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  Discussion on Injured rear suspensories
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New Member:
Netgypsy

Posted on Wednesday, Feb 9, 2005 - 12:50 am:

Our twelve year old mare has very flexy suspensories and has injured both rear legs. She weighs about 700 pounds (slim but no ribs showing) The vet has done XRays and said they are fine and that she just hyperexteded. She is totally lame on the rears and will only walk on her tippy toes although she will stand flat. The vet gave her DMSO drip, banamine and bute and suggested that we might want to try a Kimzey splint. She has not had significant heat or swelling but she winces if you pinch the sides of her fetlocks. She tend to put most of her weight on her front legs and one rear leg and if she stands for any length of time that fetlock starts sinking. She spends most of her time lying down. The vet said just to be sure she gets up at least 4 times a day and she does. She is eating and drinking and the pain has subsided a bit. We are both (vet and us) wondering if there may be a back injury also but she shows no pain upon palpation anywhere but the fetlocks. We are to keep her on bute for a few more days and see how she does. She has no heat in the fetlocks or legs but she did have a bit of edema in the suspensories. What do you think about the splint idea? She is unshod and we always keep her toes rolled. Initially we taped and booted her Friday evening when the injury occurred but removed the boots today. We have noone with a portable ultrasound and cannot yet trailer her anywhere so that will have to wait until she improves a bit. We would appreciate any suggestions as to how we should handle this other than pain control and rest.
Moderator:
DrO

Posted on Wednesday, Feb 9, 2005 - 7:52 am:

TK a few questions:
What does "she has very flexy suspensories" mean?
What breed is she?

Not knowing the extent of the injuries to the suspensory it is difficult to make treatment suggestions. I have not used a Kimzey splint but my understanding is this is not really a treatment device but used for short term stabilization. From the UCal site: The Kimzey Splint is a lightweight aluminum splint for the lower legs of horses that can be applied quickly and easily. The splint provides protection and immobility to horses with injuries that cause fetlock and pastern instability. It is designed specifically for emergency, short-term leg immobilization and is commonly used by racetrack veterinarians worldwide. The device has application, however, for use at any equine sporting event where acute injuries of the lower leg are a possibility. For further information on the Kimzey Splint contact Kimzey Welding Works, Woodland, California (telephone 530/662-9331).

Perhaps you could use it to transport your horse to a place that better diagnostics are available? Sports Medicine makes fetlock boots that do decrease the work of the suspensory and may help your horse but rest and antiinflammatory therapy (NSAID's) are the mainstay of such soft tissue injuries. The question in my mind is this a chronic degenerative process (Paso?) or a one time acute injury?
DrO
Member:
Netgypsy

Posted on Wednesday, Feb 9, 2005 - 1:03 pm:

Major injury then two repeat injuries within a few weeks. She's been checked over the last six years for DSLD and her suspensories were fine before the accident. By flexy I mean that when we got her she flexed to the horizontal at the fetlock in her fast gait. She had actually increased her angles over the last six years from 48degrees to 52 degrees and had no fetlock DrOp during her pregnancy. She developed edema in her suspensories with boots on so we removed them and the edema has resolved but now she has no support. Initially her right leg was injured the worst but now the left seems worse and she puts most of her weight on the right so we're concerned about her injuring with one more. She is on bute now twice a day and lies down most of the time. We can't transport her until she becomes more comfortable and this is one reason we're interested in the splint although with soft tissue injury we've been led to believe it's just a matter of rest and time regardless of where it is injured. Thanks for the help. In many years we've never had a serious lameness issue despite the fact that we do endurance and other rigorous riding sports so we're very concerned about how to deal with this.
Moderator:
DrO

Posted on Thursday, Feb 10, 2005 - 7:26 am:

So we are looking at a paso with hyperextended fetlocks and pain on palpation over the fetlocks (I assume the suspensory area). I think DSLD should be high on the list of possibilities. Speaking with a veterinarian who raises P Pasos several years ago she said that pain on deep palpation over the posterior of the fetlocks was often the earliest sign, even before lesions could be identified on ultrasound.
DrO
Member:
Netgypsy

Posted on Thursday, Feb 10, 2005 - 8:00 pm:

She is a paso fino, not a Peruvian paso. Her mother and father are sound in their old age as are her grandparents. There is no DSLD in her family and as I mentioned we have had her checked repeatedly because of her conformation, not because there is any propensity for this disease in paso finos. In fact DSLD is less common in paso finos than in many other brees as I'm sure you know. She has long flexy pasterns and in fact all her tendons and ligaments tend to be flexy although they have tightened with age so we're very careful not to do anything too stressful precisely to avoid strains. Now the question is how to support the better leg while the really painful one heals so she doesn't injure the better one more than it already is. In researching Peruvians when we were horse shopping we understood that they tended to sink during pregnancy. Our mare did not do this. She maintained her angles beatifully even when at term. This was a major accident where she went from totally sound to completely lame overnight and will not put her weight on one foot other than the toe and so is hyperflexing the other leg. We put SMBII's on her for support initially but since then we removed the SMBII's and she is now lying down most of the time and her angle on the less injured foot has increased. There is no longer pain on the fetlock on the one foot but the other is still painful to squeeze. We are looking for a way to prevent hyperextension of the less injured leg without restricting its normal motion and with a minimum of pressure on the fetlock. If you have any ideas we'd appreciate it. Since she doesn't put pressure on the more severely injured leg we assume it will heal and we won't splint it unless we need to transport her to a clinic.
Moderator:
DrO

Posted on Friday, Feb 11, 2005 - 7:45 am:

Hello TK,
Though I have owned several pasos for many years, I am not aware that DSLD is rarer in Pasos than other breeds. The overall breed incidence has nothing to do with that you have a horse with chronic suspensory laxity and bilateral suspensory injury. This is consistant with DSLD and horses with DSLD can have an acute onset of lameness: the degeneration occurs overtime until the suspensories fail acutely. I sense this opinion is making you uncomfortable. If you and your vet feel different thats is OK, you have the advantage of complete history and direct exam and I just put this out as a possiblility.

I cannot think of anything better than the SMB's for practicality, One of the ways you can help the better leg from overstress is by supporting the worse leg. I think you believe that by not supporting the worse leg, the horse uses it less therefore may heal better. But this is not what the horse is telling you: by lying down more he says, "overall I am in more pain without the boots than with them". I would listen to the horse on this unless it is felt that just standing will further break things down. If that is so perhaps a total body sling to hold the horse up but managing such for the months required to heal such a injury is quite a challenge.
DrO
Member:
Netgypsy

Posted on Friday, Feb 11, 2005 - 10:05 am:

Perhaps we are mistaken but the latest literature we have read on DSLD has led us to believe that the suspensory laxity is definitely an indicator of possible injury but not necessarily an indicator of the "improper" healing that produces DSLD.

Quite frankly had we noticed the suspensory laxity we wouldn't have bought the horse but we did and noticed it a few weeks after we bought her when we looked at some still shots of her in action so we researched extensively on possible problems from it and of course came across the DSLD in Peruvians in particular. This is why we've been so careful with her.

The survey we read listed Peruvian paso as number one in incidence, standardbred as number two, several other breeds, then paso fino with about the same percent of cases as most other light breeds. We're on a big paso fino BB and know of only one other case (we post these things anonymously so people are more likely to divulge them) and have seen one APPY with DrOpped fetlocks but no pain yet. One BB member lost a Peruvian to DSLD. That said we know this mare could certainly develop it but so far none of the five vets who have examined her have felt that she showed any signs of the cartilege in the suspensories. Yes of course we are worried because we also own her 9 month old son who did not inherit her flexiness but who could carry the gene for DSLD so it is very important for us to get a definitive answer on this before we use him for breeding as he is of outstanding quality.

Now regarding the SMBII's what would you suggest to prevent the edema the boots caused? It was fairly severe and resolved immediately when we removed the boots.

As of yesterday she no longer had pain in either fetlock and is up and about more so perhaps we need to give her some type of tranquilizer to keep her more quiet?? She is a very spicy, energetic horse so this is probably going to be our main concern. She's in a small outside area (10X20)that we're going to enclose with roundpen panels because as she improves she'll go through most fences to get back in with the herd and they, with her.

By the way - the pain was on each side of the fetlock, not the back which has not been at all sensitive. There is no heat or swelling in the fetlock.

We always appreciate any information you provide as we have never had a profoundly lame horse - just a bit of arthritis on our old mare, and a couple of minor injuries that resolved quickly so we're totally stressed out since this mare is very special.

