We will try to tell you how to detect that your horse is lame, what a veterinary visit consists of and what are the most frequent treatments. We will give you some points to take into account so that they receive a veterinary visit in due time and suggestions to reduce the incidence of injuries.
How do I know if it’s lame?
If the degree of lameness is severe or if the area where the problem is is inflamed, it is easier, but sometimes it is not so simple.
A horse with pain in one extremity can present various degrees of lameness. Which we veterinarians classify from 0 to 5, where 0 means that it is not lame, and 5 is not supportive).
- The horse may not support the limb (grade 5) or support only the claw (grade 4).
- I take the walk and the turns
- I trot
- Lame when mounted performs certain exercises
The main symptom of lameness in one hand is the head movements made by the animal. Although the veterinarian and the most experienced horse riding professional can detect other signs such as alterations in support, greater or lesser arc of flight, greater or lesser fetlock extension, greater or lesser advance (propulsion), etc…)
The horse will try to relieve the weight on the affected hand. So it raises its head when it supports the one that hurts and lowers its head when it supports the one that doesn’t hurt.
“Lame horse, greet healthy hand”
Foot lameness can be more difficult to identify. They are more evident when they cause the hip to rise unevenly. But the lack of propulsion, decreased arc of flight, etc., are symptoms of discomfort related to the hindquarters. (Sometimes also related to back pain or even dental problems)
What should I do?
Call the vet.
It will be the veterinarian who will best advise you for your specific case.
The information that you as the owner provide will condition the decision to visit the animal immediately, or to prescribe an initial treatment (rest for a couple of days +/- anti-inflammatories +/- application of cold, +/- support bandage )
The causes of a sudden limp can range from blows or bad gestures that cause punctual inflammation of no relevance. Which subsides completely in 24-48 hours, to more serious problems that require a complete clinical examination. Complementary diagnostic tests, and specialized treatments. some of which must be urgently established.
In inflamed areas, early treatment with cold application and a support bandage (if possible), and the administration of anti-inflammatory drugs is indicated.
Discontinue high intensity exercise!
What does the veterinary visit consist of?
A visual inspection, palpation and manipulation may be enough to locate the affected area.
But many times in this inspection there are no relevant findings that allow us not even to suspect what is happening.
In these cases, your horse will need a lameness examination carried out in a formal and organized manner.
It must be borne in mind that many horses have more than one problem. The success of the treatment is in identifying which one is causing pain.
If we do not have a diagnosis, we cannot know which is the best treatment, and what is even more important, what is its prognosis in the face of a complete recovery, or the need for a timely withdrawal with quality of life.
The exam consists of:
1- Amnesia
It is important that we get all the information
about training, onset and duration of symptoms, previous medication and response, last shoeing or trimming, …
2- Station inspection (on a hard and level surface)
- Identify their poise and consequent joint and/or ligament overloads (For example, low heels with a long clamp, break the alignment of the phalanges (podophalangeal axis) overloading the heel and navicular area)
- Detect inflamed or thickened areas (bones, joints, ligaments, tendons)
- Palpate and manipulate the limb, identifying pain or limitations in joint mobility.
- Palpation of the hoof with hoof forceps.
3- Dynamic examination:
- Observation of walking in a straight line and figure-8 turns on a hard, regular surface. We observe it from the front, behind, and from the side, taking note of alterations in support, amplitude of the flight arc, propulsion, etc.
- Observation while trotting in a straight line on a hard surface paying attention to head and hip movements.
- bending tests. Jogging after flexing the joints for one minute will reveal discomfort related to the flexed area.
- Observation in a circle with both hands on soft and hard floors.
Factors that help us in a diagnostic orientation:
➢ Improvement or worsening when heating ➢ Improvement or worsening if the
extremity is outside or inside the circle ➢ A positive flexion in the first strides simply, or that is maintained going and coming back;
4- Perineural and joint anesthetic blocks
The response to selective anesthesia by areas (starting with the area of the heels up to above the knee, if applicable) makes it possible to locate the area of pain for further investigation. When the area that causes the pain is anesthetized, the animal stops limping.
5- Radiographic examination of the selected area
It allows us to guide if the problem has an osteoarticular origin, and which one. The 4 projections (LM, DP DLO, BMD) must be taken for a complete study, and if required, other specific projections based on suspicion. There are injuries that are only seen, or are more evident, in a specific projection.
6- Ultrasound examination of the area
It allows to diagnose injuries in soft tissues (ligament, tendons, sheaths), as well as in joints (subchondral bone, degree of synovial effusion, joint capsule).
7- Other diagnostic tests:
Unfortunately sometimes we have located where it hurts but not exactly what is injured. And these animals are the candidates for more specialized tests (as well as more expensive). Scintigraphy, CT, MRI (the latter is not available in Catalonia), and depending on the case, also diagnostic and prognostic arthroscopies.
