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Topic:Lameness
Lameness in horses is a condition characterized by an abnormal gait or stance due to pain or mechanical dysfunction affecting the limbs or spine. It is a common issue in equine practice and can result from a variety of causes, including injury, infection, or degenerative diseases. Lameness can affect a horse's performance and quality of life, making accurate diagnosis and management important for equine health. Diagnostic techniques often include physical examination, imaging, and gait analysis. This page aggregates peer-reviewed research studies and scholarly articles that explore the etiology, diagnostic methods, and management strategies for lameness in horses.
Effect of induced hindlimb length difference on body-mounted inertial sensor measures used to evaluate hindlimb lameness in horses. This study has investigated the immediate effect of induced hindlimb length difference on hindlimb lameness measured as differences in minimum (Pmin) and maximum (Pmax) pelvic heights in 16 horses trotting in a straight line and lungeing on both hard and soft surfaces with body-mounted inertial sensors. Hindlimb length differences were induced by applying an Easyboot Glue-on shoe to one hindlimb. Changes in Pmin and Pmax with induced hindlimb length difference were assessed with a two-way repeated-measures ANOVA with trial (straight, lunge with inside limb elevation, lunge with outside limb el...
Effects of acepromazine and xylazine on subjective and objective assessments of forelimb lameness. To facilitate lameness evaluation, sedatives such as xylazine and acepromazine are regularly used in the clinical setting, despite concerns that they may confound lameness assessment. Objective: The objective of this study was to determine the effect of low doses of acepromazine and xylazine on subjective and objective lameness assessment. Methods: Randomised, blinded, crossover study. Methods: Six horses with experimentally induced solar pain were evaluated over a 1-hour period after treatment with intravenous xylazine (0.1 or 0.2 mg/kg), intravenous acepromazine (0.02 or 0.04 mg/kg), intra...
Magnetic resonance imaging and histopathological evaluation of equine oblique sesamoidean ligaments. Pathology involving the oblique sesamoidean ligaments (OSLs) is commonly diagnosed during magnetic resonance imaging (MRI) of the equine distal limb. Presence of striations within the ligament and magic angle artefact can result in an incorrect diagnosis of pathological change. No studies have been performed using histopathology, the gold standard, to corroborate their imaging diagnosis. Objective: (a) To determine which MRI characteristics are associated with normal vs abnormal OSLs and (b) to evaluate the ability of MRI to correctly identify abnormal vs normal oblique sesamoidean ligaments u...
Single and repeated intra-articular injections in the tarsocrural joint with allogeneic and autologous equine bone marrow-derived mesenchymal stem cells are safe, but did not reduce acute inflammation in an experimental interleukin-1β model of synovitis. Allogeneic and autologous bone marrow-derived mesenchymal stem cells (BMDMSCs) have been administered in equine joints for their anti-inflammatory effects. However, allogeneic BMDMSC offer multiple clinical and practical advantages. Therefore, it is important to determine the relative effectiveness of allogeneic vs autologous BMDMSCs. Objective: The objective of the study was to compare the inflamed joint response to autologous vs allogeneic BMDMSCs injections, and to determine if either treatment generated an anti-inflammatory effect. Methods: Randomised controlled study. Methods: Bone marrow...
The effect of continuous digital hypothermia on lamellar energy metabolism and perfusion during laminitis development in two experimental models. Continuous digital hypothermia (CDH) prevents lamellar failure in the euglycaemic hyperinsulinaemic clamp (EHC) and oligofructose (OF) laminitis models, but the mechanisms remain unclear. Objective: To evaluate the effects of CDH on lamellar energy metabolism and perfusion in healthy horses and during EHC and OF laminitis models. Methods: In vivo experiment. Methods: Archived samples were used from Standardbred geldings that received no treatment (CON) (n = 8) or underwent EHC (n = 8) or OF (n = 6) laminitis models. Both forelimbs were instrumented with a lamellar microdialysis system, a...
