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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.
Farriery for hoof wall defects: quarter cracks and toe cracks. Conditions that result in the loss of the structural integrity of the hoof wall, such as quarter and toe cracks, are not uncommon and usually manifest in lameness. The successful management of these problems involves identifying and addressing the underlying causes, stabilization of the foot, and committed follow-up.
Septic diseases associated with the hoof complex: abscesses, punctures wounds, and infection of the lateral cartilage. Hoof abscesses are probably the most common cause of acute severe lameness in horses encountered by veterinarians and farriers. Most affected horses show sudden, severe (acute) lameness; the degree of lameness varies from being subtle in the early stages to non-weight bearing. There is still debate between the veterinary and farrier professions as to who should treat a hoof abscess and the best method to resolve the abscess. Puncture wounds to the sole of the foot can introduce bacteria and debris to the solar surface of the distal phalanx and produce a fracture or a septic pedal osteitis.
Farriery for the hoof with low or underrun heels. Underrun heels are common and involve hoof capsule distortion in which the horn tubules of the heels undergo bending and lengthening, resulting in decreased strength and functionality. The syndrome varies in clinical presentation, depending on duration, severity of distortion, presence of secondary problems, and presence of lameness. Primary treatment goals are to maintain soundness and functional integrity of the foot and to establish a normal hoof capsule. Resolution of the problem is generally not achieved in horses in a heavy work schedule, and realistic goals in this situation are to main...
Nonseptic diseases associated with the hoof complex: keratoma, white line disease, canker, and neoplasia. This article addresses nonseptic diseases associated with the hoof complex, namely keratoma, white line disease, canker, and neoplasia. Keratoma is an uncommon cause of lameness, which may be surgically removed. White line disease, a keratolytic process on the solar surface of the hoof, is treated with therapeutic farriery and resection of the hoof wall when appropriate. Equine canker is an infectious process that results in development of a chronic hypertrophy of the horn-producing tissues. Neoplasia involving the equine foot is rare, and melanoma is the most common type of neoplasm reported....
Therapeutic farriery: one veterinarian’s perspective. Therapeutic shoeing is best directed at a specific diagnosis, but in the absence of a specific diagnosis, it is frequently directed at a symptom. There are only so many ways to modify the function of the foot with trimming and shoeing. The design of a horse shoe may often be modified to improve one aspect of foot function. Modifying a horse shoe to improve one aspect of foot function almost invariably impacts another aspect of foot function. The application of horse shoes may be based on a specific diagnosis or directed at a symptom. The application of shoeing principles is best approached usi...
Farriery for the hoof with a high heel or club foot. A club foot or flexural deformity may affect a horse at any stage of life from neonate through adulthood. The emphasis of this article is on defining and recommending the appropriate farriery for flexural deformities involving the deep digital flexor tendon and the distal interphalangeal joint. Clinical management of the flexural deformity is influenced by the severity, duration, and etiology of the club foot as well as the degree and source of lameness. Also discussed is the management of mismatched hoof angles, which remains a controversial subject for both farrier and veterinarian.
Treating laminitis: beyond the mechanics of trimming and shoeing. Laminitis is typically classified into developmental or prodromal, acute, subacute, and chronic phases. Scientific evidence regarding the pathophysiology of laminitis does exist, but it is often conflicting and dependent on the clinician's interpretation/understanding of the study or the model used for inducing laminitis. The diagnosis of laminitis consists of obtaining an accurate history, performing a thorough physical examination, and taking good-quality radiographs. The use of radiographs for diagnosis and interpretation of laminitis is an absolute necessity for the clinician. Laminitis is...
Acupuncture Points of the Horse’s Distal Thoracic Limb: A Neuroanatomic Approach to the Transposition of Traditional Points. Veterinary acupuncture charts were developed based on the concept of transpositional points whereby human acupuncture maps were adapted to animal anatomy. Transpositional acupuncture points have traditionally been placed in specific locations around the horse's coronet and distal limb believed to be the closest approximation to the human distal limb points. Because the horse has a single digit and lacks several structures analogous to the human hand and foot, precisely transposing all of the human digital points is not anatomically possible. To date there is no published research on the effect...
