Science > Case Study > Tendon Sheath Effusion
Case Study: Tendon Sheath Effusion


A 10-year-old Thoroughbred Jumper was presented with chronic dorsal flexor tendon sheath effusion on the left rear. The tendon sheath was distended approximately four times the horse’s normal size. History of intermittent lameness and toe walking was prevalent when he was walked out of his stall for several steps. The tendon sheath was injected with Hylovet at the time of appointment. The horse was examined seven days post HA injection and synovial effusion had decreased approximately 50%. The horse was trotted straight away on a concrete barn aisle, with 0/5 lameness. The palpation of the tendon sheath was non-painful. The horse was ridden three days in a row with no lameness; the horse became lame on the fourth day. The tendon sheath became swollen and warm to the touch. The horse was reluctant to put his heel on the ground and when hoof testers were used, it elicited 4/5 pain on the lateral heel. The heel, abaxel nerve block as performed on left rear did not improve lameness. The horse was treated with systemic antibiotic, NSAI, antibiotics in the tendon sheath, and bandages for 7 days with a small amount of improvement, 3/5 lame at trot.

The horse was presented to the hospital for treatments with the Game Ready® Equine System. Upon arrival, the horse was walking on his toe when he was brought out of the stall. The horse was lunged to the right and left and he was a 3/5 lameness both directions in the left rear. Swelling was four times normal on Cando-medial aspect of flexor tendons at the dorsal cannon level. The hock was non-painful upon palpation. The horse was treated twice a day, 30 minutes per treatment for 9 days. After treatment on the first day the horse was not walking on his toe. On the second day, the horse was walking normally out of his stall, placing his heel flat on the ground and this continued throughout the treatment. By the fourth day, swelling in the tendon sheath had reduced approximately 30% and continued to decrease daily. By the tenth day, swelling had decreased approximately 70%, but still with a moderate amount of tendon sheath swelling Cando-medially. Looking at the hock anterially and laterally, it appeared normal. On the ninth day, the horse was sound at a walk. The horse was trotted “straight away” and was 2/5 lame for 4-5 steps and then trotted sound. The horse was lunged to the left 2/5 lame the first 4-5 steps then trotted sound in both directions. On the tenth day, the horse was sound at a walk. The horse trotted straight away 2/5 lame 3-4 steps then trotted sound. The horse was lunged to the left 1/5 for 2 steps then went sound. The horse went home for further rehab.

DeRoy White, D.V.M.
Sapulpa Veterinary Hospital

Game Ready Human Products

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