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.
Harkema JR, Robinson NE, Scott JB.Twelve Shetland ponies were fed a high-starch ration. Seven ponies which had a transitory metabolic acidosis developed laminitis 56 hours (+/- 3.5, SEM) after overfeeding. These ponies also developed persistent hypokalemia, hyperthermia, and increased heart rate 24 hours before the onset of lameness. Serum sodium, serum chloride, hematocrit, plasma volume, and blood volume were unchanged. At the onset of clinical signs of laminitis, cardiac output and blood pressure increased, but total peripheral resistance was unchanged. None of the measured or calculated values predicted the onset of lamini...
Ahlengard S, Tufvesson G, Pettersson H, Andersson T.A total of 134 horses of various breeds were treated for aseptic arthritis of traumatic origin using Orgotein (Palosein). The drug was injected into 192 affected joints of these animals. Recovery rates of 94 per cent were recorded in cases which had shown lameness for less than 2 months before treatment commenced and 49 per cent in those lame for longer than 2 months.
Edwards GB.Results of the clinical and radiographic examination of 8 lame horses with tarsal sheath distension are described. In chronic cases pathological exostoses were identified radiographically in the sustentaculum tali and were demonstrated at post mortem in 4 of the horses which were destroyed. The prognosis and the feasibility of treatment are discussed in the light of these changes and the associated damage found at post mortem in the deep flexor tendon and its sheath. Trauma to the hock was known to have occurred in half the cases and was suspected in the others.
Valdez H, Adams OR, Peyton LC.Of 124 horses determined to have navicular disease during a 5-year period, 6 had clinical and radiographic signs of the disease in both hindlimbs. These 6 were all castrated males, ranging in age from 3 to 12 years, and were used for work of similar nature: roping, cutting, and pleasure. Treatment consisted of posterior digital neurectomy and corrective shoeing in 2 cases, posterior digital neurectomy alone in 2 cases, and corrective shoeing alone in 2 cases. Following treatment, lameness subsided, and all 6 horses were returned to full use.
McIlwraith CW, Fessler JF.The usefulness of inferior check ligament desmotomy as a treatment for acquired tendon contracture in horses was evaluated in 13 cases of deep digital flexor (DDF) contracture and in 3 cases of combined superficial digital flexor (SDF) and DDF contracture. In 8 of 9 cases of DDF contracture in which the dorsal surface of the hoof had not passed beyond being vertical to the ground, the surgical procedure was successful in returning the limb to a normal position and function. Compared with DDF tenotomy, inferior check ligament desmotomy was a superior treatment technique because of decreased pos...
Monin T.Physeal fractures of the tuber olecranon of 4 horses were treated, using the tension band method of compression fracture repair. A cortical bone screw and Steinmann pin were placed through the proximal fragment into the distal parent bone parallel to the palmar border of the olecranon. The tension band was placed dorsal to the Steinmann pin and anchored in a hole through the shaft of the ulna 10 cm distal to the tuber olecranon. Of the 4 foals, 2 became pasture sound, 1 is now being worked under saddle, and the 4th showed no signs of lameness 5 months after surgery.
Colles CM, Hickman J.Macroscopic, microscopic and radiological examinations of the navicular bones of 83 horses and ponies showed that the navicular bone in the adult horse has 2 principal routes of blood supply. One supply is present at birth, the other develops within the first 2 to 3 years of life, in response to increasing activity. The size of the nutrient foramina, as seen on radiographs, is related to the type, frequency and regularity of work done by the horse. These foramina are normally conical in shape, alteration to a circular, or mushroom-shape being evidence of occlusive vascular disease in the navic...
