Initial therapy is directed at reducing the inflammation. Rest, cold therapy (water, ice pack), bandaging, and the use of systemic anti-inflammatory medications are recommended. Cold therapy should be applied frequently throughout the day, but the duration of application limited to less than 20 minutes at a time. Other treatments include:
Stall rest. Rest is important until the horse is able to walk soundly. Once walking soundly, controlled hand-walking exercise can be started. Increase in intensity and duration of exercise will be directed by the progression of healing seen in sequential ultrasound evaluations.
Tendon splitting. This procedure is recommended in acute superficial digital flexor tendon lesions where the lesion is located in the center of the tendon.
Superior check ligament desmotomy. This surgical procedure results in transection of a fibrous band that connects the superficial digital flexor tendon muscle unit to the horse's forearm. It may be useful in increasing the "elasticity" of the superficial digital flexor tendon following injury.
Inferior check ligament desmotomy. This is a surgical procedure that results in transection of the check ligament between its attachment to the back of the cannon bone and where it joins the deep digital flexor tendon. The surgery is recommended in some horses that have inferior check ligament desmitis.
Desmotomy of the palmar annular ligament (annular desmotomy). This procedure is recommended for those horses that have Tendinitis in the lower third of the deep digital flexor tendon or the superficial digital flexor tendon. Transection of the ligament prevents its constriction around the swollen or enlarged injured tendons.
Intralesional therapy. The lesion is injected with B-aminoproprionitrile, polysulfated glycosaminoglycan, hyaluronan, or corticosteroid.
Home Care and Prevention
A veterinary consult is recommended for all horses that develop swelling in the region of the tendons or within the digital flexor tendon sheath, regardless of the duration of the swelling or the degree of the animal's soundness. Horses should be seen on an emergency basis if they develop acute swelling of the tendon and lameness. Early intervention can minimize progression of the lesion.
It is very important that owners adhere to the veterinarian's treatment plan. Failure to do so often leads to protracted healing and unsatisfactory long term results.
Prevention is not always possible in competitive horses. The chances of injury can be reduced by making sure horse are physically trained prior to participating.