Advanced Technologies in Lameness Diagnosis

Question: I am considering purchasing a reining horse that has a bone chip resulting from a fracture in it's left rear fetlock. The horse is 5-years-old and currently sound. The fracture occurred in its 3-year-old year as a result of getting a rear leg caught in a blanket strap. The horse was put in rest mode until two months ago and was brought back slowly with easy lunging. The mare is in regular training mode now and requires another three months or so of training to be a finshed reiner. The veterinarian that has been involved in the diagnosis and treatment said if it is not bothering her currently then leave it alone and not to worry about removing. I really like everything about this horse but I am generally not a risk taker and I am concerned about future lameness problems. How can you advise me relating to this matter?

Answer:  This will all depend on whether your mare is truly sound (upon having a veterinarian evaluating and performing flexion tests), and the exact location and configuration of the chip fracture. Some chips do not seem to ever pose a problem, others can do so after a hard training session. It will be also important to ask if the mare gets her joint medicated regularly as this might mask a potential problem. I truly recommend that you have another veterinarian give you a second opinion based on his/her examination of the horse and the radiographs.

Question: We have a 10-year-old Half Arabian that has very successfully shown since he was 5-years-old. He is shod according to AHA's rules, which includes long toe with a pad. Over the last year we have discovered he is insulin resistant (IR) and have adjusted his diet accordingly. Over the past four months he has suffered from chronic laminitis and has been confirmed with Cushing's disease. We have started him on the pergolide medication, but is it too early to see results. My question is, considering how he needs to be shod to shoe, is his shoe career over? We only want to do the best for him. Would you please advise if continuing to be shod will complicate/shorten his current health condition?

Answer: Being shod with a long toe might place more strain on the hoof wall lamina and might be detrimental to the laminitis situation. Insulin resistance (IR) and Cushing's are two different metabolic diseases that can predispose him to laminitis and to its reccurence. If the Cushing's and the insulin resistance are controlled through medication and diet, the laminitis might become stable enough for him to be sound, and at that time, based on how his feet feel and look like radiographically, you might try to get him back into show shoes. It is not the best shoeing for him by any mean, but if his laminitis is stabilized, there is a small chance to get him back going. If you have the opportunity to retire him and avoid having to push him, you should consider it.

Question: My 3-year-old gelding's right front shoulder or elbow pops when he walks. He is not lame on it, but I don't know if I should be concerned. I just noticed it a couple of months ago and it is still popping. He gets exercised about every other day due to the season. Would an x-ray need to be done or should I just ignore it for a while? Do they have new lameness tests?

Answer: If your horse is not lame, this popping noise is not likely to be a problem. This said, you should still have a veterinarian evaluate the concern as many lamenesses are subtle enough not to be noticed by owners. Radiographs of the shoulder and elbow could also be taken.

Question: My 8-year-old Morgan gelding has not been wanting to move out at the trot, and has been choppy in his front since mid-Nov. More lameness was noted in his left hind leg and a bone scan was performed in January. The results were negative for Lymes and EPM as well as negative on the chemistries done. He has been on stall-rest with hand walking two to three times a day. He continues to be lame. Are there any furhter tests that are reccomended? What are the treatment options?

Answer: Bone scan is a wonderful tool to use, generally. It involves injecting a radioactive compound in to the horse that is linked to a bisphosphonate (molecule that makes the radioactive material link to bone at sites of bone remodeling), and imaging the horse with a gamma camera. Areas of intense bone remodeling would show up as "hot spots". Unfortunately, this modality is not very sensitive for soft tissue injuries (tendons, ligaments, muscles). Ideally, having your veterinarian do nerve blocks and joint blocks to localize the lameness would be ideal. Once the lameness area is detected, imaging that area (Xrays, ultrasound and, if needed, Magnetic Resonance Imaging -MRI-or Contrast enhanced Computed Tomography -CECT-) would be the next step. Only after a diagnosis is made, would a treatment be recommended.

Reprinted with permission from AAEP. To view the entire article please visit www.aaep.org/ask_the_vet.php