LOCOMOTION - Lameness and Gait Recognition Flashcards
What is lameness?
Lameness is the incapability of normal locomotion or deviation from the normal gait
How would you describe a dairy cow with a lameness score of 0 (good mobility)?
A cow with a lameness score of 0 should walk with even weight bearing and rhythm on all four feet with a flat back
How would you describe a dairy cow with a lameness score of 1 (imperfect mobility)?
A cow with a lameness score of 1 has uneven rhythm and/or weight bearing or shortened strides. The affected limbs or limb will not be immediately identifiable
What is the course of action required if a dairy cow has a lameness score of 1?
The cow should receive routine foot trimming if needed and undergo further observation
How would you describe a dairy cow with a lameness score of 2 (impaired mobility)?
A cow with a lameness score of 2 has uneven weight bearing on a limb that is immediately identifiable and/or has obviously shortened strides. With a lameness score of 2, the cow usually has an arch at the centre of their back
What is the course of action required if a dairy cow has a lameness score of 2?
The cow should have their foot lifted to establish the course of treatment and be attended to as soon as possible
How would you describe a dairy cow with a lameness score of 3 (severely impaired mobility)?
A cow with a lameness score of 3 has the same clinical signs as a score 2 cow however is also unable to keep up with the healthy herd
What is the course of action required if a dairy cow has a lameness score of 3?
The cow requires urgent attention and further professional advice. The cow should not be made to walk and should be kept on grass or straw. In severe cases, culling may be the only option
Describe the overgrowth cycle of the bovine hoof
Increased pressure on the feet will cause an increased growth rate resulting in a loss of normal weight distribution which can result in a grossly malformed foot predisposed to several causes of lameness
Where on the bovine hoof does overgrowth occur and how does this affect weight-bearing?
In the bovine hoof, overgrowth occurs abaxially and anteriorly, causing weightbearing to shift posteriorly
What are the three steps required to prepare for a corrective bovine foot trim?
Assessment of the cow
Clean the foot
Carry out safety procedures
What are the five steps to a corrective bovine foot trim?
- Correct the length of the dorsal hoof wall
- Reduce excessive sole
- Shape the axial surface
- Attend to obvious problems with the foot
- Attend to the heels
How long should the bovine dorsal hoof wall be?
75mm between the coronary band and the tip of the toe
Which instrument is used to correct the length of the dorsal hoof wall during a bovine corrective trim?
Hand nippers
List three examples of solar lesions that commonly cause bovine lameness
Solar bruising
Solar ulcers
Solar abrasion
What causes bovine solar lesions?
Solar lesions are caused by repetitive, excessive trauma to the sole such as standing for too long or walking too far
List two examples of white line lesions that commonly cause bovine lameness
White line abscess
Axial wall lesion
What causes bovine white line lesions?
White line lesions are caused by weakening of the interdigitation between the epidermal and dermal laminae due to twisting of the foot, softening by constant moisture, sharp stones or laminitis
List three examples of skin lesions that commonly cause bovine lameness
Digital dermatitis
Interdigital dermatitis
Interdigital necrobacillosis
Which bacteria causes bovine digital/interdigital dermatitis?
Mixed treponema bacteria infection
How should bovine interdigital dermatitis be treated?
Repeated foot baths and topical antibiotic spray
What is the main bacteria that causes interdigital necrobacillosis?
Fusobacterium necrophorum
How should interdigital necrobacillosis be treated?
Systemic antibiotics
Identify this bovine hoof lesion
Solar bruising
Identify this bovine hoof lesion
Solar ulcer
Identify this bovine hoof lesion
Solar abrasion
Identify this bovine hoof lesion
White line abscess
Identify this bovine hoof lesion
Axial wall lesion
Identify this bovine hoof lesion
Digital dermatitis
Identify this bovine hoof lesion
Interdigital dermatitis
Identify this bovine hoof lesion
Interdigital necrobacillosis
Which factors should be considered when designing a roadway for cattle to reduce the lameness risk?
Dry
Smooth/even surface
Wide enough to prevent congestion (and allow dominance)
Why is it so important to provide cattle with comfortable surfaces to lie down on?
If cattle are inclined to lie down, they spend less time standing and thus there are lower lameness risks as their feet will be under less pressure
Which three factors can increase standing time for cattle?
