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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.
Adaptation strategies of horses with lameness. The skill to diagnose lameness in horses is paramount for every equine practitioner. Early recognition of locomotor deficiencies plays a central role in sports medicine management, preventing deterioration of the disease or catastrophic injuries. Horses use characteristic compensatory movements of specific body parts to decrease loading of the affected limb. This article describes the underlying changes in intra- and interlimb coordination and the resulting load redistribution between the limbs. This enables the practitioner to better understand the changes in movement associated with lameness...
Plasmid growth hormone releasing hormone therapy in healthy and laminitis-afflicted horses-evaluation and pilot study. In vivo electroporation dramatically improves the potency of plasmid-mediated therapies, including in large animal models. Laminitis and arthritis are common and debilitating diseases in the horse, as well as humans. Methods: The effects of growth hormone releasing hormone (GHRH) on healthy horses and on horses with laminitis that were followed for 6 months after a single intramuscular injection and electroporation of 2.5 mg of an optimized myogenic GHRH-expressing plasmid were examined. Results: In the first study on six healthy horses, we observed a significant increase in body mass by day 1...
Short term analgesic effect of extracorporeal shock wave therapy in horses with proximal palmar metacarpal/plantar metatarsal pain. Extracorporeal shock wave therapy (ESWT) is an accepted form of treatment for chronic cases of proximal suspensory desmitis (PSD). Subjective evaluation of horses shortly after being treated with ESWT has led clinicians to comment on an immediate reduction in lameness. This study aimed to evaluate the analgesic effect of ESWT on 16 horses with PSD or PSD-like pain in a fore- or hindlimb. To objectively assess lameness, gait analysis was performed on an instrumented treadmill before and 6, 24, 48 and 72h after ESWT of the origin of the suspensory ligament and the results compared to the effects...
Autologous platelet concentrates as a treatment for musculoskeletal lesions in five horses. Two horses with acute tendinopathy of a superficial digital flexor tendon (SDFT) and three horses with chronic proximal desmitis of the suspensory ligament (PDSL) were treated by injecting autologous concentrates of their platelets into the lesions. The lesions were monitored ultrasonographically and clinically. There were significant ultrasonographic and clinical improvements in the two horses with SDFT, but no ultrasonographic improvements in the horses with PDSL; however, they improved clinically and became less lame. All the horses had returned to their pre-injury level of performance by s...
Elbow joint luxation in a 1-month-old foal. This paper reports on luxation of the elbow joint without concomitant fracture in a 1-month-old foal. Conservative treatment, with closed reduction and full-limb bandaging, including caudal and lateral splints, seemed successful initially, however, failed to provide enough stability and luxation recurred, and open reduction and surgical placement of prosthetic collateral ligaments was required. Luxation of the elbow joint should be considered when acute non-weight bearing forelimb lameness occurs associated with pain and swelling in the area of the elbow in young foals. Closed reduction failed...
Short incomplete sagittal fractures of the proximal phalanx in ten horses not used for racing. To describe short incomplete sagittal fractures of the proximal phalanx (type Ia P1 fractures) in horses not used for racing and report outcome. Methods: Retrospective study. Methods: Horses (n=10) with type Ia P1 fractures. Methods: Retrieved data of horses with type Ia P1 fractures were signalment, history and results of orthopedic examination. Radiographs were re-evaluated for position and length of the fracture line, presence of osteoarthritis or subchondral cystic lesions (SCL), periosteal new bone formation and subchondral sclerosis. Conservative treatment (n=4) included box confinement ...
Effectiveness of administration of phenylbutazone alone or concurrent administration of phenylbutazone and flunixin meglumine to alleviate lameness in horses. To determine the effectiveness of administering multiple doses of phenylbutazone alone or a combination of phenylbutazone and flunixin meglumine to alleviate lameness in horses. Methods: 29 adult horses with naturally occurring forelimb and hind limb lameness. Methods: Lameness evaluations were performed by use of kinematic evaluation while horses were trotting on a treadmill. Lameness evaluations were performed before and 12 hours after administration of 2 nonsteroidal anti-inflammatory drug (NSAID) treatment regimens. Phenylbutazone paste was administered at approximately 2.2 mg/kg, PO, ever...
Developmental orthopaedic disease in limbs of foals: between-breed variations in the prevalence, location and severity at weaning. Developmental orthopaedic disease (DOD) affects all breeds and is a common cause of pain and lameness for horses in sports. A thorough knowledge of between-breed variations for the prevalence of DOD, for its distribution among the various joints and for its severity at earlier stages in the disease process is needed in order to improve the relevance and the cost-effectiveness of DOD screening protocols. However, no prevalence study for DOD simultaneously performed on several breeds with similar farming systems and based on radiographic findings (RF) on quite a large number of joints and views,...
