Chronic suspensory desmitis and ridden behaviour - experiences?

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Hi everyone. I'm interested to hear anyone's experience with chronic hind suspensory ligament desmitis. My mare was diagnosed with this last year, plus secondary sacroiliac pain. She's had a couple of rounds of steroid injections now but a few behavioural quirks are making me worried that she's feeling it more again. She gets bute when she's ridden, and the vet has advised fairly regular light ridden work (no jumping) to keep her hind muscles well developed to help support everything else.

Particularly she's getting harder to walk out of the field in hand, more anxious and spooky, tendency to rush more and more when transitioning to trot. Still a lovely (if mareish) temperament on the ground though, and she will behave nicely for an experienced rider but then she is a very honest and stoic mare who tries her best. My daughter, who is a very good rider and confident with other horses, feels very anxious when riding her, says she feels like she's always on the verge of taking off with her.

Has anyone had a horse with this long term problem? What was your experience of their ridden behaviour, and how did things progress long term?

Also if anyone has found any good reference material on supporting this condition could you please point me to it? TIA
 
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I'd be looking at her posture and movement, at compensations, as it absolutely sounds like there's a good chance it's pain. When we find these problems vets aren't always clear that it's part of an overall movement pattern, whether caused by one (that we might never find the cause of, eg birth trauma, see Dr Ian Bidstrup's work) or one developing because of the dysfuction of the brewing "injury". It means that we often miss other more minor issues that have been grumbling away elsewhere.

Going back to the vet is usually the best option but I would also read widely on posture and compensatory movement patterns (equitopiacenter.com is the place I recommend starting as it has a huge number of relevant resouurces and is free/cheap to join) and be prepared that any rehab, now or in the future, may need to be different, looking more closely at how the horse is using herself.
 
Hind PSD doesn’t generally respond well to steroid, the sacro may though. PSD main vet intervention would usually be shockwave or neurectomy & fasciotomy.

Sounds like pain behaviour to me, you need the vet back out. The only one I’ve owned with it was stuffy and would get his back up, he had the op and then went hacking & hunting rather than eventing.
 
We have one with similar. We took the decision to turn him away for a year after diagnosis. He is now sound and rehabbed and essentially is just going to be a hack. He has very straight hocks and also PSSM or a similar muscle myopathy that contributes to his suspensory issues. Looking back on the 6 months before diagnosis there were lots of little tells from him which in isolation we didn’t pick up on. Now we are hyper aware if he doesn’t want to cross over behind or reacts strongly to glutes being touched or any slight SI pain. It’s a question of knowing what’s normal for your horse and if you think she is trying to tell you something, however subtle. Maybe worth getting the vet out or give her a week or so off first and see if she behaves the same when she comes back.
 
Thanks. Yeah the steroid injections have been into the SI joints. After discussion with the vet we decided against shockwave therapy while we saw how she responded to rehab.

I'm going to get the vet out again to assess her, but my worry is that this is all very subtle. We know that she needs help to use her hind end correctly as she has a strong tendency to go on the forehand but she seems to need a very strong and confident rider to achieve this. Without paying for schooling we haven't been able to find anyone who fits the bill and as I say my teenage daughter gets very anxious riding her (although she's perfectly capable). It's quite a dilemma at the moment.

Sadly happy hacking isn't an option (yet) as she's very spooky and borderline dangerous when out and about. I also don't think she's a candidate for retirement yet, but this is why I'm interested in how this has gone for others. She's seventeen.
 
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bonnysmum said:
Thanks. Yeah the steroid injections have been into the SI joint. After discussion with the vet we decided against shockwave therapy while we saw how she responded to rehab.

I'm going to get the vet out again to assess her, but my worry is that this is all very subtle. We know that she needs help to use her hind end correctly as she has a strong tendency to go on the forehand but she seems to need a very strong and confident rider to achieve this. Without paying for schooling we haven't been able to find anyone who fits the bill and as I say my teenage daughter gets very anxious riding her (although she's perfectly capable). It's quite a dilemma at the moment.

Sadly happy hacking isn't an option (yet) as she's very spooky and borderline dangerous when out and about. I also don't think she's a candidate for retirement yet, but this is why I'm interested in how this has gone for others. She's seventeen.
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IMO There is no point paying a pro to essentially force her into submission when it sounds like she is clearly trying to tell you something. Dangerous to hack is not subtle! To use her hind end and not pitch onto the forehand, she needs to be comfortable in her hind end. ETA it would probably be worth treating for ulcers in parallel as these are usually present in chronic pain situations
 
ihatework said:
IMO There is no point paying a pro to essentially force her into submission when it sounds like she is clearly trying to tell you something. Dangerous to hack is not subtle! To use her hind end and not pitch onto the forehand, she needs to be comfortable in her hind end. ETA it would probably be worth treating for ulcers in parallel as these are usually present in chronic pain situations
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Thank you, you have echoed my own thoughts exactly. The hacking thing may be unrelated because she had little experience of this before we got her and had a bad experience when young.

