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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.
The mechanisms and consequences of structural failure of the foot. Many of the difficulties in managing the horse with chronic laminitis are associated with the foot's mechanical failure. The occurrence of digital collapse cannot be viewed in isolation as the primary therapeutic focus. The circulatory, metabolic, and growth pattern changes induced by the foot's mechanical collapse often serve as major limiting factors to successful rehabilitation. From the discussion above, it is obvious that a significant amount of research is needed to better understand the biomechanical pathologies of the failed foot.
Historical perspectives on laminitis. This article attempts to provide a historical perspective regarding equine laminitis. It is designed to cover, as completely as possible, the historical record of, and the research advances made, in regards to acute and chronic laminitis. With respect to the historical record, the names given to this disease, the postulated etiologies, and the various treatment protocols are discussed. This article demonstrates the historical longevity of this disease and establishes a background for the current understanding of the disease's pathologic mechanisms and treatments.
Pharmacologic and alternative therapies for the horse with chronic laminitis. This article deals with treatment of the chronically foundered horse. The first section of this article is focused on aspects of the traditional pharmacologic approaches to management of digital pain and sepsis, dietary management, and thyroid supplementation. A second section introduces the concepts, principles, and agents that are used in homeopathic treatments for laminitis. Lastly, a third section of this article reviews the use of acupuncture and traditional Chinese medicine approaches to treatment of chronic laminitis.
The pharmacologic basis for the treatment of developmental and acute laminitis. Each horse with laminitis is presented to the veterinarian at a different stage in progression of the condition and with varying severity. The pathogenic timing is often unknown and is difficult to determine. Because timing and severity are related to both the lesion's severity and responsiveness to treatment, these factors are critical to treatment selection and success. It is erroneous to assume that each horse with laminitis should receive each treatment. It is therefore important to ascertain as logically and objectively as possible the pathophysiological stage of development of each horse...
Trimming and shoeing the chronically affected horse. Several of the technical approaches applied to the foot overlap with regard to intent. Frog or solar support, for example, may be provided either to stabilize the distal phalanx within the hoof capsule or in an effort to unload regional pain arising from the solar surface of the foot. It is likewise obvious that some techniques such as lowering the heels to achieve phalangeal realignment and raising the heels to relieve deep digital flexor tendon tension are contradictory. In these instances, it is not that one technique is always correct but that differences exist among horses. Currently, it ...
Clinical presentation, diagnosis, and prognosis of chronic laminitis. This article focuses on the initial assessment of the horse affected with chronic laminitis. Variations in the clinical presentation and primary considerations in making a differential diagnosis are included. The elements of a clinical history essential to sound, therapeutic management, and prognosis are summarized. The physical and radiographic assessment of the digital lesions and diagnostic approaches to the common systemic aspects of the disease are presented and discussed.
Clinical presentation, diagnosis, and prognosis of acute laminitis. The purpose of this article is to describe the clinical features present in the patient affected with acute laminitis. The variations in the stance and characteristic lameness of the acute disease are described in relation to the disease severity and limb involvement. The elements of establishing a diagnosis including clinical history, physical and radiologic evaluation, and differential diagnosis are discussed. Difficulties and criteria used in establishing a prognosis of the acute phase patient are defined.
The digital pathologies of chronic laminitis. This review indicates that the patient-to-patient uniqueness commonly seen in chronic laminitis represents the variable presence of the digital pathologies. Although some degree of mechanical failure is always present, the secondary metabolic and growth dysplasias, vascular pathologies, and sepsis may or may not be evident. The presence and severity of these pathologies appear to have a more significant impact on the prognosis of individual cases than does the displacement of the distal phalanx. It should be reiterated that it is often the combined presence of these individual pathologies that...
