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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.
Severity and outcome of equine pasture-associated laminitis managed in first opinion practice in the UK.
The Veterinary record    September 8, 2010   Volume 167, Issue 10 364-369 doi: 10.1136/vr.c3206
Menzies-Gow NJ, Stevens K, Barr A, Camm I, Pfeiffer D, Marr CM.Data from 107 cases of pasture-associated laminitis were obtained from first opinion practices to study factors associated with severity, survival and return to ridden exercise. There were 43 mares and 64 geldings, with a median age of 11 years. Of the 107 animals, 33 were small ponies, 45 were large ponies/cobs, 17 were small horses and 12 were large horses. Ninety-seven animals were categorised as having laminitis as defined by Cripps and Eustace (1999): 76 had mild (Obel grade 1 or 2) laminitis and 31 had severe (Obel grade 3 or 4) laminitis. Forty-three animals had previously had laminitis...
MRI features of metacarpo(tarso)phalangeal region lameness in 40 horses. Gonzalez LM, Schramme MC, Robertson ID, Thrall DE, Redding RW.Lameness originating from the metacarpo(tarso)phalangeal (MP) joint has a significant effect on the use and athletic competitiveness of a horse. The identification of the cause of lameness originating from the MP joint can be challenging, given the limitations of radiography, ultrasonography, and nuclear scintigraphy. Our purpose was to describe the injury types and incidence in magnetic resonance imaging (MRI) studies from 40 horses with lameness attributable to the MP joint region where it was not possible to reach a clinically plausible diagnosis using other imaging modalities. Horses were ...
Prognostic indicators of poor outcome in horses with laminitis at a tertiary care hospital.
The Canadian veterinary journal = La revue veterinaire canadienne    September 3, 2010   Volume 51, Issue 6 623-628 
Orsini JA, Parsons CS, Capewell L, Smith G.This retrospective study investigated the factors associated with a poor outcome (death by euthanasia or from other causes) in horses treated for laminitis at a tertiary care hospital. Cases (n = 247) were defined as patients with laminitis that were euthanized or that died of other causes during hospitalization. Controls (n = 344) were patients with laminitis that survived to be discharged from the hospital. In the final multivariate analysis, the factors significantly associated with an increased risk for death and their respective odds ratios (OR) were as follows: Thoroughbred (OR = 1.57); ...
Acute lameness associated with osseous metastasis of a peri-renal carcinoma in a horse.
Australian veterinary journal    August 24, 2010   Volume 88, Issue 9 346-350 doi: 10.1111/j.1751-0813.2010.00609.x
Young AC, Hoffmann KL, Begg AP, Major DA.We present a case of aggressive metastatic carcinoma in a horse that was initially presented for shoulder lameness. Although radiography and scintigraphy were useful for localising a lesion in the proximal humerus, subsequent development of non-specific signs of systemic disease prompted further evaluation. Haematology and blood biochemistry, urinalysis and ultrasonography were all instrumental in identifying renal involvement. A diagnosis of a peri-renal mass causing secondary renal failure prompted euthanasia of the horse because of the poor prognosis. Antemortem findings were supported by n...
Orthopaedic health status of horses from 8 riding schools–a pilot study.
Acta veterinaria Scandinavica    August 20, 2010   Volume 52, Issue 1 50 doi: 10.1186/1751-0147-52-50
Egenvall A, Lönnell C, Johnston C, Roepstorff L.Orthopaedic injury is the most common reason for lameness and wastage in sport and leisure horses. Studies on racehorses have shown differences in injury risk between trainers and training strategies. The aim was to study between riding school variation in orthopaedic health status by clinical examination and horses age, and control for change of examiner, in schools with previous high (n = 4) and low (n = 4) insurance utilisation. Methods: Horses (n = 99) at 8 riding schools were examined for conformation, movement in all gaits, standing flexion tests and palpation by two veterinary surgeons ...
Quantitative evaluation of subchondral bone injury of the plantaro-lateral condyles of the third metatarsal bone in Thoroughbred horses identified using nuclear scintigraphy: 48 cases.
