Hind Suspensory Branches?

[kiwihill3000]

Okay, so my horse has swelling in his legs. Cue panic. Basically, I need someone to tell me that my horse’s leg isn’t falling off and he’s probably fine/I’m just being dramatic OR tell me to get a vet out to assess the situation. Any experiences with this would be super helpful, Google was zero help.

My horse has swelling in both his hind legs, specifically in what I believe is the distal portion of his suspensory, after it branches. It’s along his fetlock joint, on both sides (more towards the back I guess and it kind of swoops around and below it, swelling stops as you get to his pastern). It’s more swollen on both legs on the inside branch, but both inside and outside are distinctly swollen. Kinda bulging honestly, thankfully he’s got a little feathering that makes it less obvious. I pressed on it kinda hard today and he didn’t seem very bothered. He’s not distinctly lame.

He’s a 13 yo Friesian Sporthorse (3/4 Morgan, 1/4 Friesian) and he does have conformationally pretty dropped fetlocks in his hinds- it’s nothing horrendous but present. Never been lame aside from an abscess every now and then. He had been out of work for a while and I have very slowly been bringing him back into work. As a result, I expect some weakness and tightness so maybe he isn’t pushing off in his hind end as much as he could be and I just attributed it to being out of shape? Really not sure, but I do know he isn’t LAME. He did get like 5 days off in a row and that didn’t improve things with the swelling.

Does anyone have any experience with this? I don’t want to continue to try to bring him back into work, push him harder and have a huge suspensory issue… but he’s not lame and I’m not in the financial position to drop a lot of money on diagnostics if he’s fine…

[DunByMistake]

How long have you owned horse? Are you sure it isn’t windpuffs? They tend to show up in the space between suspensory and superficial digital flexor tendon and are most common on back legs. Tend to not show any reaction when palpated.

There’s also a bundle of veins and arteries that run along back of fetlock and down into foot. On my bay, this bundle of vessels often becomes more pronounced during warm weather. Can you feel a pulse anywhere along this raised area?

It is possible that it could be suspensory injury but I think it’s probably unlikely that both are injured in the same spot at the same time. However, no stranger on the internet can diagnose this from your description so if you’re worried, it is probably worth a call to the vet.

[Rosewatt]

I would have a good lameness vet down for an evaluation. Suspensory ligament damage is nothing to play around with and if there is injury or something else, then you should get it diagnosed so that you can start treatment and/or management. For now, I’d wait for a vets diagnosis before pushing further. In the case that it is a windpuff, then at least you will be sure that working this horse is not causing further damage. I understand the financial side of things though, but I don’t think there is any way around this. I’d speak with your vet and see if you could perhaps figure out some sort of payment plan before having them down.

I really hate to say it, but this sounds like degenerative suspensory ligament desmitis (DSLD), unfortunately something I’ve had some recent experience with in my own horse, who has been diagnosed for about a year now. DSLD affects the connective tissues of the body, which never correctly heal and is most noticeable in the suspensory ligaments.

Bilateral suspensory ligament thickening and dropping fetlocks are one of the poster signs of DSLD. To diagnose, you will need a vet to ultrasound the hind legs and could do a nuchal ligament biopsy too.

I sincerely hope it is not DSLD and the vet finds something else. In the initial stages of this disease, horses may not appear to be lame and the condition can come on gradually. Early on, my horse passed several lameness evaluations with some swelling in the fetlock region - vets thought it was tendon sheath inflammation at the time. It was a lameness specialist who finally gave the diagnosis of DSLD. It unfortunately meant that I had to retire my horse from dressage due to how much stress the discipline put on the hind end.

[Dutchmare433]

It sounds like wind puffs. Maybe a concern, maybe not. Are the swellings firm or soft? Hot or same temp as the leg? Do they go down after work (even just walking) or turnout? Did they get puffier after the 5 days off?

I’d be more concerned about the dropped fetlocks. Having a vet out to ultrasound both hinds wouldn’t be terribly expensive. Do you have a relationship with a vet that you could ask if they think it’s worth investigating?

[MGLpony]

Unfortunately, I agree with Rosewatt. The windpuffs, NQR, and dropped fetlocks sound very much like DSLD. Your horse could potentially be lame on both hinds or all fours meaning it’s more difficult for the untrained eye to see. Definitely find an experienced sporthorse vet to exam your horse. We did a lameness exam, nerve blocks, x-rays, and an ultrasound. You could probably go with just a lameness exam and ultrasound. The US will show the pattern of fibers that make up the suspensory and that aids in diagnosis.

