Proximal Suspensory Desmitis

[fivestrideline]

I’m wondering if there’s a communication disconnect here - maybe the vet was feeling like you want to do diagnostics to overrule/disregard/deny the PSD, when in fact you just want to know what else might be there?

I won’t sugarcoat it - I don’t hold high hopes of your horse being (edit: very) rideable, especially if you continue riding him this way. I’m not a vet, but I HAVE done the suspensory thing - you’re going LIGHTNING fast for even a basic non-PSD issue. I do realize you aren’t exactly making this up yourself, but I’m a bit floored at the pace you’ve been told to go considering the situation.

Caveat, of course, that we could be misunderstanding EVERYTHING and can only go off of what you post here. Usually I’m on the IRL vets’ sides, but this is just different than I have experienced.

[beowulf]

@Equestrianette

I never said he was sound at the June show and in October. I said the June show was an example of his peak level of fitness. Even when he is fit and the bucking stops (which reinforced to me that it was a strength issue) he is still not competitive because he can’t keep the rails up in stadium. Why? Because he has no range of motion in his pelvis. You know what else reinforced to me that it was a strength issue? Because that June show, he won the dressage in a class of 12 horses.

The clip from October was before his diagnosis after he was only back under saddle for about 3 weeks after being turned out for 7 weeks not ridden due to a wall resection. He was able to canter that day without bucking.

You captioned his October video session as “Pretty Dressage Lesson” and referenced it as a positive point in his soundness journey. It shows a horse struggling with contact because he is lame up front and behind. That’s where I got the inference.

Add in the sprinkled comments here and there about trotting and cantering this horse that bucks normal convention when it comes to PSD rehab protocol.

None of us are born knowing these things - this is not a criticism of you. But there are a lot of question[s] on this thread being raised about what is going on, really. I think most vets would see the way he moves and recognize something is amiss.

I didn’t see in your posts before this that you’d gone to Texas A&M. I am shocked they would not x-ray his back and I’m disappointed for you. This whole situation makes me hope there is something being lost in translation here or some sort of disconnect at play. It’s not the norm for any vet to decline reasonable diagnostics for a willing party and they should not be turning you down.

[Equestrianette]

I’m concerned about that too because everything I’ve read states a minimum of 6 months to a year. She said the suspensory takes 4 months to heal. I’m really conflicted over all of this. Even she told me to stop if lameness presents and when it does and I send her the video she just tells me to keep going.

[Equestrianette]

I do suppose when I said all that in the October video it means I was happy with how he was going because it was an improvement from the previous 2 weeks. Certainly not his best but at the time it was good enough for who it was for and when he cantered so nicely I dang near cried out of happiness. It’s just perspective from where we were in that moment at that time. And the it kinda slaps had to do with the music

[Sdel]

@fivestrideline

@Equestrianette

This is Texas A&M University Large Animal Hospital with the orthopedic specialist.

Texas A&M blew you off for spinal X-rays? Not that they didn’t suggest them, but didn’t do them when you asked? That’s shocking. I believe you, but I’m used to the vet schools being THRILLED to do all the diagnostics the owner will greenlight.

If TAMU, blew off X-rays of the spine (which I seriously doubt), then the OP should have driven the 10 minutes and asked Honnas to shoot them really quick before they left town. Honestly, Honnas is the one that deals with kissing spines the most in the area anyway.

[Gardenhorse]

I’m glad that some of you have never had a well-respected vet at a university vet school be dismissive and blow off your requests for additional diagnostics or ignore your questions. She’s been to 2 experienced vets. She’s now getting a 3rd opinion and posting here. She’s clearly trying her best. Maybe show some compassion or offer useful suggestions instead of attacking her for the way she titled her videos.

[Sdel]

@Gardenhorse

I’m glad that some of you have never had a well-respected vet at a university vet school be dismissive and blow off your requests for additional diagnostics or ignore your questions.

Well, I have experience with the subject vet school and they were more than happy to force the owner to track down all the zebras before looking for the horse. I’ve also had that experience with the small animal side as well.

