LIVING WITH Degenerative Suspensory Ligament Desmitis
“ERO”
PCR FORASTERO 1990-2005
"BENNY" BAILADOR DEL VIENTO MF
1 1992 – 2005
by Karel Nordstrom
I said good-bye to Benny on November 24, 2005, after having said good-bye to Ero seven months earlier. I vowed that I would tell their story as a tribute to them, and, hopefully, to help increase the understanding of this disease among other Peruvian owners.
Hindsight is usually 20/20 and Benny’s case confirms my personal diagnosis of DSLD for both he and Ero. The progression in both the horses followed the classical pattern – albeit not with every symptom and not at the same rate. It is very easy, today, to look back over my records and identify each problem we encountered with both horses as another step in this slow, insidious disease.
Many years ago, when, at the age of 5, Ero sustained an injury to the right front suspensory ligaments, we began the usual accepted therapies to help him heal. He went on to injure the left front suspensories within 2 months. At this point in time, I had never heard of DSLD, nor had anyone in my small “Peruvian World” ever mentioned that this disease existed, and with a higher incidence than usual in the Peruvian Paso breed. We struggled to make Ero heal with the help of our Vets, but after 5 more years, at the age of 10, we were told that there was nothing more that could be done for him. And still, we did not know with what we were dealing. It was only in a chance conversation overheard by Mary Donald that I was made aware of this disease.
In the subsequent years of Ero’s life, because the horse was often obviously in pain, I used hot laser therapy, magneto-pulse therapy, nutritional therapy, homeopathic therapies, as well as old stand-bys like cold hosing, ice packs, heat packs, linaments etc., etc., to make him more comfortable. The problem seemed to remain in the front suspensories with noticeable lesions forming along the ligaments and micro tears around the fetlock area. During this time, I was still trying to heal the legs by increasing the blood supply, but I was becoming increasingly aware that other things were also going on; stiffness in movement and a rigidity in carrying himself; possible back soreness; difficulty in walking for a few minutes after getting up; difficulty turning in a tight circle at times; and, acute lameness when walking on cement floors or down slight inclines. Because the horse appeared to walk out of some of the lameness, I continued to exercise him every day, hand walking if he was very sore and then riding at a walk until he improved enough to resume a normal program.
As he fretted when not being used, I felt it was psychologically better to carry on riding as long as we could. Over these years, there were times when we had quite lengthy remissions and one could almost believe that the horse was getting better. Indeed, in June of 2004, after months the previous winter of doing laser therapy, Ero was on an up-swing. So, we entered a Gaited Show for the first time in 10 years. He was superb, but tired quickly. After that the exacerbations continued to lengthen and deepen while the remissions became fewer and shorter.
During his last winter, we continued to ride daily but switched to bareback as he obviously was more comfortable without a saddle. Over that time, it became very apparent that he was rapidly losing muscle mass. In the early spring of 2005, we spent many hours on the trail and it was after one such ride that he appeared to suffer a “snap” in his right hind quarters while standing, and almost went down. From that time on, he was never able to put much weight on his right hind leg and corresponding left front leg.
Over the years, he had exhibited “pointing” of both front feet and this increased dramatically in his last year. He would also come out of balance while gaiting and “hitch” every so often as he could not maintain his timing. Ero’s pasterns were very up-right (in fact this was often commented on by Vets as it appeared to be unusual for a Peruvian) and even with all the adhesions and scar tissue on the suspensory ligaments, his pasterns never dropped. It should be mentioned that in 1999 he was diagnosed with an infection of the lymphatic system which debilitated him for 6 months. He was given an immune booster as well as Bute to get him through it. He was not able to tolerate the Bute after a period of time and we switched to Arquel which was successful for him as an anti-inflammatory and pain management drug.
In the fall of 2004, we tried Bute once again, mixing it with honey and yogurt and this he was able to tolerate. He was given a maintenance dose of 1 g/day for 7 months without a break. This helped to manage his pain level, but in the last 3 weeks it ceased to have any effect. We also used Banamine in the early stages with some success. As the disease progressed, he was given Banamine before every shoeing, but this, also, became ineffectual.
While the horse could obviously withstand a high level of pain, it became evident that the pain was increasing. So, on the advice of my Vets, Ero was euthanized on April 9, 2005 with confirmed DSLD.
