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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.
Tenoscopy of the navicular bursa: a new therapeutic approach for horses affected by “palmar pain syndrome.” Endoscopic technique review and personal experiences.
Veterinary research communications    May 25, 2010   Volume 34 Suppl 1 S125-S129 doi: 10.1007/s11259-010-9403-4
Scandella M, Lazzaretti SS, De Zani D, Cassano M, Zani DD, Ravasio G, Gualtieri M.Tenoscopy of the navicular bursa has been recently introduced as a diagnostic and therapeutic treatment in cases of palmar foot pain syndrome. A deep digital flexor tendon transthecal approach was suggested in 1999, and the endoscopic technique has been reviewed. Smith and coworkers have recently reported good and promising results. An anatomic cadaver limb study was performed, and the endoscopic technique was evaluated. Subsequently, a 14-year-old Argentine mare, affected by palmar foot pain syndrome, was treated. Clinical data, MRI and endoscopic findings, and a 6-month follow-up evaluation ...
Imaging diagnosis–Arterial and venous thromboses of the proximal limb in two thoroughbred racehorses. Vaughan B, Whitcomb MB, Puchalski SM, Poulin-Braim AE, Nieto JE, Galuppo LD.Thromboses of the cranial tibial vein (Horse 1) and brachial, median, and cranial circumflex humeral arteries (Horse 2) were identified as causes of unilateral lameness in two Thoroughbred racehorses. Nuclear scintigraphy was performed for suspicion of long bone stress fractures but instead allowed identification of unusual areas of increased radiopharmaceutical uptake within soft tissues of the affected limbs. Ultrasonography of these regions allowed identification of occlusive thrombi within a 25 cm length of the cranial tibial vein (Horse 1) and variable lengths of affected arteries in Hors...
Imaging diagnosis–Medullary tibial infarction in a horse. Sánchez J, Gonzalo-Orden JM, Ginja MM, Oliveira PA, Reyes LE, Serantes AE, Orden MA.An Andalusian Stallion with left hind limb lameness had a radiolucent lesion in the medullary cavity of distal tibial metaphysis. After euthanasia for other disease, the tibia was examined with magnetic resonance (MR). The MR imaging sequences were characterized by a double line sign, although showing quite different lesion area intensities. Histologically, the lesion was compatible with medullary infarction being characterized by normal spongy bone, areas of abundant fibrous tissue and numerous necrotic adipocytes in various stages of destruction.
Rib osteomyelitis in three foals.
Australian veterinary journal    April 21, 2010   Volume 88, Issue 3 96-100 doi: 10.1111/j.1751-0813.2009.00547.x
Neil KM, Charman RE, Vasey JR.Three foals aged between 21 and 44 days were presented for evaluation of pyrexia and lameness. Each had subcutaneous abscessation associated with osteomyelitis of a rib at the costochondral junction and pathological fracture of the affected rib; one foal had more than one rib affected. Other localised sites of infection included other sites of osteomyelitis, omphalophlebitis, uveitis, enterocolitis, and calcaneal bursitis. The subcutaneous abscessation and rib osteomyelitis was treated surgically in two foals. Salmonella typhimurium was isolated from the subcutaneous abscess in one foal and fr...
Antimicrobial delivery by intrasynovial catheterisation with systemic administration for equine synovial trauma and sepsis.
Australian veterinary journal    April 21, 2010   Volume 88, Issue 4 115-123 doi: 10.1111/j.1751-0813.2010.00553.x
Stewart AA, Goodrich LR, Byron CR, Evans RB, Stewart MC.To present the technique for intra-articular catheter placement and report the clinical outcomes of 38 cases of equine synovial trauma and/or infection treated with broad-spectrum antimicrobials administered via an intrasynovial catheter (ISC). Methods: Retrospective study. Methods: Medical records of 38 horses treated for synovial trauma and sepsis with frequent antimicrobial administration through an ISC from 1995 to 2008 were reviewed. Follow-up information was obtained via clinical re-evaluation or telephone contact with the owners. Results: The majority of horses (84%) received amikacin a...
