Degenerative Suspensory Ligament Disease, DSLD

Diagnosis Conditions or ailments that are the cause of a problem that you see - your observation.

Your vet may diagnose

Degenerative Suspensory Ligament Disease, DSLD

Synonyms: Equine Systemic Proteoglycan Accumulation, ESPA

Summary

The suspensory ligament (SL) ties into the top of the cannon bone, just below and behind the carpus in the front limb and the hock in the hind limb. The structure runs down the back of the cannon bone, between the two splint bones. Two-thirds of the way down the cannon, it splits into inside and outside branches which attach to the sesamoid bones at the fetlock. Fibers pass on as the extensor branches blend into the extensor tendons. The SL is a critical structure for the sling function of the fetlock joint and is unfortunately a common site for the development of lameness conditions. DSLD is a chronic and debilitating syndrome that results in the progressive breakdown of the SL. Recently, DSLD has been found to be a body-wide systemic problem associated with the connective tissue, similar to Marfan's Syndrome in people. The Peruvian Paso breed is plagued by this problem, although many other breeds are also affected, including the Arabian, American Saddlebred, American Quarter Horse, and Paso Fino breeds. It is a common finding in older horses, especially aged brood mares that have had many foals. Common manifestations of this problem include poor performance, lameness, short, choppy gait,unwillingness to stand for the farrier, and swelling and sinking of the fetlocks, especially in the hind limbs. Usually, more than one limb is involved. DSLD tends to be more common in the hind limbs. Definitive diagnosis requires clinical vet exam with flexion exams and ultrasound.TREATMENT- Currently, there is no specific treatment for this syndrome, although regenerative medicine may play a role in future treatments. In general, this condition progresses to debilitation and chronic severe lameness. Finally, euthanasia becomes the only option. I personally have seen several cases of mysterious sudden breakdown of the SL in otherwise healthy, young, non-Peruvian Paso Breeds. I never really understood what happened in these cases and there is little that I have learned about the sudden onset of this severe syndrome.

my vet's role

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OTHER DIAGNOSES CONSIDERED

Other conditions or ailments that might also need to be ruled out by a vet.

Very Common

• Suspensory Ligament Branch Injury

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  Suspensory Ligament Body Injury

• Proximal Suspensory Ligament Injury, Hind Limb

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  Lameness, Conditions Causing, Generally

Less Common

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  Proximal Suspensory Ligament Injury, Front Limb

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  Fetlock Arthritis, Osselets

• Flexor Tendon Injury, Tendinitis, Bowed Tendon

• Laminitis, Chronic

• Laminitis, Acute

• Bone Spavin, Distal Hock Arthrosis

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  Sole, Foot, Corn or Heel Bruise

• Sole, Foot or Hoof Abscess

more diagnoses

Diagnostics Used

These are tests that might be helpful to make this diagnosis or further characterize the condition.

Very Common

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  History & Physical Exam

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  Ultrasound, Musculoskeletal

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  Diagnostic Anesthesia, Nerve Blocks

• Lameness Exam

• Flexion Exam

Less Common

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  Radiography, X-ray, Affected Area

more diagnostics

Treatments May Include

These treatments might be used to help resolve or improve this condition.

Very Common

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  Change in Expectation

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  Change Management, Husbandry

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  NSAIDs, Non-Steroidal Anti-Inflammatories, Generally

Less Common

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  Shoeing or Trimming, Corrective Farriery

Rare

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  Nitrogen Oxide Donors, Generally

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  Acupuncture

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  Herbal Medications, Generally

more treatments

PROGNOSIS AND RELEVANT FACTORS

Prognosis is generally poor. The classic form of DSLD in Peruvian Paso horses and older horses of any breed is progressively debilitating with a poor prognosis.

my role

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I might observe

You might make these observations when a horse has this condition.

Very Common

• Fetlock Sagging Low, Hyper-Extending (in Adult)

• Lameness, Generally

• Swollen Fetlock (Ankle)

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  Will Not Stand for Farrier, Will Not Hold Leg Up for Long

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  Pain Response to Pressure on Flexor Tendons or Suspensory Ligament

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  Shifting Weight from Limb to Limb, Treading

• Short-Strided in One or Both Hind Limbs

Less Common

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  Choppy or Short Gait, Short-Strided

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  Lying Down More Than Normal, or Getting Up & Down

• Limbs Seem Rigid or Stiff

• Lame or Sore after Farrier Visit

Rare

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  Hesitant to Walk on Hard Surfaces

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  Lump, Bump, Growth on Leg

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  Pointing, Placing One Limb Forward when Standing

more observations

Skills I Might Need

I might need these skills if my horse has this diagnosis.

Very Common

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  Perform Whole Horse Exam™ (WHE)

• Assess Lameness at the Walk

• Assess Lameness at the Trot

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  Assess Injured or Affected Area

• Assess Hind Limb

• Assess Front Limb

more skills

further reading & resources

Helpful Terms and Topics

Written, reviewed or shared by experts in equine health

• Lameness & the Lameness Exam: What Horse Owners Should Know

Outside Resources

CREDIBLE EQUINE HEALTH INFORMATION ON THE INTERNET

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  Info & Management for Owners of DSLD/ESPA Affected Horses

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  Equine Podiatry - Degenerative Suspensory Ligament Disease

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  David Ramey DVM on Degenerative Suspensory Ligament Disease (DSLD, ESPA)

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  Eleanor Kellon VMD - Equine Nutrition Website

Related References:

Equine Podiatry website. Available at: www.equipodiatry.com. Accessed 2013.

Author: Doug Thal DVM Dipl. ABVP