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Many horse owners have already experienced the unfortunate situation of their horse suffering from tendon or ligament injuries unexpectedly. Various therapeutic approaches are available, ranging from stall rest to stem cell therapy.

Often, this injury marks the beginning of a “career of lameness,” where the tendon or ligament structures of one leg or another are repeatedly affected. In addition to treating the acute damage, it is essential to investigate the potential causes.

Tendons and ligaments are connected to the liver

Chinese medicine teaches us that tendons and ligaments are closely linked to the liver metabolism. Indeed, many horses with such damage often exhibit early markers for liver problems, such as white markings, eye issues, vertical stripes in the coat of approximately 2 cm wide, brown coloring of the black longhair or black coat, dark patches in an otherwise light brown coat, etc. Chestnut, palomino, and chestnut piebald horses are particularly susceptible, as their color genetics appear to predispose them to liver issues.

The liver is the body’s primary “chemistry laboratory” and is involved in numerous metabolic processes. Its tasks range from processing ingested sugars to detoxifying waste products. The detoxification process, in particular, plays a significant role in the tendon and ligament health.

If the liver cannot adequately metabolize waste products for excretion by the kidneys, it can lead to deposits in connective tissue structures, including tendons and ligaments.

Creeping process sets in motion

This implies that small injuries (microfissures), which occur daily in tendon and ligament tissue, particularly in the legs, cannot be repaired quickly enough, especially during movement.

New damage occurs every day, and the tendon becomes increasingly “threadbare,” resembling the heel of an old sock. With such a thinned tendon, even a slight additional load, such as a stumble or a twisting movement on the leg, can result in tearing of the remaining fibers and thus clinically manifest as “tendon damage.”

Therapeutic approaches distinguish between regeneration and prophylaxis

Therefore, when treating such damage, it is important to distinguish between regenerating the tendon structure itself and implementing preventive measures to avoid further damage.

For the treatment of tendon and ligament damage, it has proven effective not to immobilize the horses in the stable but to allow them to move freely in a paddock (without painkillers). Several hay nets can provide some incentive for movement. The horse should be within sight of other horses or be teamed up with a calm horse, and should not be housed in a restless open yard group where it is compelled to move.

Pain serves as a warning signal from the body, preventing the horse from exerting more strain on the leg than it can handle.

The continuous, gentle movement impulses help the newly formed fibers align themselves in the direction of tension, reducing the formation of scar tissue and making the tendon more resilient and elastic.

Help with the healing process

Healing can be accelerated by feeding diatomaceous earth and using ceramic boots that reflect the infrared radiation of the tissue, such as those from CeraTex or Back on Track. After a period of familiarization, these boots can be worn overnight, as horses tend to move less during this time, and the boots improve blood circulation.

In the morning, the boots should be removed, and a snake venom ointment can be applied locally, such as Horvizym ointment from HorviEnzymed. The snake venom is absorbed and triggers a profound immune reaction, which accelerates the healing process. In this manner, healing can typically be significantly accelerated, allowing the tendon to be exercised again.

The second step is to assess for liver stress. The detoxification function can be assessed using a urine test, known as the KPU test. Request a urine tube from the laboratory, collect urine, and have the indican value and the kryptopyrrole value determined.

The indican value provides an indication of the condition of the colon. If incorrect fermentation occurs in the colon, the body absorbs substances that it must then dispose of through the liver and kidneys, representing an additional and avoidable burden.

Further steps

The kryptopyrrole value provides an indication of the liver’s detoxification capacity. If these values are abnormal, the horse should be treated for cryptopyrroluria (KPU) to restore the liver to a normal detoxification state.

Feeding should be optimized to eliminate feed containing starch and sugar (muesli, pellets, oats, carrots, apples, bananas, bread, etc.), as well as ensiled feed (haylage, silage), and “probiotics” such as lactic acid bacteria or brewer’s yeast. They all contribute to liver stress and should be avoided at all costs in such horses.

Haylage, silage bales
Ensiled feed (haylage, silage) promotes liver stress. © Adobe Stock / Westwind

In addition to constant access to lean hay, mineral feed, a salt lick, and water, you can administer diatomaceous earth using soaked hay pellets.

Check training for muscle building and housing situation

To promote muscle development after the healing of tendon or ligament damage during initial training, it is advisable to feed sainfoin as a source of protein.

In addition, the housing situation should be checked for sources of stress. Both a high-ranking and a low-ranking position in the herd can cause stress, as can a restless group with frequent changes and stabling with limited social contact. Hoof trimming should be optimized to allow the hoof mechanism to work as undisturbed as possible.

Shoeing with wedges, plates, inserts, or bars often restricts hoof mechanics, potentially compromising blood supply to the lower limb and leading to new tendon damage. If all surrounding factors (feeding, housing, hoof care) are considered, tendon or ligament damage can typically be healed without significant consequences and without becoming chronic.