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Recognizing DSLD/ESPA

Until the recent diagnostic ultrasound protocols, it was difficult to recognize & properly diagnose DSLD/ESPA.  Dropped pastern cases are easy to recognize but are often called "dropped pastern" or "dropped fetlock" syndrome.  Sometimes it is referred to as a common condition found in old broodmares or any older horse, regardless of gender. Many times it is considered just a conformation fault.

There is also an upright form of DSLD/ESPA.  The upright form will show degrees of lameness and tenderness on palpation, but the pasterns remain upright -- not dropped. This disease has been called many things including Equine Suspensory Apparatus Dysfunction, Degenerative Suspensory Ligament Desmitis, total breakdown of suspensory function, etc.

DSLD/ESPA has been found in the following breeds: Arabians, Thoroughbreds, Quarter Horses, Paints, Appaloosa, Morgans, Saddlebreds, Standardbreds, Peruvian Pasos, Paso Finos, Canadian, Kentucky Mountain Horse, Missouri Foxtrotter, Tennessee Walking Horse, National Show Horse, Cleveland Bay, Friesian, Warmbloods, Mustang, mules, crossbreds, and others.


Symptoms may vary from case to case and depending on advancement of disease. Lameness can be severe or hardly detectable in early stages. Symptoms include:

  • Recurring unexplained lameness

  • Stumbling and/or tripping

  • May seem to move around from leg to leg in early stages. After onset will be bilateral

  • Heat & swelling in fetlock area, may be localized on inside or outside of fetlock or could be whole fetlock area

  • Soreness and pain in suspensory ligament on palpation especially in the suspensory branches

  • Enlarged Suspensory ligament and in the suspensory branches. May also be lumpy along suspensory. Some early cases have an affected check ligament

  • Palpation of suspensory may feel tight and hard like an over stretched guitar string about to snap, or may feel enlarged and mushy/soft

  • Laying down frequently and trouble getting up, dog sitting before standing

  • Reluctance to move once up

  • Back pain/soreness or soreness/stiffness in hips

  • Digging holes to stand in with toes pointing toward hole

  • Sitting on fences, buckets, large rocks, leaning against walls to relieve pain

  • Horse may become irritable, change in attitude

  • Pasterns flexing horizontal during weight bearing, or maybe upright with no sign of dropped fetlocks

  • Sweet potato fetlocks- fluid filled, odd shaped overly large fetlocks

  • Windpuffs in the fetlock area. May show no lameness at this stage

  • Extremely loose skin

Occasionally, other signs will include symptoms that occur before suspensory ligament symptoms, such as:

  • broken crest

  • horse shows sudden onset of severe allergies to fly spray, bug bites

  • total body hives for unknown reason

  • very sensitive to touch

  • False colics are sometimes seen, laying down and moaning but not rolling, looking at flanks, but normal gut sounds.

  • Walking wide in rear legs is often seen when rear legs are affected first

  • Stiff robot like movement

  • Sudden loss of weight and horse appears to look older than it's age

  • Change in conformation to coon footed and post legged stance

  • Refusal to walk downhill

  • Change in horses' normal gait--short striding or an unusual hopping gait

  • Refusal to canter

  • Touching toe first in any gait, will look like they are stabbing the toe into the ground in some cases

Diagnosis of DSLD/ESPA

1. Flex test of fetlock joint. DSLD/ESPA horses will fail in two or more legs.

2. Palpation:  Pain response especially in the suspensory branches and fetlock area. Suspensory may be enlarged. May feel very taut while weight bearing and soft /mushy when not weight bearing.

3. Ultrasound:  Follow Dr Mero's Diagnostic Protocol.  Also useful is Dr Mero's exam form for SL measurements.

4. Tissue diagnosis is available from UGA at necropsy. Tissue samples may include tendon ligament bundle of lower leg, one leg affected and one that looks nonaffected. The aortic arch, eye, liver, lungs and skin.

The amount of harvested tissue can include all tissues or just the legs, depending on the amount of diagnostic information requested by the owner.


All DSLD/ESPA cases show degeneration over time.  Unlike injuries that can heal, DSLD/ESPA does not heal but will get progressively worse.

Some cases may stabilize for longer periods of time. Some horses can live for many years and some with sudden extreme onset only live a short time before euthanasia.

Symptoms can manifest at any time, from birth to old age.

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