Treatment of acute laminitis. Supportive therapy. Over the last decade, both the farriery and veterinary professions have greatly increased their collective experience and understanding of the treatment of acute laminitis. Many horses that would have not been considered candidates for treatment 10 to 15 years ago are now saved, and some progress to successful careers as athletes. Unfortunately, the difficulties over prediction of the course of the disease persist, which continues to complicate treatment decisions. By its nature, supportive therapy is designed to make the horse more comfortable and limit further laminar injury by countering ad...
Laminitis in the horse. This article serves as an introduction to this issue on laminitis. As such, it contains the general perspectives and terminology that will be used in all subsequent articles. This article separates the clinical problem of laminitis into developmental, acute, subacute, and chronic phases and defines the criteria, duration, clinical goals, and implications of these phases. The basis for the significance of laminitis to the horse industry and the horseman is reviewed. Lastly, the organization of this issue is described.
The pathophysiology of chronic laminitis. Pain and anatomic pathology. The potential pathologic manifestations of chronic laminitis are just as varied, and possibly more so, than the list of possible inciting agents of the disease itself. The extent to which rehabilitation and return to normal function can be attained, cannot always be accurately determined by physical examination. It should be remembered that significant physiologic and pathologic alterations occur in chronic laminitis; thus, even if radiographically the patient returns to a normal appearance, residual morphologic and structural defects are likely to remain.
Detection of a radiographically occult fracture of the lateral palmar process of the distal phalanx in a horse using computed tomography. A horse with a suspected injury of the distal phalanx was examined using radiography at day two and 19 after the onset of the lameness, with no definite diagnosis. Using computed tomography an incomplete fracture of the lateral wing of the distal phalanx was diagnosed at day 25. Based on computed tomography it was determined that the fracture probably did not enter the joint or involve the palmar cortex throughout its length which were of prognostic importance. The day following the CT examination a new oblique radiographic projection was made. In this radiography which was based on, and never...
The role of prostanoids and nitric oxide in endotoxin-induced hyporesponsiveness of equine digital blood vessels. Endotoxin has been implicated in the pathophysiology of acute laminitis. The aim of this study was to examine the direct effects of endotoxin on isolated equine digital blood vessels. Equine digital veins (EDV), incubated in Krebs-Henseleit solution containing lipopolysaccharide (LPS) (1 microg/ml) became hyporesponsive to 5-HT after 16 h. Cycloheximide and ibuprofen blocked this effect of LPS and increased the maximum response obtained to 5-HT when compared to control vessels. L-nitroarginine methyl ester (L-NAME) reversed the hyporesponsiveness caused by LPS. Vessels maintained in culture me...
Expression of endothelin in equine laminitis. Biosynthesis of endothelin-1 (ET-1), the most potent endogenous vasoconstrictor yet identified, is increased following myocardial infarction (MI) in man. Pathological events which occur in the connective tissues of the equine hoof during laminitis are similar in some respects, to changes occurring in the myocardial connective tissues following MI in man. The objective of this study was to determine whether ET-1 expression in connective tissues obtained from the hoof of laminitic horses is increased compared with tissues obtained from healthy horses. Expression of ET-1 in connective tissues of ...
Factors influencing recovery from and duration of lameness in Michigan (USA) horses. The objective of this study was to identify factors that may affect recovery from and duration of a case of lameness in a stratified random sample of Michigan horses. This was done using data from Phase-II of the Michigan equine monitoring system (MEMS Phase-II), the equine health-monitoring study [Kaneene et al., Prev. Vet. Med. 29 (1997b) 277-292; Ross and Kaneene, Prev. Vet. Med. 28 (1996a) 209-224; Ross and Kaneene, Prev. Vet. Med. 29 (1996b) 59-75; Ross et al., Am. J. Vet. Res. 59 (1997) 23-29]. In this study, statistical modelling was conducted to evaluate risk factors affecting recovery...
