LH proximal suspensory injury/desmitis 30 yr old horse* Dropped fetlock* degenerative or Traumatic?

[TheHorseComesFirst]

My horse is 30 yrs old and recently had swelling below his hock around Thanksgiving.
around that time or a little before we had a new horse come to the barn who immediately went into heat and paced the paddock to pasture fenceline and made it a hock- mid cannon deep, There was nowhere else for my horses to be turned out calmly and he would be a basket case in the stall so I let him live his life and allowed him to walk out into/through the deep mud to the front pasture ( not muddy) .

Well, I had him out alone ( long story) so he would follow his fenceline neighbor out ( where the ground was good footing, because they kept back and forthing with me telling me that my horse could have the stall that went out by himself in a smaller pasture but then reneging.

So then my horse was just left with this option.

so after thanksgiving around Dec 21st. My horse comes in with a toe touch lameness,swelling of the tendons to mid cannon and a DROPPED FETLOCK!!!
I had a heart attack.

I called the ER vet, and he ultrasounded and radiographed and told me basically NOTHING.

he said " That is one swollen suspensory" and his vet assistant told the BO " He has old man things" which I took as DSLD. He then told me that he could not find a tear and that the vet who will do the shockwave will come out and possibly re ultrasound because it was borderline too cold to ultrasound so didn’t get the best image and xray to see if he missed anything ( did not give me great confidence)

so then a week later, I am expecting the attending vet to re-do all the xrays and ultrasounds but she just shockwaves and also says nothing while doing it.

so I ask did you view the ultrasounds? she responded " No, I just looked at his notes"

i forgot what I asked next because I was so shocked but she responded with kind of a snarky attitude " this is degenerative, it is Bi lateral, he has thickening of the suspensory branches on the opposite limb as well"

I told her you can’t really go by that as he has a traumatic injury from kicking a rubber corner feeder and bending the heavy duty eyehooks and ripping one out of the wall. I was at the barn later in the evening and when I came the next morning he had his feeder torn up and his RH fetlock was swollen right at the lateral suspensory branch. I iced it and bandaged it, had the vet out a couple weeks later, she said it was a sprain and to ice and bandage, 2 more weeks pass and it has gotten cold and hard and I forget about it until i had another vet out for something else and they say " that is chronic" I was like it happened a month ago…

so fast foreward and they seem to use that to say it is DSLD and it is bilateral, when in my opinion his hind legs were very tight before and then he came in with a dropped fetlock and in a lot of pain,

if it were degenerative I would think the fetlock would drop slower and be 0-60 on the pain scale. and it is only 1 fetlock and the other leg/ fetlock is super tight cold

also what have you guys done with this issue treatment wise for your old guys? corrective shoeing? PRP? shockwave? stem cell?

[Scribbler]

@TheHorseComesFirst

My horse is 30 yrs old and recently had swelling below his hock around Thanksgiving.
around that time or a little before we had a new horse come to the barn who immediately went into heat and paced the paddock to pasture fenceline and made it a hock- mid cannon deep, There was nowhere else for my horses to be turned out calmly and he would be a basket case in the stall so I let him live his life and allowed him to walk out into/through the deep mud to the front pasture ( not muddy) .

Well, I had him out alone ( long story) so he would follow his fenceline neighbor out ( where the ground was good footing, because they kept back and forthing with me telling me that my horse could have the stall that went out by himself in a smaller pasture but then reneging.

So then my horse was just left with this option.

so after thanksgiving around Dec 21st. My horse comes in with a toe touch lameness,swelling of the tendons to mid cannon and a DROPPED FETLOCK!!!
I had a heart attack.

I called the ER vet, and he ultrasounded and radiographed and told me basically NOTHING.

he said " That is one swollen suspensory" and his vet assistant told the BO " He has old man things" which I took as DSLD. He then told me that he could not find a tear and that the vet who will do the shockwave will come out and possibly re ultrasound because it was borderline too cold to ultrasound so didn’t get the best image and xray to see if he missed anything ( did not give me great confidence)

so then a week later, I am expecting the attending vet to re-do all the xrays and ultrasounds but she just shockwaves and also says nothing while doing it.

so I ask did you view the ultrasounds? she responded " No, I just looked at his notes"

i forgot what I asked next because I was so shocked but she responded with kind of a snarky attitude " this is degenerative, it is Bi lateral, he has thickening of the suspensory branches on the opposite limb as well"

I told her you can’t really go by that as he has a traumatic injury from kicking a rubber corner feeder and bending the heavy duty eyehooks and ripping one out of the wall. I was at the barn later in the evening and when I came the next morning he had his feeder torn up and his RH fetlock was swollen right at the lateral suspensory branch. I iced it and bandaged it, had the vet out a couple weeks later, she said it was a sprain and to ice and bandage, 2 more weeks pass and it has gotten cold and hard and I forget about it until i had another vet out for something else and they say " that is chronic" I was like it happened a month ago…

so fast foreward and they seem to use that to say it is DSLD and it is bilateral, when in my opinion his hind legs were very tight before and then he came in with a dropped fetlock and in a lot of pain,

if it were degenerative I would think the fetlock would drop slower and be 0-60 on the pain scale. and it is only 1 fetlock and the other leg/ fetlock is super tight cold

also what have you guys done with this issue treatment wise for your old guys? corrective shoeing? PRP? shockwave? stem cell?