The PPE vet for my mare completely missed the “excess fetlock drop” that my regular vet saw right away. Sadly for me, I had already purchased the mare. There is a genetic component to this incurable and chronic disease. Friesians and Morgans seem to have a higher incidence of DSLD or some variant of connective tissue disorder (along with some other breeds). My vet indicated that she is seeing more connective tissue disorders in general; unfortunately, research funding to trace the genetic markers just isn’t there.

One of my theories is that “we” don’t cull/select horses as heavily as we should. If a mare turns up lame, she is sold as or used as a broodmare. Nuh-uh, I don’t care what her breeding is. A mare that is unsound at 3 or 5 or even 10 should not be used as a broodmare unless the injury was acute eg. lacerated tendon. Suspensory issues - No! Arthritis - Nope! Kissing spine - Absolutely not! NQR - Are you insane?!

Sorry for getting off on that rant but my heart still hurts from euthanizing my gorgeous, wonderful, 5 y.o. this February.

[kiwihill3000]

Thank you all for your replies! My plan is to reach out to a local sports med vet and see if he’s operational for regular things right now. My current vet is lovely and great for regular day to day things, but unfortunately I have had problems with them regarding lameness associated things in the past.
@DunByMistake I have had this horse for about 2.5 years. He has always had dropped fetlocks (figured just a conformational flaw and that obviously he wasn’t going to cut it as a super high level horse but didn’t worry too much). However, now I am wondering if they have gotten worse since I got him and for the life of me I can’t remember (DSLD???)
The swellings are fairly soft. I don’t think that they are windpuffs, but I don’t have very much experience with them. Fingers crossed that that’s all it is though! @Dutchmare433 They aren’t hot, and don’t go down after work or rest. He’s turned out 24/7. I rode him for 30 min yesterday (w/t/c but pretty easy) and they seemed about the same. It’s so frustrating because he’s got some feathering going on back there which makes it difficult to see/feel. I’m assuming they’ll shave him to US though so at least it will be easier to monitor after that. I don’t think (?) there was a change after the days off, but with Covid-19 everything is wacky- when I can see him is pretty random and I’m only allowed to be at the barn for an hour (including getting him from the back pasture, bringing to barn, grooming/tacking up, riding, and doing all that again) so I’ll admit I’ve been a bit hurried every time I’m there.
@MGLpony I agree! It’s crazy to me how often I see young horses retire for chronic/inheritable things that are just thrown into the broodmare life to make a few bucks…

[mvp]

Hold up!

There are lots of things to consider-- causally and anatomically.

1. The really bad DSDL hypothesis. How old his this horse and how heavy? The condition is heritable so horses of all ages and sizes can get it, but I wouldn’t expect to find it in your cross-bred, especially if he’s relatively light and young. If I were going to investigate diagnosis this in your horse, I’d have a lameness exam that started with some pretty deep palpation of all parts of the suspensory apparatus and both flexor tendons back there. I’d do a flexion test (for what that’s worth, your vet’s mileage will vary) and then look at those ligaments with ultrasound. I wouldn’t be worried unless I saw lots of lesions bi-laterally. I’d investigate if the horse was reactive to my palpating any of his tendons or ligaments.

2. Horses are a bit notorious for poor circulation in the distal hind limb. And some horses have worse circulation (really, lymphatic return) than others. This is the reason that you get edema back there that doesn’t go with the degree of lameness you’d expect. That said, your horse living out 24/7 is the very best aid you can provide to an inefficient lymphatic system.

3. There are a lot of structures down there to get puffy. If your horse is not lame, I’d guess “windpuffs” first, especially if they originate at the level of the fetlock and seem to also fill in the spaces around the tendons and ligaments above it. After that, with anatomy book in hand, I’d palpate the area, trying to feel for ligamentous structures vs. joint capsule.

And a note when palpating: The when you feel the middle of a body of a tendon or ligament, really chase that down to as deep into the joint as you can go and still feel it. It will cross under a stout band of annular ligament before it attaches to bone. You’ll be surprised how hard and how “all the way down into the joint” you can trace those.

Also, there are different things to feel-- you can feel for the horse’s reaction to your squeeze-- look for a sudden pull away, not being ticklish. Also, you can feel the structure for big bumps. Some people can feel heat well as well as swelling in the tendon sheath vs something wrong in the tendon/ligament within it. I’m not that good. But it costs you nothing to feel around and learn what you can.

I hope this helps.