[Gardenhorse]

@Sdel

@Gardenhorse

I’m glad that some of you have never had a well-respected vet at a university vet school be dismissive and blow off your requests for additional diagnostics or ignore your questions.

Well, I have experience with the subject vet school and they were more than happy to force the owner to track down all the zebras before looking for the horse. I’ve also had that experience with the small animal side as well.

Well, that was your experience with them. Apparently hers was different.

[fivestrideline]

Ugh that’s so frustrating. Fingers crossed for your next vet.

But still, as interested as I am in the other possibilities, I strongly suggest you not lose sight of that PSD diagnosis as you go looking at the rest of him. PSD does seem to come with spine/SI problems (what came first or caused what or is genetically linked, who knows), but those suspensories are going to limit you no matter what.

Unfortunately, it is my understanding that the “best” rehab for backs is counter to the “best” rehab for suspensories. That complicates things, for sure. IIWM, having done the suspensory + back issue thing before, I’d turn the horse out for a year somewhere safe and see what you have. Get some X-rays for sure, chat with the other vet, but turn him out, keep up with his feet, and do bodywork for a year. Come back in the spring and see what you have.

I’m really sorry OP. It sounds like you’re learning fast, and probably doing some kicking of yourself when looking back (we all do it - know better, do better and all that). Best of luck!

[Equestrianette]

I do think turning him out would be the best idea. A&M vet advised against it and said because I had him turned out 24/7 that that was why his suspensory never healed. But I had to keep him turned out because if I didn’t then he would lock up in his back. My understanding from an anatomical standpoint is that the suspensory ties in just below the SI and so it would make sense that he has back pain specifically in that area. Because he doesn’t test positive on physical exam or when they do their flexions for the SI then they are denying that he has pain there.
I just rewatched my first lameness exam from Feb 2022 and this is the Texas Tech Professor and even he said he was slightly positive to the left SI but knowing what I know now and rewatching it I can see how half assed of an exam that was. When he did his flexions the longest he ever flexed a limb was 8-15 seconds and they couldn’t get him to immediately trot off.

Definitely not saying he doesn’t have PSD because the ultrasound proves that he does have it. I just want to make sure there isn’t a primary reason still hiding and have this end up being secondary and never addressing the root cause. I am reconciling with the fact he may never have a career or partial career at all but I wouldn’t be able to be at peace mentally if I didn’t do all I could to rule out other possibilities.
I will fully admit that I rotate through several emotions during this course, from stupidly optimistic, to defeated because of how serious and career ending this is. If he got hurt in my care or historically at all, ever, it wouldn’t be so hard to understand why he has this condition. For it to come out of nowhere? What could I have done differently to prevent this? Was it inevitable? Where did I fail him?

[Equestrianette]

I didn’t know Honnas was 10 minutes away from there. Thank you!!

[fivestrideline]

@Equestrianette

If he got hurt in my care or historically at all, ever, it wouldn’t be so hard to understand why he has this condition. For it to come out of nowhere? What could I have done differently to prevent this? Was it inevitable? Where did I fail him?

These questions will drive you crazy. Trust me, and I’m often asking them to myself!

Horses don’t make sense, I’ll tell you that.

[IPEsq]

I’ve been where you are with a young horse (my horse with SI issues also had widespread back pain, neck arthritis, and a variety of other issues). Thankfully I have vets like the one linked below in my area who tried very hard to help. Definitely fired others who gave up and went with the cowboy recommendation. Unfortunately, my horse was not fixable. I had a lot of trouble coming to terms with that. Trying to balance his mental and physical health with the means I had available. Even when he colicked, I’d just gotten bad news from an MRI and I told my vet that I just didn’t know when to say it’s all too much. In the end the decision was made for me, both heartbreaking and a relief.

I learned a lot from that experience to come here and say you have to be an advocate for your horse. Get demanding if you have to. Is the imaging going to be worthless? Who knows and who cares? It’s just your money at this point. But also know that we have limitations in our diagnostics. And sometimes there is no clearer answer that can be found, at least while the horse is living. Vets get frustrated too when they can’t find the answers. At some point you just have to decide what you feel is right for him…put him out in the field, take him to more vets, etc.

