Equine Lameness

Equine Lameness

EQUINE LAMENESS LAMENESS General Signs: Head bobbing, dropping hip, pointing, strong digital pulse LAMENESS Predisposing factors:

Immaturity for hard work (racing 2-year olds) Faulty conformation Poor condition or conditioning Nutritional deficiencies or imbalances

Fatigue - tendon and ligament sprains Improper shoeing Illness Local leg infections Signs of acute lameness

Increased heat Changes in shape or size Discolored spots on sole Abnormal wear patterns Soft swelling Thickening of tendons Hard lumps Causes of lameness

Poor shoeing Poorly balanced diet Cold water on a hot back Turning out a fresh horse Inadequate warm-up & Inadequate dental care & bitting problems cool-down Improper training, riding techniques Poorly fitting saddle &/or

dirty padding Leaving the cinch too tight for too long Inadequate grooming LAMENESS PREVENTATIVE MEASURES: Icing & cold hosing Massage Stable wraps Topical preparations

Braces Poultices Sweats Liniments Shoe Boil or Capped Elbow

Bucked Shins Bowed Tendon Side Bone Bucked Shin

Bucked shins is a painful, acute periostitis on the cranial surface of the large metacarpal or metatarsal bone. Seen most often in the forelimbs of young Thoroughbreds (2- to 3-yr-olds) in training and racing. This injury is generally brought about by strains placed on the long bone during high-speed exercise in young horses in which the bones are not fully conditioned. Microfractures (ie, stress fractures) are believed to be involved. Subperiosteal hematoma formation and thickening of the superficial face of the

bone may be all that is clinically apparent. It may progress to a cortical saucer fracture or incomplete longitudinal fracture. There is a warm, painful swelling on the cranial surface of the affected bone. The horse is usually lame initially, the stride is short, and the severity of the lameness increases with exercise. Definitions

Periostitis - medical condition caused by inflammation of the periosteum (layer of connective tissue that surrounds bone) Condition is generally chronic, and is marked by tenderness and swelling of the bone and pain Usually, due to infection Characterized by diffuse formation of pus, severe pain, and usually results in necrosis (death of cells and tissue) Can be caused by excessive physical activity as well, as in the case of shin splints (tibial periostitis) itis = inflammation of

Treatment of Bucked Shin Rest from training is important until the soreness and inflammation resolve. The acute inflammation may be relieved by anti-inflammatory analgesics (pain reducers) and application of cold packs. Screw fixation of fissure fractures may be indicated in older horses with dorsal cortical fractures that fail to respond to conservative treatment. Tendinitis (Bowed Tendon)

Inflammation of a tendon can be acute or chronic, with varying degrees of tendon fibril disruption. Tendinitis is most common in horses used at fast work, particularly racehorses. The problem is seen in the flexor tendons and is more common in the forelimb than in the hindlimb.

In racehorses, the superficial flexor is involved most frequently. The primary lesion is a rupture of tendon fibers with associated hemorrhage and edema. Tendinitis (Bowed Tendon) Etiology: Tendinitis usually appears after fast exercise Associated with overextension and poor conditioning, fatigue, and poor racetrack conditions Also, persistent training when inflammatory problems in the tendon already exist.

Improper shoeing may also predispose to tendinitis. Poor conformation and poor training also have been implicated. Tendinitis (Bowed Tendon)

During the acute stage, the horse is severely lame and the involved structures are hot, painful, and swollen. In chronic cases, there is fibrosis with thickening and adhesions in the peritendinous area. The horse with chronic tendinitis may go sound while walking or trotting, but lameness may recur under hard work. Ultrasonography delineates many defects and injuries that are ill-defined or undetectable by palpation. The prognosis for a racehorse to return to racing after a bowed tendon is guarded, regardless of treatment. Tendinitis

(Bowed Tendon) Treatment: Tendinitis is best treated in the early, acute stage. Horse should be stall-rested, and the swelling and inflammation treated aggressively with cold packs and systemic anti-inflammatory agents. Some degree of support or immobilization should be used, depending on the amount of damage to the tendon. Recently, the use of bone marrow injection of the core lesion (to introduce stem cells and growth factors) has been done with encouraging results. The horse should be rehabilitated using a regimen of increasing exercise. Other treatments for chronic tendinitis have included superficial point firing (of questionable benefit), tendon splitting, and carbon fiber

implantation. Capped Elbow (Shoe Boil)

Capped elbow and hock are inflammatory swellings of the subcutaneous bursae located over the olecranon process Trauma from lying on poorly bedded hard floors, kicks, falls, riding the tailgate of trailers, iron shoes projecting beyond the heels, and prolonged recumbency are frequent causes. Circumscribed swelling develops over and around the affected bursa. Lameness is rare. Bursa may be fluctuating and soft at first but, in a short time, a firm fibrous capsule forms Initial bursal swellings may be hardly noticeable or quite sizable. Chronic cases may progress to abscessation.

