J-Lu, I am glad you posted that. I found it very informative, and have sent it, and the PM to me, to my vet.
I also looked up Desmitis., and I can see that it and DSLD present with very similar symptoms.
Somewhere, I read that Mueller does not believe in stall rest.
Here is the PM that J-Lu sent to me because the questions/responses were addressing Goober’s (and my vet’s problems with getting a sufficient sample) issues:
- 1. Dr. Mueller, a vet surgeon, said he almost never sees DSLD without some kind of other trauma, because the horses are usually ridden and sport horses have a lot of wear and tear. Normal wear and tear will create scar tissue, and most horses who develop DSLD have been ridden and are often treated for something else (which may mask the pain) along the way. Horses with true DSLD will continue to decline, though.
2. He said that there is no pattern to legs developing DSLD, and by the time HE seems them (confirmed by the NC State vets), they are usually bad off because they didn't respond to the primary vet's treatments. Mostly it's bilateral or involving all 4. Mostly. But there's there's a researcher who suggest that it first shows up in hocks (upper collateral ligaments) and the horse adjusts itsself to compensate, hastening the degradation of the suspensories. Some horses, such as Friesians, with DSLD have significant collagen degradation in their aorta and are prone to aneurysms. Why in that breed? They don't know/ They study Peruvian Pasos mainly because a breeder donated many of their horses to U of GA, but they stated several times that a comparison between breeds is needed.Dr. Halpern is trying to do some genetic work, but they can only compare gene sequences to the published horse genome, and she doesn't know what breed that is (I asked her). Genes might be different in different breeds, and the breeding pool for some breeds is especially global. They can only state "facts" on horses they have seen/studied, which isn't a lot. They said they know owners and vets can be very frustrated because they cannot give a yes/no answer and some vets go to the nuchal ligament because they run out of options. One vet from NC state said he has seen a couple of cases in warmbloods over the years, but he has seen pretty much as many in the last 5 years. They talked about the fact they don't know why this is. It is, however, degenerative, and will eventually affect the horse. 3. Dr. Mueller gave a visual tutorial, as part of his presentation, on how to correctly biopsy the nuchal ligament. He said he gets samples ALL THE TIME that aren't the ligament but are just fat, or not enough ligament. Some vets try to use a needle, some try to take a punch biopsy. These methods just don't work well. Many vets go too high towards the crest and miss the nuchal ligament completely. He recommends a vertical incision (~3 inches) , at the crease of the crest muscle, dissecting down to find it, and clamping a small area with two Kelley hemostats, and cutting just cranial and just dorsal so that the hemostats are attached to it He does a simple suture and a shot of penicillin, and the wound heals well. He does it on the side the mane falls on. He showed examples, his incision site is barely noticeable. He is happy to talk to vets and owners about it all, and guide vets to get a proper sample. He stressed, stressed that the biopsy is going to be inconclusive and subjective, and has to be considered with the rest of the clinical evidence.
I’m hanging in. “Talk to as many people as you can about it and decide what is best for your horse. It is confusing and frustrating.” << Makes sense, although sometimes I think I have talked to too many people already!
; I’m about to go out of town for a month so vet endorses Dr. Green until I return and we can further diagnose; vet is not optimistic about horse’s chances of returning to soundness due to his long hind pasterns, which makes me super depressed as he is only 5 and a perfect riding horse (other than being lame, ha) whom I was hoping would be my next Grand Prix (dressage) horse