Lamellar energy metabolism and perfusion in the euglycaemic hyperinsulinaemic clamp model of equine laminitis. Hyperinsulinaemia is associated with the development of endocrinopathic laminitis; however, the mechanisms remain unclear. Objective: Evaluate the effects of hyperinsulinaemia on lamellar energy metabolism and perfusion during laminitis development. Methods: In vivo experiment. Methods: Eight Standardbred horses were instrumented with a microdialysis probe in the lamellae of a forelimb. A 24 hours baseline period (BASELINE) was followed by 48 hours of a continuous euglycaemic hyperinsulinaemic clamp (EHC) from 24 to 72 hours (CLAMP). Microdialysate was collected every 6 hours and analysed ...
Subchondral lucencies of the proximal tibia in 17 horses. To describe subchondral lucencies (SCL) in the equine proximal tibia, several treatment options, and clinical outcomes. Methods: Retrospective study. Methods: Seventeen horses with proximal tibial SCL. Methods: Medical record and radiograph review. Follow-up was obtained via examination and radiography when possible and by telephone and race records when required. The median duration of follow-up was 20 months (range, 0-48). Results: Proximal tibial SCL were associated with lameness in 14 of 17 horses. Subchondral lucencies were primary in 11 horses and secondary to an ipsilateral medial fem...
Generation of Domains for the Equine Musculoskeletal Rehabilitation Outcome Score: Development by Expert Consensus. Outcome measures (OMs) are a requirement of professional practice standards in human and canine physiotherapy practice for measurement of health status. Measures such as pain and functional capacity of specific regions are used to track treatment impact and can be used to develop optimal management strategies. To achieve comparable patient care in equine physiotherapy, OMs must be incorporated into practice; however, no reliable and valid OMs exist for equine rehabilitation. This study utilised the experience and opinion of a panel of experts working in the equine rehabilitation sphere to gain...
Infrared Thermography Applied to Monitoring Musculoskeletal Adaptation to Training in Thoroughbred Race Horses. Infrared thermography has been used to help in diagnosing lameness. It is hypothesized that, if used in a routine basis, it could help in understanding musculoskeletal modifications during race training. This study aimed to evaluate thermal variation in the musculoskeletal regions of young Thoroughbred (TB) horses during their initial months of race training. Thermographic examinations were performed once every 2 weeks on 16 (10 male, 6 female) two-year-old TB racehorses, from arrival to the racetrack in June 2016, until January 2017, for a total of 16 evaluations. Thermographic imaging was pe...
Investigation of the Effects of a Dietary Supplement on Insulin and Adipokine Concentrations in Equine Metabolic Syndrome/Insulin Dysregulation. High insulin concentrations are a common clinical feature of equine metabolic syndrome (EMS) and insulin dysregulation. Hyperinsulinemia can induce laminitis, so reduction of insulin concentrations in response to an oral challenge should decrease risk. In human studies, diets containing a polyphenol (resveratrol) led to improvements in insulin sensitivity. In rodents, the addition of leucine to a resveratrol supplement caused a decrease in the amount of resveratrol needed to achieve a clinical effect. We hypothesize a supplementation with a low dose of a synergistic polyphenol and amino acid b...
Morphine plasmatic concentration in a pregnant mare and its foal after long term epidural administration. Epidural administration of morphine has been shown to be an effective analgesic strategy in horses; however, the possible occurrence of side effects limits its usage. In order to decrease their frequency, it is important to target the minimal effective plasma concentration and avoid overdosing. As to date species-specific pharmacokinetics data are not available for epidural morphine, the dosing regimen is usually established on the basis of clinical reports and personal experience. In certain physiological conditions, like gestation, the outcome of an empirical dosing scheme can be unpredictab...
