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Lameness in equines
- 1. Lameness in equines NadeemKhalid Rg # 2017-dvmn-010 DVM ( 8th Semester) KBCMA CVAS,Narowal
- 2. Plan to talk ★Introduction ★ Causes ★ Classification ★ Different conditions rendering horse lame ★ How to perform lameness Examination
- 3. Introduction ★ What islameness ? ○ Lameness is defined as abnormal stance or gait caused by either a structural or functional disorder of locomotor system.
- 4. Causes of lameness ❏Trauma (single event or repetitive work) ❏ Congenital or acquired anomalies ❏ Developmental defects ❏ Infection ❏ Metabolic disturbances ❏ Circulatory and nervous disorders ❏ Any combination of these
- 5. Classification ❏ Lameness canbe classified into following five types, ❏ Supporting limb lameness ❏ Swinging limb lameness ❏ Mixed lameness ❏ Primary or baseline lameness ❏ Compensatory or complimentary lameness
- 6. Classification ❏ Supporting limblameness ❏ It is apparent when the foot first contacts the ground or when the limb is supporting weight (stance phase) ❏ Injury to bones, joints, soft tissue support structures (e.g., ligaments and flexor tendons), and the foot are considered causes of this type of lameness ❏ Most common type of lameness identified in the horse ❏ Swinging limb lameness ❏ It is evident when the limb is in motion. ❏ A variety of pathologic changes may be the cause, and the majority of these problems are thought to involve the upper limbs or axial skeleton
- 7. Classification ❏ Mixed lameness ❏It is evident both when the limb is moving (swing phase) and when it is supporting weight (stance phase). ❏ Mixed lameness can involve any combination of structures affected in swinging or supporting limb lameness ❏ Primary or baseline lameness ❏ It is the most obvious lameness or gait abnormality that is observed before flexion or manipulative tests. ❏ In most cases the lameness that is the worst is considered the primary lameness ❏ Compensatory or complimentary lameness ❏ It is pain and therefore lameness in a previously sound limb that is caused by uneven distribution of weight on another limb or limbs
- 8. Different conditions renderinghorse lame Lam eness N e u r o l o g i c a l Congenital Circulatory Musculoskeletal M e t a b o l i c
- 9. Different conditions renderinghorse lame Musculoskeletal Hind limb Foot 1. Laminitis 2. Navicular disease 3. Thrush 4. Sides bones 5. Corn 6. Canker 7. Bruised sole 8. Hoof cracks 9. Quiter 1. Bog spavin 2. Bone spavin 3. Stringhalt 4. Capped Hock Forelimb 1. Ring bone 2. Osselets 3. Splints
- 10. Different conditions renderinghorse lame Neurological 1. Wobbler disease 2. Stringhalt 3. Shivers 4. Cerebellar abiotrophy Circulatory 1. Aortic iliac thrombosis 2. Laminitis Metabolic 1. Grain overload 2. Polysaccharide storage myopathy 3. Hyperkalemic periodic disorder 4. Rhabdomyolysis
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- 13. 1. Laminitis ❏ Laminitis ❏Inflammation of the laminae ❏ Equine laminitis is a failure of the interdigitation between the dermal and epidermal laminae of the digit that results in displacement of the distal phalanx within the hoof capsule ❏ Displacement may be symmetrical( sinking) or asymmetrical ( rotational, medial or lateral) ❏ Laminitis is usually a sequelae to four different clinical entities: 1. Diseases associated with sepsis/endotoxemia 2. Excessive weight placed on a limb due to injury to the opposite limb 3. Cushing ’ s disease in the older horse 4. Equine metabolic syndrome (EMS)
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- 15. Laminitis ❏ Etiology ❏ Endotoxins/ sepsis ❏ Venoconstriction in digital microvasculature ❏ Coagulopathies ❏ Basal epithelial cell injury,dysadherence of the epithelial cells from the underlying basement membrane. ❏ Predisposing factors ❏ include diseases causing sepsis/toxemia (grain overload, retained placenta, colitis) ❏ EMS ❏ Cushing disease ❏ Excessive weight bearing, exercise on hard surface ❏ Use of corticosteroids The loss of adhesion of the epidermal laminae to the underlying dermal laminae permits the normal forces acting on the hoof wall to essentially “ tear ”the remaining laminae causing movement of distal phalanx.