Adrian M, Grant B, Ratzlaff M, Ray J, Boulton C.Electrogoniometry was used qualitively and quantitatively to assess the movements of the normal and pathologic metacarpophalangeal joints of selected horses. A total of 4 Thoroughbreds, 1 normal and 3 with clinical and radiographic changes in the metacarpophalangeal joints of 1 limb, were evaluated at the walk and trot. Goniograms of the affected joints were compared with those of the normal horse and the normal contralateral metacarpophangeal joint. Qualitative asymmetry was recognized on the goniograms, and the ranges of motion were quantified and related to the clinical and radiologic obser...
Colles CM, Jeffcott LB.Much has been written on laminitis and its treatment over the past 200 years. This article makes a brief review of the practical essentials of the disease and considers some of the recent trends in therapy. Knowledge of the pathogenesis and aetiology of equine laminitis is still very incomplete but recent work in the United States by Coffman and his colleagues has been particularly productive.
Ackerman N, Johnson JH, Dorn CR.In a retrospective study, 74 horses met defined historical and clinical features indicative of navicular disease. Most of the affected horses were 4 to 9 years old. Males had a greater risk of navicular disease than females, geldings had a greater risk than stallions, and Quarter Horses had a greater risk than other breeds. Diagnostic radiographic changes were found in 42 of 70 horses examined. The distribution of diagnostic radiographic changes between the right and left fron feet was equal. There was no correlation between the finding of diagnostic radiographic changes and the horse's respon...
Robinson NE, Scott JB, Dabney JM, Jones GA.Digital vascular pressures, blood flow, and vascular resistances were measured in 11 control ponies and in 8 animals (7 ponies and 1 horse) affected with laminitis created by feeding a high starch ration. Animals with laminitis had increased digital blood flow, increased arterial, small vein, and large vein pressures, and decreased vascular resistances. Comparison of digital lymph flow rates and protein concentrations in animals with laminitis and control animals revealed no differences. Digital vascular responses of the 2 groups to acetylcholine, epinephrine, histamine, or serotonin also did ...
Nickels FA, Grant BD, Lincoln SD.Villonodular synovitis was diagnosed as the cause of lameness in 14 horses. The diagnosis was based on the history, clinical signs, and arthrographic findings. Treatment consisted of surgical excision and radiation therapy. The response to treatment was favorable in 13 horses.
Walthall JC, McKenzie RA.Horses grazing manily Cenchrus ciliaris and/or Panicum maximum var. trichoglume pastures on over 30 properties in southern central Queensland developed lesions of osteodystrophia fibrosa. Horses on individual properties in coastal Queensland grazing Setaria anceps, Brachiaria mutica or Pennisetum clandestinum also developed the disease. Ill-thrift, lameness, and fibrous swellings of nasal bones, maxillae and mandibles were observed. Calcium and phosphorus levels of pasture were normal but all the above pasture species contained oxalates which were suspected of causing the disease.
Asheim A, Lindblad G.Forty-five race-horses with arthritis of non-in-fectious type in 54 joints were treated with sodium hyaluronate intra-articularly. All joints had previously been treated without lasting success by conventional methods, such as firing, blistering or intraarticular injection of cortisone. In most cases only 1 injection of 2 ml (20 mg) sodium hyaluronate was needed. To avoid subjective evaluation, the effects of the treatment were based on the joint’s capacity of withstanding extreme stress, which means that the horse should be able to train and race again. The treatment was concentrated on the...
Ball AN, Hoaglund EL, Pool R, Barrett MF, Bass LD.Lameness remains a common cause of retirement in the equine athlete and among hobby enthusiasts. The distal limb is one of the most frequently imaged areas, and recent advances in diagnostic imaging capabilities help practicing veterinarians differentiate normal variants from informative pathology. Although acute, non-weight-bearing lameness is commonly associated with etiologies, such as fractures, abscesses, and laminitis, other uncommon differentials such as cystic lesions and neoplasia might also be considered. This report describes the characterization of a large, cystic lesion in the thi...
