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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.
Foot pain and the elusive diagnosis. New information about foot anatomy, effects of local analgesia, and advances in diagnostic imaging (ultrasonography, nuclear scintigraphy, MRI, CT, and endoscopy) has opened the way for more specific diagnoses of lameness. New questions have been raised, however, and some older ideas are now in doubt. This article discusses some of these findings in the light of our own clinical experiences as they relate to diagnosis of the causes of foot pain.
The role and importance of farriery in equine veterinary practice. There is a lot of room for us to become the central source of medical information regarding shoeing and lameness in our own practice area. This takes a good bit of effort and a real "outreach" to client and farrier. It can be done with the one tool we are best at--the acquisition and careful dispensing of information that we can put together regarding the health of the foot. Such information includes the following: 1. Radiographically guided hoof trimming and shoeing. 2. Ultrasonography. 3. Digital radiography. 4. Thermography. 5. Nutritional and health counseling. Become the "local" expert in...
Examination of the equine foot. The examination of the foot must be based on observations of the hoof, followed by a careful determination of areas of pain. This must be followed by an assessment of the biomechanical forces on the hoof and limb. Finally, imaging gives insight into the nature of the injury and allows the examiner to prognosticate the outcome.
Scapulohumeral arthrodesis in miniature horses. To describe surgical arthrodesis of the scapulohumeral joint and to evaluate its efficacy in reducing morbidity associated with severe shoulder dysfunction in miniature horses. Methods: Retrospective study. Methods: Four miniature horses. Methods: Medical records and radiographs were reviewed for history, physical examination findings, lameness evaluation, radiographic evaluation, surgical techniques, postoperative complications, and outcome. A 10- or 11-hole, 4.5-mm narrow dynamic compression plate and 4.5-mm cortical screws were applied to the cranial surface of the scapula and cranial surfa...
Seasonal changes in plasma concentrations of cecum-derived amines in clinically normal ponies and ponies predisposed to laminitis. To measure concentrations of amines formed in the cecum of clinically normal ponies, determine amine concentrations in plasma samples collected in spring and winter, and compare concentrations of amines and serotonin in plasma samples obtained from clinically normal ponies and ponies predisposed to laminitis. Methods: Cecal contents obtained from 10 ponies euthanatized at an abattoir and blood samples obtained from 42 adult ponies. Methods: Cecal contents were assayed for amines by high-performance liquid chromatography (HPLC). Blood samples were collected at various times of the year from 20 ...
Osteomyelitis secondary to trauma involving the proximal end of the radius in horses: five cases (1987-2001). To determine clinical, radiographic, and scintigraphic abnormalities in and treatment and outcome of horses with trauma-induced osteomyelitis of the proximal aspect of the radius. Methods: Retrospective study. Methods: 5 horses. Methods: Data collected from the medical records included signalment; history; horse use; degree of lameness; radiographic, ultrasonographic, and scintigraphic findings; treatment; and outcome. Results: Duration of lameness prior to referral ranged from 14 to 60 days. Mean severity of lameness was grade 3 of 5, and all horses had a single limb affected. All horses had ...
Effects of topical perineural capsaicin in a reversible model of equine foot lameness. Capsaicin is a local substance P depleter with dramatic analgesic effects. We tested the hypothesis that the topical application of capsaicin ointment over the palmar digital nerves would attenuate the clinical effects of a reversible model of equine foot lameness. Seven healthy adult horses shod unilaterally with adjustable heart bar shoes were studied in a crossover design for 2 weeks. Grade 5.0/5.0 lameness (nonweight bearing) was induced by tightening the adjustable heart bar shoe. One hour later, capsaicin ointment was applied over the medial and lateral palmar digital nerves 3 cm proxima...
Biochemical characterisation of navicular hyaline cartilage, navicular fibrocartilage and the deep digital flexor tendon in horses with navicular disease. The study hypothesis was that navicular disease is a process analogous to degenerative joint disease, which leads to changes in navicular fibrocartilage and in deep digital flexor tendon (DDFT) matrix composition and that the process extends to the adjacent distal interphalangeal joint. The objectives were to compare the biochemical composition of the navicular articular and palmar cartilages from 18 horses with navicular disease with 49 horses with no history of front limb lameness, and to compare navicular fibrocartilage with medial meniscus of the stifle and collateral cartilage of the hoof...
