LLC
Scott, M. (2013, Nov 6). Suspensory Ligament Injuries: Advances in Diagnosis and Treatment.
Retrieved from http://www.horsejournals.com/suspensory-ligament-injuries-advancesdiagnosis-and-treatment
Brown, M., & Brown, L.C., (2014). Radiography for Veterinary Technicians (5th ed.) St. Louis,
MO: Elsevier, Inc.
Holtgrew-Bohling, K., (2012). Large Animal Clinical Procedures for Veterinary Technicians
(2nd ed.) St. Louis, MO: Elsevier, Inc.
Bassert, J.M., & McCurnin, D. M., (2010). Clinical Textbook for Veterinary Technicians (7th ed.)
St. Louis, MO: Elsevier, Inc.