Cohen JM, Schneider RK, Zubrod CJ, Sampson SN, Tucker RL.(1) To describe the clinical signs and abnormalities observed on magnetic resonance imaging (MRI) in 7 horses with desmitis of the distal digital annular ligament (DDAL); (2) to describe the normal magnetic resonance (MR) appearance and thickness of the DDAL in health; and (3) to describe a tenoscopic surgical technique for treating horses with desmitis of the DDAL. Methods: Retrospective study. Methods: Horses (n=7) with desmitis of the DDAL. Methods: MR examinations of 20 sound horses were reviewed to determine the normal appearance of the DDAL. Dimensions obtained from these images were com...
Specht TE, Nixon AJ, Colahan PT, Moore BG, Brown MP.Four horses with subchondral cyst-like lesions in the medial radial facet of the distal portion of the radius were examined. Joint effusion and signs of pain from flexion of the antebrachiocarpal joint were not observed, but lameness was observed in 3 of the 4 horses. Regional nerve blocks and intra-articular anesthesia were used to localize the lesions, and conservative treatment resulted in soundness for performance.
Dash RF, Minshall GJ, Wright IM.Slab fractures of the third carpal bone (C3) are a common cause of lameness in Thoroughbred racehorses. Information on fracture morphology is commonly obtained from radiographs or CT. This retrospective, methods comparison aimed to explore the agreement between radiography and CT for imaging C3 slab fractures and discuss the contribution of the latter to clinical case management. Thoroughbred racehorses with a slab or incomplete slab fracture of C3 identified on radiographs that subsequently underwent CT examination were included. Fracture characteristics (location, plane, classification, disp...
Patan-Zugaj B, Egerbacher M, Licka TF.Angiogenesis and sepsis-related equine laminitis have several features in common. Both events can be induced by endotoxin (lipopolysaccharide- LPS) and both are associated with increased expression of the enzyme cyclooxygenase (COX), of which two isoforms (COX-1 and COX-2) exist. To examine the causal relationship between LPS exposure and COX expression and to investigate the tissue distribution of COX in the LPS-exposed tissue, the technique of extracorporeal haemoperfusion of isolated equine forelimbs was utilized. Perfusion was performed for 10 hr under physiological conditions (control-pe...
Fürst A, Kummer M, Lischer C, Bertolla R, Auer J, Geyer H.Fifty-four horses with hoof cracks were referred to the Equine Hospital of the University of Zurich, for treatment. The horses were admitted because of lameness or other symptoms caused by the cracks. Deep or complicated quarter cracks were the most common type of cracks diagnosed. Poor conformation and abnormal hoof shape were the most important causes of hoof crack development, whereas injury to the coronary band was a less frequently encountered cause. Effective treatment of this problem includes corrective shoeing, removing horn from the weight-bearing surface as well as from the crack wit...
Borer-Weir KE, Menzies-Gow NJ, Bailey SR, Harris PA, Elliott J.A simple, accurate test for identifying individual animals at increased risk of laminitis would aid prevention. Laminitis-prone ponies have a greater serum insulin response to dexamethasone administration than normal ponies in the summer, but the response during different seasons is unknown. Objective: To test the hypothesis that previously laminitic ponies have a greater insulin response to dexamethasone than normal ponies, which is present during all seasons. Methods: Prospective longitudinal study. Methods: Overnight dexamethasone suppression tests were performed on 7 normal ponies and 5 pr...
Knych HK, Weiner D, Harrison L, McKemie DS.Intra-articular corticosteroids, such as isoflupredone acetate, are commonly used in the treatment of joint inflammation, especially in performance horses. Following administration in a non-inflamed joints blood concentrations of isoflupredone were low and detectable for only a short period of time post-administration compared to synovial fluid concentrations. For some drugs, inflammation can affect pharmacokinetics, therefore, the goal of the current study was to describe the pharmacokinetics of isoflupredone acetate following intra-articular administration using a model of acute synovitis. S...