Equine veterinary journal    August 19, 2010   Volume 42, Issue 6 552-557 doi: 10.1111/j.2042-3306.2010.00088.x
Parker RA, Bladon BM, Parkin TD, Fraser BS.Increased radio-isotope uptake (IRU) in the subchondral bone of the plantaro-lateral condyle of the third metatarsus (MTIII) is a commonly reported scintigraphic finding and potential cause of lameness in UK Thoroughbred racehorses in training and has not been fully documented. Objective: To characterise lameness attributable to IRU of the subchondral bone of MTIII, compare the scintigraphic findings of these horses with a normal population and evaluate the use of scintigraphy as an indicator of prognosis. Objective: IRU will be in significantly higher in horses with subchondral bone injury an...
Is there an association between ossification of the cartilages of the foot and collateral desmopathy of the distal interphalangeal joint or distal phalanx injury?
Equine veterinary journal    August 19, 2010   Volume 42, Issue 6 504-511 doi: 10.1111/j.2042-3306.2010.00100.x
Dyson S, Brown V, Collins S, Murray R.Associations between degree of ossification of the cartilages of the foot and injuries to other structures of the foot have been suggested, but have not been investigated by large scale studies. Objective: To describe the frequency of grade >3 ossification of the cartilages of the foot (possibly significant ossification, PSO), mediolateral symmetry of ossification and left-right symmetry between feet; and to investigate associations between PSO and injury of either the collateral ligaments (CLs) of the distal interphalangeal (DIP) joint or the distal phalanx. Objective: Possibly significant os...
Which anatomical region determines a positive flexion test of the distal aspect of a forelimb in a nonlame horse?
Equine veterinary journal    August 19, 2010   Volume 42, Issue 6 547-551 doi: 10.1111/j.2042-3306.2010.00075.x
Kearney CM, van Weeren PR, Cornelissen BP, den Boon P, Brama PA.The flexion test is used routinely as part of lameness and prepurchase examinations. However, little is known about the mechanisms that cause a positive response to a flexion test. Objective: To determine which anatomical regions play a role in a positive outcome of a flexion test of the distal aspect of a forelimb in a nonlame horse. Methods: Eight clinically sound Dutch Warmblood horses were subjected to a standardised flexion test (force 250 N, time 60 s) inducing a consistent lameness. To discriminate between different areas of the distal aspect of a forelimb, effects of various nerve bloc...
Outcome of medical treatment for horses with foot pain: 56 cases.
Equine veterinary journal    August 19, 2010   Volume 42, Issue 8 680-685 doi: 10.1111/j.2042-3306.2010.00081.x
Gutierrez-Nibeyro SD, White Ii NA, Werpy NM.Currently, there are limited data regarding the long-term outcome of horses with foot pain treated with corrective shoeing, rest and rehabilitation, and intrasynovial anti-inflammatory medication to target lesions detected with MRI. Objective: To report the long-term (≥12 months) outcome of horses with foot lesions following medical therapy. Objective: 1) There is no association between clinical parameters considered and a poor response to therapy. 2) Horses with a deep digital flexor tendinopathy are less likely to respond to medical therapy than horses without a deep digital flexor tendino...
Distribution of radiodense contrast medium after perineural injection of the palmar and palmar metacarpal nerves (low 4-point nerve block): an in vivo and ex vivo study in horses.
Equine veterinary journal    August 19, 2010   Volume 42, Issue 6 512-518 doi: 10.1111/j.2042-3306.2010.00076.x
Nagy A, Bodò G, Dyson SJ, Compostella F, Barr AR.Evidence-based information is limited on distribution of local anaesthetic solution following perineural analgesia of the palmar (Pa) and palmar metacarpal (PaM) nerves in the distal aspect of the metacarpal (Mc) region ('low 4-point nerve block'). Objective: To demonstrate the potential distribution of local anaesthetic solution after a low 4-point nerve block using a radiographic contrast model. Methods: A radiodense contrast medium was injected subcutaneously over the medial or the lateral Pa nerve at the junction of the proximal three-quarters and distal quarter of the Mc region (Pa inject...
Maggot debridement therapy for laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 447-450 doi: 10.1016/j.cveq.2010.06.002
Morrison S.Maggot debridement therapy is a nontraumatic, minimally invasive method to treat infections in a foot compromised by chronic laminitis. A mechanical strategy must first be in place to address the instability of the distal phalanx and hoof capsule. Adverse reactions to maggot debridement therapy are uncommon and the only side effect observed has been irritation or hypersensitivity at the site. Chronic laminitic cases of sepsis/necrosis within the hoof benefit from this procedure due to the noninvasive, continuous debridement and healing properties provided by the larvae.