Effects of endotoxaemia and carbohydrate overload on glucose and insulin dynamics and the development of laminitis in horses.
Equine veterinary journal    April 14, 2010   Volume 41, Issue 9 852-858 doi: 10.2746/042516409x479027
Tóth F, Frank N, Chameroy KA, Bostont RC.Insulin resistance (IR) is a risk factor for pasture-associated laminitis in equids and alimentary carbohydrate overload may trigger laminitis. Whether glucose metabolism responses to carbohydrate overload are more pronounced in insulin-resistant horses requires further study. Objective: Horses pretreated with endotoxin to alter insulin sensitivity differ significantly in their glucose and insulin responses to carbohydrate overload. Methods: Horses (n=24) were divided into 3 groups. A lipopolysaccharide (LPS; n=8) group that received endotoxin as an 8 h 7.5 ng/kg bwt/h i.v. continuous rate inf...
Acute laminitis: medical and supportive therapy.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 103-114 doi: 10.1016/j.cveq.2009.12.011
van Eps AW.Acute laminitis is a serious complication of many primary conditions in the horse. This article summarizes the most appropriate approach to management of the horse with acute laminitis, based on current information.
Chronic laminitis: strategic hoof wall resection.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 197-205 doi: 10.1016/j.cveq.2009.12.009
Rucker A.In the chronic-laminitic foot, severe soft-tissue compression and compromised circulation can result in osteitis and sepsis at the margin of the distal phalanx. Resultant inflammation and sepsis may cause the coronary corium to swell, drain, or separate from the hoof capsule, usually within 8 weeks of laminitis onset. Slow-onset cases of soft-tissue impingement can develop secondary to distal phalanx displacement due to lack of wall attachment. With either presentation, partial upper wall resection is required to reverse compression and vascular impingement by the hoof capsule. If the patholog...
Carbohydrate alimentary overload laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 65-78 doi: 10.1016/j.cveq.2010.01.006
Pollitt CC, Visser MB.In acute laminitis, the suspensory apparatus of the distal phalanx fails at the lamellar dermal/epidermal interface. A grading system for the histopathology of laminitis is based on the consistent pattern of histologic changes to the secondary epidermal lamellae, basal cells, and basement membrane that occur as carbohydrate-induced laminitis develops. The actual trigger factors of carbohydrate-induced laminitis remain unidentified.
Therapeutic hypothermia (cryotherapy) to prevent and treat acute laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 125-133 doi: 10.1016/j.cveq.2010.01.002
van Eps AW.Digital hypothermia successfully reduces the severity of experimentally induced laminitis. Continuous-distal limb cryotherapy may be a useful technique in clinical cases that are at risk of developing laminitis. This article examines the effects of hypothermia on tissue as well as the rationale, and suggested protocols for the usage of distal limb cryotherapy in the prevention and treatment of laminitis.
A historical perspective of laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 1-11 doi: 10.1016/j.cveq.2009.12.004
Heymering HW.The causes of laminitis are many-often interrelated, sometimes direct opposites. The history of laminitis has been a search for the cause or causes of laminitis and for effective treatment. Going in and out of fashion, many treatments have lasted for centuries, some for millennia, but very few have been proven.
80 causes, predispositions, and pathways of laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 13-19 doi: 10.1016/j.cveq.2009.12.003
Heymering HW.For most of history, the causes of laminitis have been based on observations. In the last 30 years or so, however, the number of theories has exploded, with only a few being confirmed by experiments. This article highlights these theories.
Equine venography and its clinical application in North America.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 167-177 doi: 10.1016/j.cveq.2009.12.008
Rucker A.The digital venogram uses contrast radiography to evaluate the soft tissues and vasculature of the foot, thus identifying pathology attributable to laminitis. Pathology can be detected before changes appear on plain-film radiographs. When used in conjunction with clinical and radiographic findings, information gained from a venographic study informs and directs treatment. Serial venograms assess the response to treatment and help determine prognosis early in the course of therapy. If the venographic contrast pattern does not improve, either the treatment needs to be altered, or the damage is s...
