Dynamic Assessment of the lame horse

Question 1

What is the sequence of lameness examination?

Answer 1

• History
• Clinical exam at rest
• Examination in motion =
  -straight line
  -lunge surfaces (soft + hard)
  -negotiating obstacles
  -flexion tests
  -ridden work if indicated
• Repeat examination
• Diagnostic tests

Question 2

What should be examined at walk + trot?

Answer 2

• Head nod / hip hike
• Flight of foot - arc, winging, paddling
• Foot contact with the ground - heel-toe, lateral-medial
• Length of stride
• Symmetry
• Sound of foot falls

Question 3

What does a head nod / hip hike tell you on examination?

Answer 3

• Head nod = head raised as lame limb strikes ground w forelimb
  = head lowered when hind limb lame and bears weight
• Hip hike = hind limb lameness - increased range of motion in lame limb

Question 4

How does lunging help with examination?

Answer 4

• Head nod more obvious
• Length of strides
• Footfall
• Toe drag
• Fetlock drop
• More pressure on inner leg = lameness more obvious when lame limb on the inside

Question 5

What can be seen with lameness on a canter?

Answer 5

• Reluctance to take lead
• Reluctance / inability to maintain lead
• Bunny hopping

Question 6

What can be seen with lameness on assessment under the saddle?

Answer 6

• Assess horse attitude
• Bridle lameness = rider hands, appropriate bit, teeth
• Back pain = standing in stirrups, sitting in saddle

Question 7

What could be seen if neurological deficits?

Answer 7

• Proprioception
• Irregular gait patterns - hyper / dysmetria
• Not standing square
• Hesitation

Question 8

How are flexion tests carried out?

Answer 8

• Flex joint for 45-60 seconds then trot
  -sound limb first
  -compare both limbs and to baseline