Preface. Metabolic and endocrinopathic laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 xiii-xv doi: 10.1016/j.cveq.2010.06.008
Pollitt CC.No abstract available
Clinical presentation, diagnosis, and prognosis of chronic laminitis in Europe.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 391-405 doi: 10.1016/j.cveq.2010.06.005
Eustace RA.The terminology relating to laminitis is confusing. This article describes how equine veterinarians, by using their eyes and fingers alone, can diagnose and evaluate a case of chronic laminitis. This evaluation will enable veterinarians to give a statistically significant prognosis that can be further refined by measurements taken from plain, weight-bearing lateromedial radiographs of the affected hooves. Should invasive techniques such as digital venography also be used, the results of both techniques are complementary.
Supporting limb laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 287-302 doi: 10.1016/j.cveq.2010.06.007
van Eps A, Collins SN, Pollitt CC.Supporting limb laminitis poses a threat to all horses suffering from severe unilateral lameness. Despite its devastating effects, relatively little is known about the precise pathologic processes that lead to its development. This article reviews the potential mechanisms of supporting limb laminitis, and the authors present some preliminary data based on advanced imaging and computer-based modeling techniques aimed at further elucidating the etiology of this unique form of laminitis. Gaining a better understanding of the pathologic processes that lead to supporting limb laminitis is essential...
Farriery for chronic laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 407-423 doi: 10.1016/j.cveq.2010.04.008
O'Grady SE.Laminitis is considered chronic once the distal phalanx has displaced within the hoof capsule. Chronic laminitis generally occurs as a direct sequel to acute laminitis. Clinical evaluation of chronic laminitis is best performed with a thorough clinical examination and radiography. The mainstay of hoof care is therapeutic farriery. In this article, the goals and principles of hoof care, the appropriate trim and various shoes that form the bulk of farriery for chronic laminitis, and surgical treatments are discussed.
Digital venography in horses and its clinical application in Europe.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 339-359 doi: 10.1016/j.cveq.2010.06.006
D'Arpe L, Bernardini D.Clinical diagnostic venography allows in vivo visualization of the digital venous system and the effects of venocompression related to foot load and laminitis pathology. Venography has predictive potential and helps the clinician anticipate and treat laminitis tissue damage before it is detectable by plain radiography. The authors describe the podiatry radiographic technique to correctly perform digital venography and the modifications they have developed. The authors provide guidelines for the interpretation of laminitis venograms in the context of laminitis chronology. Frequent venographic m...
Chronic laminitis: foot management.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 425-446 doi: 10.1016/j.cveq.2010.06.003
Morrison S.Laminitis is a disease of the suspensory apparatus of the distal phalanx, which can advance to the chronic stage with varying degrees of structural failure. Because the disease may ultimately lead to mechanical failure of the digit, a foot management plan is required to effectively and mechanically treat these cases. Many laminitis cases can be successfully rehabilitated back to athletic soundness, light use, breeding, or pasture soundness, whereas others suffer from permanent instability and never enjoy an acceptable level of comfort. To understand how to minimize damage in the acute laminiti...
Supporting limb laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 287-302 doi: 10.1016/j.cveq.2010.06.007
van Eps A, Collins SN, Pollitt CC.Supporting limb laminitis poses a threat to all horses suffering from severe unilateral lameness. Despite its devastating effects, relatively little is known about the precise pathologic processes that lead to its development. This article reviews the potential mechanisms of supporting limb laminitis, and the authors present some preliminary data based on advanced imaging and computer-based modeling techniques aimed at further elucidating the etiology of this unique form of laminitis. Gaining a better understanding of the pathologic processes that lead to supporting limb laminitis is essential...
Current concepts on the pathophysiology of pasture-associated laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 265-276 doi: 10.1016/j.cveq.2010.06.001
Geor RJ.Epidemiologic studies indicate that most laminitis cases occur in horses and ponies kept at pasture, hence the term 'pasture-associated laminitis'. Clinical cases of laminitis most often occur under conditions that favor accumulation of rapidly fermentable nonstructural carbohydrates (fructans, simple sugars, or starches) in pasture, and animals with an equine metabolic syndrome (EMS) phenotype (insulin resistance, abnormal insulin dynamics, +/- obesity) seem to be at highest risk for developing the condition. Although the mechanisms linking consumption of pasture forage with development of la...
