swelling of suspensory

Question
QUESTION: We have a pony that sustained an injury while foxhunting.  He is non weight bearing  on his left front and an ultrasound indicated that he had diffuse endema and that the lateral and medial branches showed alterations in the fiber pattern.  The lateral branch is 3x its normal side and the medial branch is 2x its normal size.  I have surpass to put on his pastern and I will be icing it but do you have any thoughts on his prognosis?

ANSWER: this injury should be able to be healed, but you will need to follow this with ultrasound. Also, once some of the swelling is out, I would strongly suggest considering injecting the ligament with stem cells, bone marrow or platelet rich plasma in order to help increase the speed of healing and better healing. You need a vet comfortable and familiar with this in order to do it. Also, if the pony isnt on bute, it needs to be. You should talk to your vet about a dose for it. In my opinion, Surpass is woefully inadequate for an injury of this severity, which is why your pony is still as painful as it is. feel free to contact me again if you want more info, but I would suggest strongly considering one of the injections for treatment as ive described. Ice will be very helpful and I do recommend continuing it, but you need to get this pony more comfortable soon. Follow this injury with ultrasound regularly, every 6 to 12 weeks and once the swelling is controlled, look into getting the injections ive mentioned. good luck. With good care and if the fibers are not completely ruptured, I do think the pony may return to some level of exercise, maybe to the same level, but ultrasound and clinical evaluation must be repeated regularly.

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QUESTION: the options that i was given were "stem cell injection or A-cell injection or shockwave therapy.  All of these were more expensive than I could afford $1500+.  Is there anything more that I can do?  He is bearing some weight now and he is on 2 grams of bute morning and night.  He has a pleasant expression and he is happy in his stall. Thank you so much for any advice you can give.

Answer
well to start with, shock wave therapy will do absolutely nothing for healing so dont choose that. If your vet has the ability to do so, you can inject bone marrow at a much reduced cost because it can be directly harvested from the horse, spun down and then the supernatant injected- so it requires no purchase of any product or any preparation by any lab. It could be done less expensively, but you need to find a vet who can harvest the bone marrow. that would be my recommendation. I still think by the end of this procedure it may be the better part of 500-1000. Otherwise, you are looking at supportive care, maybe splitting the ligament with a tendon knife if there is a core lesion and alot of time- maybe a year.