The lamellar wedge.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 179-195 doi: 10.1016/j.cveq.2010.01.004
Collins SN, van Eps AW, Pollitt CC, Kuwano A.In horses with chronic laminitis, an abnormal horn structure called the lamellar wedge develops within the lamellar region of the foot. This pathologic structure adversely affects normal foot function, and influences return to previous performance levels. Understanding the pathologic process that leads to the development of this structure is essential for correct supportive foot management of the horse with chronic laminitis. The ability to prevent or reduce the formation of the lamellar wedge may eventually lead to better outcomes in cases of laminitis.
Home care for horses with chronic laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 215-223 doi: 10.1016/j.cveq.2009.12.012
Orsini JA, Wrigley J, Riley P.Home care for horses with chronic laminitis has been discussed rarely in the veterinary literature even though, at any given time, most of us have at least 1 chronic laminitis case in our care that is being managed at home by the owner. Almost all of our knowledge on this aspect of laminitis treatment has been gleaned through experience, by individually working through the medical, ethical, financial, and emotional challenges these cases can present. Much has already been presented on the medical management of the laminitic horse and on strategies for trimming and shoeing the laminitic foot. T...
Progression of venographic changes after experimentally induced laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 135-140 doi: 10.1016/j.cveq.2009.12.005
Baldwin GI, Pollitt CC.Venography (retrograde venous angiography) is a relatively simple and practical method for vascular assessment of the digits in the standing horse. The technique is a useful adjunct to routine radiography. The clinical use of the laminitis venogram has resulted in a more comprehensive understanding of the collateral pathology associated with distal phalanx displacement and abnormal hoof growth. The effectiveness of therapeutic procedures such as hoof wall resection, coronary band grooving, deep digital flexor tenotomy, and therapeutic shoeing can be assessed by serial venography. This article ...
Overview of current laminitis research.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 51-63 doi: 10.1016/j.cveq.2010.01.001
Eades SC.All cases of laminitis are characterized by failure of the attachment of the epidermal cells of the epidermal laminae to the underlying basement membrane of the dermal laminae despite the diversity of diseases that underlie the syndrome. The preponderance of evidence supports roles for inflammation, metabolic derangement, endothelial and venous dysfunction, and matrix degradation as causes of laminitis. Inflammation, oxidant stress, and matrix degradation may be factors common to each of these mechanisms that lead to the laminar damage of laminitis. The understanding of the pathophysiology and...
Laminitis treatment: a personal memoir.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 21-28 doi: 10.1016/j.cveq.2009.12.010
Walsh DM.The author has completed 40 years as a veterinarian treating horses with laminitis. The article is a recollection of his experiences with laminitis and the various treatment methods he came across while trying to treat the disease.
The pharmacologic basis for the treatment of developmental and acute laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 115-124 doi: 10.1016/j.cveq.2010.01.003
Belknap JK.The treatment of laminitis has been fraught with confusion and controversy for several decades, mainly because of a lack of understanding of the pathophysiology of the disease process. However, recent advances in laminitis research have greatly improved our understanding of the disease process. This article discusses the various treatment options for laminitis in the context of the findings of recent scientific investigations of laminitis pathophysiology.
The use of the wooden shoe (Steward Clog) in treating laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 207-214 doi: 10.1016/j.cveq.2009.12.002
Steward ML.This article describes the use of the wooden shoe in the treatment of chronic laminitis. The shoe, designed to provide a solid base and full roller motion, offers mechanical advantages and enables reduction and redistribution of forces within the hoof capsule.
