There are numerous causes of lameness in horses and in each case there can be many factors contributing to the lameness and discomfort. It is important that the condition(s) affecting each horse is diagnosed at an early stage so that appropriate treatment can be started and, where possible, the horse returned promptly to ridden work. Lameness varies in severity from the obvious to the extremely subtle where refusal when jumping or difficulties with lateral work may be the only signs. If you are concerned your horse may be lame please phone for advice and we can arrange a visit where appropriate.
A thorough examination of the horse both at rest and when walked and trotted up (where possible) is an essential start to any lameness investigation. In many cases it is also helpful to see the horse lunged and possibly ridden, often on varying surfaces. If your horse goes lame intermittently or the lameness is only visible under certain circumstances, it is important that we see the horse under these conditions and that the lameness described is visible on the day. If this is likely to be an issue please let us know so we can arrange whatever is appropriate. If a horse with lameness issues is not lame at the time of initial examination we may advise that you change your usual exercise regime and see the horse on a second occasion if this helps. We usually perform this initial examination at the yard.
There is often a lot of information relevant to investigating a lameness issue so please be prepared to answer lots of questions, for example how long the horse has been lame and whether the lameness has altered since it was initially noticed.
In many cases it is possible to diagnose and treat a lameness problem on the initial visit. However, many lame horses have few external signs as to the site and cause of lameness, or further imaging is required, and in these cases we will recommend a more extensive lameness investigation. This is usually done at the practice where we have stabling, examination, diagnostic imaging and trot-up facilities in addition to nursing assistance where necessary. We will advise you whether your horse needs to come to the practice when booking the appointment. You are welcome to stay with your horse, although lameness examinations can be very time consuming, often with a lot of waiting between procedures, so many owners prefer to leave the horse with us, let our nurses do the running up and down (!), and where necessary can arrange drop off and collection times around work or other commitments.
If there are no external signs of the cause of lameness (or several possible problems) in most cases we will recommend performing nerve blocks initially. This involves injecting local anaesthetic around the nerves supplying specific areas of the limb, or in some cases into a joint, essentially to ‘numb’ the area. If the horse’s lameness resolves after a nerve block we can be confident that the site of pain is within the area we have just ‘blocked’ and will then recommend appropriate imaging of the structures in this site. In many cases several nerve blocks are required, either to numb several areas of the limb, or to localise the lameness even more specifically once the affected region has been identified.
We have high quality digital radiography (x-ray) and ultrasound at the practice which are used to image bone and soft tissue structures respectively. Both are painless procedures although we may need to give your horse some sedation to keep him still and cooperative whilst we obtain the necessary images! We can perform some x-ray and ultrasound examinations on the yard and will advise you if this is appropriate, although many more detailed images are best obtained under controlled conditions at the practice.
Sometimes advanced imaging such as Magnetic Reasonance Imaging (MRI), Gamma Scintigraphy or Computed Tomography (CT) is required. Where this is necessary we will arrange referral for these images to be obtained and will discuss options for referral centres as appropriate on an individual basis.
In some lameness cases we may recommend corrective farriery or physiotherapy as part of your horse’s treatment programme. We are fortunate in that we have excellent farriers, physiotherapists and physical therapists in this area. Where possible we will work with your usual farrier or physio, discuss your horse’s condition, arrange for them to view any relevant images and recommend treatment where appropriate. A combined approach and good communication gives the best outcome for both horse and owner and is most rewarding for us all.
If you require more information on lameness investigations or wish to discuss your horse’s condition please phone the practice.