Capped Elbow (Shoe Boil) Capped Hock Acute early cases may respond well to applications of cold water Followed in a few days by aseptic aspiration and injection of a

corticosteroid. Bursa may also be reduced in size by application of a counterirritant or by ultrasonic or radiation therapy Older encapsulated bursae are more refractory Surgical treatment (usually curettage and drainage) is recommended for advanced chronic cases or for those that become infected A shoe-boil roll should be used to prevent recurrence of a capped elbow if the condition has been caused by the heel or the shoe With capped hock, behavioral modification so the horse does not kick the stall offers the only hope of permanently resolving the problem. Side bone

Sidebone is ossification of the cartilages of the third phalanx (coffin bone) Most common in forefeet of heavy horses working on hard surfaces Frequent in hunters and jumpers but rare in racing Thoroughbreds Repeated concussion to the quarters of the feet is the essential cause

Predisposition may be inherited, but this has not been confirmed Improper shoeing that inhibits normal physiologic movement of the quarters is also predisposing Some cases arise from direct trauma Side bone

Loss of flexibility (digital palpation) of either one or both cartilages Rigidity of the cartilages (ossification) causes cartilages to protrude prominently above the coronet Lameness may occur the stage of ossification the amount of concussion sustained by the feet the character of the terrain Stride may be shortened walking horse across a slope may exaggerate soreness Mules often have prominent sidebones, yet seldom show any lameness

Side bone Sidebone may be suspected after palpation and observation, but radiographic examination is essential for confirmation Remember that ossification of the cartilages often develops without signs of lameness When lameness is present

shoe to promote expansion of the quarters protect the foot from concussion Applying a counterirritant (tincture of iodine) to the coronary region will promote hoof growth and is thought to promote expansion of the wall. Ring bone

Ringbone - periostitis or osteoarthritis of the phalanges that leads to exostoses Causes include: faulty conformation, improper shoeing, or repeated concussion from working on hard ground trauma and infection, especially wire-cut wounds, are also incriminated strain of ligaments and tendinous insertions in the pastern region Part of osteochondrosis syndrome in young, rapidly growing horses. Bilateral ringbone Characteristic bell-shaped appearance to the pastern region

Lameness due to periostitis is seen initially Once bone proliferation has occurred, lameness may not be present Lameness usually occurs and persists if the joint surfaces are involved, May progress to ankylosis. Splint Osselets High Ring Bone Low Ring Bone

Sesamoiditiis Ringbone Definitions

Osteochondrosis: temporary orthopedic disorder of rapidly growing horses in which the epiphysis (growing end) of a dies and then is gradually replaced over a period of years immediate cause of bone death is loss of blood supply - why this occurs is unclear Osteoarthritis: disease affecting the joints and affects almost every animal as they get older cartilage cushion between bones becomes thin and uneven and over time wears out completely at the same time, the joint capsule becomes thicker and more synovial (lubricating) fluid is manufactured which makes the joint swell bony spurs grow causing inflammation in the surrounding tissues

can involve all joints of the body Enthesopathy: disease process occurring at the site of insertion of muscle tendons and ligaments into bones or joint capsules. Myoclonic: A sudden twitching of muscles or parts of muscles, without any rhythm or pattern Ring bone

Clinical diagnosis is based on visualization and palpation of soft-tissue thickness and new bone proliferation in the pastern region Range of joint movement is restricted There is pain on forced flexion of the involved articular surfaces Regional nerve blocks identify the pastern region as the site of pain

Radiography confirms the diagnosis Complete rest - most important requirement for treatment Cold and astringent applications as well as radiation therapy in the early stages may be beneficial Anti-inflammatory medication may relieve the signs of lameness Surgical arthrodesis of the pastern joint is curative Can restore the performance future of young horses with osteochondrosis High Ringbone Osselets

Osselets refer to an inflammation, usually bilateral, of the periosteum on the dorsal distal epiphyseal surface of the third metacarpal bone and the associated capsule of the fetlock joint The proximal end of the first phalanx may also be involved Traumatic metacarpophalangeal arthritis Osselets constitute a form of periostitis and serous arthritis that may

progress to degenerative joint disease Cause is the strain and repeated trauma of hard training in young horses and is recognized as an occupational hazard of the young Thoroughbred. Osselets Signs:

The gait is short and choppy Palpation and flexion of the fetlock joint produce pain Careful examination reveals a soft, warm, sensitive swelling over the front and sometimes the side of the joint In the initial stages, no evidence of new bone formation early condition termed green osselets Later, enthesopathy may be seen in the area of attachment of the fetlock joint capsule to the large metacarpal bone and first phalanx New bone or spur formation may break off and appear as joint mice. Osselets

