Lecture 24 - Equine Lameness

Question 1

What are the 4 normal gaits for an average horse?

Answer 1

Walk, trot, canter, gallop

Question 2

What is a walk?

Answer 2

2-3 limbs on the ground at any time;

asymmetrical gait

Hind limbs land on hoof prints of previous steps

Question 3

What is a trot?

Answer 3

Symmetrical, 2-beated gait;

Used most commonly for lameness evaluation;

Contralateral limb pairs move (HL with FR, HR with FL)

There is a moment of suspension

Question 4

What is the difference between a trot and a jog?

Answer 4

Basically the same thing;

Trot = English, more bouncy

Jog = Western, shorter-strided, less bouncy

Question 5

What is a canter?

Answer 5

3-beated gait with a lead limb;

One limb pushes off, opposite forelimb lands, contralateral pairs take off, hind limb lands, lead forelimb lands on its own

Question 6

What is the difference between a canter and a lope?

Answer 6

Canter = English

Lope = Western

Question 7

What is a gallop?

Answer 7

4-beated gait;

Similar to canter except that pairs land separately and there is a moment of suspension

Question 8

What is lameness?

Answer 8

Pathologic gait alteration associated with pain

Question 9

What is a mechanical or neurologic pathologic gait alteration?

Answer 9

Alteration that is not associated with pain so is not a lameness

Question 10

What is the most important question to ask an owner with a lame horse?

Answer 10

What does the horse do for a living?

Question 11

What are the parts of a lameness exam?

Answer 11

Palpation, dynamic exam (jog them, lunge line on soft surface)

Question 12

During a lameness exam, what is the relationship of the head to the lameness?

Answer 12

Head region will be higher on the lame leg

Question 13

During a lameness exam, what is the relationship between the pelvis and lameness?

Answer 13

The pevis raises when stepping on the lame leg (“hip hike”)

Question 14

With lameness, the cranial phase of the stride _____.

Answer 14

decreases

Question 15

With lameness, there is _____ drop asymmetry

Answer 15

fetlock

Question 16

With lameness, there is joint _____ asymmetry.

Answer 16

flexion/extension

Question 17

With lameness, there is a difference in landing _____ and hoof _____.

Answer 17

sound, landing pattern

Question 18

What is a grade 5 lameness?

Answer 18

Minimal weight bearing in motion and/or at rest or a complete inability to move

Question 19

What is a grade 4 lameness?

Answer 19

It is obvious at a walk

Question 20

What is a grade 3 lameness?

Answer 20

Consistently observable at a trot under all circumstances

Question 21

What is a grade 2 lameness?

Answer 21

Difficult to observe at a walk or when trotting in a straight line but consistently apparent under certain circumstances (i.e. turning in a circle)

Question 22

What is a grade 1 lameness?

Answer 22

Difficult to observe and is not consistently apparent, regardless of circumstance

Question 23

What is likely the problem when there seems to be ipsilateral lameness?

Answer 23

Likely a hind limb primary lameness;

Horse attempts to get weight off of the leg that hurts

Question 24

What is likely the problem when there appears to be contralateral lameness?

Answer 24

More likely a forelimb issue

Question 25

What is the problem here and how do you know?

Answer 25

There is a problem with the peroneus tertius muscle;

It normally works with the SDF to extend/flex all joints at the same time

Question 26

When does the flexion test work better?

Answer 26

When the horse is already baseline lame

Question 27

What is a perineural block?

Answer 27

Anesthetic around a nerve in the SQ space

Question 28

What size needle should be used in a palmar digital block?

Answer 28

5/8”, 25G

Question 29

What volume should be used with a palmar digital block?

Answer 29

1.5 ml in each site

Question 30

What are the landmarks of the palmar digital block?

Answer 30

Proximal collateral cartilages of the coffin bone

Question 31

What does the palmar digital block anesthetize?

Answer 31

Palmar/plantar 2/3 of the foot

Skin: heel bulbs

Question 32

What size needle is used in the abaxial block?

Answer 32

1”, 22G

Question 33

What is the volume used for the abaxial block?

Answer 33

2ml per site

Question 34

What are the landmarks of the abaxial block?

Answer 34

Distal extend of the abaxial border of the proximal sesamoid bone

Question 35

What does the abaxial block anesthetize?

Answer 35

Foot pastern region

Skin: Dorsal coronary band and heel bulbs

Question 36

What size needle is used in the low palmar block?

Answer 36

1” 22G

Question 37

What volume is used at the low palmar block?

Answer 37

1-2 ml per site

Question 38

What are the landmarks of the low palmar block?

Answer 38

Button of the splint bones and dorsal surface of the DDFT above the flexor tendon sheath

Question 39

What does the low palmar block anesthetize?

Answer 39

Fetlock and suspensory branches

Skin: Dorsal proximal P1

Question 40

What size needle is used for the high palmar block?

Answer 40

1” 22G

Question 41

What volume is used for the high palmar block?

Answer 41

3-5 ml per site

Question 42

What are the landmarks for the high palmar block?

Answer 42

Slightly below the carpometacarpal joint bt the palmar surface of MCIII/axial surface of MCII/IV

Question 43

What does the high palmar block anesthetize?

Answer 43

Palmar aspect of the metacarpus (skin)

Question 44

How can we avoid proximal diffusion with analgesia?

Answer 44

Utilize small volume, recheck lameness efficiently

Question 45

What are the pros and cons of perineural analgesia?

Answer 45

Pros = less prep, less technical

Cons = less specific

Question 46

What are the pros and cons of intraarticular analgesia?

Answer 46

Pros = specific

Cons = require more prep, can be technically difficult