- 16. Laminitis ❏ 3 stages ❏Developmental (before clinical signs) ❏ Acute (presence of clinical signs but no movement of the distal phalanx) ❏ Chronic (movement of the distal phalanx has occurred). ❏ Clinical signs Acute laminitis 1. Sudden 2. Shifting weight 3. Stilted, shuffling gait 4. Fore feet extended – hind feet under the center of the body 5. Reluctant to move 6. Strong digital pulse Chronic laminitis 1. Abnormal hoof growth 2. long curled-up toes and collapsed heels 3. Hoof rings (laminitic rings) sometimes thickened sole. 4. Change in hoof angle
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- 19. Laminitis ❏ Treatment oflaminitis Prevent coffin bone 1. Frog support 2. Wedges & trimming 3. Reverse shoes 4. Deep bedding 5. Restricted exercise 6. Surgery Relieve the pain 1. Medications a. Elimination of primary disease b. NSAIDS 2. Poultices 3. Nerve blocks
- 20. 2. Navicular Disease ❏Navicular disease ❏ “ Navicular syndrome, ” “ Palmar heel pain, ”or “ Palmar foot syndrome ” ❏ It is associated with pain arising from the navicular bone itself, collateral suspensory ligaments (CSLs) of the navicular bone, distal sesamoidean impar ligament (DSIL), navicular bursa, and deep digital flexor tendon (DDFT). ❏ Quarter horses, Thoroughbreds, and Warmbloods, particularly geldings, are at greatest risk, whereas it is rarely diagnosed in ponies or Arabians ❏ Etiology ❏ The two proposed causes_ vascular compromise and biomechanical abnormalities
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- 24. Navicular Disease ❏ Contributingfactors ❏ Foot shape ❏ Long toes, low heels ❏ Narrow, upright feet ❏ Improper trimming, shoeing ❏ Sign ❏ Appears slowly ❏ Lameness gets progressively worse ❏ Horse tries to land toe first ❏ Intermittent lameness ❏ Heels contract & rise
- 25. Navicular Disease ❏ Treatment ❏Shoeing ❏ Drugs ❏ Vasodilators ( isoxsuprine) ❏ Anti-inflammatory ❏ Surgery ❏ Palmar Digital Neurectomy ❏ Neurectomy may render relief from pain and prolong the usefulness of the ❏ Horse, but no neurectomy should be considered curative ❏ Inferior check ligament desmotomy ❏ By cutting this ligament, the concussive forces between the navicular bone and the deep digital flexor tendon are thought to be reduced ❏ Endoscopy of the navicular bursa ❏ in select cases
- 26. 3. Side bone ❏Side bone ❏ Sidebone is ossification of the cartilages of the third phalanx (coffin bone) Most common in forefeet of heavy horses working on hard surfaces ❏ Frequent in hunters and jumpers but rare in racing Thoroughbreds ❏ Cause ❏ Repeated concussion to the quarters of the feet is the essential cause ❏ Predisposition may be inherited, but this has not been confirmed ❏ Improper shoeing that inhibits normal physiologic movement of the Quarters is also predisposing ❏ Some cases arise from direct trauma
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- 28. Side bone ❏ Signand symptoms ❏ On digital palpation, Rigidity of the cartilages (ossification) causes cartilages to protrude prominently above the coronet ❏ Lameness may occur ❏ the stage of ossification ❏ the amount of concussion sustained by the feet ❏ Stride may be shortened – walking horse across a slope may exaggerate soreness ❏ Mules often have prominent sidebones, yet seldom show any lameness
- 29. Side bone ❏ Diagnosis ❏Sidebone may be suspected after palpation and observation, but radiographic examination is essential for confirmation ❏ Treatment ❏ When lameness is present ❏ Shoeing ❏ to promote expansion of the quarters ❏ protect the foot from concussion ❏ Applying a counterirritant (tincture of iodine) to the coronary region will promote hoof growth and is thought to promote expansion of the wall.