Variation in foot conformation in lame horses with different foot lesions. Foot conformation in the horse is commonly thought to be associated with lameness but scientific evidence is scarce although it has been shown in biomechanical studies that foot conformation does influence the forces acting on the deep digital flexor tendon (DDFT) and the navicular bone (NB). The aim of this study was to determine the relationships between foot conformation and different types of lesion within the foot in lame horses. It was hypothesised that certain conformation parameters differ significantly between different types of foot lesions. Conformation parameters were measured on m...
Effect of feeding glucose, fructose, and inulin on blood glucose and insulin concentrations in normal ponies and those predisposed to laminitis. Identification of ponies (Equus caballus) at increased risk of pasture-associated laminitis would aid in the prevention of the disease. Insulin resistance has been associated with laminitis and could be used to identify susceptible individuals. Insulin resistance may be diagnosed by feeding supplementary water-soluble carbohydrate (WSC) and measuring blood glucose and insulin concentrations. The aim of this study was to assess the glycemic and insulinemic responses of 7 normal (NP) and 5 previously laminitic (PLP), mixed breed, native UK ponies fed glucose, fructose, and inulin [1 g/(kg·d) fo...
Effects of a “two-hit” model of organ damage on the systemic inflammatory response and development of laminitis in horses. The role of endotoxemia in the development of laminitis remains unclear. Although systemic inflammation is a risk factor for laminitis in hospitalized horses, experimental endotoxin administration fails to induce the disease. While not sufficient to cause laminitis by itself, endotoxemia might predispose laminar tissue to damage from other mediators during systemic inflammation. In "two-hit" models of organ damage, sequential exposure to inflammatory stimuli primes the immune system and causes exaggerated inflammatory responses during sepsis. Acute laminitis shares many characteristics with se...
Musculoskeletal Corynebacterium pseudotuberculosis infection in horses: 35 cases (1999-2009). To describe the clinical course and outcome in horses in which Corynebacterium pseudotuberculosis infections were associated with musculoskeletal disease and lameness. Methods: Retrospective case series. Methods: 35 horses. Methods: Clinical and clinicopathologic data were collected from horses diagnosed with lameness associated with C pseudotuberculosis infection between 1999 and 2009. Results: 32 (91.4%) horses had grade 4/5 lameness. Three (8.6%) horses had grade 5/5 lameness. Abscesses were diagnosed by clinical or ultrasonographic examination. Abscesses were located in the axillary or tri...
A preliminary study into the correlation of stiffness of the laminar junction of the equine hoof with the length density of its secondary lamellae. The relationship between mechanical behaviour and microscopic structure of the laminar junction of equine hooves under testing conditions requires elucidation. Objective: To determine mechanical parameters and 2D length density of profiles of secondary lamellae of the laminar junction in the dermal region and to assess possible correlations. Methods: Specimens (25 samples in total) of the laminar junction were taken from front, quarter and heel parts from 3 equine hooves and exposed to a uniaxial tensile test until rupture to obtain Young's moduli of elasticity, ultimate stress and strain. Nei...
Short-term incubation of equine laminar veins with cortisol and insulin alters contractility in vitro: possible implications for the pathogenesis of equine laminitis. This study investigated the effects of cortisol and insulin, hormones that affect both glycaemic status and vascular function, on the in vitro contractility of isolated healthy equine small laminar veins. Small veins (150-500 μm) draining the digital laminae from healthy horses or ponies were investigated by wire myography. Concentration response curves were constructed for noradrenaline (NA), phenylephrine (PE), endothelin-1 (ET-1) and 5-hydroxytryptamine (5-HT) in the presence of either cortisol (10(-6 ) m) or insulin (1000 μIU/mL). Cortisol significantly increased the maximum contractilit...
