The Lameness and Surgery Center at Performance Equine Vets
Performance Equine Vets has established the first Independent Equine Surgical Center in the southeastern United States. This model opens the door to any equine Veterinarian in need of quality surgical services. Veterinarians are encouraged to utilize this resource. The Surgical Center is equipped with the latest technology and a fully trained support staff. Independent surgeons can contact the office at Performance Equine Vets for more information.
Lameness is an abnormal gait of an animal that is the result of dysfunction of the locomotor system. In the horse, lameness is most commonly caused by pain, but can be due to neurological or mechanical dysfunction. There are several different causes of lameness in the equine patient. Orthopedic causes of lameness include trauma, inappropriate hoof care, poor conformation, and congenital defects. Metabolic conditions also can cause lameness in the horse. These would include muscular disorders such as polysaccharide storage myopathy (PSSM) or hyperkalemic periodic paralysis (HYPP). Cushing’s disease and grain overload can decrease blood flow and create inflammation which can result in laminitis in the hoof. Infection can be a major cause of lameness as well. Joint or tendon sheath infections, cellulitis, and abscesses are just a few. Neurological pain may arise from trauma or inflammation in the brain, spinal column or the nerves affecting the muscles and limbs. Examples of these would be radial nerve paralysis, shoulder sweeny, shivers, EPM, lymes disease, rabies, west nile virus, equine encephalitis, equine herpesvirus, tetanus and even neoplasia. Mechanical lameness is caused by a physical abnormality, such as scar tissue, that prevents normal motion of a limb. Mechanical lameness does not cause pain. Some examples of mechanical lameness include upward fixation of the patella and fibrotic myopathy, but any type of adhesion (often secondary to scarring during healing post-injury) or fibrosis can cause mechanical lameness.
The lameness evaluation begins with a thorough history. Information such as age, breed, discipline, past history of injuries or lameness, duration of lameness, progression of lameness, recent changes in exercise, recent changes in footing, recent changes in shoeing. If there have been treatments attempted it is good to let the veterinarian know these at this time.
The next step in the lameness examination is the physical examination. This is where the lameness diagnostician will examine in detail each and every aspect of the patient to gather information that will ultimately assist in the diagnosis of the lameness.
The physical examination is followed by the examination in motion where the horse is lunged in hand as well as on the lunge line and sometimes under tack. A gait analysis system is available which objectively assesses the horse’s movement. Small, wireless body-mounted sensors are applied to the head, leg and pelvis. Specific manipulation tests (flexions) may be performed to help the clinician isolate specific areas. These tests involve flexing or extending specific joints or portions of the limb to isolate various structures. Data is analyzed quickly and helps to determine severity of lameness and/or response to diagnostic analgesia.
Diagnostic analgesia (nerve blocks) are often used to isolate the area of the lameness. Following isolation of the lameness, imaging modalities can be utilized to determine the source of the lameness and the severity. Digital radiography, digital ultrasonography, nuclear scintigraphy (bone scan), computed tomography (CT) and magnetic resonance imaging (MRI) are all useful when appropriate to assist the clinician at arriving at conclusions. This will give the clinician the necessary information to establish a treatment protocol as well as a prognosis.
Treatment plans can be tailored to the individual needs of your horse. Various treatment modalities may be employed including therapeutic joint or tendon sheath injections, systemic medications or anti-inflammatories, joint supplementation, surgical options, regenerative therapies (IRAP, Stem Cells, PRP), as well as alternative therapies such as chiropractic and/or acupuncture. Often times the veterinarians utilize a rehabilitation protocol that may include a period of rest or modified exercise to ensure the best outcome for the patient. The lameness clinician will tailor this program to the needs of the patient.
- Full lameness exams require several hours to complete. Clients are welcome to stay for the duration of the examination or they may choose to drop the patient off at the hospital for the workup to be completed.
- Often times the clinician may have recommendations to change the shoeing. Depending on the changes required, we may utilize farriers in our hospital or alternatively we may work with the farrier of your choosing.
- In the event surgery is recommended or required the clinician will explain in detail the benefits to such surgery as well as the prognosis.
- Please bring with you radiographs, ultrasound images, or any other diagnostics that have been done on the patient to the appointment.