DSLD "diagnosis" in young, lame horse -- UPDATE post 130, he's gone

[IPEsq]

@J-Lu

Sabrina Brounts is a co-author in that PLOS one paper I linked to. The last author, Anna Plaas, studies tendon integrity after trauma or inflammation (such as arthritis) at Rush University Medical Center. Huh, nice collaboration.

Forum won’t let me tag you today, so quoting, but I’m not responding to this comment.

J-Lu, does the study say the age/job of the false positive? We know some horses, dressage horses in particular, can have some nuchal ligament damage from being put in an improper frame. Usually we think of spots of calcification, but I wonder if there might be other job-related trauma in an older horse that may cause a false positive? If that theory is reasonable, then I think it is also reasonable for Dr. Halper to consider the OP’s horse’s age and workload. Perhaps samples from other connective tissues would be better, but as you note, most of those are not very doable in the live horse.

[mckenna310]

Personally I would do the MRI and then decide on euthanasia or donation to a university. Is he insured? Could help with cost of MRI.
And in regards to being a blood donor, the one at my veterinary school has a better life than my personal horse, so don’t discount it!

[Lord_Helpus]

@Libby2563

I finally got the actual biopsy report! For anyone who is interested, this is what it says:

“Pathological findings and opinion: Tissue (2.5 x 1.5 x 1cm) fixed in formalin received. Histopathology reveals mostly ligament tissue. Bundles and fibers of the ligament are separated by a network of light blue, and in some areas by darker purplish strands of acellular material on H&E stain. This material stains blue with trichrome for collagen, but also with alcian blue for proteoglycans. In addition, alcian blue stain reveals several pools of proteoglycans. The quantity of proteoglycans appears to be excessive, especially for the age of the horse. This is likely due to underlying DSLD.”

I hate to say it, but the biopsy results seem pretty clear to me. I will ask my vet for the results on Goober’s report. The same lady did them both so it will be interesting to see how she phrases a report which comes to the opposite conclusion.

[J-Lu]

@IPEsq

Forum won’t let me tag you today, so quoting, but I’m not responding to this comment.

J-Lu, does the study say the age/job of the false positive? We know some horses, dressage horses in particular, can have some nuchal ligament damage from being put in an improper frame. Usually we think of spots of calcification, but I wonder if there might be other job-related trauma in an older horse that may cause a false positive? If that theory is reasonable, then I think it is also reasonable for Dr. Halper to consider the OP’s horse’s age and workload. Perhaps samples from other connective tissues would be better, but as you note, most of those are not very doable in the live horse.

The false positive was a 9 year old Peruvian Paso mare, who was otherwise healthy. What I find interesting was that the vast majority of the actually positive horses were Peruvian Pasos. Only one of the control horses was a Peruvian Paso and she was the false positive. I wonder if someone donated their inbred herd. The horses were all donated to the U of GA, and previous jobs weren’t described. I think they do consider the age of the horse, because they found that younger horses (they had a couple of foals and yearlings) in general had significantly different (more or less, I can’t remember right now) proteoglycan levels present than the older horses. Patella tissue seemingly had no false positives…can’t exactly sample that tissue…

[J-Lu]

Libby2563,

I’ll email you the papers in pdf form.

[Lord_Helpus]

@Stacie

As I understand it, the lesions come from tissue not healing correctly. This is why its considered a degenerative disease. Your poor guy has lesions at a very young age. If the lesions are not from disease, what do you think they are from?

I may be saying the same thing in another way, but I thought that DSLD was the connective tissue breakdown, because the tissue is lacking something. The “not healing” part is secondary. Goobs does not have DSLD, but his suspensory is “not healing correctly” because the voids are filling in with scar tissue instead of ligament

[Really]

So my big Hanoverian guy (just turned 4) also has DSLD (per testing and an all day stint at the vet school) , although he was born with very lax tendons (and an umbilical hernia, not sure if the two are related but…) he has straight hind leg conformation and his pasterns (all 4 are affected) but the hinds are…wincing to look at. I contacted the main researcher at UofGA to see if she wanted him for her studies but she is limiting her research to Paso Fino’s only …so after much thought, deliberation and heartache I am opting to put him down. I have spent so much money in diagnostics, training (thinking he will get stronger and they will “come up”…not) and I am now going to put him down. There are too many other horses in this world that would benefit from my monetary input…and have a chance at being a solid citizen, I can’t see “hoping and praying” is going to change my guys genetic outcome…so he has a date with a needle next week. May be harsh to some but to me it’s better than a truck ride to a Mexican slaughter house. Also, vet school wasn’t interested in him for a donation, already tried.