Ok. So your horse is 30 years old. That’s like over 90 for a person. He will heal slower, he will get injured more easily, and he will be presenting end of life and quality of life issues within the next few years.

I believe DSLD requires a muscle biopsy for 100 per cent diagnosis and you likely don’t want to punch a hole in his nuchal ligament.

What difference will it make if you know it’s DSLD versus just an injury at his age? In both cases you will be managing symptoms. DSLD is progressive and I would think there’d be some symptoms earlier than age 30. On the other hand even if it’s just a tear he may not heal well.

Anyhow if you don’t feel you are communicating well with one set of vets you can certainly go for a second opinion or even trailer into a university clinic. Depends on the amount of cash you are willing to dump into this.

My inclination would be to keep treating this like a recoverable injury and see where you are. I would also pay some attention to his environment so he is not kicking buckets to bits or prancing in deep mud and reinjuring himself. Perhaps the current barn is not a good fit.

I am not sure how much good the whole range of laser infrared heat etc therapies do for injuries.

[HoofHeartSoul]

I know each 30 yr old is different but he wants to live and looks great, he was tested for PPID and everything was negative and his mindset is great and is on greats spirits.

I can tell when it is time to let him go, I have done it for many of my animals.

I do not believe in laser,infrared,ceramic, etc. I don’t even think I mentioned those therapies…

PRP,Shockwave and stem cell are not in the class with those.

The diagnosis of DSLD vs a traumatic injury is actually very important imo or at least to me.

I would not do PRP or stem cell most likely in a case of degeneration, but would in a case of injury as there would be a lesion to inject it into.

The shoeing protocol I would do would also differ.

As well as the turnout for him.

Ill dump as much money as I feel I need to, to give me peace of mind that I tried my best.

[Angela_Freda]

@TheHorseComesFirst

if it were degenerative I would think the fetlock would drop slower and be 0-60 on the pain scale

My horse had DSLD/ESPA and it was a very sudden onset, initiated imo by stress.

The one leg vs both is definitely a question mark, but that might be explained by the injury simply exacerbating the obvious sign in the leg that there’s an issue.

[HoofHeartSoul]

I knew the barn is not a good fit, I mentioned to BO that I would be moving before all this happened, so he could go out in a quieter herd with better footing.

That is when she told me I could have the corner stall with individual turnout with better footing. Then when it didnt happened I asked her why he was not moved and she said she " changed her mind" without informing me at all. And of course my stall was taken at other place I was going.

I work whwre my horse is now and take care of the horses for the barn owner, AM turnout,stall cleaning, Grain prep,throw down hay for her from loft,etc. So feel it was a play to get me to stay so she didnt habe to do all that or find someone.

As for his kicking, he started that at feed time because he was not able to get to the hay feeder to eat in winter in turnout as the other horses would push him away ( through the deep mud) ( again I said he is too old to be pusjed away from food and asked he be taken out of the herd )

so when feeding time came around in the stall, he would start kicking to get his food as the stalls are open and the other horses can stick their noses over.
I was never told he started kicking! He jad been doing in for at least a month.

When I found out, I am the one that put mats up around his stall and the one that has been the most proactive.

He had been doing in for weeks or more!

I recently left for a week to go to a business function in florida and when I got back the other boarders were telling me everything didnt get done or done correctly and horses were put out together who weren’t supposed to be and they just left them or dodnt gst turned out at all.

I went over everything with everyone and was assured they would do it and were okay before I left.

So if I leave the other boarders said they won’t stay either.

Sorry for the novel but I guess this needed a backstory as to why he started kicking in the first place.

[Angela_Freda]

@HoofHeartSoul

And of course my stall was taken at other place I was going.

I work there and take care of the horses for the barn owner, AM turnout,stall cleaning, Grain prep,throw down hay for her from loft,etc. So feel it was a play to get me to stay so she didnt habe to do all that or find someone.

You work where horse is now, or at the place you had hoped to move to?

[HoofHeartSoul]

I work where my horse is now for very cheap. I go to the barn before my regular job and after my regular job. Twice daily. Sorry for confusing text.

[IPEsq]

I know one horse who had DSLD but it started with a traumatic injury to the suspensories on one hind leg. Stem cells, surgery, special shoes, all of it was done. Horse really struggled to recover from that, and that one fetlock did drop during this time. Eventually, the other one caught up and the bilateral DSLD was obvious. This was over the course of a few years. I think the acute injury just precipitated the problem on the one leg.

So, it is quite possible you have both an acute injury and DSLD. It sounds like you have not gotten good communication from this vet practice. And when the swelling is large, it can be hard to see everything on ultrasound. Might be worth a second opinion and scan from another vet.

[Scribbler]

@HoofHeartSoul

I knew the barn is not a good fit, I mentioned to BO that I would be moving before all this happened, so he could go out in a quieter herd with better footing.

