Alamo Pintado Suspensory Ligament Desmitis Report

 Alamo Pintado Equine Medical Center, Inc.

    To: Peruvian Paso horse owners

    Re: Suspensory Ligament Desmitis

    Alamo Pintado Equine Medical Center has been treating horses for over 30 years in Los Olivos, California. We see horses of all breeds and of all equine performance sports. We have always seen a large number of Peruvian Paso horses because of our locale to many top Peruvian breeders and trainers in the Santa Ynez Valley and California.

    In the last six years we have diagnosed well over 1,000 suspensory ligament injuries in horses associated with racing, jumping, dressage, cutting and endurance events. We have diagnosed approximately 8 Peruvian Paso horses with suspensory ligament injuries during the same time period. Of these 8 injuries in the Peruvian Paso horses, six were determined to be typical overuse injuries and were treated as such at APEMC. Of the other two Peruvian Paso horses that did not fit the typical overuse injury, one was due to being extremely overweight and poorly taken care of and the other horse may have had what has been called degenerative suspensory ligament disease but it was not confirmed with any histologic evidence.

    The veterinarians at APEMC have always found it to be curious that this condition of the Peruvian horse has not been described in any equine lameness or surgery text and has not surfaced as a cause of unsoundness in the Peruvian Paso horses that we have dealt with on a daily basis for the last 30 years. On the contrary, we have found suspensory desmitis to be very rare in the Peruvian Paso population that we treat compared to a relatively high incidence in the racehorse, jumper and dressage horses. We feel that these high rates are a factor of footing, training and shoeing problems. We do feel that some of these injuries are related to abnormal conformation in some horses and are not just occupational hazards. Some large breed broodmares that have had numerous foals will often develop a chronic progressive suspensory ligament degeneration and breakdown that is very difficult to treat as long as they remain heavy and continue to carry heavy pregnancies. Once this degenerative process develops it is not possible to reverse and return the suspensory branches to normal with rest or treatment. Weight management in any breed of horse is critical to health and soundness.

    I am sure that this condition has been diagnosed and documented in a certain number of Peruvian Paso horses on some farms in the United States, but I have not heard of the numbers and the overall incidence as of yet. We have seen this identical problem in Thoroughbreds and Quarter horses, but these are horses that were poorly conformed and passed the predisposing conformation to their offspring. The simple answer to this problem is to not breed bad-legged horses to bad-legged horses, or to breed any horse with a severe inherited conformation fault. Once that becomes obvious, the problem goes away.

    In our experience, the Peruvian Paso, as a breed, is a very tough, durable and sound breed of horse when compared to all the other breeds of horses we see at APEMC. I hope that the excitement and confusion over a small group of isolated horses does not continue to cast irresponsible unwarranted connotations on a very strong and sound breed of horse.

    Doug Herthel, DVM Mark Rick, DVM
    Greg Parks, DVM Ed Hamer, DVM
    Carter Judy, DVM DACVS


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Note that the date of issue has been removed. This letter has been floating around and cussed and discussed for a number of years.

LOL ..."cussed and discussed". Indeed it has. Unfortunately, it becomes highly irrelevant to the owner of an affected horse. I believe it's high time people quit looking at this as a breed problem and start looking at it as an equine problem! 


Note that the article reproduced above is titled "Suspensory Ligament Desmitis" - which is not the same as the disease commonly known as "DSLD" (for *Degenerative* Suspensory Ligament Desmitis - more recently renamed ESPA for Equine Systemic Proteoglycan Accumulation). 


DSLD/ESPA is a devastating disease. In my opinion all horse owners should be as informed as possible about it. There are very few breeds in which it has not been seen. Rates of incidence in any breed matters little when one's own beloved horse is suffering with this.


I urge everyone to recognize that the disease is the enemy. Let's spend our efforts in a positive way to defeat the disease itself, rather than to quibble about percentages and incidences in this breed or that.

In response to the above article, I would like to agree with Alamo Pintado that yes indeed there are some horses in the Peruvian Paso breed that suffer from suspensory injuries that have nothing to do with degenerative suspensory ligament desmitis and I also agree that there are many strong Peruvian Paso horses within the breed.  However, it is a proven fact that DSLD does exist.  It exists in a number of breeds such as Arabs, QH, Standardbreds, Thoroughbreds and some warmblood breeds. 


