Another NQR Horse... Next Steps

[ClearDonkey]

It’s my first time posting here, so bare with me a bit to try to accurately represent my horse and her background. As for me, I’m an adult amateur trying to learn dressage after competing in a bit of everything growing up.

2013 Morgan mare, working on training/1st dressage.

• 2017 foaled/nearly starved to death/became nearly feral, entered a “rescue”.
• 2019 I brought her home and lightest of the light started her.
• 2020 more light work, 2 month break thanks to Covid, more light-moderate work, tripped and fell undersaddle resulting in lead swapping behind - resolved with bodywork.
• 2021 light-moderate work, began working with a dressage trainer in the fall in moderate work.
• 2022 moderate-full work, competed at schooling shows in intro/training dressage, making leaps and bounds of progress - WTC, leg yields, starting shoulder ins - occasional issues under saddle but not frequent enough to cause major concern - trainer attributed it to introducing new things to a sensitive horse.
• 2023 moderate-full work, issues under saddle becoming more frequent, my trainer stopped a training ride with her, vet visit in April, time off for most of the summer for rider injury - trying to bring back into work now, but having issues + need saddle fit adjusted.

During the vet visit in April 2023, I had a basic lameness exam and rear suspensory ultrasounds completed with suspicions of DSLD. She flexed 1/5 on her left hind, with the joint of origin being the stifle - the vet felt rounding. She also had SI pain with palpation. As far as her suspensories go, the vet described it as “extensive wear and tear” with fluids on the suspensories but not with the label of DSLD - vet agreed that it could be the result of starving + foaling as a 3/4 year old. The vet suggested I could inject stifle + SI, but I opted to focus on strengthening before starting maintenance… Until I got hurt and my horse got the summer off.

Since being in full-ish work (starting in late 2021), actively working towards dressage, various issues have cropped up:

• If ridden 3 days in a row, day 1 will be great, day 2 will be okay, and day 3 will be terrible
• Usually is best after a day or two off
• Emotional, reactive, occasionally explosive when asked for ‘regular’ things and even moreso when asking for ‘unexpected’ things
• Tension, tension, tension
• Mouthing the bit, gaping
• Travels crooked, I believe haunches to the left
• So far unable to train haunches in, immediately reactive
• Resistance and tension in leg yielding, moreso yielding left to right
• BTV+low going in snaffle, or hollow, stiff
• Hollows, slams on brakes seemingly randomly
• Reluctant or reactive to changes of bend
• Lack of connection in canter
• History of lead swapping and disunited in canter
• History of stumbling behind
• Suspicions of hormonally related behavior, potentially better on Happ-e-mare supplement
• Rides better in a bareback pad, even with a ‘fitting’ saddle - difficult behavior happens regardless though
• Can stand camped out, or one hind foot cocked - never square by choice (but better while in full work)

I am currently scheduling again with the vet who did the exam in April 2023 to dig deeper, and I have a saddle fit appointment scheduled (loss of muscling definitely made the fit of our current saddle not great). I’m hoping to complete a bute trial before the vet appointment (and potentially a gabapentin trial?). Beyond completing a basic lameness exam again, what would you do/suspect? I’m curious of neck/back issues, open to injecting the stifle + SI, EPM testing, a neuro exam, doing x-rays of all four legs… But I also want there to be a cut off point, because of her suspensories and always being a bit sensitive/emotional/NQR mentally - a career change is also on the table if she just can’t handle dressage, but that’s a whole other can of worms.

And some pictures for context… 2017 rescue intake photo:

Feb 2023 - in full work

Oct 2023 - to show loss of muscling from summer break (and reason for saddle fit being meh)

Pictures of hind legs 2023

Happy to answer any questions or provide anything else.

[IPEsq]

The behaviors do sound related to left hind and SI. Tracking haunches left means more weight bearing on the better right leg. Disunited canter, falling out behind, lack of forward can all be SI pain symptoms. The stance can also be SI related.

I’d probably flex and palpate again, take hind hoof, basic hind limb joint, and spine X-rays. But I don’t think you are at the point of chasing weird things yet.

The work pattern could be a muscle related issue potentially, but it could also be that she’s just more sore in the already sore places without days off.

[JB]

I hate to say it but her hinds really are suspicious of ESPA/DSLD You could try a nuchal ligament biopsy.

Her back has dropped a lot since her 2017 picture. Do you have any pics from in between '17 and '23? The dropping of the back could be related to ESPA, since that’s a whole-body systemic issues with connective tissue

[ClearDonkey]

That’s one of my concerns…I do have the option of trying a vet nearby that did palliative care for a acquaintances DSLD horse, instead of the vet that did the check in April - who is more of the opinion of keeping them comfortable and keeping on… Not sure if that is my opinion if this is truly DSLD.

2019 -

2020 - not the best angle (and a terrible clip)

2021 -

2022 -

[JB]

Wow, yeah, the back drop is pretty signifcant in the last 4 years.

I’d test for PPID too. December is the time for the TRH Stim test, so if your vet can do that, it’s worth testing then

[ClearDonkey]

Just what I need - another PPID horse - though I can’t think of a symptom that falls under the PPID umbrella with her. I will say from the thread that really brought me to making this post - this is my young, unsound horse and there is a line where my maintenance of her ends… Especially if DSLD is involved.

[JB]

the failing topline is one symptom. Not always, not THE one, but it’s A symptom.

As I see it, there are 2 test options - nuchal ligament biopsy for ESPA, and PPID. I’d probably start with ESPA, since if she has that, that will likely take her out before PPID does, although uncontrolled PPID will likely speed up the ESPA degeneration if both are present.

