Q: How can owners and veterinarians reduce a horse’s joint pain when they have DSLD?

A: Degenerative suspensory ligament desmitis (DSLD) results in degeneration of the suspensory ligament in all limbs, but usually we see more clinical signs in the hindlimbs than the forelimbs. The job of the suspensory ligament is to suspend the fetlock joint, hence the name. And so, horses that have DSLD will have progressive hyperextension or a dropped appearance to their fetlocks, typically in the hindlimbs. What you often see is fetlock joint pain and effusion, as well as effusion within the tendon sheath because the changes in their fetlock angle, as well as all inflammatory mediators (regulate the immune and inflammatory responses) at the suspensory branches, leak into the adjacent synovial structures, causing secondary joint inflammation and pain. The other thing to know is the suspensory ligament originates at the top of the cannon bone, right next to the distal (farthest from the center of the body) hock joints in the hindlimb.

There are a few things you can do to improve horses’ comfort level if they have DSLD. The first is to have your farrier put a heel extension shoe on their hind feet. This changes the biomechanics of their fetlocks and provides support, so they should drop their fetlocks a bit less. I also put these horses on systemic pain medications. I usually use firocoxib on them and acetaminophen because they do typically need to stay on these long-term due to the progressive nature of the disease over time.

The other thing you can do is you can inject their hock joints, their hind fetlocks, and their tendon sheath to make those adjacent joints more comfortable. The product injected into the joint will also diffuse into the surrounding soft tissues, which is the suspensory ligament, so it can make the suspensory ligament feel better too and might help promote a little bit of healing. I always use orthobiologics and I never use steroids when injecting these horses because we know that steroids can worsen ligament injury, meaning it might make things worse instead of better.

Also, if your horse is older, I would have your veterinarian check them for pituitary pars intermedia dysfunction (PPID, formerly equine Cushing’s disease). We know that PPID results in increased circulating steroid levels in the horse’s body, and that will also weaken the horse’s tendon ligaments.

If you notice your horse losing hair, first consult your veterinarian and determine the underlying cause. Many causes for equine hair loss require medical treatment, but once health issues have been ruled out, investigating the diet is the next step. When feeding to improve coat health, first ensure that your horse’s basic nutrient needs are met with a high-quality ration balancer, then consider an additional supplement of biotin and an omega-3 fatty acid source. If you are unsure if your horse’s current diet is meeting his nutrient requirements, reach out to a qualified equine nutritionist.