Lameness and current treatment options in the Performance Horse by Rich Bristow, BVetMed CertAVP MRCVS.
There are 2 principal categories of lameness in the performance horse - Developmental Orthopaedic Disease and Traumatic Orthopaedic Disease.
Conditions falling under the umbrella of Developmental Orthopaedic Disease are those that typically arise in foals and young horses. Some, such as Angular Limb Deformities or Contracted or Lax Tendons occur in foals from a few days to a few months after birth. Others such as Subchondral Bone Cysts (SBC) or Osteochondrosis (OCD) become apparent at a slightly older age.
Angular limb deformities are most frequently managed by trimming or supporting the hoof with acrylic hoof extensions or glue on shoes. More severe limb deformities that don't respond to conservative treatment may require surgery to correct.
Many foals are born with Lax tendons, which tighten up over a few days after birth, with relatively little input required other than the application of some light bandages or use of a deep bed to prevent skin abrasions.
Contracted tendons may cause more of a problem, and if severe may prevent the foal from nursing. They may be treated using intravenous oxytetracycline to cause relaxation of the musculotendinous unit and permit stretching. If this fails to work then it may be necessary to force the tendons to stretch through the application of an acrylic extension to the hoof, or through the use of a splint. Surgical intervention may be attempted but only in severe cases that don’t respond to any of the above treatments.
Subchondral Cystic Lesions, which occur when there is incorrect development of the bone just beneath the cartilage of a joint, typically cause lameness in the first 2 years. They may be treated by conservative treatment (rest) with concurrent intra-articular injection, or through a number of surgical interventions including injecting the cyst or drilling through it with a screw.
Osteochondrosis Dissecans (OCD), lesions are frequently found between 1 and 3 years. They occur when there is abnormal development of the cartilage within joints potentially leading to fragments of cartilage floating within the affected joint. Young horses with small lesions, that do not detach, may resolve with rest but larger lesions that are causing swelling and lameness require surgical removal of the fragment(s) and assessment of the interior of the joint.
Horses with Subchondral Bone Cysts and/or OCD lesions that have undergone treatment can benefit from post-operative joint medication. This can help to aid healing and to maintain joint health when back in work. Pinkham Equine offers a number of different types of joint medication – see below.
Traumatic Orthopaedic Disease commonly affects athletic horses during their competitive career, and frequently requires on-going management to enable continued high-level performance. Pinpointing the location and the degree of damage is crucial to deciding which treatment option to use.
Horses may present as overtly lame or with a loss of performance or change in behaviour. Initially the horse should be seen moving on hard and soft surfaces, and often ridden. Nerve or joint blocks may be necessary to identify which structure is affected, which can then be imaged using our high quality, mobile ultrasound and digital radiography systems. At this stage a treatment options will be discussed – sometimes surgical in the case of a fracture repair or a bone fragment needing removal, but often where surgery is not required, treatment takes the form of an injection into a joint, tendon sheath or directly into a tendon or ligament injury under ultrasound guidance. The aim of these medications is to reduce inflammation, to promote healing and to facilitate the early return to athletic performance.
The following are the different types of medication that can be used: -
In recent years the use regenerative medications have become increasingly widespread. Various types of regenerative medication are now available: -
As part of Pinkham Equine's commitment to providing the most advanced treatments to our clients, in addition to utilising the best quality diagnostic equipment, we have also recently invested in a centrifuge that permits us to offer both Pro Stride and Platelet Rich Plasma (PRP) treatments on your yard. We wish to see your horses perform to the utmost of their ability, and this will enable us to offer the very latest anti-arthritic and soft tissue injury treatments to your horse, on your yard, in a single visit.
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