Pull-through technique for palmar digital neurectomy: forty-one horses (1998-2004). To report outcome of horses treated for navicular syndrome using a pull-through (PT) technique for palmar digital neurectomy (PDN). Methods: Retrospective study. Methods: Horses (n=41) with navicular syndrome (NS). Methods: Medical records (1998-2002) for horses that had NS and failed to respond to conservative management that had unilateral or bilateral forelimb, biaxial PDN were reviewed. Outcome for up to 6 years was obtained by telephone questionnaire or lameness examination. Survival analysis was used to assess time to recurrence of lameness. Results: One year after PDN, 36 horses (88%) w...
Effects of single-dose intravenous phenylbutazone on experimentally induced, reversible lameness in the horse. The objective was to test the hypothesis that phenylbutazone (PBZ) alleviates lameness in an adjustable heart bar shoe model of equine foot pain. Eight Quarter Horse mares underwent 4-weekly treatments randomly: 0.9% saline placebo (SAL: 1 mL/45 kg body weight i.v.) with no lameness; SAL with lameness; PBZ (4.4 mg/kg body weight i.v.) with no lameness; and PBZ with lameness. Blinded heart rate (HR) and lameness score (LS) were assessed every 20 min for 2 h and then hourly through 9 h. At 1 h SAL or PBZ was administered. Jugular venous samples were obtained at hours 0, 1, 2, 4, 6, and 8 and wer...
Equine laminitis: membrane type matrix metalloproteinase-1 (MMP-14) is involved in acute phase onset. Enzymatic separation at the hoof lamellar dermal-epidermal interface may play a role in the development of laminitis and characterising and locating matrix metalloproteinases (MMPs) and their inhibitors (tissue inhibitors of MMPs or TIMPs) in lamellar tissues may further understanding of pathogenesis. Objective: To clone and sequence the cDNA encoding lamellar MMP-14 and TIMP-2, and quantify their transcription in normal and laminitic tissue; and to develop antibody to locate MMP-14 in lamellar tissues. Methods: Tissue samples were obtained from an oligofructose induced model of laminitis. Tot...
Retrospective study of palmar/plantar annular ligament injury in 71 horses: 2001-2006. Constriction of the digital flexor tendon sheath (DFTS) and its contents by the palmar/plantar annular ligament (PAL) is well recognised. However, primary injury of the PAL has not been well documented. Objective: To describe the clinical features of PAL injury, determine its prevalence with or without subcutaneous fibrosis and/or concurrent injury within the DFTS, and assess response to treatment. Methods: Horses were selected for inclusion based upon clinical features consistent with PAL injury and the presence of a thickened PAL (> or =2 mm) verified ultrasonographically. A retrospective...
Comparison of efficacy and safety of paste formulations of firocoxib and phenylbutazone in horses with naturally occurring osteoarthritis. To compare efficacy and safety of paste formulations of firocoxib and phenylbutazone in horses with naturally occurring osteoarthritis. Methods: Randomized controlled clinical trial. Methods: 253 client-owned horses with naturally occurring osteoarthritis. Methods: Horses were treated with firocoxib (0.1 mg/kg [0.045 mg/lb], PO, q 24 h) or phenylbutazone (4.4 mg/kg [2 mg/lb], PO, q 24 h) for 14 days. Physical examinations and lameness evaluations were performed prior to treatment and after 7 and 14 days. Clinical improvement was defined as a reduction of at least 1 lameness grade or a combined...
Lameness, athletic performance, and financial returns in yearling Thoroughbreds bought for the purpose of resale for profit. To characterize lameness during training and compare exercise variables and financial returns among yearling Thoroughbreds that were bought for the purpose of resale for profit. Methods: 40 yearling Thoroughbreds. Methods: Prospective study. Methods: Horses purchased at yearling sales (summer 2004) were trained prior to resale at 2-year-olds in training sales (spring 2005). Horses were monitored daily for diagnosis and treatment of lameness during training. Selected variables, including sex, age, purchase price, lameness, distance (No. of furlongs) galloped during training, and financial retur...
Hypertension and insulin resistance in a mixed-breed population of ponies predisposed to laminitis. To determine the metabolic phenotype of a group of laminitis-prone ponies when at pasture in summer, compared with when at pasture in winter. Methods: 40 ponies of various breeds predisposed to recurrent pasture-associated laminitis and 40 unaffected control ponies. Methods: Body condition score and size of the crest of the neck were assessed, blood samples obtained, and blood pressure measured by use of an indirect oscillometric technique, while ponies were kept on winter pasture (last week of November or beginning of December) and again on summer pasture (June). Serum insulin concentration a...