Treatment mild cases: Rest, PT, topical capsaicin or DMSO+cortisone Treatment acute cases: Four to six weeks rest, cold hydrotherapy for 48 hours, followed by warm hydrotherapy + topical capsaicin or DMSO+cortisone

Treatment - unresolved acute cases: Intra-articular or systemic admin of sodium hyaluronate, followed by 3-4 days rest Treatment - chronic cases: Intra-articular or systemic sodium hyaluronate and systemic polysulfated glycosaminoglycans Splints Interosseous Desmitis

Splints involve the interosseous ligament between the large (third) and small (second) metacarpal bones Can also involve the metatarsal bones (less frequently) The condition is a periostitis with production of new bone (exostoses) along the involved splint bone Caused by: Trauma from concussion or injury

strain from excess training (especially in the immature horse) faulty conformation imbalanced or over-nutrition improper shoeing Splints Splint Sesamoiditiis Splints

Splints most commonly involve the medial rudimentary metacarpal bones Lameness is seen only when splints are forming and is seen most frequently in young horses Lameness is more pronounced after the horse has been worked In the early stages, there is no visible enlargement

In the later stages, a calcified growth appears After ossification, lameness disappears, except in rare cases in which the growth encroaches on a ligament or carpometacarpal articulation Radiography is necessary to differentiate splints from fractured splint bones. Splints

Complete rest and anti-inflammatory therapy is indicated Intralesional corticosteroids may reduce inflammation and prevent excessive bone growth Corticisteroid use should be accompanied by counterpressure bandaging In Thoroughbreds, it has been traditional to point-fire a splint, the aim being to accelerate the ossification of the interosseous ligament If the exostoses impinge against a ligament, surgical removal may be necessary Sesamoiditis Popped Sesamoid

The inflammation or dislocation of the proximal sesamoid bone(s) May involve an actual fracture of a sesamoid bone Sesamoiditis can be the result of direct injury, uneven weight bearing, or

fatigue. Or, sesamoiditis can be totally due to soft tissue inflammation All components of fetlock are subject to high strain during extreme extension (vigorous exercise) Tearing of fibrous attachments to the sesamoid bones can occur Lameness occurs Sesamoid bones change new bone laid down, contours change Sesamoiditis Popped Sesamoid

Changes in sesamoid bone morphology are permanent Focus on treating the causative inflammatory process Confined rest with NSAIDS (phenylbutazone) and cryotherapy Complete healing requires prolonged rest (as in any ligamentous injury) Once sesamoid morphological changes are seen on the radiographs, return to full athletic ability is unlikely Quittor

Quittor - chronic, purulent inflammation of the cartilage of the third phalanx characterized by necrosis of the cartilage and one or more sinus tracts extending from the diseased cartilage through the skin in the coronary region follows injury to the coronet or pastern over the region of the cartilage may follow a penetrating wound through the sole first sign is an inflammatory swelling over the region, followed by abscessation and sinus formation During the acute stage, lameness occurs

Quittor Surgery to remove the diseased tissue and cartilage is usually successful Local or parenteral (injection or infusion) therapy (or both) without surgery is likely to fail Can lead to chronic lameness and extension to deep structures

If distal interphalangeal joint has been invaded, the prognosis is unfavorable It is seldom encountered today but used to be common in working draft horses Popped Knee Carpitis

Inflammation of synovial membranes of bones of carpal joint, producing swelling, pain, and lameness Common acute or chronic inflammation of joint capsule of carpus Accompanied by pain (dorsal surface of carpal bones) and during flexion and swelling There may be exostoses in chronic cases Overextension of the carpus (TBs & Jumpers) bruises bones and sets up a periostitis Rest, PT, NSAIDs and intra-articular or systemic sodium hyaluronate and systemic polysulfated glycosaminoglycans

Popped Knee Wind Puff Quarter Crack Carpitis Wind Puffs Tenosynovitis

Tenosynovitis - an inflammation of the synovial membrane and usually the fibrous layer of the tendon sheath, characterized by distention of the tendon sheath due to synovial effusion. various types of tenosynovitis include idiopathic, acute, chronic, and septic (infectious). idiopathic synovitis refers to synovial distention of tendon sheaths in young animals, in which the cause is uncertain acute and chronic tenosynovitis are due to trauma septic tenosynovitis may be associated with penetrating wounds, local extension of infection, or a hematogenous infection

Wind Puffs Horses are markedly lame in septic tenosynovitis Chronic tenosynovitis is common in horses in the tarsal sheath of the hock (thoroughpin) and in the digital sheath (tendinous windpuffs) these 2 entities must be differentiated from bog spavin and synovial effusion of the fetlock Treatment:

In idiopathic cases, no treatment is initially recommended Acute cases with clinical signs - treated symptomatically with cold packs, NSAID, and rest Application of counterirritants and bandaging has been used in more chronic cases Radiation therapy is helpful Septic tenosynovitis requires systemic antibiotics and drainage If adhesions develop between the tendon sheath and the tendon, persistent effusion and lameness is the rule Wind Puffs Sand Cracks

Toe Crack, Quarter Crack Cracks in the wall of the hoof - beginning at the coronet and running parallel to the horn tubules Most common in racehorses Excess drying of the hoof, trauma, and conformational factors are most likely causes

Extensive injury to the coronet may give rise to a crack in the wall This false quarter is characterized by buildup and overlapping of the hoof wall at the site of injury Sand Cracks Toe Crack, Quarter Crack

A crack in the horn emanating from the coronet is most obvious sign Horse is not usually lame If infection is established, there may be a bloody or purulent discharge and signs of inflammation and lameness Therapy involves surgery and corrective shoeing to change the distribution of weight on the hoof Growth of new horn may be encouraged by application of a counterirritant (eg, tincture of iodine) to the coronet over the crack If the crack has become infected, apply an antiseptic pack wall. Sand Cracks

Toe Crack, Quarter Crack Patching techniques, using acrylics or fiberglass, are useful Complete stripping of the wall, caudal to crack, being careful not to damage the coronet, - treatment in early and severe quarter cracks The hoof is then bandaged until new horn formation is evident The horse is then shod with a three-quarter or three-quarter-bar shoe to relieve any pressure over the stripped portion of the wall

Stifled True dislocation of the patella is uncommon in horses. When it does occur, it is usually a serious injury The most frequent problem involving the patella is upward fixation locking of the medial patellar ligament over the proximal part of the medial femoral trochlear ridge patellar luxation is seen in immature animals with poorly developed thigh muscles

may be uni- or bilateral classical signs are of an intermittent locking of the limb in extension followed by a sudden jerk or hyperflexion as the patellar ligament becomes freed from the medial trochlear ridge Stifled Capped Hock Bog Spavin Bone Spavin Thoroughpin

Curb Stifled In many cases, a general improvement in fitness and muscle tone of the hindquarters effects a cure In the more severe and persistent cases, desmotomy of the medial patellar ligament is indicated. However, desmotomy, which has been commonly used in the past, is

currently in disfavor fragmentation of the distal extremity of the patella is believed to follow the surgery, particularly if postoperative exercise is initiated early when surgery is done, rest should be sufficient (eg, 4-6 wk) to permit complete healing before training is resumed Bog Spavin Bog spavin is a chronic synovitis of the tibiotarsal joint characterized by distention of the joint capsule Faulty conformation leads to weakness of the hock joint and increased production of synovia

In such cases, both limbs are affected The unilateral case is more likely to be a sequela of a sprain or some underlying problem within the joint (eg, osteochondrosis) Bog Spavin Bog Spavin The excess fluid within the joint capsule can be aspirated Intra-articular corticosteroids provide variable and transient relief

Repeat procedure in three weeks, if necessary Arthroscopy should be done when osteochondral involvement is suspected Bog spavin tends to recur, especially if poor conformation is a factor. Bog Spavin

The horse usually is not lame unless the condition is complicated by bone involvement The primary distention of the joint capsule is on the dorsal medial surface of the hock, while smaller swellings develop on each side of the proximal caudal aspect Uncomplicated bog spavin rarely interferes with the usefulness of the horse but is an unsightly blemish and indicates the need for radiographic evaluation The distention may spontaneously appear and disappear in weanlings and yearlings

Bone Spavin Bone spavin is osteoarthritis or osteitis of the hock joint, usually the distal intertarsal and tarsometatarsal articulations, and occasionally the proximal

intertarsal joint Lesions involve degenerative joint disease, particularly on the craniomedial aspect of the hock with periarticular new bone proliferation, which eventually leads to ankylosis Bone spavin usually causes lameness Theories to explain this condition include faulty hock conformation, excessive concussion, and mineral imbalance All breeds can be affected, but it is most prevalent in Standardbreds and Quarter Horses. Bone Spavin

The lame horse tends to drag the toe The forward flight of the hoof is shortened, and hock action is decreased The heel may become elongated Standardbreds develop soreness in the gluteal musculature (so-called trochanteric bursitis - secondary to spavin.