Bertoni L, Forresu D, Coudry V, Audigie F, Denoix JM.To characterize the clinical features, diagnostic procedures, treatment, and outcome for horses with an exostosis on the palmar or plantar cortex of the third metacarpal bone (MC3) or third metatarsal bone (MT3). Methods: Retrospective case series. Methods: 16 horses. Methods: Records from 2001 through 2010 were evaluated to identify horses with radiographic and ultrasonographic evidence of an exostosis on an MC3 or MT3. Signalment, history, lameness examination results, diagnostic imaging results, surgical and histopathologic findings, treatment, and outcome were evaluated. Results: 9 horses ...
Nagel H, Lang H, Sole Guitart A, Lean N, Allavena R, Sprohnle-Barrera C, Young A.This case series presents a 20-year-old Quarter horse gelding and a 10-year-old Thoroughbred gelding with a histologic diagnosis of aggressive submural neoplasia, including an anaplastic sarcoma and a squamous cell carcinoma respectively. The current case series describes these neoplasias with radiography, computed tomography, magnetic resonance imaging and histopathology with immunohistochemistry. The purpose of this case series is to identify the clinical pattern of chronic reoccurring lameness in these cases and highlight the appearance of expansile osteolytic pathology of the distal phalan...
Delarocque J, Frers F, Huber K, Feige K, Warnken T.Insulin dysregulation (ID) goes along with lasting or transient hyperinsulinemia able to trigger equine laminitis, a painful and crippling foot condition. Promoting weight loss through dietary changes and physical activity is currently the main option to prevent this disease. This study aimed at describing the relationship between weight variations and the level of ID as determined by oral glucose tests (OGT). Therefore, the insulin response of 19 Icelandic horses to repeated OGTs was retrospectively analysed considering the variations in their body weight. Results: There was a strong linear r...
Morgan R, Dyson S.Previous descriptions of incomplete longitudinal fractures and fatigue injury of the proximopalmar aspect of the third metacarpal bone (McIII) have focused on diagnostic imaging findings, especially in racehorses. Objective: To document the case details, clinical features, response to diagnostic analgesia, diagnostic imaging findings and follow-up data in a large group of horses with an incomplete longitudinal fracture or fatigue injury of the proximopalmar medial aspect of the McIII. Methods: Horses were included in the study if pain was localised to the proximopalmar aspect of the metacarpal...
Dern K, van Eps A, Wittum T, Watts M, Pollitt C, Belknap J.Although continuous digital hypothermia (CDH) protects lamellae from injury in the oligofructose (OF) model of sepsis-related laminitis (SRL), conflicting results exist from these studies regarding effects of CDH on lamellar inflammatory events. Objective: To determine the effect of CDH on lamellar inflammatory events in normal and OF-treated horses when instituted at a clinically relevant time point (onset of clinical signs of sepsis in this model). Methods: Standardbred geldings (n = 15) aged 3-11 years were used. Methods: In a randomized, controlled discovery study, animals were administ...
Pownder SL, Caserto BG, Bowker RM, Lin B, Potter HG, Koff MF.Few noninvasive methods are available for equine hoof wall evaluation. The highly organised wall structures and composition of proteoglycans and collagens may make this region amenable to quantitative MRI (qMRI) techniques of T1ρ and T2 mapping to identify pathology related to proteoglycan content and collagen organisation respectively. Objective: To establish normative T1ρ and T2 values of the equine hoof wall of 3-year-old Quarter Horses with histological comparison. Methods: Cadaveric anatomical study. Methods: Six cadaveric left thoracic feet from 3-year-old racing Quarter Horses with no...
Little C, Hilbert B.The clinical features of 19 horses with pelvic fractures were reviewed. The most common problem was a grade III or IV unilateral hind limb lameness. The prevalence of fractures was greater in females and horses less than 4 years old. All horses were treated with a combination of analgesic administration and stall rest for 2 to 6 months. Seven of 11 horses (64%) available for long-term follow-up evaluation recovered and 4 of 11 (36%) had no lameness when being ridden. Five of seven (71%) horses with fractures that involved the acetabulum recovered, and 4 (57%) had complete resolution of lamenes...