Nonsurgical treatment of suprascapular nerve injury in horses: 8 cases (1988-1998). To determine the outcome of horses with suprascapular nerve injury treated with stall rest alone. Methods: Retrospective case series. Methods: 8 horses. Methods: Information on signalment, history, limbs affected, severity of lameness, degree of muscle atrophy, gait abnormalities, and results of radiography and electromyography was obtained from medical records. All horses were treated with stall rest. Follow-up information on severity of lameness, gait abnormalities, degree of muscle atrophy, time between injury and resolution of gait abnormalities, and outcome was obtained during reexaminati...
Acquired flexural deformity of the metacarpophalangeal joint in five horses associated with tendonous damage in the palmar metacarpus. Five cases of acquired flexural deformity of the metacarpophalangeal joint (MCPJ) in older horses and ponies were studied. The mean age of affected horses was 14-8 years. Four deformities developed following desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT) and superficial digital flexor tendon (SDFT) and one following tendonitis of the SDFT alone. All cases were markedly lame and demonstrated variable degrees of flexural deformity. Ultrasonographic examination was performed on all cases which revealed extensive adhesion formation between the ALDDFT and SDFT and red...
Prevalence of severe welfare problems in horses that arrive at slaughter plants. To assess the prevalence of severe welfare problems in horses that arrive at slaughter plants and to identify horses that were unfit for travel. Methods: Prevalence survey. Methods: 1,008 horses. Methods: Horses arriving at 2 slaughter plants were observed. The following were rated severe welfare problems in horses: body condition scores of 1 or 2 (emaciated) of 9; recumbency (down) or the inability to walk; fractured limbs or other foot or limb problems that extremely impaired mobility; severe wounds, such as deep cuts, extensive lacerations, abrasions on the head or back, eye injuries, negle...
Disease-specific changes in equine ground reaction force data documented by use of principal component analysis. To assess the force plate as a diagnostic aid in equine locomotor abnormalities, particularly for abnormalities such as navicular disease that do not have specific diagnostic criteria. Methods: 17 Thoroughbreds without observable locomotor abnormalities (group A), 6 Thoroughbreds with superficial digital flexor tendon injury (group B), and 8 Thoroughbreds with navicular disease (group C). Methods: Using a force plate, ground reaction force patterns were recorded at the trot. Peak limb vertical force and force/time curve parameters were derived from 4 identifiable points at the beginning and en...
Tack and saddle fit. Examining the fit of the saddle is perhaps the most important aspect of examining a horse with a suspected back problem. If the back problem is corrected and a poorly fitting saddle is placed on the back, the problems will return. An ill-fitting saddle contributes to direct and compensatory lower leg lameness making it even more imperative to correct the fit. A correctly fitting saddle enhances both the horse and rider's ability to perform with accuracy, lightness, and freedom of movement.
Back problems. Chiropractic evaluation and management. A thorough knowledge of equine spinal anatomy, biomechanics, and potential pathology is required to understand the principles and theories behind chiropractic and to apply its techniques properly. Chiropractic provides additional diagnostic and therapeutic means that may help equine practitioners to identify and treat the primary cause of lameness or poor performance. Specialized training in the evaluation and treatment of vertebral joint dysfunction and neuromusculoskeletal disorders places chiropractic in the forefront of conservative treatment of spinal-related disorders. Nevertheless, limi...
Equine back rehabilitation. This article introduces the importance of considering all related physical findings, evaluating the whole horse and determining the root cause in order to achieve the best treatment results, prevent recurrence, and return the patient to full function. The roles of shoeing, turnout, teeth, training aids and devices, compensatory lameness, working surface (footing), longing, ponying, hot walkers, and swimming are discussed in relationship to back dysfunction and rehabilitation. Postural analysis and measures for muscle and postural corrections are also presented. Ground and under saddle rehabili...
Spinal muscle pathology. Clinical signs that are easily referred to spinal muscle pathology include atrophy of epaxial muscles, focal swelling and palpable tenderness, as well as enlarged muscles with increased tone. Less easily recognized signs include rigidity of the spine, shortened stride, hindlimb lameness, and indicators of poor performance. Muscle biopsy is one option in evaluating sore backs and is best used when physical examination and imaging procedures do not reveal a likely diagnosis or when conventional treatments are unsuccessful. Rhabdomyolysis of spinal muscles may be due to nutritional myodegeneratio...
