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DSLD vs "Chronic" Traumatic Hind Suspensories

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    DSLD vs "Chronic" Traumatic Hind Suspensories

    Some background:
    I just bought my old horse back after he'd been gone for a year. I told them I would buy him back for any reason - not a problem - so he's back with me now, thankfully, given the issue that has cropped up.

    He's 14 now, a quarter horse who had done the HUS and WP divisions for years, and has been a little stiff as long as I've owned him (since he was 7). As long as I can remember, he had a small windpuff on the outside of his left hind. When he came back, his hind fetlocks were both swollen. Farrier thought perhaps it was his angles (they were bad when I got him back) I initially thought he was just a bit stocked up (he doesn't move around of his own accord much, despite having an attached paddock). I started to notice small hock sores from him lying down. Fixing the feet didn't seem to help matters, and though he presents as stiff, he doesn't present as "lame". Does not bunny hop at canter, but is reluctant to move forward until a long period of "warming up". This is not unusual, he's always been like this, but he seems stiffer than he used to be. At this point, I was thinking arthritis, maybe some hock is the age for it.

    I call the vet, anticipating some injections....aaaaand we discover that both hind suspensories are upset, and lesions can be seen on ultrasound (both hinds, outside branch). He did not think it was an injury within the last month.

    His pasterns do look a little dropped, but it's hard for me to remember what they looked like before, having not seen the horse for a year. He does NOT have long pasterns by any stretch of the imagination, and he's not a flexible guy. However, when I think about the rest of the presentation - I've had him vetted multiple times for being NQR. Prior to his sale, I had a full lameness workup, and everything was fine, the vet just said he was stiff. He did develop an allergy right after I sold him, which he had never had before, but I had just moved him across the country, so I chalked that up to new allergens. I doubt that the folks I sold him to worked him all that hard, they had a little kid riding him, and he's just not the kind of horse you can really "overdo" it with, with the exception of leaving him in the pasture, which he hates. There's a chance it's related to his care while he was there, but both hind suspensories? And no - I don't think they knew. They are good people, just beginners, so they probably had no clue there was an issue at all.

    The vet recommended Stem Cell combined with PRP, plus shockwave. I've booked it, but I'm a little conflicted. I'd hate to subject him to a bunch of medical stuff that ends up "not working" only to have to put him down afterward. 14 is still young, but he's not 6. If it's DSLD it's a downward slide (no pun intended) anyway. That being said, he's a very very useful horse. He's broke to death, and the horse that I go to when I want to have a "fun" ride of the horses I own. Could this buy him more time? Maybe. But I'm having trouble finding stats on treating middle-aged horses with DSLD. Most of the articles and experiences that I've read about are either young horses, or dealing with the final years of the older horse.

    He's already on a joint supplement with MSM (which he has been on since I got him, actually, which leads me to believe that he might have *always* been like this and the folks that sold him to me weren't super honest), and I just added bute-less to his mix.

    So - does anyone have any useful experiences you can share? Opinions? Care advice?

    Oh no, sorry you are dealing with it.

    Some vets diagnose DSLD (now called ESPA, as it's recognized to be systemic and not limited to just the limbs) by ultrasound, as the fraying of the suspensories under film is usually telling.. but the only real way to diagnose it is by nuchal ligament biopsy, which is not exactly harmless, quite invasive, and hard to watch.

    Because ESPA is degenerative, most care is palliative, keeping the horse comfortable. That being said, keeping their bodies conditioned and in work is often good for them. See what your vet says regarding retirement - every ESPA case is different, but I have known a few now that were kept in light work until it was detrimental for them to do so.

    Staying on top of the feet is imperative, as ESPA can be hastened by things like chronic discomfort and even illness.

    As much turnout time as possible - 24/7 is best, to keep inflammation down and horses in condition.

    If he is uncomfortable, no reason to not do stem cell therapies and PRP if it is within your budget. It will make him feel better.


      Interesting! The issues are down in the outside branches, not up in the body of the suspensory? How does his shoeing look? Does he flex badly in his hocks or stifles? Does he block out to the suspensory branches? Perhaps he's moving differently because of pain somewhere else, and these injuries are secondary to that.