First aid for the laminitic foot: therapeutic and mechanical support.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 451-458 doi: 10.1016/j.cveq.2010.06.004
Reilly PT, Dean EK, Orsini JA.The goals of mechanical treatment during the acute phase of laminitis are to preserve the lamellar interface by reducing the forces that are compromising its integrity and to make the horse more comfortable. Early decision making is important in managing acute laminitis. This article helps the practitioner to identify some of the commonly used and accepted methods of protecting the laminitic foot. The materials available and the theories behind their use are also described. The laminitic foot needs to be understood before determining methods for its support. Most treatment options involve shif...
Efficacy of intramuscular polysulfated glycosaminoglycan in a controlled study of equine carpitis.
Journal of veterinary pharmacology and therapeutics    July 22, 2010   Volume 33, Issue 4 357-362 doi: 10.1111/j.1365-2885.2009.01154.x
Verde C, Ferrante M, Simpson MI, Babusci M, Broglia G, Landoni MF.Twelve healthy horses were subject to the monoioidoacetate (MIA) carpitis model, which was allowed to develop for 7 days. The horses were then randomly divided into two groups. Group A (control) received an intramuscular injection of normal saline every 4 days for a total of seven injections while group B received 500 mg of a PSGAG (SYNTEX CSY36) intramuscularly every 4 days for seven treatments. Efficacy of the PSGAG was evaluated by three clinical outcomes: lameness score, carpal circumference and maximum carpal flexion. Clinical outcomes were measured on days -8 (previous to carpitis induct...
Tiludronate infusion in the treatment of bone spavin: a double blind placebo-controlled trial.
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 381-387 doi: 10.1111/j.2042-3306.2010.00120.x
Gough MR, Thibaud D, Smith RK.Tiludronate regulates bone remodelling through a decrease of the resorptive process and should therefore ameliorate the remodelling processes active in osteoarthritis of the distal tarsal joints ('bone spavin') and alleviate pain associated with abnormal bone lysis. Objective: To confirm the efficacy of tiludronate, administered as a single infusion at a dose of 1 mg/kg bwt, in the treatment of bone spavin in the horse. Methods: A double blind placebo controlled trial on 108 clinical cases of bone spavin was undertaken. The lameness score of the lamest limb was assessed following distal tarsal...
Intra-articular opioid analgesia is effective in reducing pain and inflammation in an equine LPS induced synovitis model.
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 412-419 doi: 10.1111/j.2042-3306.2010.00077.x
van Loon JP, de Grauw JC, van Dierendonck M, L'ami JJ, Back W, van Weeren PR.Intra-articular administration of morphine as a local analgesic and anti-inflammatory drug is widely used in human medicine. In equids, little is known about its clinical analgesic and anti-inflammatory efficacy. Objective: To use an inflammatory orthopaedic pain model to investigate the analgesic and anti-inflammatory effects of intra-articularly administered morphine as a new treatment modality in horses with acute arthritis. Methods: In a crossover study design, synovitis was induced in the left or right talocrural joint by means of intra-articular injection of 0.5 ng lipopolyssacharide (LP...
Muscle strain injuries of the hindlimb in eight horses: diagnostic imaging, management and outcomes.
Australian veterinary journal    July 17, 2010   Volume 88, Issue 8 313-321 doi: 10.1111/j.1751-0813.2010.00597.x
Walmsley EA, Steel CM, Richardson JL, Hesse KL, Whitton RC.To describe the clinical presentation, ultrasound findings, management and outcome in horses with muscle tear injuries of the hindlimbs. Methods: Retrospective case series Procedure Medical records of eight horses were reviewed and information on signalment, history, presenting complaint, physical examination findings and further diagnostic tests were recorded. Diagnosis of muscle injury was determined by the presence of abnormal ultrasound findings, compared with the contralateral limb, and, when required, nuclear scintigraphy. Follow-up information was obtained via telephone interviews with ...
Repeatability and reproducibility of the Obel grading system for equine laminitis.