- 30. 4. Thrush ❏ Thrush ❏Thrush are bacterial diseases of the foot. These diseases are often associated with dirty, wet stalls and paddocks. Thrush affects the frog and is characterized by a foul discharge
- 31. Thrush ❏ Cause ❏ Fusobacteriumnecrophorum invades ❏ Occasionally fungal infection ❏ Long heel conformation predispose ❏ Diagnosis ❏ A foul smelling, black discharge is found in the affected sulci of the frog ❏ Horse demonstrates pain when pressure is applied to the affected area ❏ Infection may result in a general swelling of the distal limb
- 32. Thrush ❏ Treatment ❏ Dry,clean environment ❏ Clean foot thoroughly and remove necrotic debris ❏ Pared the sulci to reveal the healthy tissue beneath and allow air to reach any remaining damaged tissue ❏ Scrub Frog daily with a dilute iodine solution ❏ Uunhealthy tissue should be regularly plugged with cotton wool soaked in antiseptic (e.g. povidone iodine) ❏ Tetanus antitoxin injection
- 33. 5. Canker ❏ Canker ❏Rare condition commonly affects hind feet ❏ Horse kept in wet tropical climate ❏ Proliferative, foul smelling infection starts at the frog and spread to the adjacent sole and hoof wall ❏ Results In formation of characteristic hoof growth, which are fragile and wart- like. ❏ If untreated ,progressive destruction of hoof
- 34. Canker ❏ Cause ❏ Mixedinfection with bacteria and fungi ❏ wet, unhygienic stable condition ❏ Diagnosis ❏ Early stage: ❏ Foul smelling, moist, vegetative mass is seen ❏ Lameness is rarely encountered ❏ Cheesy foul smelling discharges ❏ Advanced stage: ❏ A cauliflower-like, proliferative growth along the heel, bars, sole and wall ❏ Lameness may seen ❏ Swelling in the pastern and lower limb
- 35. Canker ❏ Treatment ❏ Removalof all abnormal, dead and infected tissue under general anesthesia ❏ o Packing with sterile gauze socked in antiseptic solution, ❏ o Foot bandage ❏ o Antibiotic (cloxil LA 1ml/10kg) ❏ o Tetanus toxoid
- 36. 6. Quittor ❏ Quittor ❏Quittor is septic condition which involves the necrosis of the collateral cartilages of the pedal bone following an infection in the foot. ❏ Quittor more commonly affects the front feet and more frequently seen in the heavy breeds of horses
- 37. Quittor ❏ Cause ❏ Thecollateral cartilages of the pedal bone have a poor blood supply and so they respond poorly when infected and consequently infections can become chronic and damaging. ❏ Quittor can be cause by ❏ 'Treads': ❏ Occurs following external trauma or interference injuries to the pastern and coronary band. ❏ May occur, very rarely, extending from a sub-solar abscess.