Poor access to beds
Poor cubicle design
Time locked out of the bedded area
How would you describe a horse with a lameness score of 0 according to the AAEP scale?
Lameness not identifiable
How would you describe a horse with a lameness score of 1 according to the AAEP scale?
Lameness is difficult to observe and not consistently apparent regardless of the circumstances
How would you describe a horse with a lameness score of 2 according to the AAEP scale?
Lameness is difficult to observe at a walk or when trotting in a straight line but consistently apparent under certain circumstances (lunge and ridden)
How would you describe a horse with a lameness score of 3 according to the AAEP scale?
Lameness is consistently observable at a trot under all circumstances (straight line, lunge and ridden)
How would you describe a horse with a lameness score of 4 according to the AAEP scale?
Lameness is obvious at a walk with a marked head nod or shortened stride
How would you describe a horse with a lameness score of 5 according to the AAEP scale?
Lameness causes minimal weight-bearing in motion or at rest with a marked head nod or a complete inability to move
What is a stride cycle in terms of the equine gait?
A stride cycle is a complete cycle of repetitive movements of a pair of limbs for a particular gait
What are the three phases of the stride cycle?
Stance (foot on ground)
Push off
Swing (limb swings forward)
Describe the normal head movement for a full forelimb stride cycle
Head moves up and down twice
Minimum head height occurs mid stance
Maximum head height occurs prior to start of stance phase of contralateral limb
Describe the normal tuber sacrale (pelvis) movement for a full hindlimb stride cycle
Tuber sacrale moves up and down twice
Minimum pelvis height occurs mid stance
Maximum pelvis height occurs prior to start of stance phase of contralateral limb
Describe the normal tuber coxae (pelvis) movement for a full hindlimb stride cycle
Tuber coxae at minimum height during ipsilateral stance phase
Tuber coxae at maximum height during ipsilateral push-off phase
How can you identify forelimb lameness?
There will be less downward head movement on the lame limb compared to the ‘sound’ limb as the horse will be attempting to reduce weight bearing on the lame limb
“down on the sound, up on the lame”
How can the head movement differ with severe pain on weight bearing (i.e. severe lameness)?
The head can move upward during the stance phase (usually the min height phase) to further reduce weight bearing
What are the four steps of equine lameness investigation?
- Take a focused history
- Focused physical examination
- Gait evaluation
- Diagnostics
Which diagnostic techniques are often used during equine lameness investigation?
Diagnostic local analgesia
Diagnostic imaging
Which five things should you ask about when gathering patient data during an equine lameness evaluation?
Age, breed, sex?
Use of the horse?
Was a pre-purchase examination performed?
Duration of ownership?
Management (exercise, shoeing, feeding)?
Which four things should you ask about when gathering patient medical history during an equine lameness evaluation?
Owner description of the lameness (severity, nature of onset, progression)
External trauma
Response to therapy
Previous lameness
What should you evaluate via subjective observation during an equine lameness evaluation?
Posture
Asymmetry
Body condition scoring
Foot and limb confirmation
What should you carry out during objective observation during an equine lameness evaluation?
Palpation
Manipulation
Compare left and right limbs
Which five factors are you looking for when you carry out equine limb palpation?
Heat
Pain
Swelling
Muscle atrophy
Digital pulse strength
Which three factors are you looking for when you carry out equine limb manipulation?
Pain
Range of joint movement
Instability
What is indicated by increased digital pulse strength?
Inflammation
What is indicated by decreased digital pulse strength?
Poor peripheral perfusion caused by shock or an impaired blood supply
Which instrument is used to identify areas of foot sensitivity during an equine lameness exam?
Hoof pinchers
What should be carried out if a region of foot sensitivity is identified during an equine lameness exam?
If an area of sensitivity is identified, use a hoof knife to remove the superficial solar horn within the sensitive areas to carry out a more detailed inspection
What should be carried out during a gait evaluation?
Watch the horse walk and trot in a straight line and watch the horse lunge in a trot or canter in both directions
When should you avoid carrying out a gait evaluation during an equine lameness exam?
If you suspect a fracture
What are the three perineural (nerve block) techniques that can be carried out?
Palmer/planter digital nerve block
Abaxial sesamoid nerve block
Low four point nerve block
What is the most appropriate local anaesthetic to use for an equine nerve block?