There are several of us here who have put down young horses who were never really right or only had little glimmers of being right in between a whole lot of not right. We understand.

There’s no such thing as a “bad” horse

[2tempe]

Agree with your comments. And will add - way back , post 34, report said the horse also has mild chronic bilateral suspensory branch desmitis. This could easily be part of the problem, and does not have a great prognosis. Discomfort in two different parts of the suspensories in both hinds could well be throwing off the rest of his body as he tries to compensate.
EDITED to add: https://horsedvm.com/disease/suspensory-desmitis-branch-lesions

[PonyApocalypse19]

I’ve been following along. While I have no direct experience with PSD, I do understand the frustration with vet schools and diagnostics. I had a clearly lame/abnormally moving horse that they basically said we can’t find what’s wrong using diagnostics. There was no smoking gun. We ran out of things to test. It came down to go home or do a questionable standing surgery. I opted for the surgery and while it worked out - the recovery was not what I was told to expect and ended up being an 18 month ordeal.
If you’re not getting the level of service you expect, then stop going there (I will never go back to that vet school). If they’re not listening to you, then stop going there. Are there any smaller drive in clinics near you that would do some spine x-rays?
Ultimately, it is up to you if you want to keep pushing for an answer or not or if you want to wait and see. Don’t second guess yourself. Maybe set some self imposed boundaries that make sense based on what you ultimately want. Like examples: I will only spend XX amount more or I will keep doing the recovery treatment till the next milestone and reassess and either continue with treatment or go a different path like full retirement or throw out to pasture based on that assessment, etc. There’s nothing wrong with planning and making decisions for the future now.
You are a compassionate owner, don’t doubt yourself.

[Heinz_57]

@Equestrianette

I am reconciling with the fact he may never have a career or partial career at all but I wouldn’t be able to be at peace mentally if I didn’t do all I could to rule out other possibilities.

So you need a fresh set of eyes that can focus on other-than-the-PSD, what is going on here. It sounds like you think they have some tunnel vision and they think you are refusing to see the trees for the forest.

I don’t know which direction you are in, as far as being 3 hours from A&M, but there are other very qualified vets to choose from in the same general area that won’t say no to a request for imaging and investigation. Dr. Honnas at TEH and Dr. Warnock at BVEH in Navasota are generally highly recommended by sporthorse owners in the area for lameness issues. There are others too.

[fivestrideline]

@2tempe

And will add - way back , post 34, report said the horse also has mild chronic bilateral suspensory branch desmitis. This could easily be part of the problem, and does not have a great prognosis.

Oh I missed that. Or forgot about it anyways.

I’m not a vet, but OP, that’s a lot of problems with the suspensories to be 1. doing accelerated riding rehab and 2. be hunting other reasons this horse hurts.

I’m not saying you shouldn’t be digging for ways to make him more comfortable. I’m just saying that looking for gelding scars and KS and whatever else is all well and good, but I don’t think you’re going to fix one of those and suddenly have a sound horse. That kind of soft tissue degradation, regardless of cause, isn’t really giving much chance of any sort of career.

OP, take this kindly, but I can see where the vets might be coming from. You have an unsound horse that has been unsound for a while, has PSD that isn’t healing much as well as chronic bilateral suspensory branch desmitis. Perhaps the one vet telling you to work him is waiting for him to be lame “enough” to give you some firm answers. I don’t agree, but I’ve seen it before.

Turn him out. X-ray his back if you have money to burn. Be ready to make some tough calls and listen to what the horse is trying to tell you.

[Equestrianette]

I’m going to see Dr. Warnock on Thursday fingers crossed

[Equestrianette]

I had a feeling that’s what they were doing which is why I speculated “am I supposed to fail these rehab plans before getting further answers?”

And y’all are the only ones that have talked to me about the branch desmitis. Yes they include that in my discharge papers but their entire focus has been on the proximal suspensory and they’ve never talked to me about the branch suspensory or what exactly that means.

[Heinz_57]

Fingers crossed! ’

I’ll also be there Thursday - for a follow up check on my youngster’s corpora nigra cyst surgery.