Proximal suspensory desmitis — robust diagnosis and successful management

Abstract

The proximal suspensory ligament and its surrounding tissues have a complex anatomy that contributes to the difficulty of diagnosis and persistence of the condition in many cases. Regional analgesia, radiography and ultrasonography are mandatory for a robust diagnosis and advanced imaging may also have a role. Successful management is more likely with early diagnosis and prognosis is favourable in the forelimb. Proximal suspensory desmitis in the hindlimb often requires more aggressive treatment and the prognosis is more guarded, especially with a straight hock conformation combined with hyperextension of the metatarsophalangeal joints. Surgical neurectomy is described for refractory cases and has become a common procedure in the hindlimb