Surgical PSD Treatment
Surgical PSD treatments involve neurectomy of the deep branch of the lateral plantar nerve (cutting or transecting the nerve) and fasciotomy (ligament splitting). | Photo: Erica Larson/The Horse

Perhaps better known as PSD, proximal suspensory desmitis can effectively sideline horses for months. Hind-limb cases can be especially challenging to manage—conservative treatment can mean a poor prognosis for a horse, and while surgery generally produces better results, not all horses with PSD are good candidates for it. The good news? Veterinarians can carefully select surgical cases to improve outcomes.

“A horse owner recently said to me, ‘Gee, it seems like hind-limb proximal suspensory desmitis is an epidemic among horses. I don’t remember this problem from 20 or 30 years ago,’” said Ashlee Watts, DVM, PhD, Dipl. ACVS, an assistant professor of large animal surgery at the Texas A&M University College of Veterinary Medicine and Biomedical Sciences, in College Station.

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