Upregulation of articular synovial membrane μ-opioid-like receptors in an acute equine synovitis model. Intra-articular injection of opioids provides analgesia in painful equine joints and μ-opioid receptors (MORs) have been demonstrated in equine synovial membranes. The aim of this study was to determine whether acute inflammatory conditions will lead to up-regulation of MOR in equine synovial membranes and whether anti-inflammatory treatment can prevent any such upregulation. In a two-period, blinded, placebo-controlled randomised cross-over design, lipopolysaccharide (LPS, 1.0 ng) was injected into the left or right middle carpal joint of seven healthy ponies. Arthroscopy and synovial membra...
Distribution of insulin receptor and insulin-like growth factor-1 receptor in the digital laminae of mixed-breed ponies: an immunohistochemical study. Hyperinsulinaemia has been implicated in the pathogenesis of laminitis; however, laminar cell types responding to insulin remain poorly characterised. Objective: To identify laminar cell types expressing insulin receptor (IRc) and/or insulin-like growth factor-1 receptor (IGF-1R); and to evaluate the effect of dietary nonstructural carbohydrate (NSC) on their expression. Methods: Mixed-breed ponies (n = 22) received a conditioning hay chop diet (NSC ∼6%); following acclimation, ponies were stratified into lean (n = 11, body condition score [BCS]≤4) or obese (n = 11, BCS ≥7) groups and ea...
The isolated perfused equine distal limb as an ex vivo model for pharmacokinetic studies. Even though intra-articular injections play an important role in the treatment of joint-related lameness in horses, little is known about pharmacokinetic properties of substances used. Therefore, an ex vivo model for pharmacokinetic studies was developed using distal forelimbs of slaughtered horses. The extremity was perfused with gassed Tyrode solution for up to 8 h. Tissue viability was confirmed by measurements of glucose consumption, lactate production, and lactate dehydrogenase activity in the perfusate. Standard criteria for tissue viability had been determined in preliminary experiments...
Evaluation of the inflammatory response in experimentally induced synovitis in the horse: a comparison of recombinant equine interleukin 1 beta and lipopolysaccharide. To compare two transient models of synovitis-osteoarthritis (OA) in horses by characterizing biological changes in synovial fluid and joint tissue. Methods: Twelve skeletally mature mares were utilized in a block design. Synovitis was induced by an intra-articular injection of 100 ng recombinant equine interleukin 1 beta (reIL-1β) or 0.5 ng lipopolysaccharide (LPS) into a middle carpal joint in 1 ml volumes. One ml of saline was injected into the contra-lateral control joint. Lameness evaluations were conducted through post-injection hour (PIH) 8 (at which time arthroscopic removal of syno...
Validation of an equine inertial measurement unit system in clinically normal horses during walking and trotting. To validate an equine inertial measurement unit (IMU) system rigidly attached to a hoof against a 3-D optical kinematics system in horses during walking and trotting. Methods: 5 clinically normal horses. Methods: 5 swing phases of the hooves of the right forelimb and hind limb were collected via both 3-D optical and IMU systems from 5 horses during walking and trotting. Linear and angular positions, velocities, and accelerations were compared between the 2 systems. Results: Of the 55 variables compared between the 2 systems, 25 had high correlations (r > 0.8) and 18 had moderate correlation...
Development of a quantitative multivariable radiographic method to evaluate anatomic changes associated with laminitis in the forefeet of donkeys. To establish and validate an objective method of radiographic diagnosis of anatomic changes in laminitic forefeet of donkeys on the basis of data from a comprehensive series of radiographic measurements. Methods: 85 donkeys with and 85 without forelimb laminitis for baseline data determination; a cohort of 44 donkeys with and 18 without forelimb laminitis was used for validation analyses. Methods: For each donkey, lateromedial radiographic views of 1 weight-bearing forelimb were obtained; images from 11 laminitic and 2 nonlaminitic donkeys were excluded (motion artifact) from baseline data det...
Return to use and performance following exploratory celiotomy for colic in horses: 195 cases (2003-2010). There are few objective data on return to use and performance in horses following colic surgery. Objective: To investigate return to functional use of horses following colic surgery and factors associated with a negative outcome. Methods: The North Carolina State University Equine Colic Database was reviewed for horses that underwent exploratory celiotomy for colic (2003-2010). Horses were excluded from the study if they survived <6 months, had no intended use preoperatively, or if further data were not available at attempted follow-up. Information retrieved included history, background, us...
