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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.
Descriptive epidemiological study of equine laminitis. A descriptive and matched case-control study of laminitis was conducted in 7 private practices and at the Texas Veterinary Medical Centre (TVMC) between May 1992 and July 1993. Out of 108 horses with laminitis, 19 acute (49%) and 20 chronic (51%) cases were seen in private practice and 16 acute (23%) and 53 (77%) cases at the TVMC. Gastrointestinal disease was the most common problem in 19/35 horses (54%), occurring just prior to the onset of acute laminitis in all hospitals. Among all horses in the study, most commonly used drugs were phenylbutazone (68%), acepromazine (34%), dimethyl sulphox...
Aseptic tenosynovitis of the digital flexor tendon sheath, fetlock and pastern annular ligament constriction. The anatomy of the digital flexor tendon sheath and related tendons and ligaments is described. Diagnosis and management of acute tenosynovitis and long-term tenosynovitis and associated tendon injuries are discussed, as well as the syndrome of stenosis of the fetlock canal (or fetlock annular ligament constriction) and palmar annular ligament constriction. Desmitis of the palmar annular ligament is also described.
Prothrombotic events in the prodromal stages of acute laminitis in horses. Prothrombotic changes occurring in the prodromal stages of carbohydrate-induced laminitis were investigated. Hemostatic alterations were evaluated by determining platelet counts, platelet survival, activated partial thromboplastin time, one-stage prothrombin time, and monocyte procoagulant activity. Thrombosis of vessels in the hoof wall was evaluated by contrast arteriography and histologic examination. Of 5 horses, 4 became lame between 28 and 52 hours after carbohydrate administration. Mean platelet count in laminitis-affected horses was lower throughout the prodromal stages of laminitis, c...
Effects of ketoprofen and phenylbutazone on chronic hoof pain and lameness in the horse. The analgesic effects of the nonsteroidal anti-inflammatory drugs, ketoprofen (2.2 and 3.63 mg/kg bwt) and phenylbutazone (4.4 mg/kg bwt) were compared in 7 horses with chronic laminitis. Hoof pain was quantified objectively by means of an electronic hoof tester and lameness was subjectively graded on a modified Obel scale. Ketoprofen at a dose of 3.63 mg/kg bwt (phenylbutazone equimolar dose) reduced hoof pain and lameness to a greater extent than the 2.2 mg/kg dose and phenylbutazone. These effects were still present at 24 h in 3 of the 4 pain tests, including lameness grade. These data sugg...
Arthroscopic findings in the carpal joints of lame horses without radiographically visible abnormalities: 41 cases (1986-1991). Arthroscopy was performed in 1 carpal joint unilaterally in 27 horses and either in 2 carpal joints unilaterally or 1 carpal joint bilaterally in 7 horses. All horses were lame, but the cause of lameness could not be determined from radiographs. Twenty-seven carpi did not have radiographically visible abnormalities; the remaining 14 had only mild to moderate lucency or sclerosis of the radial facet of the third carpal bone. The primary abnormalities identified during arthroscopy included a crush fracture of the third carpal bone (7 carpi), an incomplete fracture of the third carpal bone in the...
Use of autogenous cancellous bone grafting in the treatment of septic navicular bursitis and distal sesamoid osteomyelitis in horses. Six horses with septic navicular bursitis or distal sesamoid osteomyelitis were treated by means of surgical debridement and lavage, followed by packing of the wound created in the bottom of the foot with an autogenous cancellous bone graft. Two horses were euthanatized, one 18 months after surgery because of complications in the contralateral support limb, and one 68 days after surgery because of continuing severe lameness. Four horses were alive 9, 16, 21, and 42 months after surgery. One horse was used as a broodmare and did not have observable lameness. Two horses were being ridden. The re...