Benny’s first episode, which now appears significant, took place in July of 1997 when he injured himself playing in the field. He slipped and tore his right fore shoulder muscle. It was not able to be diagnosed for about 2 months during which time he remained completely out of balance and hitching on the right fore. Swelling finally appeared in his chest area briefly. He continued to be out of balance with uneven gait, so we rested him over the winter.
By April of 1998, he still had an interrupted gait, but did not appear to be in any pain. He was used only on the trails until the spring of 1999 when we began a program to strengthen muscles and bring him into balance. We did many hours of walking and hill climbing as well as lengthening and shortening his frame. I should mention at this point that this horse was very long backed and to complicate matters, was 2 ½ inches higher at the croup than at the withers. He also had a sway-back which dropped 4 inches below a level with the withers/croup.
He always found it difficult to drive his hind legs under himself and to bend through the body and as a result was very much on his forehand. During the months of conditioning, he would have days when he gaited well, but every so often he would appear very tired and/or grumpy. We assumed he was sore but were unable to identify the spot. When using the Peruvian saddle, he always developed a sore back, so I rode in an English saddle when training.
By late June 1999 the work-outs became more and more doggy and he was no longer a forward moving horse. He lost all animation and when asked to gait would swing his head and shoulders from side to side, producing a rolling gait instead of advancing in a straight line. On the 28th of June he was very lethargic, although still eating, and showed a temperature of 103.2 f. By the next morning he spiked a temperature of 106.5 f. He was examined fully, and nothing was found to indicate the cause – and still he was eating. He was treated and a complete blood panel taken. The results indicated a completely normal horse. One week later he was perky and alert and the only indication of the episode was swollen neck glands. His neck remained sore and he tired easily for about 2 weeks.
For the rest of the year and up until June of 2000, Benny trained and worked well with very little resistance. In June he became extremely sore after a trim, which was unusual and he began to pasitrot, was not smooth or consistent but quite stiff and reluctant to move out. Again he exhibited grumpiness. We felt there was pain somewhere, but could not identify the site. He continued to improve but was stiff and often out of balance and it wasn’t until the fall that he began to carry himself and move freely.
In the spring of 2001, he suffered an abscess of the right front hoof, but it was an otherwise good year with very little in the way of soreness, grumpiness or refusals and this continued through 2002.
By June of 2003, Benny began to look very depressed and was dull and flat. All 4 feet were tender and he appeared to be uncomfortable everywhere. We thought it might be attitude and tried to “wake” him up, but to no avail. He continued to be lethargic and suffer from tender feet until the winter.
March of 2004 brought with it the realization that Benny was having difficulty getting up after lying down – the longer he lay down, the more difficult it was for him to get up. He would be very lame on the left front for about 5 minutes and then he would walk out of it. All that could be diagnosed was a slight stiffness in the left front fetlock. Even the cramp test did not indicate much, only that the left front took longer to recover than the right. At this time, a visiting Vet noticed micro-tears around his fetlocks.
It was time to have ultrasound and x-ray images taken. The ultrasound confirmed an injury in the left front suspensories at the point of the check ligament and nothing else significant. The x-rays showed very clean joints – as remarked by the Vet “beautiful joints – as clean as any I have ever seen”. The total examination indicated no swelling, no heat, no head bobbing, and no noticeable lameness. The Vet prescribed DMSO for the affected leg and liniment massage for the other 3 legs. Steps were taken by the farrier to trim and shoe to relieve stress on the suspensories. He was shod with half-rounds on the front for easier breakover and with heel support. Benny seemed more comfortable right away. I began using laser therapy twice a day on his leg and added Equine Recovery, a nutritional supplement, as well as Vitamin B-6 to his diet. He was hand walked twice a day. When he improved enough to carry a rider, I exercised him bareback.
We noticed that the area above the top of his tail, which already had a deep depression, was sinking further, his footfalls were no longer clean and crisp but ploppy, his pasterns were becoming more elastic and his gait was short striding and bouncy instead of long striding and fluid. By May he still had a sore back and did not respond to Bute. Then we decided to try the magneto-pulse and treated him for 30 minutes a day for a week. This seemed to help and he was brighter and happier until July when once again he exhibited tiredness and a reluctance to move out. Bute appeared to help at this time.
By August we decided to see if acupuncture would help him. The assessment confirmed chronic pain in the front legs and fetlocks, the neck and along his back, particularly in the croup area. By the 4th treatment there was a noticeable improvement and he was a much happier horse. We were able to extend the time between acupuncture treatments to 6 weeks as of October. He remained active, carrying himself well, tracking up and very bright for the winter months. He was ridden bareback 5 days a week for most of the winter.
