Lameness Examination

Lameness Examination



Basic Information image



Overview and Goal(s)




• A normal horse moves in a balanced manner with all limb movements in equilibrium.


• If lameness is present, movement is unbalanced or asymmetrical.


• The examiner’s task:


image Identify the gait abnormality

image Locate the source of the lameness

image Identify the likely cause(s)

image Recommend appropriate treatment

• Evaluation of lameness requires:


image An ability to visualize gait abnormalities

image Skill in applying techniques that localize the abnormality to a specific site

image Obtaining and interpreting appropriate images of the site(s). These findings must be consolidated to determine a diagnosis.


Indications


Gait abnormality



Equipment, Anesthesia




• Hoof tools


image Hoof testers

image Local anesthesia

image Lunge line

image Access to even, flat surfaces preferably both firm and soft

• Site to have horse ridden during the examination is helpful for low-level lameness



Anticipated Time


30 minutes to 2+ hours



Procedure




• History


image Reasons for a complete anamnesis of a horse presented for lameness

image Helps to narrow the list of differential diagnoses

image Determines the effect of previous treatment or shoeing protocols

image May help to narrow the focus of the examination

image The signalment of the horse (age, sex, breed, and use of the horse) should be clearly elucidated.

image Specific questions to ask during the history:

image Date and circumstances of lameness onset

image When is the lameness most obvious?

image Have you noticed any swelling or thickenings?

image Has the horse undergone any treatment for this condition?

image When was your horse last shod?

image Is this a new condition or a continuation of a previous injury?

• Visual examination at rest


image Before observing the horse in motion

image Carefully evaluate the horse’s conformation, stance, and limbs.

image Evaluate the horse from a distance to view its stance, general conformation, areas of swelling or atrophy, and attitude.

image Evaluate wear patterns of the hoof or shoes.

image Closer inspection should involve:

image Palpation of each limb in its entirety.

image Subtle effusion of the carpal joints and medial femorotibial joints may only be noticed with palpation.

image Swollen regions should be palpated to evaluate tissue temperature and the degree of sensitivity to deep palpation. A swelling that is sensitive to touch and is warmer than surrounding areas is likely undergoing active inflammation. A cold, insensitive swelling may be a lesion that has healed and is no longer actively inflamed.

image Digital pulses should always be palpated.

image Elevated pulses are associated with injury or inflammation in the distal limb and may help localize the lesion to medial or lateral aspects of the limb.

image Tendons and ligaments should be palpated with the limb in both weight bearing and flexed positions. Tendon sheath effusions are best evaluated with the limb bearing weight. When the limb is flexed the tendons and ligaments on the palmar or plantar surface are more easily defined and separated. Deep palpation of the mid to proximal suspensory ligament often elicits some discomfort in the normal horse. Compare contralateral limbs if there is a concern regarding palpation sensitivity.

• In-motion examination


image Examination of the lame horse in motion is necessary to characterize the nature and intensity of the gait abnormality.

image The lameness should be graded using a consistent scale.

image The AAEP scale is most commonly used:

image Grade 0 = no lameness

image Grade 1 = intermittent lameness evident under special circumstance such as lungeing or following manipulations

image Grade 2 = consistent lameness evident under special circumstances

image Grade 3 = consistent lameness readily evident without special circumstances

image Grade 4 = severe, consistent lameness

image Grade 5 = non–weight bearing lameness

image The in-motion lameness exam should be conducted in controlled surroundings to add consistency to the findings.

image The ideal location to examine a horse for lameness
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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Lameness Examination

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