Lancaster LS, Bowker RM, Mauer WA.To quantify the density of primary epidermal laminae (PELs) around the solar circumference and evaluate the relationship between regional PEL density and hoof capsule morphology in horses. Methods: Forefeet from nine 3-year-old Quarter Horse cadavers. Methods: Data pertaining to gross features of hoof morphology and PEL variables, including number, density, and distribution patterns around the perimeter of the hoof wall and number of bar PELs, were collected. Tissues of the laminar junction were examined histologically. Results: No significant differences were found between left and right fore...
Frisbie DD, Kawcak CE, McIlwraith CW, Werpy NM.To assess clinical, biochemical, and histologic effects of polysulfated glycosaminoglycan (PSGAG) or sodium hyaluronan administered intra-articularly in treatment of horses with experimentally induced osteoarthritis. Methods: 24 horses. Methods: Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. Eight horses received hyaluronan (20 mg) and amikacin (125 mg) intra-articularly on study days 14, 21, and 28. Eight horses received PSGAG (250 mg) and amikacin (125 mg) intra-articularly on study days 14, 21, and 28. Eight control horses received 2 mL of saline (0.9% N...
Mespoulhès-Rivière C, Martens A, Bogaert L, Wilderjans H.Distal limb lacerations are common injuries in horses, with a better prognosis reported for extensor tendons lacerations compared to flexor tendons lacerations. The objective of the present study was to determine the influence of type and location of injury, modalities of treatment and post surgical complications on the outcome of extensor tendon lacerations. The medical records of 156 horses surgically treated for extensor tendon lacerations over a 10-year period were analysed retrospectively. Information was obtained for 124 horses with a minimum of 18 months follow-up. Statistical analysis ...
Compagnie E, Ter Braake F, de Heer N, Back W.Report long-term clinical and radiological follow-up in horses after removal of large extensor process fragments occupying >25% of the joint surface of the distal interphalangeal joint (DIJ). Methods: Retrospective case series. Methods: Friesian horses (n=18) that underwent arthroscopic removal of a large extensor process fragment. Methods: Arthroscopic examination of the DIJ was performed in dorsal recumbency with the affected foot in extension using routine portals. Visualization of the fragment was improved using motorized synovial resectors. A dissection plane between the common digital ex...
Williams GE.To determine whether force-plate evaluation of horses with navicular disease would reveal an abnormal gait that persists despite loss of sensation to the palmar foot region, which may predispose such horses to navicular disease. Methods: 17 clinically normal Thoroughbreds and 8 Thoroughbreds with navicular disease. Methods: Data on ground reaction forces were obtained in trotting horses, using a force plate. Force-time curve variables for clinically normal horses were derived from 4 points at the beginning and 4 points at the end of the vertical and craniocaudal horizontal plots. Principal com...
Peham C, Licka T, Girtler D, Scheidl M.The aim of this study was to compare supporting forelimb lameness determined by a motion analysis system with the subjective grading of a trained equine orthopaedic surgeon. Trotting on a treadmill, 29 individuals with a supporting forelimb lameness were measured with the SELSPOT II system and judged by the clinician. The vertical motion of the head was measured, analysed using Fourier transform, and the percentages of symmetry determined. The veterinarian evaluated the lameness and graded it according to a clinical routine. Veterinarian and system for motion analysis assigned the lameness to ...
Foreman JH, Bergstrom BE, Golden KS, Roark JJ, Coren DS, Foreman CR, Schumacher SA.There are no refereed controlled documentations of the skeletal analgesic efficacy of different dosages of flunixin meglumine (FM). Objective: The objective of this experiment was to compare the efficacy of various dosages of FM with a negative control. The hypothesis was that higher doses would result in improved efficacy in a dose-dependent manner when tested in a reversible model of foot lameness. Methods: Ten horses shod with adjustable heart bar shoes had weekly modified AAEP grade 4.0/5.0 lameness induced by tightening a set screw against the heart bar. Heart rate (HR) and lameness score...
