Sinking fetlocks in hind limbs while working-lameness-help!

[Cakemom]

Hi-

My 17 year old warmblood gelding began stopping at jumps in December (never did that before), lack of impulsion. (Last summer he began standing with his right hind leg pointing at the ground).

Vet came out, adjusted saddle and shims for possible bone spurs, treated for possible EPM for a few weeks, came back, ultra-sounded and found bursitis in hips so injected those. Improved with work for a few weeks, turned him out for like 5 minutes and came back lame, hand trotting on different surfaces and under saddle. (We can’t lunge him–he tears off from past experience.)

Vet and bodyworker said lame front left, trainer said lame right hind. There was some head bobbing and right hind was digging dirt at the canter and not coming through all the way. (Fetlock sink might have been present then in both hinds.)

Restarted and have almost finished full course of EPM meds, walked under saddle for a couple of weeks, just started trotting under saddle and noticed that both of his hind fetlocks are almost ground level at the trot (they are ok while standing or walking). His right hind is also tracking in a bit and he feels more lame to the right. He has also recently dug a hole in his pen and now stands with his hind feet pointed down into it.

Vet doesn’t think it’s DSLD. Trainer think he needs more work (she had a horse with what she called “sloppy suspensaries” before and work fixed him). So we have started doing pole work. She thinks he looks a bit better; I’m discouraged that he is still lame and I don’t understand the fetlock drop.

Does this sound familiar to anyone? I would appreciate feedback from someone with first hand experience with this type of situation. It’s a “pulling my hair out” type of situation.

Thank you so much in advance!

[Highflyer1]

I would have the hind suspensories re-ultrasounded by the best lameness vet you can find. And you absolutely need to stop riding and keep him in a small turnout or a stall until you have it done. If he has a chronic suspensory injury (which it sure sounds like) the more you aggravate it the less likely it is to repair itself even with complete rest and proper treatment.

[173north]

Just seconding @Highflyer1 - definitely get a second opinion from the best lameness vet you can find, and take him out of work. I’d operate under the assumption that he’s injured one or both suspensories and put him on stall rest immediately.

These injuries often start off really subtle (ie, resting a hind leg unusually, lack of impulsion, sticky lead change) and aren’t caught or even visible on ultrasound until they’re farther along, which is super frustrating.

I’ve never heard of a horse digging a hole in his turnout so he can rest his feet at a more comfortable angle but that suggests to me he’s in a lot of chronic pain.

[Libby2563]

@Cakemom

Vet doesn’t think it’s DSLD.

Did the vet give you a reason for this belief, and how familiar are they with DSLD? I had to euth a young Hanoverian with DSLD a couple of years ago and early on in his lameness I asked a very experienced sports medicine vet about DSLD, and he said, “I wouldn’t worry about that.” One year of rest and $15k of pointless vet bills later, the poor horse was still hopelessly lame and the necropsy confirmed DSLD. Most vets just don’t know much about it.

Whether he has a systemic issue or not, I would be terribly concerned about the degree of fetlock hyperextension you’re describing.

ETA: I totally missed the age of the horse on first read. Seems like DSLD would have become apparent sooner than 17. But I would still be very concerned and absolutely would not try to work through it.

[ladyj79]

More work sounds like a trainer I probably wouldn’t work with anymore. 17 with soundness issues and dropping fetlocks does not sound like add more work.

[mvp]

In your spot, I’d ultrasound the whole suspensory in both hind legs. You might find a bunch of legions. I knew a horse whose DSDL started this way, including those ultrasound pictures. The horse moving dirt around so as to find a way to stand with his heels tipped up is not normal. I wouldn’t do any forced exercise with him again until I figure out what was going on.

[PonyPenny]

As I have a horse that had a severe left hind suspensory tear with an avulsion fracture, you need to stop work immediately and get a competent lameness vet out pronto. Your horse has all the classic signs of a suspensory injury.

[Moneypitt]

No first hand experience but friends with TB and Warmblood horses that have/had DSLD.

Dropping hind fetlocks, shifting subtle lameness and digging holes to stand in.

http://matildebrandt.no/blogg/2017/01/dsld-espa/

I would take your horse to a Veterinarian teaching hospital or a large equine clinic for diagnostics.

It’s a heart breaking condition.

[Martina]

I recall a comment my lameness vet made when examining my horse for hind end lameness. He said that my horse’s fetlock/pastern/hoof was well-supported and that they will often see older jumpers who come in with sinking fetlocks… That conversation took place while horse was in his stall. Does your horse’s fetlocks sink at rest?
Also, a red flag with the digging the hole and placing toes down. That sounds like heel pain which could be DDFT.

