Anyone
who is involved with competition horses at any level will have experienced the
frustrations of having their horse suffer from lameness.
Treating sport horse injuries is a specialized area of equine
veterinary work since many of the underlying causes of lameness are difficult to
accurately locate. The animals conformation and action in addition to the
terrain can all play a part in determining the concussion that has to be
absorbed.
Foot Problems
The tremendous impact forces incurred during fast work can result in a
variety of injuries. It is vital that the horse be well shod and that the shoes
are refitted every four to five weeks. The farrier must ensure that the foot is
well balanced with a straight foot pastern axis and that the shoe is fitted so
that it has no contact with the sole, especially at the seat of corn. This will
allow all the concussion to be transferred to the hoof wall and will help to
prevent bruising. Bruising on the sole at the junction between the hoof wall at
the heel and the bar is termed a corn and is a common cause of foot lameness.
Joint Sprains
Soft tissue injuries to the lining can result in painful
tense swellings within equine joints. The most susceptible joints are the coffin
and fetlock joints of the front limbs but other joints, such as the large mobile
joint of the hock can also be affected. The swelling frequently appears very
rapidly following strenuous exercise. First aid for such injuries involves ice
wrapping the affected joint for 30 - 60 minutes before applying a snug well
padded stable bandage. There are many ice bandages available but if you do not
have one available a simple solution is to bandage a pack of frozen peas into
position around the affected joint.
Tendon Injuries
There are four main tendon structures in the lower limb:
the superficial digital flexor tendon is the most common
area of damage. During fast work, the digital flexor tendon is functioning
close to its maximum strength.
deep digital flexor tendon
the inferior check ligament, located just below the back of
the knee
suspensory ligament.
Inflamed tendons are at risk of being overstretched. The
horse has no muscles below the knee and hock. These tendons are protected by
sheaths, or tendon bursae. Constant irritation of the sheath will result in
excess fluid (edema) buildup.
Veterinary attention should be sought immediately if a tendon injury is
suspected because it is vital that the inflammatory process within the tendon is
suppressed. Up to 50% of the damage in a strained tendon occurs after the
injury and is the result of the inflammation which develops during the first 12
hours in response to the strain. Bandaging will help reduce tissue swelling
which is also vital and is combined with strict box rest in the early stages
after injury.
If a veterinary is not available for some reason you can use a Swelling
Technique to reduce the edema (see below). Apply hydrotherapy before using the
Swelling Technique. This will induce vasoconstriction and numbing of the nerve
endings.
Choose the most practical device (hose or ice cup). With
acute swellings use cold water. With sub-acute cases use hot/cold water to
create a vascular flush.
The Swelling Technique (image shown
below)
Swellings on your horse are the result of trauma, which
include OVERWORKING your horse. The temperature will be higher than normal and
you must use light pressure, (1 to 3 pounds).
The technique starts with light strokes over the body to
relax the animal and help him accept your work. When the initial tenderness
seems to be relieved you can use a vibration movement to stimulate the
circulation. Then resume the stroking, around the outside of the swollen area,
draining toward the heart.
Next, proceed with a very gentle double-thumb kneading
massage at the edge of the swelling, going clockwise around the area and
draining excess fluid toward the outside of the area. Always start at the
outside. Using just a light pressure will be sufficient to drain the swelling.
When you have completed this technique, use light stroking,
draining away from the outside of the trauma and move towards the heart.
Repeat, using the kneading technique in a spiral fashion
toward the center of the area, alternating with light stroking.
AFTER the massage apply cold
water to reduce nerve irritation.
FRACTURES
The very nature of the work that we ask horses to perform
carries risks of injuries from collision with fences or other obstacles.
Fractures are, thankfully, a relatively rare consequence of such injuries but
are seen occasionally. The term fracture means any damage to a bone in the
skeleton which can range from tiny fragments inside a joint to complete
disruption of a major long bone such as the cannon bone. Any severe lameness
associated with joint swelling should be investigated by X-ray to determine if a
fracture fragment is involved.