In advanced cases, the bony proliferation may be visible on the distal craniomedial aspect of the hock When standing, the horse may rest the toe on the ground with the heel slightly raised Lameness often disappears with exercise and returns after rest. Bone Spavin The spavin test (ie, trotting after limb flexion for ~60 sec) may be a useful

aid to diagnosis but is not specific for this condition or even this joint In so-called occult spavin, there are no visible or radiographic exostoses Local anesthesia of the individual tarsal joints is necessary to localize the exact site of pain responsible for the lameness. Bone Spavin

The disease is self-limiting, ending with spontaneous ankylosis of the affected joint(s) and a return to soundness In the early stages, intra-articular injection of corticosteroids or sodium hyaluronate (or both) may be beneficial NSAIDs (phenylbutazone) eliminate or reduce the clinical signs Working the horse after this treatment is aimed at accelerating ankylosis and resolution of lameness Surgical arthrodesis - another means to accelerate ankylosis of the joint Cunean tenotomy is commonly used - of questionable value by itself

Deep-point firing used to be advocated for hastening ankylosis, but it is doubtful that it has any beneficial effect beyond encouraging rest Corrective shoeing - raising the heels and rolling the toe - may help but is unlikely to eliminate lameness on its own. Capped Hock

Capped elbow and hock are inflammatory swellings of the subcutaneous bursae located over the tuber calcaneus Trauma from lying on poorly bedded hard floors, kicks, falls, riding the tailgate of trailers, iron shoes projecting beyond the heels, and prolonged recumbency are frequent causes. Circumscribed swelling develops over and around the affected bursa. Lameness is rare. Bursa may be fluctuating and soft at first but, in a short time, a firm fibrous capsule forms

Initial bursal swellings may be hardly noticeable or quite sizable. Chronic cases may progress to abscessation. Capped Hock

Acute early cases may respond well to applications of cold water Followed in a few days by aseptic aspiration and injection of a corticosteroid. Bursa may also be reduced in size by application of a counterirritant or by ultrasonic or radiation therapy Older encapsulated bursae are more refractory Surgical treatment (usually curettage and drainage) is recommended for advanced chronic cases or for those that become infected A shoe-boil roll should be used to prevent recurrence of a capped elbow if the condition has been caused by the heel or the shoe With capped hock, behavioral modification so the horse does not kick the stall offers the only hope of permanently resolving the problem.

Curb Curb is a thickening or bowing of the plantar tarsal ligament due to strain This ligament may become inflamed and thickened after falling, slipping, jumping, or pulling Most common in Standardbreds, in which poor conformation of the hock is a predisposing factor Seen as an enlargement over the caudal surface of the fibular tarsal bone ~4 in. (10 cm) below the point of the hock It is easily seen when observing the horse from the side.

Curb A recently formed curb is associated with acute inflammation and lameness Horse stands and favors the limb with the heel elevated In chronic cases, there is rarely any lameness or pain If the curb is due to / accompanied by acute inflammation, cold packs and rest can help Little can be done to overcome the curb that is secondary to poor conformation Problem is self-limiting, without lasting effects on performance

Thoroughpin Thoroughpin is a distention of the tarsal sheath of the deep digital flexor tendon just above the hock It is characterized by fluid-filled swellings visible on both medial and lateral sides proximal to the tibiotarsal joint, which distinguish it from bog spavin

It is usually unilateral and varies in size Thoroughpin is referred to as a tenosynovitis of traumatic origin, but it may not be associated with any detectable inflammation, pain, or lameness Thoroughpin It is a blemish and so is of clinical importance in show horses Treatment is by withdrawal of the fluid and injection of hyaluronic acid or a long-acting corticosteroid May need to be repeated until the swelling does not recur Radiation therapy also helps reduce the secretory property of the tendon sheath

Stringhalt Stringhalt is a myoclonic affliction of one or both hindlimbs seen as spasmodic overflexion of the joints The etiology is unknown, but lesions of a peripheral neuropathy have

been identified in the sciatic, peroneal, and tibial nerves. Horses of any breed may be affected; it is rare in foals All degrees of hyperflexion are seen, from the mild, spasmodic lifting and grounding of the foot, to the extreme case in which the foot is drawn sharply up until it touches the belly and is then struck violently on the ground In severe cases, there is atrophy of the lateral thigh muscles Stringhalt

Mild stringhalt may be intermittent Signs are most obvious when the horse is sharply turned or backed In some cases, the condition is seen only on the first few steps after moving the horse out of its stall Signs are often less intense or even absent during warmer weather. Stringhalt is regarded as unsoundness, but may not materially hinder the horses ability to work, except in severe cases when the constant

concussion gives rise to secondary complications The condition may also make the horse unsuitable for equestrian sports Stringhalt Diagnosis is based on clinical signs but can be confirmed by electromyography If the diagnosis is in doubt, the horse should be observed as it is backed

out of the stall after hard work for 1-2 days False stringhalt sometimes appears as a result of some temporary irritation to the lower pastern area or even a painful lesion in the foot The occasional horse with momentary upward fixation of the patella may exhibit a stringhalt-like gait (??) Stringhalt Many of these cases apparently recover spontaneously In chronic cases, tenectomy of the lateral extensor of the digit, including removal of a portion of the muscle, has given best results Improvement may not be evident until 2-3 wk after surgery