A Farrier Making Every Contact Count: A Microlevel Analysis of Farrier-Client Interaction for Partnership Working in Managing a Horse With Laminitis. There is an evidence base in human and small animal veterinary health care contexts which understands how practitioners engage in partnership working with patients and owners to support adherence to treatment/care plans. However, as yet, it is believed there is no similar evidence base for how practitioners in equine health care contexts work with equine owners. It is argued that this is essential for understanding complex equine practitioner-owner interaction involving the prevention and management of laminitis. The aim of this study was to explore farrier-client interaction where risk manage...
An atypical presentation of leiomyosarcoma causing extremity compartment syndrome of the crural region in a Dutch Warmblood mare: a case report. A 12-year-old Warmblood mare was presented with an acute onset left hindlimb lameness associated with generalised soft tissue swelling of the entire limb and medial saphenous vein (MSV) thrombophlebitis. A presumptive diagnosis of extremity compartment syndrome (ECS) was made. Due to the clinical deterioration, emergency fasciotomy of the crural fascia and biopsy was performed. Histological and immunohistochemical examination of the samples confirmed a diagnosis of leiomyosarcoma likely originating from the tunica media of the MSV. This report is the first to describe an unique combination of ...
Induction of Noninflammatory Pain in an Experimental Foot Lameness Model in Horses. The mechanism by which nonsteroidal anti-inflammatory drugs mitigate pain caused by a heart bar shoe (HBS) model of lameness is unknown. The purpose of this study was to determine if this HBS model of lameness induces inflammation in horses. Five healthy adult horses from a university teaching herd were enrolled. A custom HBS was applied to the left front foot of each horse, followed by induction of the American Association of Equine Practitioners Lameness Score of 4. Inflammatory markers including serum amyloid A (SAA) concentration, local venous tumor necrosis factor alpha and prostaglandin ...
Impact of Size and Shape of Equine Femoral Subchondral Bone Cysts With a Transcondylar Screw on Predicted Bone Formation Area in a Finite Element Model. Equine subchondral bone cysts (SBCs) develop most often in the medial femoral condyle (MFC) of yearlings intended for performance. SBCs often cause lameness and can cause secondary injuries to the meniscus and tibial cartilage. A novel surgical technique using a transcondylar lag screw (TLS) across an MFC SBC has shown success in lameness resolution and radiographic healing of MFC SBC. In a previous study using finite element analysis, our lab showed that a TLS stimulated bone formation on the inner surface of the SBC and altered third principal stress vectors to change the direction of surfac...
Successful Treatment of a Coxofemoral Luxation in a Shetland Pony by Closed Reduction and Prolonged Immobilization Using a Full-Body Animal Rescue Sling. A 12-year-old, 170 kg, Shetland pony mare was presented with an acute severe right pelvic limb lameness and concurrent upward fixation of the right patella. The affected limb was rotated externally and adducted with a prominent greater trochanter and the right calcaneal tuber being more proximal than its left counterpart. Radiographic examination revealed complete dislocation of the right femoral head from the acetabular cavity in a dorsal and caudal direction. A closed reduction of the coxofemoral luxation was performed successfully under general anaesthesia. A full-body animal rescue and t...
Effect of 3% chloroprocaine hydrochloride when used for median and ulnar regional nerve blocks in lame horses. To assess onset of analgesia for 3% chloroprocaine hydrochloride and 2% mepivacaine hydrochloride when used for median and ulnar nerve blocks in lame horses. Methods: 6 naturally lame horses. Methods: A crossover experiment was conducted. Horses were assigned to 1 of 2 treatment groups (3% chloroprocaine or 2% mepivacaine first). Median and ulnar nerve blocks were performed in the lame limb with the assigned treatment. Lameness was objectively evaluated before treatment administration and at various points for 120 minutes after treatment with a wireless inertial sensor-based motion analysis sy...