Clinical presentation, diagnosis, and prognosis of chronic laminitis in North America.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 141-153 doi: 10.1016/j.cveq.2009.12.006
Hunt RJ, Wharton RE.Chronic laminitis involves laminar morphologic changes resulting in digital collapse and can vary greatly in its clinical manifestation depending on duration, severity of lameness, and stability of the distal phalanx/hoof wall interface. Accurate assessment of the whole patient is mandatory and consideration must be given to signalment, occupation, and owner expectations, as well as history and etiology, which often predict the broad course of the disease. Diagnosis is made via physical examination with adjunctive serial radiographic evaluation and possibly venography. Eventual functionality o...
Microbial events in the hindgut during carbohydrate-induced equine laminitis.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 79-94 doi: 10.1016/j.cveq.2010.01.007
Milinovich GJ, Klieve AV, Pollitt CC, Trott DJ.Equine laminitis is the most serious foot disease of the horse, often resulting in death or euthanasia. Laminitis has long been recognized as an affliction of horses, as has the association of this condition with the ingestion of carbohydrates. Research into the pathophysiology of this condition has been facilitated by the development of reliable models for experimentally inducing laminitis, and DNA-based techniques for profiling complex microbiomes have dramatically increased the knowledge of the microbiology of this disease. Recent studies have provided substantial evidence showing equine hi...
The anatomy and physiology of the suspensory apparatus of the distal phalanx.
The Veterinary clinics of North America. Equine practice    April 13, 2010   Volume 26, Issue 1 29-49 doi: 10.1016/j.cveq.2010.01.005
Pollitt CC.The equine hoof capsule protects the softer, more sensitive, structures within. Failure of the connection between hoof and bone (suspensory apparatus of the distal phalanx or SADP) results in the crippling lameness of laminitis. Active basal cell proliferation occurs principally in tubular hoof and proximal and distal lamellae. The remaining lamellae are virtually non-proliferative and the hoof wall moves past the stationary distal phalanx, by controlled activation and inhibition of constituent proteases. The lamellar corium derives most of its blood supply from the branches of the terminal ar...
Analgesic efficacy of intra-articular morphine in experimentally induced radiocarpal synovitis in horses.
Veterinary anaesthesia and analgesia    March 17, 2010   Volume 37, Issue 2 171-185 doi: 10.1111/j.1467-2995.2009.00521.x
Lindegaard C, Thomsen MH, Larsen S, Andersen PH.To compare the analgesic effect of intra-articular (IA) and intravenous (IV) morphine in horses with experimentally induced synovitis. Methods: Eight adult horses. Methods: Randomized, observer blinded, double dummy trial with sequential crossover design. Methods: Radiocarpal synovitis was induced by IA injection of lipopolysaccharide on two occasions separated by a 3-week washout period. In one study period horses received treatment IA; morphine IA (0.05 mg kg(-1)) plus saline IV and in the other study period they received treatment IV; saline IA plus morphine IV (0.05 mg kg(-1)). Lameness an...
A technique for laser-facilitated equine pastern arthrodesis using parallel screws inserted in lag fashion.
Veterinary surgery : VS    March 10, 2010   Volume 39, Issue 2 244-253 doi: 10.1111/j.1532-950X.2009.00627.x
Watts AE, Fortier LA, Nixon AJ, Ducharme NG.To report a technique for laser-facilitated, minimally invasive proximal interphalangeal joint (PIJ) arthrodesis in horses. Methods: Case series. Methods: Horses (n=6); 5 thoracic and 2 pelvic limb PIJ. Methods: PIJ osteoarthritis (OA) diagnosis was confirmed by radiography. A diode laser was used to apply 2000 J of energy to the joint followed by insertion of 3 parallel 5.5 mm screws in lag fashion through stab incisions to achieve PIJ arthrodesis. After anesthetic recovery, limbs were maintained in bandages (n=2) or bandage casts (5) for 3 weeks. Horses were allowed exercise or turnout by 3 ...
Long-term outcome after arthroscopic debridement of distal phalanx extensor process fragmentation in 13 horses.