Retrospective evaluation of equine prepurchase examinations performed 1991-2000. Prepurchase examinations of horses are used increasingly as a means of evaluating future soundness. Data is lacking in the literature of the radiographic findings and results of the lameness examination of comprehensive prepurchase examinations. Objective: To summarise the clinical and radiographic findings of prepurchase examinations and determine if radiographic findings correlated with the lameness examination and sale outcome. Methods: Records of 510 cases were reviewed, radiographs evaluated and grades assigned the navicular bone, distal phalanx, and tarsus. Follow-up information on the h...
The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases. Tibial stress fractures are an important cause of lameness in the Thoroughbred racehorse. While it is recognised that these injuries can vary in clinical presentation and radiographic or scintigraphic appearance, little has been done to quantify lesion severity. By contrast the scintigraphic grading of tibial stress fractures in human athletes is widely reported and assists in the selection of appropriate management regimes. Objective: To determine the relationship between scintigraphic grade, clinical severity and radiographic appearance of tibial stress fractures. Methods: The current study ...
Tiludronate as a new therapeutic agent in the treatment of navicular disease: a double-blind placebo-controlled clinical trial. Bisphosphonates, such as tiludronate, are used to normalise bone metabolism via inhibition of bone resorption. Areas of increased bone resorption and formation are typical lesions in a diseased navicular bone. Objective: To determine if bone remodelling changes occurring in navicular disease may be corrected with therapies regulating bone metabolism. Methods: We designed a double-blind, placebo-controlled clinical trial to compare 2 doses of tiludronate, 0.5 mg/kg and 1 mg/kg bwt administered via daily i.v. injections over 10 days for the treatment of navicular disease. Seventy-three horses, s...
Meniscal tears in horses: an evaluation of clinical signs and arthroscopic treatment of 80 cases. There is little published information available describing clinical signs, arthroscopic findings and prognosis of meniscal injuries in horses. Objective: To evaluate the effect on the outcome not only of the arthroscopic findings and treatment, but also of the clinical and radiographic signs in these horses. Methods: The following were recorded for each case: the meniscal injury, graded according to severity; clinical and radiographic findings prior to surgery; any concurrent injury in the joint seen at arthroscopy. The effect of these factors and the grade of injury on the outcome were analys...
The effects of local anaesthetic solution in the navicular bursa of horses with lameness caused by distal interphalangeal joint pain. Analgesia of the palmar digital (PD) nerves has been demonstrated to cause analgesia of the distal interphalangeal (DIP) joint as well as the sole. Because the PD nerves lie in close proximity to the navicular bursa, we suspected that that analgesia of the navicular bursa would anaesthetise the PD nerves, which would result in analgesia of the DIP joint. Objective: To determine the response of horses with pain in the DIP joint to instillation of local anaesthetic solution into the navicular bursa. Methods: Lameness was induced in 6 horses by creating painful synovitis in the DIP joint of one f...
Submural histopathologic changes attributable to peracute laminitis in horses. To describe submural histopathologic changes attributable to peracute laminitis in horses. Methods: 20 adult horses. Methods: A concurrent-control design was used to compare laminar lesions in 10 horses subjected to carbohydrate-induced laminitis with laminar characteristics of 10 sex- and aged-matched control horses with normal feet. Horses in the treatment group were administered an overload of carbohydrate. Tissues were obtained by biopsy 4 to 8 hours after onset of lameness or 72 hours after administration of the carbohydrate overload when lameness did not develop. Sections were stained wi...
Use of a dynamic compression plate and a cable cerclage system for repair of a fracture of the radius in a horse. A pregnant 9-year-old Peruvian Paso mare was evaluated because of a fracture involving the left radius. On examination, grade IV/V lameness of the left forelimb was observed; radiography of the limb revealed a longitudinal oblique displaced fracture that extended from the caudal cortex of the radial mid-diaphysis into the humeroradial joint. To minimize the development of degenerative joint disease in the humeroradial joint, repair with internal fixation was recommended. A dynamic compression plate was applied to the cranial aspect of the radius; three 2-mm stainless steel cable cerclages were...
