What is a lame horse?
A horse's change in gait, mostly brought on by discomfort in a limb, but occasionally as a result of a mechanical limitation on mobility, is referred to as lameness. We typically associate lameness with a horse that is visibly hobbling, but lameness can also result in a subtle alteration in stride or even just a diminished capacity or eagerness to work.
Almost every anatomical area of a leg can be affected by a multitude of illnesses or ailments that might cause a horse to become lame. Some illnesses are simpler to identify and treat than others.
Lameness diagnosis and treatment for equine veterinarians is a combination of science and art. It necessitates a thorough knowledge of equine anatomy and physiology, conformation, biomechanics, and medicine. It also necessitates adaptation in response to shifting environmental factors, horse kinds, uses, and personalities, as well as owner requirements.
The equine industry loses hundreds of millions of dollars a year as a result of lameness. Lameness has a variety of effects on individual horses, ranging from slight performance reduction to loss of use to chronic, excruciating agony that necessitates euthanasia. Sadly, because riders fail to notice lameness, many horses are asked to perform when they are in agony.
Both accurate and helpful information on lameness can be found online in large quantities. As a horse owner, you must contend with a plethora of well-marketed but untested "wonder cure" treatments that promise to treat all ailments. A proper diagnosis, which can only be made by a veterinarian with training and expertise, is what's missing from the situation.
Origins of lameness
Lameness typically originates from discomfort in anatomical areas of a limb, although it can also be caused by mechanical limitations on painless limb movement. A mechanical obstruction to a horse's movement can cause noticeable gait impairments that are difficult to identify from unpleasant diseases. The most well-known instance of this is fibrotic myopathy, which is scar tissue brought on by a hamstring muscle tear in the hindquarters. Regardless of pain, the scar shortens the hamstring muscle unit and results in a distinctively aberrant gait.
Pain emanating from any area of a limb with nerve endings causes lameness. Lameness that cannot be distinguished by looking at the horse's gait can be brought on by discomfort from skin wounds, connective tissue bruises, muscle pain, arthritis (joint inflammation), tendon sheath and bursal inflammation, tendon and ligament injury, and bone injury.
Specific lameness issues are more likely to develop in certain breeds and disciplines. Examples include knee (carpus) arthritis in racehorses, hock arthritis in cutting horses, and suspensory lameness in the hind limbs in dressage horses.
It's crucial to understand that the location and type of the injury cannot always be identified by looking at the lameness or the way the horse moves.
The majority of people find it simpler to identify forelimb lameness than hind limb impairment. Lameness is typically more recognizable to the untrained eye and more consistent in appearance due to the mechanics of the forelimb.
It is typically far more challenging to identify and diagnose hind limb lameness. This is especially true with mild disorders affecting the upper hind limbs. Even for a skilled examiner, it is much more challenging to see and feel deeper tissues in the upper hind leg, and it is more challenging to image these structures using radiography and ultrasound.
The hoof accounts for a sizable portion of forelimb lameness. Lameness of the upper forelimbs is uncommon in adult horses.
The mechanical function of a limb is intimately correlated with conformation, and specific conformational traits can lead to specific lameness situations. Horses with poor conformation are more likely than "regular" conforming horses to have issues with their feet, joints, tendons, and ligaments.
The lameness exam
The lameness exam is a multi-step, thorough veterinary examination where a veterinarian attempts to ascertain the source and type of limb pain. The optimal treatments can only be selected after a diagnosis has been made.
Typically, a thorough history is taken before a standing examination. (3) a mobility examination, (4) flexion and hoof tester tests, (5) diagnostic anesthetic, including nerve and joint blocks, and (6) imaging the injury site using techniques such as radiography, ultrasound, and MRI. Findings from all of the aforementioned components of the lameness exam are used to create the diagnosis and treatment strategy.
History: A complete history of the horse and the ailment is taken as the first step in a lameness evaluation. The horse's breed, age, and previous uses are all pieces of information that help solve the mystery. The date that lameness was first discovered, the severity of the lameness, and the cause, if known, are all included in the history of the injury. Veterinarians ask all of these crucial questions, so you should make an effort to be as thorough as you can in your responses.
Standing test: To assess the horse's conformation and overall appearance, a standing inspection is performed from a distance. A more thorough visual inspection and palpation of the targeted anatomic areas to check for edema, heat, and pain follow.
Exam in motion: The following portion of the exam involves watching the horse move. Lameness is primarily assessed during running. The most thorough lameness examinations are conducted on stable, firm to hard ground. Trotting in both directions in circles and straight lines while being examined is a common practice. Additionally, it could entail leading a horse through predetermined patterns or up and down hills. Having a rider up might be helpful for diagnosing some forms of lameness issues.
Flexion tests: Flexion evaluations entail applying stress to particular joints or parts of the leg for a predetermined and repeatable amount of time. Both before and after flexion, the horse's degree of lameness is evaluated. The outcome, which is the change in lameness severity after flexion, reveals more details about the pain's cause. Flexion tests are subjective, as are many other aspects of the examination, and the veterinarian must interpret them in light of what is thought to be typical for that particular horse.
Hoof testers: Hoof testing involves applying pressure to certain areas of the foot with a tool resembling a pincer to see if a pain reaction occurs. Understanding what defines a typical reaction in a hoof tester examination is crucial for appropriate interpretation, just like with flexion exams. Only a thorough approach and extensive experience working with various breeds of horses and hooves will enable you to achieve this.