I would like to make a note about shaving or not the area to be ultrasounded, or the joint to be infiltrated.
Many owners are reluctant to shave their hair because of the scar it can leave at any given time. (That his horse has a problem).
It must be known that the quality of the ultrasound image improves through hairless skin, which improves the diagnosis of subtle lesions and that intra-articular infiltration requires extreme asepsis due to the risk of septic arthritis (joint infection), and it is undoubtedly the risk is lower without hair.
Many times we put other criteria before the circumstances before an action with less risk for the patient.
What are the most frequent treatments?
We have to take into account that there are factors that determine the probability of an injury, the frequency of injuries in certain areas, and the sporting life time for a horse:
- The age at which they start training and the years in active
- sports discipline
- training level
- The conditions of the tracks on which he trains
Obviously the injuries of a riding horse will be more related to accidental traumas and blows, due to irregular exercise, joint wear from age, bruises and sun abscesses on the hoof, etc.
A competition horse is subjected to excessive overloads during training and during competition, which makes them very susceptible to more frequent injuries.
A lame horse has pain in the affected limb. Treatment will depend on the cause.
Your veterinarian, once the problem has been diagnosed, will decide the most appropriate treatment available to its owner.
most common treatment
- Drainage of solar abscesses
- Absolute rest or daily walks (with consequent decrease in the energy intake of the diet)
- Application of cold in inflamed areas (due to its analgesic and anti-inflammatory effects)
- support bandages
- Nonsteroidal anti-inflammatory drugs (topical, intravenous, or oral)
- Intra-articular/intrasynovial infiltrations (anti-inflammatory corticosteroids, Hyaluronic acid, IRAP, Ozone)
- Intra-articular infiltrated regenerative therapy, or in ligaments and tendons (PRP, Stem cells)
- Shock waves
- mesotherapy
- Chondroprotectors (glucosaminoglycans and chondroitin)
- Training schemes and coadjuvant therapies for a smooth and progressive rehabilitation (Physiotherapy, Chiropractic, magnetotherapy, swimming*…)
*Although in Catalonia we do not have it within our reach, swimming is an aerobic exercise and is used to maintain the physical condition of the animal when it is “low” due to injury, without failing to take into account that it may be contraindicated in certain pathologies ( e.g. muscle problems)
- surgical treatments
There are certain pathologies that require surgical treatment under general anesthesia.
- Wounds that affect synovial structures (joints, sheaths…)
- Extraction of osteochondral or fracture fragments via arthroscopy
- Removal of fractured rudimentary bones
- Resolution of compartment syndromes
- Neurectomies: Neurectomies consist of cutting the nerve and thus eliminating the sensitivity of the area affected by a progressive degenerative process whose pain is limiting for their quality of life (eg: navicular syndrome, desmitis of the origin of the suspensory ligament in the posterior, etc.. ). In our opinion, and from the point of view of respect for the animal, carrying out this technique necessarily implies the withdrawal of the animal from its sporting activity so as not to overload and aggravate its condition. Since without sensitivity, it does not cause pain, and its use for a demanding activity leads to a worsening of the problem.
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- Withdrawal from your activity. When the ailment suffered is incompatible with the level of training, the animal must be withdrawn for walks, withdrawn to live in a herd, or withdrawn for reproduction, if applicable.
What can I do then to prevent?
It must be taken into account that a horse exercising any discipline will perform movements that it would never perform in freedom with the same intensity (small circles, lateral work, jumping complex obstacles, etc…).
In addition, a horse in the wild does not feel the need to let off steam by running uncontrollably like a horse stabled in a box that does not go out daily as should be the correct and obligatory thing to do.
Therefore, whether in competition or for a walk, the stabled horse is more susceptible to injury.
Some suggestions
- A call to the vet at any suspicion can help prevent further injury after training or testing.
- The Veterinarian-Farrier relationship is very important given the prevalence and importance of hoof-related lameness and an incorrect foot-phalangeal axis.
- A pre-purchase examination before purchasing an animal can detect injuries or poise that suggest limitations in desired sports performance. For example: subclinical injuries such as OCD identified early can be treated and minimize the impact on your sports career).
- A regular physical activity according to your sporting condition and on work tracks in good condition
- Warming up at pace before work and walking at pace after intense exercises improve recovery
- The use of support bandages are useful for the prevention of injuries during work (work bandage), or during transport (rest bandage).
- The use of protectors, protect against blows due to interference (ranges between their legs), or by obstacles or during transport.
- The application of cold has anti-inflammatory and analgesic effects, and decreases the metabolic demand. Which is why it is very useful after each high-intensity workout.
- Administration of Nutraceuticals (in the long term they have shown to have a better preventive than curative effect). The most complete are composed of glucosamine + chondroitin sulfate, hyaluronic acid, MSM, fatty acids, collagen, Vit C, Vit E, Se, Zn…).