By March of 2005, we noticed his body shape was changing. Some of the muscle in his neck was disappearing and his chest was beginning to sink in dramatically. Where he had been higher on the croup all his life, it was now level with his withers and by the April acupuncture treatment, he was as sore as he had been at the first treatment. He had also begun to stumble frequently when being ridden, appeared to tire easily and seemed uncertain of where his feet were. This time Bute seemed to make him more comfortable.
We decided to take another set of ultrasound photos. These showed only slight amount of deterioration, not as much as one would have expected given Benny’s pain level. It was suspected that other ligaments were affected as the hip girdle was very sore as well as all fetlocks and there were muscle spasms along the back and in the croup area. Over the years, Benny had always shown a biting motion when being palpated in the girth area. Later on, he began to show the same reaction to palpations along his neck and deep in his chest. This we attributed to pain.
The effective acupuncture treatments lasted a shorter and shorter time and finally there was only slight relief for a few hours. There were small soft swellings on the inside of both front suspensories and the tissue around the coronary bands became soft and spongy. Noticeable changes were occurring daily. He had lost muscles on his back and in the loin area, was moving stretched out even at a walk, did not use himself and found it hard to track up at all. A complete massage treatment was done and the therapist found muscles in the hamstrings and glutes to be pitted (possibly not firing) and hindquarters that were not round but flat on the back side. She also found muscles in his neck and sides that appeared uneven and ropey.
July 18, 2005 was a red flag day. Benny stumbled and fell while gaiting on a familiar trail with good footing. He lost all 4 legs, went down completely and hit his nose on the ground. He seemed stunned and was not in any hurry to get up. As he seemed very sore, we again started Bute. There was very little observable difference in his comfort level this time.
A complete exam was done by the Vet which identified the things we had noticed plus possible muscle atrophy, loss of balance, stumbling, stabbing of the toes and a general malaise similar to that of a very old horse. In fact, the comment was made that he had aged 10 years in 1 year. From that time on, he was never ridden with a saddle. There were short remissions when he was happy to go out on the trail, but the time came when he was walking with such difficulty that he was diagnosed with slight laminitis in all 4 hooves, the left front being the worst. There were also symptoms of navicular. He was close to founder, brought on, we believe, by pain and indeed his eyes were no longer bright but very flat from the pain. A complete blood test was again done and showed results comparable with that of a healthy horse.
We were able to maintain somewhat of a comfort level with increased amounts of Bute, but he began to experience more and more difficulty taking steps. He lost more muscle mass in the hindquarters and in the chest, and we noticed hair standing up along nerve paths on the sides of his lower belly. He could no longer walk on cement, and in his last assessment, his heels were contracting, his feet were coming closer to a center line when walking, he was stabbing his toes both front and hind, and was very heavy on his feet – uncoordinated and tripping. Even with all of this, his pasterns never dropped.
Benny was euthanized on the morning of November 24th, 2005.
Just to add a note to Benny’s story: many conversations were held with the 3 Vets involved, and the degeneration progression of this disease had us speculating on the root of the problem. We felt that it might be neurological and could see some similarity with the progression in humans affected with Multiple Sclerosis.
It was evident, when following the protocols outlined for confirmation of this disease that the many physiological changes would not be evident to the average horse owner and consequently would not be recognized as steps in DSLD. In fact, it was only after observing and attempting to treat each individual problem over a period of about 10 years that I was able to follow the degenerative process.
In my opinion, the management of the horse showing symptoms of this disease requires that he be kept moving, be given a supplement for connective tissue repair as well as a mineral supplement and an immune booster. There will be times when the exacerbations are severe enough to require an anti-inflammatory drug such as Bute or Arquel, but these do not always work.
Supplements that appeared to help maintain the horse longer in the remission phases:
- Dr. Reed’s Minerals – supportive balance of minerals
- Equine Recovery – to assist in rebuilding of connective tissue
- Vitamin B-6 – to help the immune system
- Visorbin – to increase the energy level
It should be noted that:
- Banamine did not work in the final years – had no effect on severe pain – i.e. pre and post feet trimming;
- Bute was given to both horses in yogurt and honey – sometimes it worked, sometimes not. Bute was given without a break at the end, as days off caused too much increase in pain.
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