Arthroscopic surgery for subchondral cystic lesions of the medial femoral condyle in horses: 41 cases (1988-1991). Clinical signs, radiographic and arthroscopic findings, and outcome for 41 horses with subchondral cystic lesions of the medial femoral condyle treated by arthroscopic surgery were reviewed. There were 17. Quarter Horses, 15 Arabians, 8 Thoroughbreds, and 1 Holsteiner, with 28 (68%) of the horses being 1 to 3 years old. For all horses, the owners' complaint was mild to moderate hind limb lameness or an altered gait. Bilateral radiographic abnormalities of the medial femoral condyle were detected in 27 horses. Nineteen of the 27 horses had lesions identified bilaterally at arthroscopic surgery....
Diagnosis and management of incomplete fracture of the distal palmar aspect of the third metacarpal bone in five horses. Incomplete fracture of the distal palmar aspect of the third metacarpal bone was diagnosed in 5 horses. Mild to moderate lameness and positive response to flexion of the metacarpophalangeal joint were evident in all horses. Fractures were not detectable in 4 horses when the routine 30 degrees proximodorsal-palmarodistal radiographic view was used. Visualization of the fractures in these 4 horses required imaging of the palmar condylar surface by use of a dorsopalmar view of the flexed joint or a 125 degrees dorsoproximal-dorsodistal view. The dorsopalmar view of the flexed joint was used in a ...
Vertical tears of the cranial horn of the meniscus and its cranial ligament in the equine femorotibial joint: 7 cases and their treatment by arthroscopic surgery. Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cran...
Aggregate risk study of exposure to endophyte-infected (Acremonium coenophialum) tall fescue as a risk factor for laminitis in horses. Loline and ergot alkaloids found in endophyte-infected (Acremonium coenophialum) tall fescue (EITF) cause vasoconstriction of equine vessels in vitro. An aggregate risk study was used to evaluate the association between horses exposed to EITF and development of laminitis. Veterinary teaching hospitals participating in the Veterinary Medical Data Base were grouped by whether equine accessions were likely to have been at high, moderate, or low risk for exposure to EITF. From 1980-1990, there were 185,781 accessions, of which 5,536 had diagnosis of laminitis. Proportion of equine accessions with ...
Use of sodium monoiodoacetate to fuse the distal hock joints in horses. Intra-articular injection of sodium monoiodoacetate (MIA) was investigated as an agent for chemical arthrodesis of the distal hock joints in the horse. Five horses diagnosed with either spavin (three horses), a small tarsal bone fracture or a failed surgical arthrodesis, had 150 mg of MIA injected into the tarsometatarsal (TMT) joint of the affected hock(s). Eight joints were treated in the five horses. Follow-up evaluation by clinical and radiological examination took place over 9 to 14 months. Two of the five horses were sound at the conclusion of the study and one horse, although lame after...
Acute laminitis. Laminitis is an inflammation of the sensitive laminae along the dorsal aspect of the digit and is considered to be a secondary complication of several predisposing or primary factors. Affected horses are usually very lame, have increased digital pulses, are painful to hoof testers along the toe of the foot, and have evidence of downward rotation or distal displacement of the distal phalanx present on radiographs. Treatments for acute laminitis include anti-inflammatory drugs, anti-endotoxin therapy, vasodilators, antithrombotic therapy, corrective trimming and shoeing, and surgical procedures....
Effects of 0.05% chlorhexidine lavage on the tarsocrural joints of horses. In six horses, a 0.05% solution of chlorhexidine diacetate was used to lavage one tarsocrural joint; the contralateral control joint was lavaged with lactated Ringer's solution. Horses were evaluated daily for lameness. Synovial fluid samples were collected on days 1, 4, and 8 for determination of protein concentration, total and differential leukocyte counts, and mucin clot formation. After death on day 8, synovium and osteochondral samples were collected from the tarsocrural joints for examination of morphology and proteoglycan staining. Lavage with chlorhexidine solution caused lameness tha...
Experimentally-induced synovitis as a model for acute synovitis in the horse. The use of extremely small dosages of intra-articular E. coli lipopolysaccharide (LPS) endotoxin can create a model of synovitis that mimics acute synovitis in horses. Dosages of 5000 ng, 25 ng, 0.5 ng, 0.25 ng, 0.17 ng and 0.125 ng per joint were injected into various joints of a total of 6 horses. The dose response of LPS on clinical signs and synovial fluid parameters was evaluated at baseline and 12, 24, 36 and 48 h after LPS injection. Peripheral venous blood analysis was performed at baseline and at 0, 4, and 12 h after LPS injection. Dosages greater than 0.5 ng/joint resulted in clinica...