One other question - are you permitted to post pictures on the forum and if so what are the size requirements? How about links to pictures since many times a picture gives so much more information?
Moderator:
DrO

Posted on Friday, Feb 11, 2005 - 8:34 pm:

Yes DSLD is more commonly reported in some other breeds but when you compare the relative number of STBs to PFs in the reporting area, I am not sure you can say PFs are less likely to develop it than these other breeds, perhaps quite the opposite.

Acutely injured suspensories don't typically develop laxity, this is more a characteristic of DSLD. I think the laxity is significant because it creates a situation where extra stress is placed on the suspensory, making it more prone to recurring injury which is why DSLD lesions and clinical sighs tends to accelerate as it progresses.

The swelling could be that the degree of hyperextension causes the boot to put extra pressure in some areas. Another theory could be if the horse is standing more dependent edema is forming (gravity pulls the fluid down the leg). You could try putting extra padding under the boots to relieve pressure points but if this is edema that gravity is preventing from being picked up it is another problem that has to be managed. I don't know of a better made support boot.
DrO
Member:
Netgypsy

Posted on Friday, Feb 11, 2005 - 10:27 pm:

The survey that I read and the other literature uses percentages, not number of individuals affected. This is not a common problem in paso finos although of course it exists. In fact some people we know who used to breed Peruvians have advised potential clients to buy paso finos for that very reason.

Our mare is improving significantly each day and our main problem is keeping her quiet and relatively inactive. Is there any particular tranquilizer that is used for this type thing?
Member:
Shirl

Posted on Friday, Feb 11, 2005 - 10:51 pm:

TK, Dr. O can direct you as far as actual traquilizers, but I do know that Magnesium is a calmer in a lot of horse. I gave my mare Quiessence type Magnesium when she was hyper and it helped a lot. Got it from EquineFoxDen.com
Shirl
Moderator:
DrO

Posted on Saturday, Feb 12, 2005 - 1:10 pm:

I agree that DSLD is not common in any of the nonPPaso breeds. TK where have you seen large surveys of breeds concerning the incidence of DSLD. I would interested in such numbers as we have been trying to collect such information for the last 3 years. The folks I talk to can only relate the relative number of cases they have seen. Even researchers in DSLD tell me the true incidence is PPasos, what I think would be the most studied breed, is unknown.

For tranquilizers daily ace or for more long term reserpine and fluphenazine could be used. For more information on each of these see Equine Medications and Nutriceuticals » Sedatives & Anesthetics.
DrO
Member:
Netgypsy

Posted on Saturday, Feb 12, 2005 - 5:15 pm:

I notice you had an earlier thread on DSLD so you've probably seen this one but this is the survey we found:
https://esadinfo.tripod.com/page7.html
This one lists standardbreds as number 1
We came across another that listed PP's as number 1 and standardbreds and number two but didn't bookmark it and can't find it now.
This is the best link for info because of the pictures and ultrasounds as well as info that contradicts commonly held opinions on DSLD.
https://www.dsld.org/regularindex.shtml

I'll DrOp you an email about the PP owner who posted about losing her PP to DSLD.

Thanks for the info on tranquilizers.

She's moving around a lot more, her angle has come up on the right foot and she's putting weight on the left foot instead of on the toe. All we can do is wait and worry!

According to some long time breeders of paso finos there is the opinion within our breed that most or all of the few paso finos who are diagnosed with DSLD have some Peruvian ancestry. Quite a while ago Peruvian crosses were allowed into the paso fino registry but no longer and there isn't a lot of Peruvian in our breed.

Thanks a lot!
Moderator:
DrO

Posted on Sunday, Feb 13, 2005 - 7:52 am:

You are welcome. TK those numbers do not represent the incidence of DSLD. The database query that produced those numbers was for "Suspensory Ligament Desmitis, Suspensory Ligament Rupture, Suspensory Ligament Sprain, and Suspensory Ligament Laxity". It is unknown how many of these horses had DSLD and I maintain the incidence in a particular breed is unknown.

Delighted to hear the horse is doing better.
DrO
Member:
Netgypsy

Posted on Sunday, Feb 13, 2005 - 1:03 pm:

I'll keep looking because the other survey we found was DSLD.
I have so many bookmarks I can't find half of what I've seen.
If you are still doing the PP survey I sent this board info to the lady who lost her Pervian to DSLD.
Member:
Netgypsy

Posted on Sunday, Feb 13, 2005 - 1:04 pm:

Thanks for the info Shirley. She's up a lot more now so we may have to try it.
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