The veterinarian usually knows which limb is lame and may even know where the pain is inside that limb once these procedures have been completed.
To pinpoint the exact location of the discomfort at this point, nerve blocks could be required.
Nerve & joint blocks: By methodically numbing a part of the leg, joint and nerve blocks help doctors identify the source of pain by eliminating potential candidates. "Blocking" refers to the injection of a local anesthetic around particular nerves or into particular joints or other tissues. It is sometimes referred to as diagnostic anesthesia. Before the block, the horse is inspected at the trot to assess its level of lameness. After numbing the troublesome area, the horse is once more asked to trot away. Either the lameness is getting better or it's not.
If not, the technique is repeated on particular nerves that travel up the limb until the lameness is clearly reduced. A more precise localisation of lameness can also be achieved by blocking particular joints and tendon sheaths. In order to prevent infection of these structures, blocks into a joint or tendon sheath require surgical cleanliness and expertise. The diffusion of local anesthetics to nearby areas is a limitation of blocking that makes it difficult to evaluate the findings.
Imaging the site of pain: Once the pain's source has been identified, diagnostic imaging is utilized to inspect the nearby structures and learn more about the type of injury that has occurred. Radiography is used to image the bone, and ultrasound is used to image the soft tissues.
The primary imaging diagnostic method used to image bone is radiography. Despite the fact that it does provide some information, it is thought to be less useful for imaging soft tissues. In the field, radiographs are frequently taken using portable equipment. It is frequently preferable to conduct more challenging research on larger body parts in a clinic setting. Digital radiography has evolved into the norm in equine veterinary practices during the past ten years. Within seconds, high-quality digital photographs are displayed on a screen. Fractures and chronic arthritis are two examples of diagnoses that can be made by radiographic interpretation.
To visualize tissues, ultrasound uses sound waves that are passing through those tissues. While it can image soft tissues very well, healthy bone cannot be penetrated by it. It is frequently used to visualize soft tissues such as tendons, ligaments, bone surfaces, and others. A tear or strain of a particular ligament or tendon is an illustration of a diagnosis that could be determined with ultrasound technology.
Other, more expensive diagnostics like MRI, Nuclear Scintigraphy (bone scan), and CT Scan are frequently saved for cases of lameness that are more challenging to diagnose or to support the diagnosis. Direct visualization of the interior of joints is made possible by the significant and often used diagnostic procedure known as arthroscopic surgery exploration.
My horse is lame, what to do and who to call?
When a horse is limping, it should never be taken lightly. Whether the lameness is impressive or just discomfort, you need to act immediately. Here's what to do.
Your horse is limping, start by examining him
Your first instinct if you notice that your horse is limping should be to examine him carefully from head to toe. Sometimes the cause of the lameness is very obvious. If your horse is wearing a blanket, remove it immediately. Check for an open wound, hematoma, deformity, swelling, or a hot or painful area in a joint or tendon. Even a sore on the rump or back, if significant, can cause lameness. Also clean the feet well, feel them to see if they are warm or not, and look for foreign objects in them.
Above all, don't give any anti-inflammatory or pain medication until you are 100% sure of the cause of the lameness and have been advised to do so by a qualified professional in the field. An anti-inflammatory drug given to a horse with an abscess will delay the abscess and greatly increase the pain and damage. A horse that has been given a painkiller may aggravate a sprain, tendonitis or muscle tear by straining more than necessary. Do not take these risks!
Determine if it's a veterinary emergencyNot all lameness is an emergency. Therefore, after examining your horse, you should determine whether or not it is an emergency. If it is, you should call a veterinarian immediately. Here are the emergency cases:
- The horse has an open wound that is bleeding profusely
- The horse has an open wound on a limb with engorgement or swelling
- Abnormal temperature: fever (temperature over 38°) or hypothermia (temperature under 36°)
- A clear deformity is visible in a tendon or a joint
- It refuses to move or is almost unable to move
There is no question in any of these cases. Regardless of the time or day, it is imperative that the horse be shown to a veterinarian. In the rest of this article, we will only talk about the other cases, therefore non-emergency situations.
If a horse's hoof is hot, call a groom or farrier
Compare the temperature of all four of your horse's hooves. You may notice abnormal heat in one or more feet. If only one foot is affected, it is probably an abscess or a bleeding hoof. A groom or farrier will be able to confirm this.
If both forefeet or all four feet are hot, it could be laminitis, even if the horse is just a little sensitive but moves quite well. In this case, the horse adopts a characteristic posture by shifting its weight to its hindquarters. He is bent over from the front and under him from the back. If he stands normally, he may suffer from inflammation of the sole pododerms. This can happen if a trimming is too short or if a barefoot horse goes for a long ride on ground that is too hard for his feet. A good groom or farrier will be able to tell you what is going on.
If you don't see a reason for the horse to be lame, call an equine osteopath.
Your horse is limping but you can't find any heat, deformation, engorgement, hematoma or wound? He is still moving and his temperature is normal? Then the best thing to do is to call an equine osteopath.
When a horse is limping for no clear reason, the lameness is usually caused by restricted joint movement or muscle or tissue tension. Before you go to the expense of performing head-to-toe imaging on your horse, it is best to verify this hypothesis. A good osteopath who knows horses well will certainly be able to relieve your horse.
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