DJD (degenerative joint disease), causes lameness in affected
horses. The condition develops when the cartilage that protects the bones of the
joint is destroyed. Although it may develop in any joint, areas most commonly
affected include the upper knee joint, front fetlocks, hocks, and coffin joints
in the forefeet. Degenerative Joint Disease (DJD) may result from injury, loose
joints, an abnormal growth pattern, or inherited factors. Over time, the
cartilage may erode entirely, resulting in bone-on-bone grinding and further
disability. Although Degenerative Joint Disease (DJD) can affect any joint, it
usually affects the: Hocks (ankles) where it is commonly referred to as Bone
Spavins. Since excess weight puts stress on the weight-bearing joints, heavier
breeds and obese horses are more prone to the condition. Repeated overuse and
injury of a joint can damage the cartilage and be a contributory factor.
Improper shoeing can cause problems in the muscles and
joints, leading to Degenerative Joint Disease (DJD).
The following symptoms are indicative of Degenerative Joint
Disease (DJD):
Pain, stiffness and swelling around a joint that lasts
longer than two weeks. In the early stages of the disease, an affected horse's
joints may ache after activity.
Stiffness that tends to follow periods of inactivity, such
as sleep or prolonged standing.
Decreased performance and inability to perform activities
that were once performed with ease.
A thorough orthopedic examination will reveal joint pain,
swelling and tenderness.
Treatment
~ Degenerative Joint Disease (DJD)
The chosen treatment will depend on the severity of the disease and the
amount of work the horse is expected to perform. On occasion, stall rest and use
of ice packs is all that is needed to reduce inflammation and swelling.
Treatment for established arthritis normally includes analgesic and
anti-inflammatory medications, exercise management and, occasionally,
surgery. Instead of using "Bute" you may want to try an alternative such as,
white willow, wintergreen or glucosamine.
Recovery EQ is another route to
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Recovery with the
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Analgesic and Anti-inflammatory medications ~ Ideally, these
should only be used for the short term, when necessary to encourage movement.
Although the horse may respond quickly to a anti-inflammatory, this is because
your horse is suppressing pain, and not because the condition itself is
improving.
Acetaminophen ~ For mild to moderate arthritis
in horses, your veterinarian may recommend acetaminophen to relieve pain. Since
acetaminophen is only a pain reliever and has no anti-inflammatory properties,
it can generally be safely combined with anti-inflammatory medications. High
doses of acetaminophen can cause liver damage.
Cortisone ~ is a corticosteroid that reduces
inflammation and swelling. For severe pain and inflammation, a corticosteroid,
such as cortisone, may be injected directly into the affected joint. Although
corticosteroids closely resemble cortisol, they exert a powerful
anti-inflammatory effect. An injection can provide an immediate relief for a
tender, joint.
This
is a picture of a swollen annular ligament. The annular ligament of the flexor
tendon is a thick band (acts like a "girdle") or tissue that runs from one
proximal sesamoid over the back of the tendons to the other sesamoid in close
contact with the flexor tendon sheath.
THE LAMENESS DILEMMA
Acupuncture is an excellent aid to our conventional lameness
examination. It may not tell you exactly where the lameness is or what the cause
is, but it does indicate that something is reactive in that region.
During an equine lameness exam, a certified practitioner will
palpate particular acu-points.
For example, suppose a veterinarian feels sensitivity along
the bladder meridian, (a point on the back right above the flank). This may
indicate there is a hind limb lameness related to the stifle or hock, or a
primary back problem related to the saddle fit or seat position of a rider, or a
conformational problem.
The veterinarian will also look for trigger points, which are
knots or tight bands in the muscle. For instance, when a lower forelimb lameness
is present, a triceps trigger point will become quite sensitive to palpation.
Acupuncture can be a very valuable tool in an equine lameness
exam that includes flexion tests, diagnostic nerve blocks, radiographs,
ultrasounds and fluoroscopy. But it can also be used in various muscle
conditions.
For example, suppose a horse was injected with an intra-articular
(within the cavity of a joint) substance and, though the horse is not lame, he
seems to be "off." Acupuncture may be used to treat secondary problems of the
hock such as neck and back disorders.
Tips for successful therapy
Be sure the therapist is certified in acupuncture.
Before treating your horse, check with your regular
veterinarian first. Discuss all options.
Never replace good management with acupuncture. Integrate
proper saddle fit, riding and shoeing for your horse at all times.