Prognosis after surgery is guardednot all cases respond Other methods of treatment include large doses of thiamine and phenytoin. Sweeney Shoulder Atrophy, Slipped Shoulder

Sweeney is either disuse atrophy or neurogenic atrophy of the supraspinatus and infraspinatus muscles Disuse atrophy, sometimes involving the triceps also, follows any lesion of the limb or foot that leads to prolonged diminished limb use Neurogenic atrophy is due to damage to the suprascapular nerve, which supplies the supraspinatus and infraspinatus muscles Polo ponies are occasionally affected because of collision during competition Draft horse sweeney(??) Sweeney

If the trauma is not evident, pain may be absent, and lameness may not occur until atrophy develops If injury is evident, there may be some difficulty in extending the shoulder As atrophy progresses, there is a noticeable hollowing on each side of the spine of the scapula, especially in the infraspinous area, resulting in

prominence of the spine Because the tendons of insertion of the two affected muscles act as lateral collateral ligaments to the humeroscapular joint, atrophy of the muscles leads to a looseness in the shoulder joint In severe cases, this is sometimes erroneously diagnosed as a dislocation Sweeney

The affected limb, when advanced, takes a semicircular course and, as weight is borne by the limb, the shoulder joint moves laterally (shoulder slip Treatment for disuse atrophy consists of removing the cause of the failure to use the limb For neurogenic atrophy, massage with stimulating liniments or by an electrical vibrator may be of benefit. Rhythmic muscular contractions by faradism have maintained muscle bulk until the nerve regenerates Surgical release of the suprascapular nerve from scar tissue impingement,

by notching out the rostral border of the scapula, has also been recommended Sweeney The prognosis for cases of disuse atrophy depends on removal of the primary cause In neurogenic atrophy, the prognosis is guarded; mild cases should recover in 6-8 wk When damage to the nerve has been severe, spontaneous recovery may take many months, if it occurs at all Such cases are candidates for surgical release If the nerve has been severed, recovery is unlikely

Navicular Disease Navicular disease is a chronic degenerative condition of the navicular bursa and navicular bone involves damage to the flexor surface of the bone and the overlying deep digital flexor tendon

With osteophyte formation on the lateral and proximal borders of the bone It is a syndrome with a complex pathogenesis rather than a specific disease entity One of the most common causes of chronic forelimb lameness in horses but is essentially unknown in ponies and donkeys Navicular Syndrome Navicular Syndrome Weight Bearing

Activates navicular bone Compression of navicular bone Abnormal increase In bone density Tension of supporting ligaments Navicular Bursitis? Fracture? Cartilage degeneration,

Especially on flexor surface Abrasion of flexor Tendon by eroded cartilage Navicular Syndrome Weight Bearing Activates navicular bone Compression of navicular bone Tension of supporting ligaments Tearing of

Ligament(s)? Ligament strain & Inflammation, especially At bottom Reduced blood flow To & from navicular bone Cavities (flasks or lollipops) along lower edge

New bone Production at Sides (canoeing) Compensation from Vessels at upper edge Increased blood Pressure within navicular bone Loss of bone Density around vessels

NAVICULAR SYNDROME Contributing factors: I. Foot shape Long toes, low heels Narrow, upright feet Improper trimming, shoeing II. Activity NAVICULAR SYNDROME Signs

Appears slowly Lameness gets progressively worse Horse tries to land toe first Intermittent lameness Heels contract & rise NAVICULAR SYNDROME Treatment Shoeing Training

Drugs Vasodilators Anti-inflammatory Surgery Palmar Digital Neurectomy Navicular Disease

Exact cause is unknown, but it is likely to be multifactorial Involves the navicular bone and its blood supply, the suspensory ligament, the distal phalangeal joint, the navicular bursa, and the deep digital flexor tendon Considered to be a disease of the more mature riding horse, but radiographic signs have been seen in 3-yr-olds May be partially hereditary Associated with upright conformation of the forefoot

Conformation of the foot in chronic cases becomes abnormal; it is upright and narrow and has a small frog Defective shoeing that inhibits the action of the frog and the quarters may be contributory Navicular Disease

Concussion between the flexor tendon and the navicular bone causes a local bursitis that leads to hyperemia and rarefaction of the bone with resultant alteration of the flexor surface of the bone Usually, the disease is insidious in onset Attention is first directed to the affected foot or feet by the attitude of the horse when at rest Horse relieves the pressure of the deep digital flexor tendon on the painful area by pointing or advancing the affected foot with the heel off the ground - both forefeet affected, they are pointed alternately Navicular Disease