There have been papers properly presented before such institutions as the American Assn of Equine Practitioners and also published in Equus Magazine, a highly respected publication.  At the present moment research is being conducted of a highly scientific nature to search for a possible genetic marker for DSLD.  Dr Gus Cothran is working diligently at Texas A & M to search for such a marker that would help all breeders make conscious decisions to not breed affected animals.  At the University of Georgia Dr Y. Halper is currently working on the systemic affects of DSLD.  To say that no scientific work has been done in the field of DSLD is untrue.  Dr J. Mero conducted a 20 horse study in the field with conclusive ultrasound work showing that in every horse in the study there were consistent tears and fluid filled holes in the suspensories as opposed to horses used in the study showing no such tears or fluid filled holes.  This helped her to conclude that those horses showing there were such dramatic influences on their suspensories were indeed suffering from what we now know as DSLD.  The protocol she developed from her  findings helps verterinarians be able to diagnose (note I said 'diagnose") affected horses, not the why or how or what of DSLD, only that it exists at the time of ultrasound.


So, although there are many thoughts floating around about whether or not the Peruvian Paso horse is strong let us make one thing is most definitely a strong horse.  However it tends to suffer from this mysterious degenerative disease, it does not make it good or bad or indifferent from other breeds, it simply means it suffers or appears to suffer more in proportion to other breeds this disabling disease.  It is my opinion that DSLD is not brought on by hard or bad training, overwork, or overweight, is simply a disease that will or will not manifest itself due to reasons we do not yet understand. When one is confronted by something one does not have an answer for, one is inclined to clutch at the proverbial straw.


In conclusion, although Alamo Pintado may feel in the course of it's practice it has not come across this disease in the number of Peruvian Paso horses it has treated in relation to other breeds it does NOT mean that DSLD does not exist in the Peruvian Paso breed.  It does.  Therefore it would be indicative for all owners of horses no matter what the breed to educate themselves from every perspective and all material present to help them make a conclusive decision as to how they would breed affected animals. 


If breeders would take the time to thoroughly study the bloodlines of animals they have known truely or falsely to be affected by DSLD, to know the signs and symptoms of DSLD and then not breed an affected animal to an affected animal, surely the breed would slowly rise above the scourge of DSLD.  And as time progresses science will be able to put the definitive cap on this disease such as the QH breed did with HYPE and from that day onward the PP breed will be able to eliminate DSLD altogether.


Human beings were not born with the long neck of the ostrich and must not therefore, continually try to hide their heads in the sand, it will not work.  The only way to understand and eliminate DSLD from all breeds is to face it head on, contribute to the research, be responsible in breeding non affected horses and keep a level head and an open mind in all things pertaining to DSLD.  If all PP horse owners who love the breed would keep an open mind and realise that there is no shame connected to owning a horse that may or may not have this disease.  It is not the horses fault, it is not the owners fault.  It is a quirk of nature.  Therefore, it would behoove us all to keep a calm head and realise that continually contradicting anyones oppinion or anyones knowledge is nothing but counterproductive.


These thoughts are my own, they are not meant to be disrespectful to anyone, nor to inflame passions one way or the other as to thoughts or feelings regarding this monumental problem that faces so many horse owners.  Please respect the right to express one's opinion.



Pam Johnston

I wanted to reassure you that my own horse has DSLD.  It has been noted and a sad state that my horse while after being diagnosied and while on stall rest was actually worse after 1 month of rest!  I understand the sad affects of DSLD not only on the horse, but on the human.  Although my horse has had PRP and is doing well, it is in the back of my mind to remember that this is a disease.


The reason for posting this article was because I have read numerous articles stating that PP's were "prone' to DSLD, etc.  I was so tired of reading it, but when I found this article online, I wanted to share it with everyone!  :)  I wanted it to be known that PP's are still a very strong horse in many ways and that other horses are also subject to DSLD. 


I love the input that eveyone has stated here because it all so true.  Us DSLD horse owners must stick together, but to remember that our horses are strong beings and there are a variety of things we can do to help ease the pain and increase their chance of having a "normal" horse life.


I hope you all enjoy the artice and see it the way I have seen it as being hopeful.  I do hope and pray that their is a cure for this horrible disease.


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