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Your
Horse Needs a Lameness 'Work-Up' - What is the Procedure?
by Steve
Orrel - Ashbrooks Equine Hospital
Lameness
accounts for approximately 50% of equine veterinary work,
particularly in summer. Many of these lameness's have no
obvious cause that can be seen or detected on the affected
limb/s. Unfortunately, the horse cannot tell us where it
hurts! This means that we have to apply a procedural examination
of the lame horse in order to determine the problem and
effect treatment. This procedure is termed a 'lameness work-
up'. The procedure may vary slightly between veterinary
practices however the fundamentals are the same.
These are
carried out at the Hospital and will all begin with a thorough
examination of the horse standing on a flat level surface
followed by observation at a walk and then a trot in a straight
line. The veterinary surgeon will be assessing the degree
of lameness present at this stage and may well go on to use
flexion tests on the affected limb/s. This involves holding
up the limb for a period of 30 - 60 seconds (flexion) and
then trotting the horse away immediately after release. This
procedure may exacerbate a lameness and certainly in the forelimb
can be applied to individual joints, which is not the case
with the hind limb. Useful information may be gleaned by the
veterinary surgeon by this procedure. The horse will then
be examined on the lunge at a walk and trot and occasionally
at the canter and further flexions may be carried out. This
initial examination allows the veterinary surgeon to determine
on which limb and how lame the horse is.
The
next step in the process is to ascertain the site of pain
within the limb causing the lameness. This is done by using
'nerve blocks' in much the same way as a dentist deadens
your teeth. A horse's limb can be deadened with the use
of local anaesthetic in a sequential pattern starting from
the heels of the foot and if necessary right the way up
to the top of the leg. This process works by infiltrating
local anaesthetic around the nerves that supply the particular
regions of the leg. More specific blocks may be carried
out in which a 'suspect' joint is injected with a local
anaesthetic, again deadening the pain, if this is the source.
Following each block the horse is trotted and lunged to
see if the lameness has disappeared. (Horses are great patients
since on the abolition of pain, they will trot sound and
not 'put it on'!) Once the source of pain has been isolated
then further investigation will occur involving either the
use of X-rays or ultrasound depending on whether it is bone/joints,
or soft tissue involvement.
In most cases, this will bring about a diagnosis and enable
effective treatment to be applied or given. However, a small
percentage of horses may require further investigation using
more specialized techniques like arthroscopy, echo-scintigraphy
and magnetic resonance imaging (MRI). The latter two will
require further referral to specialized units.
Treatment
for lameness is much more effective, when lameness is diagnosed
properly and the treatment is targeted. A correct diagnosis
of a lameness enables us to give a more accurate prognosis.
Reproduced
by kind permission of the Ashbrook Equine Hospital,
Cheshire
http://www.ashbrookequine.com
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