Lameness is a common problem in both pleasure and competition horses, consequently we spend a lot of our time investigating lameness. Whilst in some horses the cause of the lameness may be easily determined in others, a more detailed lameness work up is required. A lameness work up involves-
1. Physical examination.
We will carefully examine the horse by visual inspection and palpation. This will identify any asymmetry’s or limb swellings that may suggest the cause of the lameness. The foot is a common site of pain in horses and is inspected carefully.
2. Walk and trot up in a straight line
Depending on the degree of lameness the horse will be walked and trotted up in a straight line on a hard flat surface. This identifies the leg (or legs) that the horse is lame on. We also evaluate the gait of the horse as the way in which the horse moves and loads the limb can sometimes give clues to the site of pain and cause of the lameness.
3. Flexion tests
Flexion tests involve holding each leg up in turn for approximately 60 seconds before trotting the horse away. Flexion tests increase pressure on joints and may exacerbate lameness associated with joint pain. This might help to give a better idea of what is causing the lameness.
4. Lunging/ ridden exercise.
Examining a horse on the lunge or at ridden exercise is useful to assess the gait of the horse and may exacerbate a subtle lameness.
5. Nerve blocks.
Nerve blocks use local anaesthetic to ‘numb’ different areas of a horse’s leg. If the painful area is nerve blocked the lameness improves and the site of the pain causing the lameness has been identified. Agnew Equine vets routinely perform nerve and joint blocks efficiently and safely at our client’s home premises. If the case requires it 2 vets will attend to perform the nerve block (all at no extra cost!)
Once the site of the pain has been established our mobile digital x-ray and ultrasound scanners allow us to image the area to establish a diagnosis. In certain circumstances referral for specialist imaging techniques is required. An MRI (magnetic resonance imaging) is particularly useful for investigating horses with foot pain and produces highly detailed images of the complicated soft tissue and bony structures of this area. Nuclear scintigraphy (bone scan) is an invaluable tool in lameness and poor performance investigations with areas of damaged or inflamed bone identified as ‘hot spots’.
Once the cause of the lameness has been established our vets will be able to advice you on appropriate treatments and management strategies including medication, corrective shoeing, surgery and controlled exercise programmes.
And sometimes …Specialist input. Whilst all our vets are experienced in the procedures described in some cases referral to an equine orthopaedic specialist is appropriate particularly in cases where lameness is intermittent or subtle. Specialist centres have the necessary experience and equipment (MRI, nuclear scintigraphy etc ) that is considered essential in the investigation of these cases. No orthopaedic specialists are based in Cheshire, Derbyshire or Staffordshire. We therefore utilise the expertise of Liverpool Veterinary School and the world renowned Newmarket Equine Hospital.