Basic Concepts in Lameness

Question 1

What are some things you should consider when a horse is having poor performance?

Answer 1

Musculoskeletal Injury - lameness
Airway (upper or lower)
Cardiovascular

Question 2

What is the order of a lameness exam?

Answer 2

History
Exam from a distance
Palpation/Hoof Tester
Physical Exam
Movement
Flexions
Diagnostic Analgesia
Imaging
Diagnosis
Follow-up exam

Question 3

What is recognition?

Answer 3

Determination of which limbs are lame

Question 4

What is localization?

Answer 4

Use of technique to isolate the cause of lameness to particular region

Question 5

What are pertinent history questions for lameness?

Answer 5

Activity Level? What kind of work?
Characteristic of Lameness (Under saddle or work)
When did it start?
Progression?
Farrier out last?
On any medication?

Question 6

How can signalment help?
Young horse:
old:
Female:
Male:
Breed?

Answer 6

Young: OCD/SBC
Olde: OA
Female Recurrent Exertional Rhabdomyolysis
Male: Cryptorhid

Question 7

When you begin to palpate what are you looking for in the limb in quesiton?

Answer 7

Heat, pain, swelling, range of motion, loss function, crepitus, digital pulse, palpation, anatomy, surgical scar or trauma

Question 8

What should you palpate?

Answer 8

Fetlock and phalangeal joints, heel, coronary band, collateral cartilage, dorsal and palmar pouch fetlock, digital flexor tendon sheath, SDF, DDF, Suspensory ligament (origin, body, medial and lateral branch), hocks, long plantar ligament, femopatellar joint, back

Question 9

How do you perform the hoof tester exam?

Answer 9

Use fingers first, then testers with light pressure and get heavier as you go. (dont need to remove shoe unless think its under it)
-No coronary band
-3-5 sites *heel to toe medial to lateral, frog, across heel)

Question 10

What are the AAEP lameness grades:
Grade 1:
Grade 2:
Grade 3:
Grade 4:
Grade 5:

Answer 10

Grade 1: Inconsistent and hard to observe
Grade 2: Hard to observe walk/trot, straight but consistent in circle, incline or hard surface
Grade 3: Consistently observable at trot
Grade 4: Marked nodding, hitching and short stride
Grade 5: minimal weight bearing, can’t move

Question 11

Head is down on…

Answer 11

Sound

Question 12

More excursion is found in the hip on the … side

Answer 12

lame

Question 13

What is fetlock drop?

Answer 13

Joint of sound limb drops farther during weight bearing

Question 14

What is drifting?

Answer 14

Horses drift away from the lame hindlimb, tail carried away from it

Question 15

Describe the cranial and caudal phase of stride:

Answer 15

Cranial: Extending foot forward beyond verticle (hurt heel won’t want to extend)
Caudal: Behind verticle when flexed (soft tissue pain)

Question 16

How do you identify forelimb lameness?

Answer 16

Head drop, down on sound

Question 17

How do you identify hind limb lameness?

Answer 17

Lame has more gluteal excursion
Hip hike or drop
-Stride length shorter
-Height of foot flight arc - lower lame limb
-Fetlock drop (sound limb bearing weight)
- Sound limb louder
-Drift away from lame and hold tail away

Question 18

Are flexion test sensitive or specific?

Answer 18

Not very, no replacement for diagnostic analgesia
-Source of pain could be soft tissue tension, compression, articular, vascular, Strech

Question 19

How long should you flex Distal limb? Hock/stifle?

Answer 19

Distal: 30 seconds
Hock/Stifle: 90 seconds

Question 20

Where do you put your hands to flex the digit in the forelimb?

Answer 20

one on carpus and one on tip of toe

Question 21

Where do you put your hands to flex the fetlock in the forelimb?

Answer 21

Hand on carpus and flex at pastern

Question 22

Where do you put your hands to flex the carpus?

Answer 22

hold at fetlock and pull limb up as high as possible

Question 23

Where do you put your hands to flex the digit in the hindlimb?

Answer 23

grab toe and pull up

Question 24

Where do you put your hands to flex the hock/stifle?

Answer 24

Grasp the fetlock in hind and pull straight up

Question 25

When you circle an animal where is the Strech?

Answer 25

more weight inside and strech soft tissue outer limb