That is when she told me I could have the corner stall with individual turnout with better footing. Then when it didnt happened I asked her why he was not moved and she said she " changed her mind" without informing me at all. And of course my stall was taken at other place I was going.

I work whwre my horse is now and take care of the horses for the barn owner, AM turnout,stall cleaning, Grain prep,throw down hay for her from loft,etc. So feel it was a play to get me to stay so she didnt habe to do all that or find someone.

As for his kicking, he started that at feed time because he was not able to get to the hay feeder to eat in winter in turnout as the other horses would push him away ( through the deep mud) ( again I said he is too old to be pusjed away from food and asked he be taken out of the herd )

so when feeding time came around in the stall, he would start kicking to get his food as the stalls are open and the other horses can stick their noses over.
I was never told he started kicking! He jad been doing in for at least a month.

When I found out, I am the one that put mats up around his stall and the one that has been the most proactive.

He had been doing in for weeks or more!

I recently left for a week to go to a business function in florida and when I got back the other boarders were telling me everything didnt get done or done correctly and horses were put out together who weren’t supposed to be and they just left them or dodnt gst turned out at all.

I went over everything with everyone and was assured they would do it and were okay before I left.

So if I leave the other boarders said they won’t stay either.

Sorry for the novel but I guess this needed a backstory as to why he started kicking in the first place.

So despite you being the work exchange barn help, there have been obvious signs this place is physically dangerous to your horse, and also that the barn management is not able to follow through on your requests to improve his situation.

First, you need to step up and get your horse to a place that’s safer for him. He’s going to continue to get injured at this barn. And he won’t heal in all this mud kicking and incompetent management.

Second, in the absence of a definitive diagnosis I would treat as an injury and see if he makes progress.

But you need to get out of there like yesterday. You don’t like or trust the barn management and your horse has sustained two serious injuries because of the barn set up.

[4horses]

I don’t think it matters if it’s degenerative or not at this point. I’m assuming this horse is retired.

With my retired horses I don’t invest in lengthy difficult treatments. They get pain meds, and might get treatment for Cushing’s disease. That’s about all I do for them.

Do you have pictures of the horse? DSLD is very obvious. Once you can recognize it, it’s easy to see. More early in the disease process you can see it during the walk.

DSLD can present with just one leg. The other leg may swell later on. At 30 your horse has outlived most other horses. So I would probably just monitor his soundness and comfort levels and take it from there. If you want to treat it like an injury go ahead and do so.

One thing that really helped my mare when she was first diagnosed was Diclofenac gel. We treated one leg with it and that leg had more improvement than the other leg which wasn’t treated as aggressively. If it is DSLD you will have swelling in other limbs eventually. It started with one back leg, then the other and eventually she bowed a tendon in the front. My friend has the same in her horse. Both back legs plus a sprain/strain in the front leg. Her horse is not an advanced case yet. He is still being ridden lightly.

If you want to shockwave or treat for injury that is probably going to help no matter what. If you want to discontinue treatment and focus on pain management that’s fine too.

If you are worried about unsafe turnout, move to a better place. Older horses are like older people. One fall can cause severe injury.

[2tempe]

OP: i have a coming 21 yr old mare who was diagnosed with bi-lateral suspensory branch desmitis about 5 years ago. Vet said “could be degenerative”. She had little pain or swelling, was just NQR in her trot. Like the prior poster, she also had a bow in front. I chose immediate retirement, 12 hr turnout and support shoes on the back. (I had, in past, dumped a potload of $ into this mare, so am kind of emotionally done). Vet said even with standard suspensory rehab, stall rest, walking, etc, her prognosis was poor.
Since then she has gotten more post-legged in hinds, the fetlock drop is noticeable but not awful and she is pasture sound. The fetlock area looks bigger to me. My vet did tell me that the changes are generally slow, UNLESS she gets stupid and adds injury to the problem.
So far she has not needed any pain meds but is now on prascend due to recent cushings diagnosis. We will see how that all goes.

[ClaireBear_NZ]

My friend’s elderly Standardbred did something similar - sudden injury and one leg dropped, then the other leg looked like it was likely to go too. As he already had other issues (Cushings, an old sacral injury, etc etc) she had him put down after stuffing him full of carrots.

[TheHorseComesFirst]

I did have a 2nd vet come out to access. He believes it is NOT DSLD/ESPA but rather degenerative as in the ligament as he aged just began to stretch over time and possibly from a past injury ( As I might have thought) and weakened enough to give way/drop. he said a lot of older broodmares have this happen to them and it is not genetic just wear and tear.

He currently did not see a tear but the swelling and inflammation is generalized to the whole tendon.

He does NOT think PRP or Stem cell would help for that reason.

I will be making another post about a question I have but just an update for you all.
I have been in search of a barn but this injury makes it more difficult.

[Pippigirl]

You have my sympathies. It’s not always easy to find another suitable place for you and your horse in this condition. Lots of places may seem available but suitability is another thing. I get it.

[TheHorseComesFirst]

Thank you, this is exactly it. Thanks for your understanding.