Hugs

[ClearDonkey]

I appreciate it. She’s a special horse, but there is certainly something wrong. She’s overcome terrible circumstances and I’ve given her a few very good years, so if it is DSLD… I know I’ve done right by her.

I’ll have to call around and see who can do a nuchal ligament biopsy. I’m not sure if my acquaintances horse had the biopsy done for diagnosis, but he was euthanized within the year as it advanced so quickly.

[blue_heron]

How is she on the longe with side reins short enough to be working on the bit?

I would follow up on the DSLD for sure. Is she shod? Can be she be shod? If your farrier could do something to get some weight off her hind suspensories, her overall posture behind her withers might improve.

Beyond that, x-rays of the back and possibly neck.

[ClearDonkey]

We very rarely lunge in side reins, but in-hand working at the walk and trot in the bridle, I’d say she’s normal. Her tendency is to be more reactive and worrisome no matter what, but I can do some nice quality leg yields and shoulder ins with her in-hand.

On the lunge without side reins, her quality of gait is nice, especially her canter compared to under saddle. I’m not a fantastic rider, but we had a nicely developing canter undersaddle last year which is rarely ever seen this year.

She is not currently shod, and I would really, really prefer to not shoe her. If we were to go all in with maintenance and therapeutic shoeing, I could trailer to my trainers and use their therapeutic farrier but beyond that I’m limited in access to someone I’d be willing to pay for anything considered therapeutic to address pain issues.

[NaturallyHappy]

There is a lot of wisdom up thread. I’m just chiming in to say how lucky she is to be yours.

[Lunabear1988]

What a lucky mare to land with you, OP! No advice but best of luck.

[IPEsq]

In the first pic, she still has pregnancy pelvis, which makes her back look different, somewhat roached. With the various angles of the photos and her positioning, I’m not really seeing a significant back change other than clear differences in muscling (but you said she was out of work) for her rather curvy conformation.

[IPEsq]

Isn’t the current thinking that nuchal ligament biopsy is mostly worthless? I thought I read some updates on other DSLD threads…

[Scribbler]

@IPEsq

Isn’t the current thinking that nuchal ligament biopsy is mostly worthless? I thought I read some updates on other DSLD threads…

I thought it was that you couldn’t get results from it until the horse had symptoms.

[barnesthenoble]

I was thinking the same. I haven’t done a deep dive to find any info to provide, but I do know that there have been issues with the biopsy, false negatives (and possibly false positives but I can’t recall), etc. Having thrown myself into DSLD research after dealing with my own horse of mysterious NQR-ness (still don’t have a confirmation of why other than a bunch of reasons, consensus is probably not DSLD but he does have bilateral suspensory damage although I’m still not convinced it’s not DSLD LOL /cry), I would be very concerned about DSLD in the mare pictured. Between the breed, the hind leg conformation, the back dropping, the behavior/lameness, and confirmed significant bilateral damage to hind suspensories despite relatively light workloads, worsening behavior/resistance with age and work…

Good luck with your lovely mare, I’ll echo the sentiment that she is lucky to have landed with you.

[Old_Mac_Donald]

My first thought from her rescue photo was: wow, she’s really roached!

My second thought from her after photo was: Wow, she looks like she has lordosis (my first thought was “what an improvement, well done OP!”)

Poor little mite. I would definitely look at DSLD, followed by ECVM (neck malformation) because her symptoms undersaddle are similar to my ECVM horse, particularly in the fact that they lunge great and refuse to travel in travers in one direction and ‘straight’ in the other.

[Libby2563]

@IPEsq

Isn’t the current thinking that nuchal ligament biopsy is mostly worthless? I thought I read some updates on other DSLD threads…

Yes, based on updates I got from the vets studying the nuchal ligament biopsy (to whom I donated my DSLD horse—there’s a long thread, OP), I wouldn’t do it again. They’ve found it doesn’t have good predictive value, and it’s pretty invasive. Poor @Lord_Helpus’s horse had a pretty rough go of it with an abscess or infection, and in the end the vet haven’t even gotten enough tissue for testing. So if you do it, make sure the vet has done a ton of them—but probably don’t even do it in the first place.

[ClearDonkey]

Looking more into the details of the nuchal ligament biopsy, I think it’d be a very poor decision for my mare who lives outside 24/7, going into mud season winter, with potential PPID which could mean a compromised immune system. I looked up a picture of the biopsy, and I will say that will likely not happen, ever… Unless she ends up being donated to a university (which I’m not sure if there is anyone close that actively takes horses at this point).

I have an appointment with a second opinion vet on the 21st, and a follow-up appointment with our normal vet the following week depending on the results of the first appointment.

[Libby2563]

@barnesthenoble

the hind leg conformation, the back dropping, the behavior/lameness, and confirmed significant bilateral damage to hind suspensories despite relatively light workloads, worsening behavior/resistance with age and work…

OP, I hate to say it and I’m sorry to be blunt, but based on all this I don’t think she is likely to be your dressage horse no matter how much money you spend or how many vets you consult. BTDT and while I don’t exactly regret spending a year and $10k trying to fix my lovely 4 yo who ended up having DSLD, in retrospect I probably should have listened to the vet who watched his hind pasterns/fetlocks and told me to cut my losses about 5 months in because “he’s a breakdown horse.” Yes, some horses with that hind leg conformation stay sound, but once they go lame and there’s confirmed suspensory damage, I don’t see good prospects for recovery, regardless of whether it’s truly DSLD.

I also found that even really elite vets weren’t well-versed in DSLD and only the “breakdown horse” vet ended up being realistic about what time and treatment could or couldn’t do. Which is to say, your vets may happily try this and that, but the only things I’d personally spend vet money on at this point are a PPID test and neck/back X-rays if you’re so inclined. I’m sorry you’re in this position. She’s lucky to have you!