This two-part post was three months coming, and even now I’m not certain that I’m quite ready to articulate how I feel. I’ll start with an explanation of the devastating news, and in part two I’ll attempt to tackle the emotions.
The nitty gritty of heartbreak
On September second, while I was across the country celebrating the nuptials of a dear friend, my esteemed veterinarian was making a diagnosis that no one wants to hear. It looks like my beloved five year old Fritz has a degenerative deterioration of the ligaments and likely will never again be a riding horse.
After a few days of stiffness in his right hind and observing him having difficulty rising, what we had assumed was a loose stifle was confirmed as something entirely different when an ultrasound showed a damaged suspensory ligament. Coupled with some swelling behind the fetlock, sciatic soreness and my vet’s most worrisome observation, his hocks have straightened significantly.
The diagnosis: Degenerative Suspensory Ligament Desmitis “DSLD,” also known as Equine Systemic Proteoglycan Accumulation (ESPA) is a systemic disease of the connective tissue of the horse.
DSLD was once considered a condition of the legs only, as one of the most visible signs is when the fetlocks/pasterns, particularly on the hind legs, collapse and fall until they’re almost horizontal. However, research has shown DSLD horses can be affected not only in the tendons and ligaments of all legs and the patella, but can have affected tissues in the nuchal ligament, eyes, aorta, skin and fascia, lungs and other organs, as well as ligaments and tendons throughout the body. Because of its systemic nature, and because connective tissue is present everywhere, the entire body becomes affected in multiple ways as the disease progresses.
To have a completely positive diagnosis, a biopsy of the nuchal ligament is required. While I’ve been reassured by three veterinarians that this would not be exceedingly stressful on the horse, I’ve also been cautioned that neither a positive or negative test result would change the recommended course of treatment and so have not proceeded yet with the biopsy.
There is a chance still that it’s something else. However even if he tests negative for DSLD, the vets believe that there is some bigger degenerative issue causing the demise of the ligaments. For his age and workload, it is very unusual to have the damage he has in his suspensory. And the straightening of the hocks leads them to believe that the entire mechanism of his leg isn’t functioning correctly. The fetlock can’t support the suspensory, which affects the hock, which affects the stifle, and then into the sciatic.
In DSLD horses the ligaments don’t heal properly. Rather than re-bonding with normal tissue, a more brittle cartiledge forms. So I’ve been told that traditional approaches to suspensory repair (stem cell, iwrap, etc) likely won’t be effective. My wonderful vet is willing to try anything and has access to the newest treatments, but she’s cautioned me against wishing for a miracle.
That being said, one can’t help but hope.
DSLD is the only condition of its kind that affects the limbs in pairs; both hind legs, both front legs or all four. Fritz is only presenting the conditions in his right hind at the moment. But we’re catching it much earlier than most cases, so perhaps the lateral symptoms are coming? There is very little research suggesting how quickly onset occurs and when I can expect the other leg to show symptoms.
For now, he is allowed turnout (because lets face it, he won’t do well on stall rest), he’s been fitted with special suspensory shoes and he’s benefiting from some previcoxx. There is a DSLD owners group that suggests some alternative treatments and feeding regimens, and I’m looking into all options.
My concern is for his comfort. In some moments, he gets a fit of Fritzy energy and seems ready for adventure. In others, I’ll notice him holding his leg up, resting on his bucket, and piling up shavings under his hoof for support.
I’m thankful that he’s still here, still up to his old tricks and still as cute as ever. For now I’ll have to be content with counting down the days until he gets his six month ultrasound in March and hope for a surprise.