Incidence of osteochondrosis (dissecans) in Dutch warmblood horses presented for pre-purchase examination. Data are lacking in the literature regarding the incidence of osteochondrosis (dissecans) [OC(D)] in relation to lameness evaluation in Dutch Warmblood horses. The objective of this retrospective study was to assess the incidence of radiological abnormalities consistent with osteochondrosis or osteochondrosis dissecans in 1,231 sound Dutch Warmblood (DW) horses presented for pre-purchase examination. Standardised (Dutch) pre-purchase examination protocols were evaluated. The pre-purchase examination included a clinical, lameness and radiological evaluation, performed at a private equine clinic...
Evaluation of a new strategy to modulate skeletal development in racehorses by imposing track-based exercise during growth: the effects on 2- and 3-year-old racing careers. No data exist on the effects of conditioning exercise at foal age on workload and subsequent clinical injury rate during their 2- and 3-year-old racing careers. Objective: To investigate the effects of subjecting TB foals to conditioning exercise prior to the start of race training on: the workload required to reach a level of fitness sufficient to compete; and the prevalence of orthopaedic injury during the first 2 seasons of their racing careers. Methods: Twenty 18-month-old TBs, 12 subjected to conditioning exercise at foal age (CONDEX) and 8 exercised spontaneously at pasture only (PASTEX)...
The effect of induced hindlimb lameness on thoracolumbar kinematics during treadmill locomotion. There are no detailed studies describing a relationship between hindlimb lameness and altered motion of the back. Objective: To quantify the effect of induced subtle hindlimb lameness on thoracolumbar kinematics in the horse. Methods: Kinematics of 6 riding horses were measured during walk and trot on a treadmill before and during application of pressure on the sole of the left hindlimb using a well-established sole pressure model. Reflective markers were located at anatomical landmarks on the limbs, back, head and neck for kinematic recordings. Ground reaction forces (GRF) in individual limbs...
Radiographic, scintigraphic and magnetic resonance imaging findings in the palmar processes of the distal phalanx. Increased radiopharmaceutical uptake (IRU) in the palmar processes of the distal phalanx is recognised but its clinical significance has not been established. Objective: To investigate the relationship between radiographic, scintigraphic and MRI findings in the palmar processes of the distal phalanx. Objective: Increased radiopharmaceutical uptake in the palmar processes of the distal phalanx is associated with MRI abnormalities; IRU and MRI abnormalities are over-represented in lame limbs. Methods: Clinical data, radiographic, scintigraphic and MRI findings of 258 horses with unilateral or bi...
Review of genetic aspects of radiological alterations in the navicular bone of the horse. Navicular disease or podotrochlosis has long been known to cause forelimb lameness in horses. It had been proposed that the development of podotrochlosis has similarities to the human osteoarthritis (OA) complex. Alterations of the navicular bone can be made visible early in life only on the basis of radiographs. Reports on the prevalences of navicular disease indicate that radiological alterations in the navicular bone are present in different warmblood populations at frequencies of between 14.9% and 87.6%. Genetic factors play an important role in the development of the radiological signs. E...
Effects of analgesia of the digital flexor tendon sheath on pain originating in the sole, distal interphalangeal joint or navicular bursa of horses. Specific analgesic techniques are required in diagnosis of lameness to isolate the exact origin of pain to the many structures of the foot that may be involved. Objective: To determine if analgesia of the digital flexor tendon sheath (DFTS) results in anaesthesia of other portions of the foot, such as the sole, distal interphalangeal joint (DIPJ), or navicular bursa (NB). Methods: Lameness caused by pain in the dorsal margin or heel region of the sole of the foot was induced in 18 horses by: using set-screws to create solar pressure (Trial 1: n = 5); or administering endotoxin intrasynovially ...
Evaluation of foot pain in the standing horse by magnetic resonance imaging. The records of 41 horses with previously undiagnosed foot pain that had been examined by standing magnetic resonance imaging were reviewed and follow-up information was obtained from their owners two years after the examination. A range of soft tissue and osseous abnormalities were identified, with multiple lesions frequently occurring. Deep digital flexor tendonitis was recorded in 12 of the horses, and distension of the distal interphalangeal joint was identified in 15, but it was not always associated with lameness; in contrast, distension of the navicular bursa was always associated with l...