The Veterinary record    July 14, 2010   Volume 167, Issue 2 52-55 doi: 10.1136/vr.c3668
Menzies-Gow NJ, Stevens KB, Sepulveda MF, Jarvis N, Marr CM.The aim of this study was to evaluate both the repeatability (intraobserver agreement) and reproducibility (interobserver agreement) of Obel grading, the most widely accepted method for describing the severity of equine laminitis. The study comprised two parts. In study A, to test intraobserver agreement, 25 ponies were graded twice by a single blinded experienced equine veterinary surgeon, on the first occasion via clinical examination and on the second occasion via a video recording of the initial clinical examination. In study B, to test interobserver agreement, video recordings of 13 ponie...
Novel keratins identified by quantitative proteomic analysis as the major cytoskeletal proteins of equine (Equus caballus) hoof lamellar tissue.
Journal of animal science    July 9, 2010   Volume 88, Issue 12 3843-3855 doi: 10.2527/jas.2010-2964
Carter RA, Shekk V, de Laat MA, Pollitt CC, Galantino-Homer HL.The dermo-epidermal interface that connects the equine distal phalanx to the cornified hoof wall withstands great biomechanical demands, but is also a region where structural failure often ensues as a result of laminitis. The cytoskeleton in this region maintains cell structure and facilitates intercellular adhesion, making it likely to be involved in laminitis pathogenesis, although it is poorly characterized in the equine hoof lamellae. The objective of the present study was to identify and quantify the cytoskeletal proteins present in the epidermal and dermal lamellae of the equine hoof by ...
In vivo priming and ex vivo activation of equine neutrophils in black walnut extract-induced equine laminitis is not attenuated by systemic lidocaine administration.
Veterinary immunology and immunopathology    June 30, 2010   Volume 138, Issue 1-2 60-69 doi: 10.1016/j.vetimm.2010.06.016
Loftus JP, Williams JM, Belknap JK, Black SJ.Laminitis is a crippling disease of horses characterized by an inflammatory response in the tissue that suspends the axial skeleton within the hoof. Pain is a common feature of laminitic pathology and its management is an important component of the treatment regime for this disease. Systemic lidocaine administration is commonly utilized to manage pain in equine laminitis; however, the potential anti-inflammatory effects of this drug during the treatment of equine laminitis have not been investigated. Here, we sought to determine if lidocaine concentrations achieved in the plasma (therapeutic c...
Demographic characteristics of horses donated to the North Carolina State University Equine Health Center, 1996-2008.
Journal of the American Veterinary Medical Association    June 17, 2010   Volume 236, Issue 12 1334-1337 doi: 10.2460/javma.236.12.1334
Bowman SG, Marshall JF, Blikslager AT.To determine demographic characteristics of horses donated to the North Carolina State University Equine Health Center (EHC) between 1996 and 2008. Methods: Retrospective cohort study. Methods: 122 horses donated to the EHC between January 1996 and December 2008, and 246 horses offered for donation to the EHC between January 2007 and December 2008. Methods: Telephone and medical records were examined. Data were collected in 5 categories: age, sex, breed, reason for donation, and use prior to donation. Results: From January 1996 through December 2008, 122 horses were donated to the EHC (median,...
Endocrinopathic laminitis.
The Veterinary clinics of North America. Equine practice    June 11, 2010   Volume 26, Issue 2 233-237 doi: 10.1016/j.cveq.2010.04.009
McGowan CM.In laminitis occurring in the field, as opposed to laminitis occurring during hospitalization or severe illness, endocrinopathic laminitis is the predominant form of laminitis. Prevalent causes of endocrinopathic laminitis are ECS and EMS. Exclusion of inflammatory or weight bearing causes of laminitis and focussing on the identification and treatment of underlying endocrine conditions will improve laminitis management strategies.
Neuropathic pain management in chronic laminitis.
The Veterinary clinics of North America. Equine practice    June 11, 2010   Volume 26, Issue 2 315-337 doi: 10.1016/j.cveq.2010.04.002
Driessen B, Bauquier SH, Zarucco L.Managing pain in horses afflicted by chronic laminitis is one of the greatest challenges in equine clinical practice because it is the dreadful suffering of the animals that most often forces the veterinarian to end the battle with this disease. The purpose of this review is to summarize our current understanding of the complex mechanisms involved in generating and amplifying pain in animals with laminitis and, based on this information, to propose a modified approach to pain therapy. Furthermore, a recently developed pain scoring technique is presented that may help better quantify pain and t...
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