Alisandro, Peruvian Paso Gelding

Age 15
Examining Vet Report: 

• LH leg-dropped pastern/fetlock. 

• Pain to palpation across LH SL branches, none on RH.

• Owner reported positive to flexions on all 4 limbs.  Suspected DSLD.  Ultrasound requested 05/19/05.

• U.S. exam at LH.
• No defects or enlargement at SL body. 
• Thickening and increased echogenicity at medial branch at insertion and thickening of lateral branch along majority of length, with areas of local hypoechogenicity.

Diagnosis: Suspensory Desmitis of branches of LH limb.

Second opinion by Dr. Mero, after viewing ultrasounds:
Sonograms clearly show increase in size of the suspensory branches and body and a somewhat major lesion (black hole) in the medial branch on one of the views.
Clinical: Enlargement of suspensory branch and body.
Diagnosis:  DSLD mid stage 

Ultrasound Photos:

Necropsy Report

Pathological findings and opinion:  Both left legs showed changes consistent with DSLD in all submitted tendons (superficial and deep digital flexor tendons, suspensory ligaments). In addition, the nuchal ligament showed similar changes.  These tissue changes suggest fairly advanced disease. The liver revealed mild siderosis (presence of iron). The skin showed mild irregularities in collagen fibers and almost total absence of elastic fibers.   Aorta and lung were normal.
Pathologist:  Jaroslava Halper, MD, PhD

Owner Notes:

Alisandro, "Alex", age 15, in late March, 2005, started to exhibit brief lameness and stiffness after getting up from lying down or rolling. He seemed to walk out of it and be ok.By mid April, Alex was stumbling under saddle and dropping on the left hind fetlock as he walked. There was some mild swelling and tenderness in the suspensory of that leg and swelling that came and went in the other hind.
In May, he failed a flex test on all four legs and an ultrasound of the left hind showed enlargement in both body and branches of the suspensory, with a fairly large lesion or "black hole" in the medial branch.
A few weeks later, Alex was clearly swelling and dropping on the right hind as well. There was also some intermittent swelling and hard, lumpy spots on the front suspensories and tendons, though no dramatic dropping.
I also noticed his skin getting looser. He developed multiple, "Char Pei" like wrinkles under his chest by the forelegs. Friends commented on how rapidly he seemed to be aging.  I began to see conformational changes in his hind legs and muscle degeneration in his back and hips.
I had to use Bute to manage Alex's pain. Herbal pain relief such as B-L solution didn't seem to work well for him. He was also on MSM. He stabilized briefly at the end of the summer and seemed to be doing better.
In late October, Alex was becoming stiffer and obviously having pain. I increased his Bute to 2 grams/day. On November 29, he was humanely euthanized and tissues sent to Dr. Halper at the University of Georgia.