Osteochondral fragmentation of the plantar/palmar proximal aspect of the proximal phalanx in racing horses. The clinical presentation and outcome of treatment is presented for 26 cases of osteochondral fragmentation of the plantar/palmar proximal aspect of the proximal phalanx. Twenty-three were racing Standardbreds and three were racing Thoroughbreds. The most common reason for presentation was an inability to run straight at high speed. Only eight horses presented for lameness, although on examination 19 were lame. A positive flexion test was recorded in 90% of affected fetlock joints and effusion in 48%. Arthroscopic fragment removal was performed on 23 occasions in 21 horses and arthrotomy in on...
Acute effects of perineural administration of sodium hyaluronate on palmar digital neurectomy sites in horses. Biaxial palmar digital neurectomy of all limbs was performed on 6 mixed-breed castrated adult male horses, using a standard guillotine method. Using a Teflon catheter, 20 mg (2 ml) of sodium hyaluronate (group 1), 2 ml of phosphate-buffered saline solution (group 2), or catheter placement with no infusion (group 3) was applied to 4 (group 1) or 2 (groups 2 and 3) of 8 incisions/horse. Treatments were administered after closure of the neurectomy incision, and the catheter was removed. Horses were evaluated daily for 1 week, then weekly over a 9-week period for evidence of lameness, swelling, an...
Camera speeds for optoelectronic assessment of stride-timing characteristics in horses at the trot. Quantitated locomotion analysis is increasingly being used during assessment and treatment of gait disorders in human beings. Locomotion analysis is also thought to have potential for enhancing the assessment of lameness in horses. Availability of high-speed video recording systems has simplified the process of quantitated locomotion analysis; however, the high cost of such systems has limited their use for routine clinical assessment in horses. The temporal resolution of 500- to 1,000-images/s (Hz) recording systems is beyond what has been considered necessary for precise quantitation of shor...
Effect of betamethasone and exercise on equine carpal joints with osteochondral fragments. Osteochondral fragments were created arthroscopically on the distal aspect of both radial carpal bones in 12 horses. On day 14 after surgery, one middle carpal joint of each horse was injected with 2.5 mL Betavet Soluspan (3.9 mg betamethasone sodium phosphate and 12 mg betamethasone acetate per milliliter) and the contralateral joint was injected with 2.5 mL saline as a control. Intra-articular treatments were repeated on day 35. On day 17, six horses began exercising 5 days per week on a high-speed treadmill. The other six horses were kept in box stalls throughout the study as nonexercised c...
Diagnostic and operative arthroscopy of the coxofemoral joint in horses. Arthroscopic examination of the hip joint was performed in mature and juvenile horses, using a lateral approach and standard or long instruments depending on body weight. Nine hip joints were examined in three cadavers and four anesthetized horses. The lateral, cranial, and caudal regions of the femoral head and acetabulum were accessible, and, after distraction of the limb, the ligament of the head of the femur and the acetabular notch were also visible. In small horses, the medial regions of the hip joint were visible but were inaccessible in larger horses. Iatrogenic injury to the sciatic n...
The basement membrane at the equine hoof dermal epidermal junction. In the equine hoof, the basement membrane connects the heavily keratinised hoof wall to the dense connective tissue of the distal phalanx, a region able to withstand considerable mechanical stress. This study investigated the properties of this important anatomical and physiological structure. In contrast to haematoxylin and eosin, the connective tissue stains, periodic acid Schiff, periodic acid silver methenamine and Azan showed good resolution of lamellar basement membrane. The lamellar basement membrane cross-reacted with mouse monoclonal antibodies raised against human laminin, thereby pr...