Morphological and Imaging Evaluation of the Metacarpophalangeal and Metatarsophalangeal Joints in Healthy and Lame Donkeys. The donkey is of socio-economic value yet imaging techniques in both healthy and abnormal limbs are a limiting factor in research and medicine. The objective was to determine anatomical features of both healthy and clinically abnormal donkey metacarpophalangeal and metatarsophalangeal joints (n = 13) using anatomical dissection, casting, X-ray and computed tomography. The joint capsule contained two palmar/plantar and two dorsal recesses. The proximal-palmar or plantar recess was larger than the distodorsal recess and potential sites of approaches to the recesses were determined. Soft tissue ...
Multimodal Imaging to Identify and Characterize a P3 Cystic Lesion and Pathologic Fracture. Lameness remains a common cause of retirement in the equine athlete and among hobby enthusiasts. The distal limb is one of the most frequently imaged areas, and recent advances in diagnostic imaging capabilities help practicing veterinarians differentiate normal variants from informative pathology. Although acute, non-weight-bearing lameness is commonly associated with etiologies, such as fractures, abscesses, and laminitis, other uncommon differentials such as cystic lesions and neoplasia might also be considered. This report describes the characterization of a large, cystic lesion in the thi...
An investigation of the equine epidermal growth factor system during hyperinsulinemic laminitis. Equine laminitis is a disease of the digital epidermal lamellae typified by epidermal cell proliferation and structural collapse. Most commonly the disease is caused by hyperinsulinemia, although the pathogenesis is incompletely understood. Insulin can activate the epidermal growth factor (EGF) system in other species and the present study tested the hypothesis that upregulation of EGF receptor (EGFR) signalling is a key factor in laminitis pathophysiology. First, we examined lamellar tissue from healthy Standardbred horses and those with induced hyperinsulinemia and laminitis for EGFR distrib...
Chondromalacia of the cranial medial femoral condyle; its occurrence and association with clinical outcome in a population of adult horses with stifle lameness. Chondromalacia of the cranial medial femoral condyle (CMFC) is a potential cause of stifle lameness in adult horses. However, there is scant published evidence of either its occurrence or its clinical significance. Objective: To document the occurrence of CMFC seen during diagnostic arthroscopy in adult horses with stifle lameness and to investigate its prognostic significance. Methods: Retrospective cohort study. Methods: The records were reviewed of all horses with unilateral or bilateral lameness localised to the stifle that underwent diagnostic arthroscopy of the cranial medial femorotibia...
Efficacy of orally administered gabapentin in horses with chronic thoracic limb lameness. To evaluate the analgesic effects of orally administered gabapentin on horses with chronic thoracic limb lameness. Methods: Randomized, crossover design. Methods: A total of 14 adult horses with chronic thoracic limb lameness. Methods: Following baseline measurement of lameness, horses were administered each of four treatments orally in grain: treatment G, gabapentin (20 mg kg) twice daily for 13 doses; treatment F, firocoxib (171 mg once, then 57 mg once daily for six doses); treatment GF, gabapentin and firocoxib at previously stated doses and frequencies; or treatment C, grain only as a con...
Management of Primary Injuries of the Medial Collateral Ligament of the Carpus in Two Horses. This case report describes the successful management of two horses with medial carpal collateral ligament injury. This is a rare cause of forelimb lameness and existing reports indicate a poor prognosis for return to athletic function with conservative management. Both horses were treated with a combination of box rest with controlled exercise and high-intensity laser therapy (HILT). Both horses returned to previous athletic function, one at Grand Prix level dressage and one at Novice level eventing. With appropriate management, the prognosis for carpal collateral ligament injury may be good. ...
Metabolomic analysis of synovial fluid from Thoroughbred racehorses diagnosed with palmar osteochondral disease using magnetic resonance imaging. Palmar osteochondral disease (POD) is a common cause of lameness in competition horses. Magnetic resonance imaging (MRI) is the most sensitive diagnostic modality currently available, however it may not be financially or logistically practical for routine screening of POD. There is increasing interest in the use of metabolomics for diagnosis prior to progression to irreversible damage. Objective: To determine metabolite levels in synovial fluid (SF) of horses with a clinical diagnosis of POD based on diagnostic analgesia and MRI, with the hypothesis that metabolomic profiles differ between dis...