Laminar regulation of STAT1 and STAT3 in black walnut extract and carbohydrate overload induced models of laminitis. STAT1 and STAT3 are important signaling molecules in disorders of systemic inflammation and are likely to be involved in laminitis, as laminar and systemic inflammation have been well documented in experimental models of laminitis. Objective: The STAT1 and STAT3 activation (via phosphorylation of tyrosine and serine moieties) is occurring in the laminar tissue during the developmental and onset of lameness time points in both the black walnut extract (BWE) and carbohydrate overload (CHO) models of laminitis. Methods: Archived laminar tissue from horses. Methods: Experimental studies of induced...
Indwelling cephalic or saphenous vein catheter use for regional limb perfusion in 44 horses with synovial injury involving the distal aspect of the limb. To describe indwelling cephalic or saphenous vein catheter use for intravenous regional limb perfusion (ID-IV-RLP) to treat horses with synovial injury (contamination/infection) of the distal aspect of the limb. Methods: Retrospective case series. Methods: Horses (n = 44; 45 limbs) treated with proximal ID-IV-RLP. Methods: Horses had ID-IV-RLP using a cephalic (21 limbs) or saphenous (24 limbs) vein. Amikacin was the most frequently used antibiotic. Number of perfusions ranged from 3 to 21 (median 7). A cast was applied to 14 injured limbs (1 tube cast, 1 full-limb cast, 2 foot casts, and 10 h...
The biomechanics of the equine foot as it pertains to farriery. Shoes were originally applied to horses' feet to protect against excessive wear. Over the years, countless types of shoes and farriery techniques have been developed not only as a therapeutic aid to treat lameness but also to maintain or enhance functionality. The past 3 decades have provided equine veterinarians and farriers with new information relating to limb biomechanics and the effects of various farriery methods. This article describes the principles of foot biomechanics and how they are affected by some of the more common farriery and shoeing techniques.
Clinical significance and prognosis of deep digital flexor tendinopathy assessed over time using MRI. Deep digital flexor (DDF) tendinopathy is one of the most frequent causes of foot lameness and the prognosis is guarded. The progress of lesion healing may be followed by magnetic resonance (MR) imaging to formulate a prognosis and to adapt the rehabilitation program. We assessed the correlation of outcome with total tendon damage and temporal resolution of MR abnormalities. Images from 34 horses with DDF tendinopathy that had undergone at least two low-field standing MR examinations of the foot (mean 2.5 ± 1.3 times) were reviewed. No horse having a T1-GRE hyperintense lesion over 30 mm in l...
Effects of cleavage by a disintegrin and metalloproteinase with thrombospondin motifs-4 on gene expression and protein content of versican and aggrecan in the digital laminae of horses with starch gruel-induced laminitis. To determine whether increased gene expression of a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4) in laminae of horses with starch gruel-induced laminitis was accompanied by increased enzyme activity and substrate degradation. Methods: Laminae from the forelimb hooves of 8 healthy horses and 17 horses with starch gruel-induced laminitis (6 at onset of fever, 6 at onset of Obel grade 1 lameness, and 5 at onset of Obel grade 3 lameness). Methods: Gene expression was determined by use of cDNA and real-time quantitative PCR assay. Protein expression and processing were ...
Apophyseal avulsion fracture of the greater trochanter of the femur in a Thoroughbred filly. The case report of a 14-month-old Thoroughbred filly with acute onset of severe right hindlimb lameness is presented. The horse had a severe and sudden abduction of the hindlimbs due to a side effect of an overdose of lidocaine, which had been administered in a constant rate infusion after a colic surgery. Transcutaneous ultrasonography and standing radiography of the pelvis revealed proximal and cranial displacement of the greater trochanter and free bone fragments consistent with an apophyseal avulsion fracture of the greater trochanter. The complete diagnosis was obtained with the horse in ...