Semi-quantitative analysis of hoof-strike in the horse. The initial forelimb loading of a horse trotting at 3.7 ms-1 on a treadmill was studied by use of an instrumented shoe, accelerometers and high-speed cinematography. At the beginning of the stance phase the forelimb was loaded successively from the hoof. This is suggested to be an important factor for effective shock force absorbency in the extremities. Shearing forces may appear in the carpus before the onset of the longitudinal loading of the limb. These forces are proposed to depend on speed, locomotion pattern and the friction and hardness of the surface. It is suggested that shearing forc...
Diagnostic techniques for identification and documentation of tendon and ligament injuries. Conventional clinical examination remains of medical and economic value for diagnosis of soft tissue injuries in the equine athlete. This procedure requires concentration and rigor to establish the diagnosis, and, if possible, some experience to better evaluate the prognosis. None of the new imaging techniques can replace the physical examination, but each may provide additional information. These sophisticated methods are bringing considerable progress in the knowledge of locomotor injuries in the horse and a tremendous improvement in our ability to diagnose precisely lamenesses and limitatio...
Long-term fate and effects of exercise on sternal cartilage autografts used for repair of large osteochondral defects in horses. Bilateral osteochondral defects (10 mm2 x 3 mm deep) were created on the distal articular surface of the radial carpal bone of ten, 2- to 3-year-old horses. One defect of each horse was repaired, using a sternal cartilage autograft (treated), and the other was left untreated (control). The horses were exercised on a high-speed treadmill at incrementally increased speed and duration over the course of 12 months. Horses were evaluated arthroscopically at 6 to 7 weeks, and clinical examinations were conducted weekly at exercise. Twelve months after surgery, carpuses of each horse were radiographe...
Arthroscopic removal of osteochondral fragments from the proximal interphalangeal joint of the pelvic limbs in three horses. Osteochondral fragments detected in the proximal interphalangeal joint in the pelvic limbs of 3 horses (2 Standardbreds and 1 Thoroughbred) caused joint enlargement and lameness. Fragments were removed by use of arthroscopy. Accurate placement of the arthroscope into the dorsal joint space was necessary to obtain an adequate view of the fragments. After surgery, 2 of the horses resumed racing without joint problems, and the third was in training to race. High-detail radiographs are necessary to detect osteochondral fragments in horses with joint enlargement or lameness localized to the proxima...
The structure, innervation and location of arteriovenous anastomoses in the equine foot. In the foot of the horse, arteriovenous anastomoses (AVAs) of epithelioid type occurred in the dermis of the coronary band, in the coronary and terminal papillae, in neurovascular bundles and at the entrance to and along the length of the dermal laminae. A particular feature of the epithelioid segment of AVAs in the horse, compared with that of other species, was the height and surface complexity of many of the endothelial cells. They extended into the lumen, forming undercut and tunnel-like areas which correlated with the characteristic surface marking of AVAs observed in vascular casts. The ...
Bilateral tibial metaphyseal stress fractures associated with physitis in a foal. A 7-month-old Appaloosa foal had bilateral hind limb lameness and was unable to rise from recumbency without assistance. Lameness could be exacerbated by tarsal flexion and a firm swelling at the distomedial aspect of the tibias was associated with a marked pain response when palpated. Radiography revealed enlargement of the distal tibial metaphysis physis (compared with normal), and radiolucent fissure lines extending proximally from the physis into the metaphysis at its medial aspect. Treatment included rest and dietary adjustment. Although clinical signs initially resolved following treatme...
Arthroscopic removal of a fragment from an intercondylar eminence fracture of the tibia in a two-year-old horse. A 2-year-old Standardbred colt was admitted because of lameness of the left hind limb. Physical examination revealed marked effusion of the left femoropatellar and femorotibial joints and grade IV/V lameness of the left hind limb. Radiography of the left stifle revealed a complete fracture of the medial tubercle of the intercondylar eminence of the tibia. Arthroscopy was used to provide diagnostic, therapeutic, and prognostic information. A cranial approach to the medial compartment of the femorotibial joint was performed. Manipulation of the medial tubercle revealed it to be unstable, but a d...
