Reasons for horse having trouble getting up?

Any pictures of the horse? As DSLD is typically pretty obvious once you know what to look for.

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not really something you hear of over here
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which is more the reason I would get a second opinion from a top vet medical center. You cannot know and recognize something you dont see much of.

high cervical arthritis and / or soft tissue dysfunction needs to be rules out. You said back xrays were done but dont know if that includes neck.

this horse sounds like he is edging towards potentially dangerous

I haven’t quite got to grips with this forum for posting pictures yet. He doesn’t present as DSLD when standing, he isn’t post legged and has no fetlock drop when stood square. His fetlocks aren’t big and he has no swelling anywhere. His legs are incredibly clean and tight, like they have been vacuum sealed! It’s just during movement, or when he rests a hind (which is always) that you see how low they drop.

I have now consulted with a different vet in same practice. The plan is they will come out this week to run the neuro tests at home (as at the clinic the adrenaline masks a lot), then go in for Xrays of neck and the facet joints in Thoracic and lumbar spine. In the mean time he is now on danilon, daily massage and red light therapy to try to ease some of the muscular tension. He’s at a major UK university teaching hospital, generally extremely well thought of, but as you say, if something isn’t common even they won’t think of it early.

Make sure they check muscle enzyme levels. CK and AST. Pssm type 2 can cause muscle issues and can look neurological.

Enzymes are all normal. He has RER rather than PSSM.