Rutherford DJ, Textor J, Fretz PB.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...
Danton CA, Peacock PJ, May SA, Kelly DF.A 16-year-old showjumping gelding was examined because of a non-painful, slowly progressive caudal thigh swelling, which was associated with 2/10th lameness at the trot. Radiography, real time beta-mode ultrasonography and gamma-scintigraphy of the caudal thigh for the presence of chip fractures, sequestrum formation and, or, abscessation were inconclusive. Radiographic examination of the chest revealed multifocal, nodular cannon ball-like opacities throughout the entire lung fields from which a diagnosis of a primary soft tissue tumour with metastasis to the thorax was made. An anaplastic sar...
Keg PR, Schamhardt HC, van Weeren PR, Barneveld A.Controversy exists with respect to the innervation of the suspensory ligament (SL) in the fore limb of the horse. It is uncertain whether this structure is exclusively innervated by branches of the ulnar nerve or also to some extent by median nerve branches. Ground Reaction Forces (GRF) were determined in horses before and after the induction of a tendonitis in the lateral branch of the SL by the injection of collagenase, and before and after a high palmar and an ulnar block respectively. The high palmar block succeeded in bringing all GRF variables back to their original values which the ulna...
Foreman JH, Ruemmler R.Using an adjustable heart bar shoe model of foot pain, the objective of this study was to test the hypothesis that the combined use of phenylbutazone (PBZ) and flunixin meglumine (FM) would prove more efficacious in alleviating lameness than either drug alone. Methods: One hour after induction of lameness at weekly intervals, 8 healthy adult Thoroughbred horses randomly underwent one of 4 i.v. treatments: saline (SAL) placebo (1 ml/45 kg bwt), PBZ (4.4 mg/kg bwt), FM (1.1 mg/kg bwt) or PBZ+FM (at the same dosages as given individually). Heart rate (HR) and lameness score (LS) responses were as...
Dutton DM, Honnas CM, Watkins JP.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...
Katzman SA, Spriet M, Galuppo LD.OBJECTIVE To describe the use of CT in the diagnosis of and presurgical planning for equids with keratomas treated by hoof wall resection and determine postoperative complications and outcome. DESIGN Retrospective case series. ANIMALS 29 horses and 3 mules with keratomas treated by partial or complete hoof wall resection following CT imaging of the distal portion of the affected extremity from 2005 through 2016. PROCEDURES For each equid, physical examination and lameness evaluation were performed, followed by imaging of the distal portion of the affected extremity. A tentative diagnosis of ke...
Kalck KA, Frank N, Elliott SB, Boston RC.To ascertain whether laminitis can be induced via administration of oligofructose (OF) at doses of 5.0 and 7.5 g/kg in horses and to assess glucose and insulin dynamics before and after treatment. Methods: 19 adult horses. Methods: Horses were fed OF (1.0 g/kg) mixed with oats for 6 days. Oligofructose at doses of 5.0 and 7.5 g/kg was then mixed with 4 L of water and administered (0 hours) to 8 (group A) and 4 (group B) horses, respectively, via nasogastric intubation; 8 horses received water alone. One horse in group A that did not develop laminitis was subsequently treated again and included...
Keg PR, Barneveld A, Schamhardt HC, van den Belt AJ.To answer the question whether it is possible to differentiate, by means of a high plantar nerve block in the hind limb, flexor tendon lameness from a suspensory ligament lameness, mid-plantar tendinitis or desmitis was induced with collagenase in five Standardbred horses in two trials. Before the induction of lameness, and on the fourth (D4) and fourteenth day (D14) after the induction of lameness the horses were evaluated subjectively (clinical lameness score), objectively (ground reaction force (GRF) measurements), and ultrasonographically. Clinical evaluation and GRF measurements were also...