[Angela_Freda]

@Really

So my big Hanoverian guy (just turned 4) also has DSLD (per testing and an all day stint at the vet school) , although he was born with very lax tendons (and an umbilical hernia, not sure if the two are related but…) he has straight hind leg conformation and his pasterns (all 4 are affected) but the hinds are…wincing to look at. I contacted the main researcher at UofGA to see if she wanted him for her studies but she is limiting her research to Paso Fino’s only …so after much thought, deliberation and heartache I am opting to put him down. I have spent so much money in diagnostics, training (thinking he will get stronger and they will “come up”…not) and I am now going to put him down. There are too many other horses in this world that would benefit from my monetary input…and have a chance at being a solid citizen, I can’t see “hoping and praying” is going to change my guys genetic outcome…so he has a date with a needle next week. May be harsh to some but to me it’s better than a truck ride to a Mexican slaughter house. Also, vet school wasn’t interested in him for a donation, already tried.

Not harsh at all. Kind, really because those hind legs can fail and lead to suffering as you wait for a Vet to get there.
Pre-emptive euth to avoid suffering is a kindness.

I hear you on the wincing when looking at the hind legs. Yo’s were too.

I’m sorry for your loss.

[theresak]

@Really

So my big Hanoverian guy (just turned 4) also has DSLD (per testing and an all day stint at the vet school) , although he was born with very lax tendons (and an umbilical hernia, not sure if the two are related but…) he has straight hind leg conformation and his pasterns (all 4 are affected) but the hinds are…wincing to look at. I contacted the main researcher at UofGA to see if she wanted him for her studies but she is limiting her research to Paso Fino’s only …so after much thought, deliberation and heartache I am opting to put him down. I have spent so much money in diagnostics, training (thinking he will get stronger and they will “come up”…not) and I am now going to put him down. There are too many other horses in this world that would benefit from my monetary input…and have a chance at being a solid citizen, I can’t see “hoping and praying” is going to change my guys genetic outcome…so he has a date with a needle next week. May be harsh to some but to me it’s better than a truck ride to a Mexican slaughter house. Also, vet school wasn’t interested in him for a donation, already tried.

There are other university vet schools that are collecting samples and DNA (U of WI is one). If you are able, check with them and see if they would like your horse to participate in the studies. It’s heartbreaking that this happened to your horse, but the more data they can collect, the faster they can figure out the genetics, progression, etc. and more horses they can help in the future.

[Lord_Helpus]

If they are collecting DNA, then all they need are strands of mane hair. It would / will be great if a test for DSLD could be developed based just on that!

[Libby2563]

So I went ahead with the MRI of his front feet. It’s “just money” after all, the left front lameness is his most limiting issue right now and has blocked very consistently, lots of horses overcome crappy conformation, based on the current state of knowledge he may or may not have DSLD, and I’m not ready to give up on him based on probabilities.

The good news is that it showed an injury of the collateral ligament severe enough to cause his lameness but moderate enough that he should recover. Since he hasn’t improved in 6 months of rest with turnout, he’s on stall rest now. He’s getting a special shoe this week and the vet recommended shockwave too. I’m really glad I did the MRI because now I have an actual diagnosis and something to work with. (Even though I’m dreading the whole stall rest thing.)

I asked if there were any unusual findings in the MRI that would suggest DSLD and they said no, everything looks normal. Of course to my knowledge no one knows what an MRI of a DSLD horse looks like (Dr. Halper said she’d be interested to see one as they’ve never done one at Georgia), but I’m still glad to hear that there are no obvious signs of breakdown.