Demographic and clinical characteristics of geriatric horses: 467 cases (1989-1999). To describe the demographic and clinical characteristics of a population of geriatric horses. Methods: Retrospective study. Methods: 467 horses that were > or = 20 years of age. Methods: Medical records of 539 geriatric horses that were evaluated at a university large animal hospital between 1989 and 1999 were reviewed. Data collected included signalment, reason for evaluation, specific diagnoses, surgical procedures, inpatient or outpatient care, duration of hospitalization, and outcome. Results: 467 horses met the criteria for inclusion in the study. Horses that were > or = 20 years of...
Evaluation of beta3-adrenoceptor-mediated relaxation in intact and endotoxin-treated equine digital veins. To investigate the functional expression of beta3-adrenoceptors (beta3-ARs) in equine digital veins (EDVs) and to examine whether beta3-AR relaxation was altered in EDVs incubated with endotoxin. Methods: Forelimbs obtained from 30 horses. Methods: Forelimbs were obtained from horses in an abattoir. Equine digital veins were carefully removed from distal portions of the forelimbs. Rings of dissected EDVs were mounted in 5-mL organ baths to record isometric tension in the presence of various beta3-AR agonists (SR 58611A, ZD 2079, and ZM 215001). Results: In intact EDVs, isoprenaline, SR 58611A,...
Tenoscopic release of the equine carpal canal. To develop a tenoscopic method to divide the carpal flexor retinaculum and decompress the carpal canal. Methods: Cadaver specimen study and prospective trial. Methods: Twelve cadaveric limbs, 4 clinically normal horses, and 2 clinically affected horses. Methods-A tenoscopic approach to the proximolateral aspect of the carpal sheath was used to identify and facilitate endoscopic division of the inner and outer layers of the carpal flexor retinaculum in cadaver limbs. The technique was further evaluated in 4 normal and 2 clinically affected horses. Results: Anatomic dissection, intraoperative ob...
Severe carpometacarpal osteoarthritis in older Arabian horses. To report a severe form of carpometacarpal osteoarthritis (CMC-OA) affecting primarily older Arabian horses. Methods: Retrospective study. Methods: Thirty-one horses with CMC-OA. Methods: Carpal radiographs (405 sets) from 3 hospitals were evaluated to identify horses with marked osteoproliferative reaction across the medial aspect of the CMC joint. Owners were contacted to obtain detailed histories and status updates. Necropsy specimens of the CMC joint were evaluated at 2 hospitals to determine the prevalence of 2 variations in the articulation between the proximal second and third metacarpa...
Cylindrical press-fit osteochondral allografts for resurfacing the equine metatarsophalangeal joint. To investigate the feasibility of resurfacing the equine fetlock joint using cylindrical, orthotopic, press-fit, osteochondral allografts. Methods: Experimental study. Methods: Ten mature, mixed-breed horses. Methods: Cylindrical, osteochondral grafts (6.5-mm diameter) were harvested aseptically from cadaveric equine metatarsophalangeal joints. Allografts were transplanted into 6 horses; 4 horses were sham operated. The surgical approach involved creation of a bone block at the origin of the medial collateral ligament and luxation of the metatarsophalangeal joint. Grafts were placed into the m...
The effect of perineural anesthesia on infrared thermographic images of the forelimb digits of normal horses. Infrared thermography is an imaging modality gaining popularity as a diagnostic aid in the evaluation of equine lameness. Anecdotal reports of skin hyperthermia induced by local anesthesia, detected by thermography, have been made; however, no controlled studies have been reported. The purpose of this study was to examine the effects of perineural anesthesia on infrared thermographic images of the forelimb digits in normal horses. After environmental acclimation, infrared thermographs were made at intervals of 0, 5, 10, 15, 30, and 45 min from administration of mepivacaine hydrochloride or pho...
The sacroiliac joints: evaluation using nuclear scintigraphy. Part 2: Lame horses. Sacroiliac (SI) joint disease is difficult to diagnose definitively on clinical grounds. Objective: Lameness not attributable to SI joint pain may result in asymmetrical uptake of radiopharmaceutical in the tubera sacrale and SI joints; and that horses with clinical signs suggestive of sacroiliac joint disease would have differences in the ratios of radiopharmaceutical uptake between the fifth lumbar vertebra (L5) and either the tubera sacrale or SI joints compared with normal horses. Objective: To determine whether differences in radiopharmaceutical activity could identify individuals with pr...