Power Doppler to investigate superficial digital flexor tendinopathy in the horse. Recent advances in tendinopathy research have focused on tendon vascularization detected with Color Doppler (CD) ultrasound. The use of CD has also been described in horses in a study on chronic lesions of superficial digital flexor tendon and suspensory ligament. The aim of this study was to investigate the occurrence and distribution of power Doppler (PD) signal in horses with superficial digital flexor tendinopathy. Twenty-five horses with tendinopathy were included and 10 healthy horses with no lameness and no ultrasonographic abnormalities were used for comparison. In all horses with tend...
Endotoxin-induced changes in expression of cyclooxygenase isoforms in the lamellar tissue of extracorporeally haemoperfused equine limbs. Angiogenesis and sepsis-related equine laminitis have several features in common. Both events can be induced by endotoxin (lipopolysaccharide- LPS) and both are associated with increased expression of the enzyme cyclooxygenase (COX), of which two isoforms (COX-1 and COX-2) exist. To examine the causal relationship between LPS exposure and COX expression and to investigate the tissue distribution of COX in the LPS-exposed tissue, the technique of extracorporeal haemoperfusion of isolated equine forelimbs was utilized. Perfusion was performed for 10 hr under physiological conditions (control-pe...
The Equine Hoof: Laminitis, Progenitor (Stem) Cells, and Therapy Development. The equine hoof capsule, composed of modified epidermis and dermis, is vital for protecting the third phalanx from forces of locomotion. There are descriptions of laminitis, defined as inflammation of sensitive hoof tissues but recognized as pathologic changes with or without inflammatory mediators, in the earliest records of domesticated horses. Laminitis can range from mild to serious, and signs can be acute, chronic, or transition from acute, severe inflammation to permanently abnormal tissue. Damage within the intricate dermal and epidermal connections of the primary and secondary lamellae...
Use of Physical Self-Experience for Teaching Lameness Evaluation: Short-Term Effects on Lameness Evaluation of Horses with Mild Forelimb Lameness by Novice Veterinary Students. Lameness evaluation (LE) is an important veterinary skill, but it can be a challenging task to teach. Acoustic and visual input in conjunction with acting are the three major learning channels for acquiring new information. Acting (e.g., physical self-experience) has not been reported as a didactic tool for LE; therefore, we investigated two physical self-experience techniques, imitation of lameness during LE instruction and head nod during LE. Undergraduate veterinary students ( = 78) who had not yet received any instructions for LE underwent standard instruction for LE, followed by instructi...
Quantitative magnetic resonance imaging and histological hoof wall assessment of 3-year-old Quarter Horses. Few noninvasive methods are available for equine hoof wall evaluation. The highly organised wall structures and composition of proteoglycans and collagens may make this region amenable to quantitative MRI (qMRI) techniques of T1ρ and T2 mapping to identify pathology related to proteoglycan content and collagen organisation respectively. Objective: To establish normative T1ρ and T2 values of the equine hoof wall of 3-year-old Quarter Horses with histological comparison. Methods: Cadaveric anatomical study. Methods: Six cadaveric left thoracic feet from 3-year-old racing Quarter Horses with no...
Factors associated with euthanasia in horses and ponies enrolled in a laminitis cohort study in Great Britain. Euthanasia is a complex topic, with animal owners using multiple factors to shape their decision-making process. Previous epidemiological studies have described causes of equine mortality in specific populations, but there is limited evidence regarding factors contributing specifically to equine euthanasia in Great Britain (GB). This observational study used a prospective cohort design: the objectives were to describe owner-reported reasons for euthanasia, estimate the rate of euthanasia and identify associated factors in horses/ponies enrolled in a web-based epidemiological study of laminitis...