Thank you all for the input, well wishes, and info (looking at you especially, J-Lu!). It may be a while until anything happens that’s worth reporting but I’ll update this thread when it does!

Really: I’m so very sorry to hear about your horse! Sent you a PM.

[Lord_Helpus]

I used to look at other parts of a horse, but now my eyes go straight to the pasterns. At Rolex (it will always be Rolex to me) I saw several horses whose fetlocks almost touched the ground when weight bearing, even at a trot. And yet, here they are at a **** event. I wince when I see these horses in dressage, and I am gobsmacked when I think of those long and sloped pasterns going x/c.

Even more amazing (in a bad way) is a picture of one of the year-end champions in the hunter breeding division. The front pasterns are longer and more sloped than Goober’s. To think that this conformation is acceptable (and being rewarded) is very sad.

It seems to me, based on this relatively small survey that the difference between those horses and Goober, is the leg above the pasterns. These horses have very angular hocks. Again, I am assuming that these hocks absorb more than their fair share of the shock absorption, so the fetlocks are not responsible for carrying the entire load.

It would be interesting to have some of these sound, but suspiciously pastern’d, horses tested for DSLD. Perhaps when the test is not so invasive**, such a test will be carried out.

** Goober is now 7 (8?) weeks post harvesting of nuchal ligament from his neck. The site is still open and oozing bloody puss. My vet suggested that Goobs go to his clinic for a week to be treated intensively with antibiotics. And the clinic will not be charging me… Do we think that the vet is every bit as worried as I am?

[IPEsq]

Yes that lack of healing is not good. I’d take them up on that offer LH!

[Lord_Helpus]

Well, this is a fine howdy-doo. Evidently, the whole shiteree is messed up and we do not have Goober’s result because everyone was basing their beliefs on the email we got from Georgia for the first (insufficient tissue) test. Evidently, this one said (paraphrasing) that he did not have DSLD based on the tests they were able to perform.

The vet feels horrible. He said, over and over again, that he had been remiss in not catching the issue/confusion. When the “results” came in, he had been in Atlanta, and the new assistant had told him that the results from the lab said that he did not have DSLD… Vet is back. Goober is over there for a week of intense antibiotic therapy and irrigation. Vet has a call into the lab in Georgia, which, hopefully will call back this afternoon. Libby, if I had not repeatedly asked for the results to be sent to me, so we could compare notes, the issue might not ever have been discovered…

What a shift in fortune/misfortune. Libby had an MRI which has given her hope (YIPPIE!) while I am back on the edge of depression.

Horses will make you crazy…

[IPEsq]

Hoping the end result is still negative and that his neck heals!

[J-Lu]

Lord Helpus, I sent you a PM. The Georgia researchers will be in NC this week.

[Libby2563]

Wait…Lord Helpus, am I understanding correctly that you are now awaiting results again!? What the hell is up with this vet’s office? I can’t believe his neck is still so bad either. My boy got his stitches out Thursday after 3 weeks and if the hair weren’t clipped around the incision, I don’t think you’d even notice it (see pic). I’m really glad I had it done by a surgeon who had done the procedure twice before. I’m sorry you’re in limbo again. Please let us know when you hear something! I had good luck contacting Dr. Halper directly when the fax machine at the vet’s was on the fritz and they didn’t get the report for several days.

Re: the horses at Rolex with horizontal pasterns, when I asked the vet who did the MRI whether there were DSLD indicators and we started talking about it, she told me about an upper-level event horse she treated who blew both superficial flexor tendons, had a “positive” nuchal ligament biopsy, and is currently back in work and about to return to upper-level competition.

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[Lord_Helpus]

@J-Lu

Lord Helpus, I sent you a PM. The Georgia researchers will be in NC this week.

AARRGGHHHH. I have not gotten a PM from you. I will PM you with my email, etc. info. I would LOVE to have them talk to my vet (or even see Goober!)

[Lord_Helpus]

I wonder how long it will be until he breaks down again.

[J-Lu]

@Lord Helpus

AARRGGHHHH. I have not gotten a PM from you. I will PM you with my email, etc. info. I would LOVE to have them talk to my vet (or even see Goober!)

PM and email sent.