Physical examination of horses with back pain. The diagnosis of back pain is often a diagnosis of exclusion of other problems in the face of poor performance. It requires careful observation, thought, an open mind, and experience. The signs of back pain can be extremely variable and range from subtle to obvious. Obvious forelimb or hind limb lameness is not usually a sign of back pain. The most common differential diagnosis may be back pain secondary to degenerative joint disease of the hocks, fetlocks, or stifle. These diseases can mimic signs of back pain including lack of impulsion, shortening of the stride length, and change in the str...
Medical management of back pain. The most common causes of back pain and their medical treatment are discussed. These include: dermatologic problems and conditions resulting from saddle trauma; discomfort and stiffness owing to injured paraspinal muscles; pain associated with supraspinous ligament damage; osseous pain and nerve dysfunction related to the spine and sacroiliac area; and neurologic diseases that can manifest as back pain. Bitting problems, cervical pain, and coexisting lameness are also considered.
Spinal ligament pathology. Young elite athletes, particularly horses used for jumping, are at a relatively high risk for injury to the ligaments associated with the axial skeleton. Extreme back flexion appears to be a contributing factor to ligament damage. Back pain due to injury of the ligaments of the axial skeleton has often been considered to be secondary to lower limb injury, to the extent that a separate definitive diagnosis, treatment, and prognosis were unnecessary. Diagnostic imaging, ultrasound in particular, has demonstrated ligamentous damage that can be the limiting factor in return to previous athletic us...
Palmar digital vessel relaxation in healthy horses and in horses given carbohydrate. To compare in vitro smooth muscle relaxation of palmar digital vessels from healthy horses with those from horses in the prodromal stage of experimentally (carbohydrate) induced laminitis. Methods: 16 adult horses. Methods: Segments of palmar digital vessels were obtained from 5 healthy horses and 6 horses given carbohydrate. Vascular rings from the palmar digital artery and vein were suspended in individual organ baths containing buffer solution and indomethacin; isometric tension was recorded, and contraction and relaxation were compared. Smooth muscle contraction in response to cumulative a...
Pathologic changes in the lumbosacral vertebrae and pelvis in Thoroughbred racehorses. To describe the prevalence, characteristics, and severity of soft-tissue and osseous lesions in the caudal portion of the thoracic and lumbosacral vertebral column and pelvis in Thoroughbred racehorses. Methods: 36 Thoroughbred racehorses that died or were euthanatized at California racetracks between October 1993 and July 1994. Methods: Lumbosacral and pelvic specimens were collected and visually examined for soft-tissue and osseous lesions. Results: Acute sacroiliac joint injury was observed in 2 specimens. Signs of chronic laxity or subluxation of the sacroiliac joint were not observed in a...
Methods, applications and limitations of gait analysis in horses. Over the last 30 years, the increase in interest in horses for racing and riding activities has stimulated scientific research in equine locomotion. This paper presents a review of the measurement methods and their applications used to assess equine locomotion. After describing gaits and velocity-related changes in stride variables, the current applications of gait analysis are presented. The economic consequences of lameness justifies the great effort now being put into lameness quantification and prevention. To improve breeding and reduce the costs of training, early performance evaluation t...
Deep digital flexor tenotomy as a treatment for chronic laminitis in horses: 35 cases (1988-1997). To determine long-term prognosis for horses with laminitis treated by deep digital flexor (DDF) tenotomy and to identify factors affecting success of the surgical procedure. Methods: Retrospective study. Methods: 35 horses with laminitis treated by DDF tenotomy between 1988 and 1997. Methods: Information was obtained from individual medical records and follow-up telephone interviews with owners and referring veterinarians. Cumulative proportions of horses that survived 6 months and 2 years after tenotomy were determined. Effect of Obel grade of lameness on 6-month and 2-year survival and effec...