Mepivacaine
Which type of needle should be used for an equine nerve block?
25g 5/8” (orange one)
How should you prepare the site for an equine nerve block?
- Clip excess hair
- Clean site with chlorhexidine
- Clean injection site with alcohol
Where is the palmer/planter digital nerve located relative to the vein and artery within the neurovascular bundle?
The palmer/planter digital nerve is the most axial structure within the neuromuscular bundle
Where should you insert the needle during a palmer/planter digital nerve block?
Insert the needle distally into the palmer/planter nerve over the palmer/planter aspect of the distal pastern, both medially and laterally
Which six structures are desensitised by a palmer/planter digital nerve block?
Navicular bone
Navicular bursa
Distal deep digital flexor tendon
Digital cushion
Distal interpahalangeal joint
Distal phalanx
Where should you insert the needle during an abaxial sesamoid nerve block?
Insert the needle into the dorsal and palmer/planter digital nerves over the abaxial surface of the proximal sesamoid bones, both medially and laterally
Which six structures are desensitised by an abaxial sesamoid nerve block?
Proximal interphalangeal joint
Distal interphalangeal joint
Distal sesamoidean ligaments
Superficial digital flexor tendon
Deep digital flexor tendon
Fetlock joint
What should you do if blood appears in the needle hub during a palmer/planter digital equine nerve block?
Redirect the needle axially without removing it
How does evaluating limb conformation help to identify causes of equine lameness?
Abnormal limb conformation can often be an indicator of specific musculoskeletal diseases and thus help to indicate causes of lameness
What causes abnormal limb conformations?
Abnormal limb conformations can be caused by abnormal pre- or postnatal musculoskeletal development, secondary to orthopaedic disease or due to inadequate foot care
What is carpal valgus?
Carpal valgus is the medial deviation of the carpal joint accompanied by outward deviation of the limb
What can occur if the carpal joint is deviated more than 4° due to carpal vagus?
Joint disease
What is sickle hocks?
Sickle hocks is excessive angulation of the hock
What are the common consequences of dorsopalmer foot imbalance (long toe, low heels)?
Increased loading of the heels, deep digital flexor tendon and the navicular bone (distal sesamoid)
What are the common consequences of mediolateral foot imbalance?
The longer side of the hoof wall will hit the ground first and receive more impact leading to tearing and bruising of the dermal laminae on that side
How can dorsopalmer and mediolateral foot imbalance be corrected?
Farriery
What is the normal four beat pattern seen in a walking horse?
Right hindlimb -> Right forelimb -> Left hindlimb -> Left forelimb
What is the normal two beat pattern seen in a trotting horse?
Right hindlimb and Left forelimb -> Left hindlimb and right forelimb
What is the normal three beat pattern seen in a right lead canter?
Left hindlimb -> Right forelimb and Left forelimb -> Right hindlimb
What is the normal three beat pattern seen in a left lead canter?
Right hindlimb -> Left forelimb and Right forelimb -> Left hindlimb
What are the canine and feline species differences when it comes to lameness presentation?
Canines are more likely to present with physical indications of lameness however felines are more likely to only present with behavioural and lifestyle changes
What are the six steps of a gait evaluation in small animals?
Evaluate animal sitting
Evaluate animal rising from sitting
Standing
Walking/running
Turning
Up and down stairs
(T/F) When carrying out a physical examination, you should examine the lame leg last
TRUE.
Which four factors are you looking for when you carry out small animal limb palpation?
Heat
Pain
Swelling
Muscle atrophy
Which three factors are you looking for when you carry out small animal limb manipulation?
Pain
Range of joint movement
Instability
Which manipulation test can be used to indicate hip dysplasia?
Ortolani test
Which two manipulation tests can be used to indicate cranial cruciate ligament rupture?
Cranial draw test
Tibial thrust test
What are the four palpable landmarks for the cranial draw test?
Patella and Lateral fabella
Tibial tuberosity and Head of the fibula
Which diagnostic techniques are often used during small animal lameness investigation?
Diagnostic imaging
Arthrocentesis (joint tap)
Stifle arthroscopy
Which diagnostic imaging methods are best for imaging bone?
Radiography
CT
Which diagnostic imaging method is best for imaging muscles, tendons and ligaments?
Ultrasound