Magnetic resonance imaging features of proximal metacarpal and metatarsal injuries in the horse. Magnetic resonance (MR) imaging abnormalities in horses with lameness localized to the proximal metacarpal or metatarsal region have not been described. To accomplish that, the medical records of 45 horses evaluated with MR imaging that had lameness localized to either the proximal metacarpal or metatarsal region were reviewed. Abnormalities observed in the proximal suspensory ligament or the accessory ligament of the deep digital flexor tendon included abnormal high signal, enlargement, or alteration in shape. Twenty-three horses had proximal suspensory ligament desmitis (13 hindlimb, 10 fore...
Radiographic technique and anatomy of the equine sacroiliac region. Radiography is part of evaluating horses with poor performance and pelvic limb lameness; however, the radiographic appearance of the sacroiliac region is poorly described. The goal of the present study was to describe the use of a simple technique to obtain radiographs of the sacroiliac region in the anesthetized horse and to describe the radiographic appearance of this region. Seventy-nine horses underwent radiography of the pelvis under general anesthesia in dorsal recumbency. During a 5s exposure time the horse was actively ventilated to blur the abdominal viscera, which allowed assessment ...
Retrospective study of the effect of intra-articular treatment of osteoarthritis of the distal tarsal joints in 51 horses. Osteoarthritis of the distal tarsal joints, affecting the centrodistal and tarsometatarsal joints, is a common cause of hindlimb lameness in horses. This paper describes the outcome of the intra-articular treatment of 51 horses with the condition with either methylprednisolone acetate (mpa) or triamcinolone acetonide (tr), either with or without hyaluronic acid (ha). The outcome was assessed in terms of the changes in the horses' grade of lameness. Follow-up information was obtained from the owners by means of a telephone questionnaire. Horses treated once with mpa or tr, either with or withou...
Effect of dietary fructans and dexamethasone administration on the insulin response of ponies predisposed to laminitis. To determine whether pasture, and specifically the addition of fructan carbohydrate to the diet, induces exaggerated changes in serum insulin concentration in laminitispredisposed (LP) ponies, compared with ponies with no history of the condition, and also to determine insulin responses to the dexamethasone suppression test. Methods: Prospective study. Methods: 10 LP and 11 control adult nonobese mixed-breed ponies. Methods: Insulin-modified IV glucose tolerance tests were performed (5 ponies/group). In diet studies, ponies were kept on pasture and then changed to a hay diet (10 ponies/group)....
Early laminar events involving endothelial activation in horses with black walnut- induced laminitis. To determine proinflammatory gene expression, endothelial adhesion molecule gene expression, and matrix metalloproteinase (MMP) concentrations in laminar specimens at 1.5 hours after administration of black walnut extract (BWE) and to compare these values with later time points. Methods: 25 horses. Methods: After nasogastric administration of BWE, anesthesia was induced at 1.5 hours in early time point (ETP) horses (n = 5), between 3 and 4 hours in developmental time point horses (5), and between 9 and 10 hours in acute onset of lameness time point horses (5). Anesthesia was induced at 3 and 1...
Diagnostic imaging of the equine tarsal region using radiography and ultrasonography. Part 1: the soft tissues. The equine tarsus is the most commonly affected hindlimb region associated with lameness. Diagnostic imaging is routinely applied but because of its complexity, being composed of 10 multifaceted bones and different joints, multiple ligaments, tendons and bursae, imaging this region can be a challenge. This is the first part of a two-part review of the structures and disorders of the equine tarsus. It describes the principal disorders affecting the soft tissues of the tarsal region and addresses some of the technical aspects in taking radiographic, ultrasonographic and scintigraphic images of t...
Neuropathic changes in equine laminitis pain. Laminitis is a common debilitating disease in horses that involves painful disruption of the lamellar dermo-epidermal junction within the hoof. This condition is often refractory to conventional anti-inflammatory analgesia and results in unremitting pain, which in severe cases requires euthanasia. The mechanisms underlying pain in laminitis were investigated using quantification of behavioural pain indicators in conjunction with histological studies of peripheral nerves innervating the hoof. Laminitic horses displayed consistently altered or abnormal behaviours such as increased forelimb lifti...
Surgical management and outcome of a type-III Salter-Harris fracture of the frontal plane of the distal radial physis in a foal. A 4-week-old Thoroughbred filly presented with lameness of acute, severe onset of the left foreleg (LF) of 3 days' duration. Results: Diffuse swelling was present around the distal radius and carpus of the LF. Carpal varus that could be reduced manually was present. Radiographs revealed an intra- articular frontal-plane fracture in the distal radial epiphysis, which continued cranially through the distal radial physis (DRP). The lateral aspect of the DRP was wider than expected. Latero-medial carpal instability was resolved by placement of a lag screw from the dorsal midline through the epiphy...