Because I only have a few year's experience I worry that I'm seeing things that aren't there, especially when pro riders tell me she just needs a stronger hand. But I think my daughter is definitely picking up on something as she doesn't get anxious like this riding any other horse and on the ground they have an amazing bond. And the fact we know she has these conditions I feel like we need to assume pain rather than "trying it on".
 
Having had one like this who was retired at 12 as became spooky and nappy on hacks and was obviously uncomfortable in the school, it sounds like pain.
Ours rehabbed nicely became a super low level dressage horse for a couple of years ( was bought to event but never enjoyed it even in the early days). However a couple of years down the line it all became uncomfortable for him again.
He would go nicely some days, others he'd bronk and run backwards in the school. So no more schooling.
He hacked for another year nicely and happily but when the obvious discomfort returned he was retired.
It's all very well the vet saying work lightly to encourage correct muscle support etc, but if your mare is uncomfortable and needs a strong rider to "ride her through it" I'd guess she's trying to say something.
 
misst said:
Having had one like this who was retired at 12 as became spooky and nappy on hacks and was obviously uncomfortable in the school, it sounds like pain.
Ours rehabbed nicely became a super low level dressage horse for a couple of years ( was bought to event but never enjoyed it even in the early days). However a couple of years down the line it all became uncomfortable for him again.
He would go nicely some days, others he'd bronk and run backwards in the school. So no more schooling.
He hacked for another year nicely and happily but when the obvious discomfort returned he was retired.
It's all very well the vet saying work lightly to encourage correct muscle support etc, but if your mare is uncomfortable and needs a strong rider to "ride her through it" I'd guess she's trying to say something.
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Can I ask how he was rehabbed initially? I'm not sure we can even do that again if she has more injections as my daughter won't even trot her any more. She's working with her in walk only, which she (our mare) seems reasonably comfortable with although I think she's been looking a bit stiffer recently.
 
bonnysmum said:
Can I ask how he was rehabbed initially? I'm not sure we can even do that again if she has more injections as my daughter won't even trot her any more. She's working with her in walk only, which she (our mare) seems reasonably comfortable with although I think she's been looking a bit stiffer recently.
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I’d vet with a view treat the psd (which she seems not to have had done yet), potentially reinject the sacro and then invest in pro rehab (this is different to schooling!)
 
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ihatework said:
I’d vet with a view treat the psd (which she seems not to have had done yet), potentially reinject the sacro and then invest in pro rehab (this is different to schooling!)
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Thanks. Sadly I also have to consider the financial angle so it will need careful thought and discussion.
 
A horse being on the forehand except with a really good and strong rider is not a horse that is moving in good balance.

Think of it as "falling forward" instead of "on the forehand" and do have a look at the links I mentioned (as well as my FB page where I shared lots of stuff like this) to start understanding this, it's too easy for "experienced" riders and trainers to say that a horse needs a strong rider without understanding what it really means.

When we ride with a strong hand we compress the horse in front, they cannot lift through their thoracic sling and the hind legs work dysfunctionally as they have nowhere to go. It even goes back to the CDJ issue - strong hands shut the hind end down and then we end up using all sorts of inappropriate driving aids.

She may feel less on the forehand with the strong rider but I bet her musculature tells a different story, ie they simply force her to resort to the wrong muscles to hold herself up in front. It's super common.
 
sbloom said:
A horse being on the forehand except with a really good and strong rider is not a horse that is moving in good balance.

Think of it as "falling forward" instead of "on the forehand" and do have a look at the links I mentioned (as well as my FB page where I shared lots of stuff like this) to start understanding this, it's too easy for "experienced" riders and trainers to say that a horse needs a strong rider without understanding what it really means.

When we ride with a strong hand we compress the horse in front, they cannot lift through their thoracic sling and the hind legs work dysfunctionally as they have nowhere to go. It even goes back to the CDJ issue - strong hands shut the hind end down and then we end up using all sorts of inappropriate driving aids.

