Lameness concerns can vary from a consistent limp you or your trainer notice, to a mild drop in performance. The following is a basic description of the process our veterinarians will go through for a lameness concern that is not urgent.
A horse with sudden lameness, inability or extreme difficulty to stand or walk on any leg(s), or a leg with sudden swelling is a horse that should have an EMERGENCY visit.
Lameness examinations can be performed at any time but are recommended any time your horse is performing or moving differently than it should, you suspect your horse is experiencing a source of pain or you are noticing a decline in performance (often called ‘poor performance’).
Signs of pain in horses can be subtle and flexion tests +/- diagnostic analgesia (‘blocks’) and imaging are almost always necessary to help determine where the orthopedic pain is coming from.
The veterinarian will first gather a complete history. You can prepare for this by being ready to describe the horse’s trimming/shoeing history including when last done, when the lameness first showed up and any/all treatments or medications that have been done. Especially important is any noticed improvement (of lack of) after treatments have been performed. Please let us know when scheduling the appointment if your horse is on any medications as we may ask you to stop them prior to the exam.
A comprehensive exam includes a hands-on examination including palpation, hoof testing and watching the horse move both in circles on the lunge line and in straight lines in hand. Flexions +/- diagnostic analgesia (nerve and/or joint blocks) are important to help narrow down where the lameness is originating from PRIOR to performing imaging.
Radiographs are the most common imaging modality used during lameness evaluations and these images (commonly called ‘x-rays’) are used to help determine diagnosis, prognosis, and appropriate treatments. We will, with very few exceptions, recommend 3-5 images PER joint as the study is not complete without looking at all views. There are times other imaging will be recommended (ultrasound for soft tissues or even referral for more advanced imaging such as MRI or bone scan).
Treatment is extremely case and patient specific. Intra-articular injections (“joint” injections) are often recommended if indicated. Systemic Legend (intravenous hyaluronic acid), NSAIDs such as Bute or Equioxx, appropriate rest, and/or rehabilitation protocols may be advised. There is NO one size fits all formula for horses that are experiencing lameness concerns.