LA Lameness Exam

Question 1

Lameness

Answer 1

A clinical sign; manifestation of signs of inflammation, including pain, or mechanical defect that results in gait abnormality, characterized by limping

Question 2

Baseline lameness

Answer 2

Gait abnormality recognized when horse is examined at a walk or trot in hand, before manipulative tests are used

Question 3

Induced lameness

Answer 3

Lameness observed after manipulative tests

Question 4

Lameness distribution

Answer 4

Forelimb > hindlimb

Center of gravity closer to forelimbs so 60/40 weight distribution

(but lameness will depend on job)

Question 5

Lameness in a thoroughbred racehorse

Answer 5

Forelimb > hindlimb

Question 6

Lameness in a standardbred racehorse

Answer 6

Hindlimb ~ forelimb (weight pulled back by cart)

Question 7

Most common location of forelimb lameness

Answer 7

95% at the level or distal to carpus

Question 8

Lameness scale

Answer 8

0 - not perceptible under any circumstances
1 - difficult to see, inconsistent regardless of circumstances
2 - difficult to see, consistent under stressed circumstances
3 - consistently observed at a trot in a straight line in hand with no stress test
4 - obvious at a walk
5 - minimal weight bearing

Question 9

Components of lameness exam

Answer 9

History
Exam from a distance (conformation, symmetry, posture)
Palpation (weight bearing + no weight bearing)
Movement - baseline + potential manipulative tests

Question 10

Selective manipulation

Answer 10

Flexion
Lunging
Riding/driving
Different surfaces

Question 11

Other tests

Answer 11

Diagnostic analgesia
Imaging

Question 12

Palpation

Answer 12

Palpate every structure
Feel digital pulses
Hoof test
Voluntary neck flex ions
Detect signs of inflammation (swelling, effusion)

Question 13

Assessment of movement

Answer 13

Evaluate lameness on both hard + soft surface
Evaluate from front, back, side
Evaluate on straight line + in circles

Question 14

Key observations in lameness exam

Answer 14

• Head /neck nod
• Pelvic hike/drop
• Shorting of cranial phase of stride
• Drifting (away from lame limb)
• Fetlock drop (overweight bearing in sound leg)

Question 15

Stress test : flexion

Answer 15

Jog horse in straight line to get baseline

Hold limb flexed for a period of time —> have horse job again

Results highly variable by length of time, practictioner, patient cooperation, etc

Full limb vs upper/lower (separate in forelimb, harder in hind due to connectivity)

Question 16

Localization of cause of lameness

Answer 16

Nerve/joint/tendon sheath blocks - systematically numb the leg

Question 17

Mechanical lamenesses

Answer 17

Stringhalt (ingestion of a particular weed, idiopathic)
Upward fixation of patella
Fibrotic myopathy (fibrosis/calcification of semis)
Peroneus tertius injury
Neurological disease

Question 18

Palmar / plantar digital nerve block

Answer 18

Vol - 1-2 cc, 25 g/3/4 in needle

Palpate later/medial palmar/plantar digital neuro vascular bundle
Place needle axial to collateral cartilage as low in foot as possible

Question 19

Coffin joint block

Answer 19

Dorsal approach is vascular / well innervated —> will bleed
Bandage after injection
Blocked structures: coffin joint, navicular bursa (by diffusion)