Veterinary surgery : VS    March 10, 2010   Volume 39, Issue 1 107-114 doi: 10.1111/j.1532-950X.2009.00608.x
Crowe OM, Hepburn RJ, Kold SE, Smith RK.To report long-term outcome after arthroscopic removal of fragmentation of the extensor process of the distal phalanx in horses. Methods: Case series. Methods: Adult horses (n=13). Methods: Medical records (2003-2004) of horses that had arthroscopic debridement of fragmentation of the extensor process of the distal phalanx were reviewed. Inclusion criteria included: lameness localized to the foot, fragmentation of the extensor process of the distal phalanx debrided arthroscopically, and a follow-up period of > or = 4 years. Results: Of the 13 horses, lameness was resolved in 11 (85%) initia...
Modified tenoscopic method for carpal flexor retinaculum release in a horse.
Veterinary surgery : VS    March 10, 2010   Volume 39, Issue 2 239-243 doi: 10.1111/j.1532-950X.2009.00631.x
Byron CR, Benson BM, Karlin WM, Stewart AA.To report the use of a proximolateral endoscopic portal with a distolateral instrument portal for carpal retinaculum release in a horse clinically affected with carpal canal syndrome. Methods: Clinical report. Methods: A 4-year-old Thoroughbred female. Methods: Carpal canal syndrome secondary to traumatic suppurative tenosynovitis was treated by accessory carpal bone debridement and carpal retinaculum release using a tenoscopic approach to the carpal flexor synovial sheath through a proximolateral endoscope portal and a distolateral instrument portal. Results: Resolution of carpal sheath effus...
Effects of domperidone on digital laminar microvascular blood flow in clinically normal adult horses.
American journal of veterinary research    March 2, 2010   Volume 71, Issue 3 281-287 doi: 10.2460/ajvr.71.3.281
Castro JR, Adair HS, Radecki SV, Kiefer VR, Elliot SB, Longhofer SL.To determine effects of domperidone and acepromazine maleate on microvascular blood flow in digital laminae of clinically normal adult horses. Methods: 8 clinically normal adult horses (4 mares and 4 geldings). Methods: In a 4-period crossover study, domperidone was administered PO at 1.1 mg/ kg and 5.5 mg/kg and IV at 0.2 mg/kg; acepromazine was administered IV at 0.04 mg/kg. The washout period between treatments was 1 week. A 3-minute measurement of laminar microvascular blood flow (LMBF) was obtained with laser Doppler flowmetry. Baseline measurements were obtained at -2, -1, and 0 hours pr...
Clinical, magnetic resonance, and sonographic imaging findings in horses with proximal plantar metatarsal pain. Labens R, Schramme MC, Robertson ID, Thrall DE, Redding WR.Sonography is commonly used for diagnosis of desmopathy of the proximal part of the suspensory ligament in horses. However, magnetic resonance (MR) imaging has been stated to be superior for detecting disease and localizing lesions. In this retrospective study of 39 horses or 46 hind limbs with lameness due to proximal plantar metatarsal pain, the clinical and diagnostic findings are discussed and sonography and MR imaging compared for examination of the proximal part of the suspensory ligament. With MR imaging interpreted as the clinical gold standard, desmopathy of the proximal part of the s...
Equine laminitis: induced by 48 h hyperinsulinaemia in Standardbred horses.
Equine veterinary journal    February 17, 2010   Volume 42, Issue 2 129-135 doi: 10.2746/042516409X475779
de Laat MA, McGowan CM, Sillence MN, Pollitt CC.Hyperinsulinaemia is known to induce laminitis experimentally in healthy ponies with no history of the condition. Horses are more insulin sensitive than ponies and whether prolonged hyperinsulinaemia and euglycaemia would have a similar laminitogenic effect requires study. Objective: To determine if laminitis results when the prolonged euglycaemic hyperinsulinaemic clamp technique (p-EHC) is applied to clinically normal Standardbred horses, and to monitor hoof wall temperature seeking an association between vascular activity and laminitis development. Methods: Eight young, clinically normal St...
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