She may feel less on the forehand with the strong rider but I bet her musculature tells a different story, ie they simply force her to resort to the wrong muscles to hold herself up in front. It's super common.
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Thank you, I'm certainly going to take up that Equitopia free trial when I have time to make use of it, and continue reading around the subject.
 
bonnysmum said:
Can I ask how he was rehabbed initially? I'm not sure we can even do that again if she has more injections as my daughter won't even trot her any more. She's working with her in walk only, which she (our mare) seems reasonably comfortable with although I think she's been looking a bit stiffer recently.
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He had shock wave treatment and box rest. He had his SI treated when he broke the second time. That's when he hacked. Eventually I think his SI was injured again and he was "on the forehand" then due to not using his hind end properly. He developed bilateral forelimb lameness and was PTS as he was retired and we couldn't keep him sound long term.

His initial rehab was on a professional rehab yard. It wasn't as expensive as feared. 12 weeks of professional help was so good after box rest with a feisty TB especially the walking in hand. He then came home to do weeks of walk in straight lines. Trot in straight lines building up to canter and schooling. I dont think he worked in circles for months. It paid off for a while at least.

I've known a few with PSD and even the young ones don't seem to have a long term working life. They usually need careful management and a low workload. All seem to show similar signs prior to obvious lameness, refusal/unwillingness to go forward, planting, napping etc before the behaviour escalates. I'd listen to your daughter. Mine always knew when ours was going downhill even when it wasn't obvious to others.

I dislike horses being "ridden through" things, it doesn't help an amateur rider as the horse is just responding to the greater pressure from a strong rider. It is less uncomfortable to work with mild discomfort than to fight a strong rider so the problem appears fixed but it's not. At least that's my take on it. Our horses owed us nothing so if they couldn't do the job they didn't have to. I'm a bit of a softie though. It's hard when they look well and others encourage keeping on. I hope she comes right for you
 
Thanks @misst , do you think the shockwave treatment helped? I'm not even sure there are any professional rehab facilities anywhere close to us sadly, we're not in an area with very good provision for anything like that, but I'll ask the vet.

I know after we bought her much was said about the need to ride her "correctly" but what does that really mean? I don't like seeing her resisting the bit and being wrestled into a frame and it feels to me (in my probable naivety) like she should be able to carry herself "correctly" (by which I mean comfortably for her without using the wrong muscles) without anyone having to fight with her? My daughter is a really gentle and sympathetic rider, but maybe some horses need more than that if ridden exercise is to be of any benefit to them?

But this is where my knowledge falls really short as I'm not a rider and I have to defer to the judgement of others (vet and instructors). I know absolutely no one involved would knowingly cause her any discomfort.
 
I am a pretty much non rider
It's difficult but listen to your gut and your daughter. You know your horse and you know what you think xxx I'm sorry you are in this situation xxx
 
I rode a young horse later diagnosed with PSD. She always humped her back up for the first few minutes when ridden. Too polite to buck but it felt like she was about to. She trotted like she was wearing a wet nappy and bucked into canter. Moved both hind legs together in canter like a sort of bunny hop. This horse had monthly physio and exercises / stretches to be done daily. After about four months she was brought back into 6 months ridden work, walk only including hills and keeping up physio. She went on to show jump and had no further issues. Still currently sound and competing in her late teens.
 
Lucky Snowball said:
I rode a young horse later diagnosed with PSD. She always humped her back up for the first few minutes when ridden. Too polite to buck but it felt like she was about to. She trotted like she was wearing a wet nappy and bucked into canter. Moved both hind legs together in canter like a sort of bunny hop. This horse had monthly physio and exercises / stretches to be done daily. After about four months she was brought back into 6 months ridden work, walk only including hills and keeping up physio. She went on to show jump and had no further issues. Still currently sound and competing in her late teens.
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Nice to hear a good outcome and I'm curious about what the physio did to help. The two physios I've consulted about my mare seemed quite clueless about suspensory ligament problems which surprised me. This isn't PSD incidentally, it's further down.
 
bonnysmum said:
Nice to hear a good outcome and I'm curious about what the physio did to help. The two physios I've consulted about my mare seemed quite clueless about suspensory ligament problems which surprised me. This isn't PSD incidentally, it's further down.
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I can recommend a really good physio to support you in this if you want to DM me, really turned things around for my friend’s horse but don’t want to share her story publicly without permission.
 
So I have a retired cob with PSD and he started out by just stopping, napping essentially in a very kind manner. He had shockwave and steroids and happily came back into work for a bit so was definitely worth doing. He then had problems with his front feet (collateral desmitis) as a result of the psd behind which was treated but then he looked off behind. His behaviour never escalated he just told me how he was struggling so we stopped work.

My young cob had just been diagnosed with PSD sadly, had surgery and is currently on box rest. I do have a fab rehab physio coming out to see him this week, as how he carries himself going forwards is going to be crucial to his soundness. So if you can find a physio who can help/advise on rehab that is so important - I agree with the others it does sound like a pain reaction.
 
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