      Without a definitive diagnosis of DSLD, major pain, or fetlocks severely dropped, I'd certainly give rehab a chance. If money were no object, I'd do shockwave and stem cells because I've had luck with those treatments in the past. But there is nothing wrong with doing just shockwave, or just rest/ice/time and good hoof care.


        Original Poster

        Originally posted by joiedevie99 View Post
        Interesting! The issues are down in the outside branches, not up in the body of the suspensory? How does his shoeing look? Does he flex badly in his hocks or stifles? Does he block out to the suspensory branches? Perhaps he's moving differently because of pain somewhere else, and these injuries are secondary to that.

        Without a definitive diagnosis of DSLD, major pain, or fetlocks severely dropped, I'd certainly give rehab a chance. If money were no object, I'd do shockwave and stem cells because I've had luck with those treatments in the past. But there is nothing wrong with doing just shockwave, or just rest/ice/time and good hoof care.
        Great questions - the main issues are down in the outside branch, not up in the body. He is barefoot behind (although the vet recommended a special shoe) and the farrier was able to fix his angles prior to seeing the vet (a week or two ago). He was balanced poorly side-to-side in both the fronts and the hinds and I seem to remember the farrier saying he was low on the outside and high on the inside on the hinds, which would correlate with a potential injury. I'm not 100% on that though, as again, I thought he was just kind of arthritic and his feet looked like crap. He also had long toes the whole way around and the heels looked a bit underrun, but they look much better post-farriery. We need to get the special shoes, but the vet visit was just yesterday and the farrier hasn't been able to be out yet.

        We did not block. The vet palpated and the reaction was super dramatic, then flexed with similar dramatic effects, then ultrasounded. He does not look "off" except during the flex tests but he looks stiff as all get out. He said to be more definitive we could do an MRI, but the lesions were pretty obvious on the ultrasound (I could see them, and I'm no ultrasound tech). So we know we're dealing with *at least* the suspensories. I have a suspicion that navicular will be on the plate at some point as he is halter-bred on the bottom and reining-bred on top, but with the halter-type body (and subsequent itty bitty feet) which, I'm not going to lie, is part of my hesitation. If we fix the suspensories, is he still going to be in pain because of the 00 feet that he has on his 1200 lb body? It's hard to even tell he's in "pain" unless he has been in pain as long as I've known him. He cleans up his dinner, he loves his peppermints, his ears are still forward at the trot, he only pins them when asked to canter, and even then he is cranky but complies. He's rested a hind foot since he was a 3 year old - I've seen pictures of him from his early show life, in the winners' circle, cocking a foot - but I've always chalked that up to his extreme mellow-ness.

        I don't have any great conformation pictures handy, but the first two pictures of him are as a 5 and 6 year old before I got him. You can see that he wants to unweight that LH.

        The yellow-shirted fourth picture is of him when I had him. He almost looks a bit upright there.

        The fifth and sixth picture are from a few weeks ago, and you can see that he looks dropped some but this was before the farrier work (he was ridden very lightly).

        Now all pastern angles are starting to look a bit whacky to me, so I feel like I'm going a bit crazy

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          I had one that had to be put down at only 7 due to dsld, and his were the branches also. Hope your guy just needs a better farrier!
          "You can't really debate with someone who has a prescient invisible friend"


            I have an 18 yr old oldenburg mare. Three + years ago she was "NQR" under saddle; diagnosed with hind branch suspensory desmitis (sp?) both legs. One side was both branches, the other side just outside if I remember correctly. For a bunch of reasons I chose retirement; the cost of treatments was not IMO justified; extensive stall rest and rehab did not sound realistic. Vet said " not certain, but the fact that both legs impacted and what I see on ultrasounds, could be degenerative". Fast forward, she is turned out 12 hours/day, shod in back with support and barefoot in front. Her hind legs have become more post like and fetlocks have dropped some but not horrible. She apparently still does a periodic gallop around and is otherwise fine. I'm convinced she will live to be 100 to spite me (there is history here...) But she has not been ridden or otherwise stressed. On 1/2 equioxx per day.