Tenosynovitis of the digital flexor tendon sheath and annular ligament constriction syndrome caused by longitudinal tears in the deep digital flexor tendon: a clinical and surgical report of 17 cases in warmblood horses. Inflammation of the digital flexor tendon sheaths is a chronic and nebulous condition often unresponsive to medical and surgical treatment. Objective: To evaluate the incidence of longitudinal tears (LT) as the underlying cause of chronic tenosynovitis and annular ligament constriction syndrome (ALCS) in warmblood horses. Methods: The records of 25 horses with chronic tenosynovitis and ALCS in which tenoscopical inspection of the digital flexor tendon sheath (DFTS) was performed between 1999-2000 were reviewed. Of 25 horses, 17 were diagnosed with an LT in the deep digital flexor tendon (DDFT)...
Pain associated with the sacroiliac joint region: a clinical study of 74 horses. There has been no large study of horses with suspected sacroiliac (SI) joint region pain in which the clinical diagnosis has been supported by either abnormal radiopharmaceutical activity in the SI joint region or by periarticular infiltration of local anaesthetic solution. Objective: To describe the clinical features of horses with SI joint region pain, to document the age, breed, sex, discipline, size and conformation of affected horses and to compare these with the author's (SD) normal case population and to document the results of infiltration of local anaesthetic solution around the SI jo...
Osteomyelitis of the pelvis caused by Rhodococcus equi in a two-year-old horse. A 2-year-old female Quarter Horse was evaluated for hind limb lameness, fever (40 degrees C [104 degrees F]), and lethargy of 2 weeks' duration. Hypoproteinemia characterized by hypoalbuminemia and hyperfibrinogenemia was detected. Abdominal ultrasonography revealed thickening of the right dorsal colon wall. Treatment was instituted for putative right dorsal coliis. Lameness evaluation localized signs of pain to the lumbar vertebrae or pelvis. Radiography performed with the horse standing and nuclear scintigraphy revealed no abnormalities. Ventrodorsal pelvic radiography revealed a focal area ...
Desmitis of the straight sesamoidean ligament in horses: 9 cases (1995-1997). To determine clinical signs, diagnostic findings, and outcome for horses with desmitis of the straight sesamoidean ligament (SSL) near its insertion on the middle phalanx. Methods: Retrospective study. Methods: 9 horses. Methods: Medical records were reviewed, and information on signalment, history, clinical signs, diagnostic findings, and treatment was obtained. Follow-up information was obtained through telephone conversations with owners. Results: In all horses, the diagnosis was made by use of high-resolution ultrasonography. Seven horses had moderate lameness on initial examination; lamen...
Identification of equine cecal bacteria producing amines in an in vitro model of carbohydrate overload. Acute laminitis has been associated with the overgrowth of gram-positive bacteria within the equine hindgut, causing the release of factor(s) leading to ischemia-reperfusion of the digits. The products of fermentation which trigger acute laminitis are, as yet, unknown; however, vasoactive amines are possible candidates. The objectives of this study were to use an in vitro model of carbohydrate overload to study the change in populations of cecal streptococci and lactobacilli and to establish whether certain species of these bacteria were capable of producing vasoactive amines from amino acids....
Evaluation of systemic immunologic hyperreactivity after intradermal testing in horses with chronic laminitis. To determine whether systemic immunologic hyperreactivity exists in horses with chronic laminitis, compared with responses for nonlaminitic horses. Methods: 7 nonlaminitic horses and 7 CL horses. Methods: In experiment 1, intradermal testing (IDT) was performed on 7 nonlaminitic and 7 CL horses to evaluate the response to a combination of 70 allergens at 15 and 30 minutes and 4 and 24 hours after injection. Three nonlaminitic and 3 CL horses used in experiment 1 were used in experiment 2 to determine whether histologic differences existed between the 2 groups. The H&E-stained tissue sectio...
Unilateral white line disease and laminitis in a quarter horse mare. A 5-year-old quarter horse mare presented with unilateral, severe, chronic forelimb lameness. Radiographs revealed extensive hoof wall separation and capsular rotation of the distal phalanx. Treatment included dorsal hoof wall resection, phenylbutazone, a bar shoe, and stall rest. Whether white line disease or laminitis was the primary lesion remains unclear.