Intermittent lameness is manifest early in the course of the disease Stride is shortened, and the horse may tend to stumble A flexion test, involving the distal forelimb, usually produces a transient exacerbation of lameness There may be soreness in the brachiocephalic muscles secondary to the

changes in posture and gait, thus the frequent complaint of shoulder lameness Because the condition is both chronic and degenerative, it can be managed in some horses but not cured With severe lameness, rest is indicated Navicular Disease

Foot care is directed to trimming and shoeing that restores normal phalangeal alignment and balance Thinning the quarters with a rasp and proper hoof moisturization may relieve hoof contraction Assist hoof expansion, but the normal angle must be maintained and only three nails used in each branch; a fourth nail in the heel will nullify the slipper effect Toes should be rounded to facilitate the break-over NSAIDs (phenylbutazone), along with proper foot management, extend

serviceable soundness in some horses Intrabursal injection of corticosteroid also is more palliative than curative Navicular Disease Neurectomy may render relief from pain and prolong the usefulness of the horse, but no neurectomy should be considered curative Digital neurectomy can be accompanied by severe complications such as painful neuroma formation

A technique of desmotomy of the collateral sesamoidean ligament has also been described By cutting this ligament, the concussive forces between the navicular bone and the deep digital flexor tendon are thought to be reduced Although the prognosis is guarded to poor, a carefully designed therapeutic regimen can prolong the usefulness of most horses Over months or years, all affected horses reach a point of nonresponsiveness to treatment.

Hoof Wall Made up of keratinized epithelial cells Cells are arranged in tubules and run from coronary band to ground surface Thickest at toe becoming thinner at quarters (sides) Contains pigment Hoof Wall Function: Weight-bearing surface of the hoof

Helps retain moisture Protect internal structures of the foot Laminae Two Layers: Insensitive-forms inner layer of hoof wall Sensitive-covers surface of coffin bone, acts as attachment for hoof wall and coffin bone, and acts as main area of circulation within foot White Line-yellowish area where layers intermesh

Bars Where hoof wall is reflected back toward toe Located in heel area of hoof Function: Prevent over-expansion of hoof wall Sole Covers bottom of coffin bone Sensitive

Self-limiting growth Sloughs off when thickness > hoof wall Concave at ground surface Shape prevents sole from directly bearing weight Easily bruised Occurs when bearing weight: heavy riders, flat feet Frog Occupies area between bars

Wedge-shaped Apex point of frog Cleftridge in rear portion of frog Sensitive Produced by papillae Elastic Moisture content ~ 50% Greasy secretions from fat glands bet. digital cushion and frog Digital Cushion

Also called plantar cushion Fleshy heel Back half of hoof Fibro-elastic, fatty Functions: Shock absorber for foot

Pumps blood from foot back to heart Bones Three Bones: Short pastern Partly in and partly above hoof Navicular bone Smallest bone Increases articular surface and movement of coffin bone

Bones Continued Coffin bone Location-to the front and slightly to outer side of hoof Largest bone Provides shape to foot and rigidity needed for weight-bearing Resembles miniature hoof in shape The Horses Second Heart What do I mean??

The Hoof, of course! How? Blood is pumped to the hoof from the heart through arteries With each step, pressure is put on the veins in the plantar cushion of hoof which pumps the blood back to the heart As this pressure is released, the blood flows back to the hoof through the arteries by a combination of heart pulses and gravity

Lameness Most lameness can be prevented How? Proper foot care and management Healthy Hooves Frog is a good indicator of foot health Daily maintenance prevents lameness Good foot care should include: Regularity--Routine cleaning Frequency--Periodic trimming

Cleanliness Use of proper corrective measures--Corrections and treatment Routine Cleaning Includes use of: Hoof pick Fine-bristled wire brush Always clean from heel toward toe Do not apply too much pressure with either tool. This can cause:

Damage-bruising, abcess, infection, etc. Disturbance of moisture balance Trimming Goal: To maintain proper shape and length of the hoof Hooves should be trimmed every 4-6 weeks depending on usage of your horse Tools: Hoof knife Nippers

Rasp What causes lameness? Stone in the foot Stones lodge between shoe and frog Bruised sole Direct injury of flat of foot by stones or irregular ground Corns Bruising of sole between bar and hoof wall Caused from poorly fitted shoes or neglect to reshod regularly Causes continued...

