Intro and investigation of lameness Flashcards
Outline approach to the lame horse
History (Anamnesis) • Observation from a distance: – Symmetry – Posture – Conformation • Palpation – Incl. hoof testers • Gait Observauion / Movement – Baseline – Addiyional Movement • Selected Examination Steps – Manipulations – Flexion Tests • Diagnostic Analgesia • Diagnostic Imaging • Treatment
Name 2 objective tests
- kinetics
- kinematics (motion of points, bodies and systems/ groups of bodies without consideration of the causes of motion)
What are the 2 types of observation?
- subjective
- objective (kinetic and kinematic)
What basic info is important in the hx?
• SIGNALMENT – Sex, Breed, Age*, Use
• CURRENT LAMENESS: What is the problem?
– hx of trauma
– Duration of lameness
– Deterioration or improvement, circumstances
– Effects of exercise
– Management Changes
• Changes in shoeing or related changes
• Changes in training or performance intensity
• Changes in stable/working/turn-out surface
• Changes in housing
• Changes in health & diet
• Current medication and response, response to rest
• Past Lameness Problems
Specifc aspects of hx that are important in a lameness work up
TYPE OF SPORTING ACTIVITY – Level of Competition (past, current, intended) • ADDITIONAL SOURCES – Images / Video tapes – Records – Diagnostic Imaging – Discussion with others
Where might chronic porgressive OA affect the older horse? 8
– PIP joint – DIP joint – MCP joint – Carpometacarpal joint – Coxofemoral joint – FemoroRbial joints – Tarsus – Previous injury (retired racehorses)
What should you observe from a distance?
- symmetry, posture and conformation
- poor conformation doesn’t necessarily mean lameness
- significant variations usually obvious
What should you palpate?
- SDFT origin and insertion
- distal sesamoidean ligaments
- digital pulses
- hoof testers
- tendons (loaded and unloaded)
What are you looking for when palpating joints?
- distension
- temperature
- pain
- ROM
What should you palpate along equine back?
- back
- pelvis (tuber coxae adn tuber ischii)
What is limb movement composed of? 2
horse’s travel and action
Define a horse’s ‘travel’
- flight of a single hoof in relation to other limbs
- often viewed from side or behind
Define a horse’s ‘action’
– Overall description of gait characterisyics
– Takes into account joint flexion, stride length, suspension and other qualities – Variation between different types and breeds
What are the phases of an equine stride?
- landing
- slide
- loading
- stance
- breakover (heel lift and toe pivot)
- swing
Describe gait - walk
- Even rhythm four-beat gait
* Not very suitable to recognise subtle lameness
Describe gait - pace
- Two-beat lateral gait
– Ipsilateral fore- and hindlimbs elevate alternatively
– Viable gait for STB racehorses and some other breeds
– Considered an impure gait for most “normal” horses
Describe canter
- Three-beat gait with lead preference
– Difficult to identify subtle lameness
– Useful for back/rider/saddle associated problems
Describe trot
- Two-beat diagonal gait
• Steadiest and most rhythmic gait in most horses
Which gait is preferred for a lameness exam?
trot
If you are in doubt as to the location of a lameness, what can you do?
- palpation
- nerve and joint blocks
What should you determine with gait observation/ movement?
- is the animal lame? which legs?
2. How lame (grading system, will i be able to appreciate a difference with diagnostic analgesia)
Goal - lameness exam
localise the source of lameness in the limb(s) to allow for targeted diagnostic imaging and tx (helps cost and specificity)
Name 2 lameness grading scales
- American Association of Equine Practitioners (AAEP, scale 0-5)
- Wyn-Jones scale (0-10)
- doesn’t matter which scale you use so long as you use one scale consistently
Outline the AAEP lameness grading scale
0:Lameness not perceptible under any circumstances
1:Lameness difficult to observe and not consistently
apparent, regardless of circumstances (e.g. weight
carrying, surface, circling, inclines, hard surface etc.)
2:Lameness is difficult to observe at a walk or when
troqng in a straight line but consistently apparent
under certain circumstances (e.g. weight carrying,
surface, circling, inclines, hard surface etc.)
3:Lameness consistently observable at a trot under all
circumstances
4:Lameness is obvious at a walk
5:Lameness produces minimal weight-bearing in moRon
and/or at rest or a complete inability to move