[GraceLikeRain]

@Cakemom

Trainer think he needs more work (she had a horse with what she called “sloppy suspensaries” before and work fixed him). So we have started doing pole work. She thinks he looks a bit better; I’m discouraged that he is still lame and I don’t understand the fetlock drop.

The idea of a trainer recommending pole work for a lame horse to fix “sloppy suspensories” is shocking and a blazing red flag. I’d haul your horse to the best teaching hospital or full service lameness vet in your area for ultrasounds of both rear suspensories and a full work up. He sounds super uncomfortable. Sinking fetlocks screams DSLD to me.

[Go_Fish]

It showed up in a mare I had at 19. She was a retired broodmare and we eventually had her put down about a year later. I agree…my first thought with the OP’s post was DSLD.

[beowulf]

@Cakemom

His right hind is also tracking in a bit and he feels more lame to the right. He has also recently dug a hole in his pen and now stands with his hind feet pointed down into it.

Vet doesn’t think it’s DSLD.

Bold is one of the most unique symptoms of DSLD/ESPA. There is significant overlap in symptoms between other disorders and DSLD, like toe drag and shifting forelimb lameness, but digging a hole to alleviate hind end discomfort is one of the most unique symptoms of the disease.

17 is not too old for onset of DSLD/ESPA. It varies from horse to horse, and certain events such as management, injury, or age can hasten onset.

[NancyM]

This is not that uncommon in older horses. Failure of suspensory apparatus, seen in hind limbs. When it is seen in young horses, it’s called DSLD and is a soundness flaw, haven’t heard it called DSLD in older horses though it is much the same situation. There is no treatment that works to “cure” the condition in either case. How long it takes until the condition becomes uncomfortable to the point that the owner has to make a decision is variable. Riding the horse with an issue like this would be a decision of questionable value or care. Sorry, it’s a heart breaker. I’ve had one.

[Moneypitt]

Cakemom

How is your horse doing?

[beau159]

@Cakemom

Does this sound familiar to anyone? I would appreciate feedback from someone with first hand experience with this type of situation. It’s a “pulling my hair out” type of situation.

This may or may not be it, but when I see someone saying their horse is being treated for EPM and possibly having a front foot AND a rear foot problems, did you check your horse’s NECK?

Neck issues can manifest in many different ways but certainly not all vets are comfortable with neck issues. So if you are to the point where you are pulling your hair out, xray his neck.

[Cakemom]

An update and many thanks to posters.

The lameness vet has ruled out DSLD (thank God!). She believes his symptoms are secondary to a front left foot issue/pain. Specifically, x-rays show that the impar ligament (between coffin and navicular bones and at the base of the coffin joint) has ossified. Also broken back P3 angle and mild to moderate arthritis.

She has suggested a mild wedge for his shoe to alleviate discomfort in the impar ligament and create a more normal coffin bone angle. Potential treatment: 1. Osphos or systemic tildren (not local infusion) 2. Injection of the coffin joint/navicular bursa.

She says the issue with the impar ligament gives a pretty poor prognosis for soundness, but want to do a full MRI on the foot. I need to find out why it’s worth doing an MRI if the prognosis is poor.

Any feedback again would be great.

Thanks again so much!

[Moneypitt]

No experience with the ossified impar ligament. Did the Veterinarian find that with xrays or ultrasound? Did they ultrasound the hind legs too? Otherwise, I would be concerned the sinking hind fetlocks could still be an issue.

Not sure what your goal is at this point with your horse? Serviceable for light riding/flatwork? Sounds like expensive shoes and Tildren is being suggested might help but might not necessarily get to a rideable outcome? Might be worth a try.

If the goal is to try for pasture sound IE a comfortable retirement; then ask your Veterinarian about what might be long term treatment options?

I know in some cases, owners have opted to nerve a foot. In other cases, just pulling the shoes and allowing the horse to wear the hooves down the way they are most comfortable has made an improvement. In these cases let your trusted Veterinarians guide you.

Best wishes!!

[2tempe]

Warmblood mare diagnosed with suspensory branch ligament desmitis in BOTH hind legs at about 15. Though not labeled DSLD vet said the bilateral presentation made him think it would be a degenerative situation with poor prognosis for soundness. I trusted the vet so no second opinion obtained. For many reasons I did not want to dump money on this mare.

This was 4 years ago; I retired her, put her in support shoes hind end, daily equioxx. Definitely pasture sound, but the legs have changed. Fetlocks are mildly-moderately dropped, clear angle difference between pastern/hoof and she has become more post-legged.