Pricked foot or Puncture wounds Result from foreign objects entering sole (stone, glass, wire, etc.) Foreign objects can stay in foot for as long as a year Hoof cracks Occur mostly in dry or untrimmed hooves Can also be caused by injury of hoof forming tissue Thrush Bacterial infection of frog and sole due to irregular cleaning and dirty conditions Causes continued... Laminitis Inflammation of laminae

Caused by overeating of grain, ingestion of cold water by a hot horse, retained afterbirth, overfatness, idle horse on a lush pasture Navicular disease Caused by injury to navicular bone Common in breeds with genetic defects in conformation Increased probability with heavy use on hard ground ACUTE LAMINITIS Sudden Shifting weight Stilted, shuffling gait

Fore feet extended hind feet under the center of the body Reluctant to move LAMINITIS - FOUNDER Prognosis 30% return to soundness 10% intermittently lame 10% permanent severe lameness 50% death

ACUTE LAMINITIS Resists lifting feet Elevated heart rate Sweaty Distressed Strong digital pulse

CHRONIC LAMINITIS Pressure on the sole from a rotated or sunken pedal bone Breakdown of the hoof wall-pedal bone bond Permanent changes in blood supply to the hoof wall CHRONIC LAMINITIS More susceptible to: Sole bruises Abscesses Flaring & separation of the wall at the toe

Infection beneath the separated wall Hoof wall cracks Degeneration of the tip of the pedal bone Chronic lameness Slowed hoof wall growth LAMINITIS FOUNDER Contributing Factors Bacterial Toxin

Colic Colitis Potomac Horse Fever Pleuropneumonia Endometritis Water founder

Postoperative colic Black walnut wood shavings LAMINITIS FOUNDER Contributing Factors

Carbohydrate overload Severe dehydration or shock Corticosteriods Pituitary gland dysfunction in older horses Extreme load Repeated concussion (road founder) Stress related LAMINITIS - TREATMENT Prevent or limit coffin bone rotation

Frog support Wedges & trimming Reverse shoes Deep bedding Restricted exercise

Surgery LAMINITIS TREATMENT Relieve the pain Medications Poultices Nerve blocks Improve blood flow in feet Medications

Recently Viewed Presentations

  • John West File na nGael 2017 JUNE 16

    John West File na nGael 2017 JUNE 16

    LIMERICK A WINNERS. GALWAY A WINNERS. Division 1 Camogie. Group A. PILTOWN THOMASTOWN CLARE A WINNERS TIPPERARY A WINNERS. Division 1 Camogie. Group B. ST. MARTINS GLYNN / BARNTOWN CORK A WINNERS TIPPERARY A RUNNERS UP. Division 1 Camogie. Group...
  • IES PE Short Course

    IES PE Short Course

    Series impedance of a 3-phase transmission line 3 3 Zpq=R + jX p q Ypq=G - jB Observe: Shunt susceptance of a 3-phase transmission line 3 3 p q Ypp=jBc/2 Yqq=jBc/2 Observe that the total capacitive susceptance, jBC, is halved,...
  • CONOPS Elements

    CONOPS Elements

    Regional Contracting Offices (RCOs): Joint-staffed contracting organizations under the command and control of an RCC. Normally led by a contracting officer and made up of between 2-8 warranted contracting officers, NCOs, and DoD civilians. Size and makeup is based on...
  • "Rumor Has It You Need A Dell" - ERIC JAMES HYDE

    "Rumor Has It You Need A Dell" - ERIC JAMES HYDE

    "Rumor Has It You Need A " ... Dell has shown with the launch and implementation of consumer ideas that IdeaStorm is beneficial and especially with the Command Center how dedicated Dell is to interacting with consumers by the integration...
  • Managing Coastal Vulnerability (MCV) Project DoT Fremantle  Marine

    Managing Coastal Vulnerability (MCV) Project DoT Fremantle Marine

    Managing Coastal Vulnerability (MCV) Project DoT Fremantle - Marine Data Available Online. MCV PROJECT. Good Morning ladies and Gentlemen . My name is RalphTalbot-Smith and Project Manager for the Managing Coastal Vulnerability Project.
  • John Milton - Cornell College

    John Milton - Cornell College

    The passage from The Odyssey was included to display how Paradise Lost compared to Homer's poem as an epic. Placing them side-by-side shows both how Milton's poem in an epic because he invokes the Muse, but also attempts to surpass...
  • AQA P2 Physics Booster

    AQA P2 Physics Booster

    Speed vs. Velocity. Speed is simply how fast you are travelling… Velocity is "speed in a given direction"… This car is travelling at a speed of 20m/s
  • Subcultures - Sociology at Girton

    Subcultures - Sociology at Girton

    A youth subculture is a youth-based subculture with distinct styles, behaviors, and interests. Youth subcultures offer participants an identity outside of that ascribed by social institutions such as family, work, home and school. Youth subcultures that show a systematic hostility...