- 38. Quittor. ❏ Treatment ❏ Topicaland systemic antibiotics ❏ Dead and infected material must be surgically trimmed away ❏ Remove a section of the hoof wall or drill ❏ Holes in the hoof to allow the infected area to drain. ❏ Wound is packed with sterile gauze soaked in antiseptic solution (i.e. dilute povidone iodine) and the foot is bandaged until it has completely healed. ❏ Tetanus antitoxin injection given
- 39. 7. Hoof wallcracks ❏ Hoof wall cracks ❏ Many factors can result in hoof wall damage: poor hoof quality, overgrowth, poor foot/limb balance, poor nailing and shoe fit, trauma, disease and environmental conditions ❏ Cracks are either complete (extend the entire length of the hoof wall) or incomplete (extend part-way up or down the hoof wall)
- 40. Hoof wall cracks ❏Treatment ❏ Crack is trimmed out to debride the cavity and hoof wall, exposing the area to air ❏ Infected crack is flushed with a topical antibiotic ❏ Proper shoe (i.e. full-bar shoe) is applied to stabilize the foot ❏ If crack is recent and uncomplicated it is wired or laced together ❏ If crack is long-standing and complicated it is filled with an acrylic hoof repair material to hold the edges of the crack ❏ Hoof hardener can be applied
- 41. 8. Corn ❏ Corn ❏Important cause of lameness in shod horses ❏ Specific bruise of the sole, found in the 'seat of corn (angle between the hoof wall and bars) ❏ Caused by an injury which results in hemorrhage into the sensitive tissues of the sole, increasing pressure and causing pain and discoloration ❏ Three types of corns ❏ 1. dry corns, ❏ 2. moist corns, ❏ 3. suppurating corns
- 42. Corn ❏ Causes ❏ Shoeswhich fit improperly ❏ Shoes left for long period ❏ Stones or other debris becoming lodged between the shoe and the seat of corn ❏ Excessive weight bearing at the heels (low heel) ❏ Diagnosis ❏ Shortened cranial phase of stride with toes contacting the ground, saving the heels ❏ Lameness is usually increased on hard ground ❏ Feet may feel warm to the touch ❏ After sole paring, a dry, moist or suppurating bruise can be seen at the seat of corn ❏ There is pain response to hoof testers specifically over the seat of corn rather than all over the sole
- 43. Corn ❏ Treatment ❏ Horseshoes are removed. ❏ In dry or moist corns the sole is pared out to relieve pressure ❏ Suppurating corns are opened and drained ❏ Hole is flushed with hydrogen peroxide and/or antiseptic foot spray ❏ Poultice is applied ❏ Poultice is removed 24 to 48 hours later and hole treated with antiseptic foot spray ❏ Foot is dry bandaged for a further 24 to 48 hours ❏ Horse is rested until it is better.
- 44. 9. Bruised sole ❏Bruised sole ❏ It is an injury which results in hemorrhage into the sensitive tissues of the sole ❏ Hemorrhage increases pressure in the sensitive tissues of the sole which results in pain ❏ Hemorrhage also causes discoloration in the typical manner of a bruise ❏ Causes ❏ A bruised sole is caused by trauma resulting from the following: ❏ Treading on a stone or another hard object ❏ Poorly fitting shoe ❏ Excessive work on hard ground
- 45. Bruised sole ❏ Treatment ❏Steps in the treatment of a bruised sole include: ❏ Trimming the overlying solar horn may relieve the painful pressure of haemorrhage ❏ Applying an antiseptic spray to help keep the damaged horn clean ❏ Applying a poultice and bandage ❏ Applying a shoe with a pad
- 46. 10. Ring bone ❏Ring bone ❏ Ringbone is a horseman’s term for osteoarthritis, or bony arthritis, of the pastern and/or coffin joints. ❏ Ringbone in the pastern joint is called high ringbone ❏ If in the coffin joint low ringbone ❏ Diagnosis ❏ Clinical diagnosis is based on visualization and palpation of soft-tissue thickness and new bone proliferation in the pastern region ❏ Range of joint movement is restricted ❏ There is pain on forced flexion of the involved articular surfaces ❏ Regional nerve blocks identify the pastern region as the site of pain ❏ Radiography confirms the diagnosis
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- 48. Ring bone ❏ Treatment ❏Complete rest - most important requirement for treatment ❏ Cold and astringent applications as well as radiation therapy in the early stages may be beneficial ❏ Anti-inflammatory medication may relieve the signs of lameness ❏ Surgical arthrodesis of the pastern joint is curative Can restore the performance future of young horses with osteochondrosis
- 49. 11. Osselets ❏ Osselets ❏Osselets refer to an inflammation, usually bilateral, of the periosteum on the dorsal distal epiphyseal surface of the third metacarpal bone and the associated capsule of the fetlock joint ❏ The proximal end of the first phalanx may also be involved ❏ Traumatic metacarpophalangeal arthritis ❏ Osselets constitute a form of periostitis and serous arthritis that may progress to degenerative joint disease ❏ Causes ❏ Cause is the strain and repeated trauma of hard training in young horses and is recognized as an occupational hazard of the young Thoroughbred.
- 50. Osselets ❏ Signs ❏ Thegait is short and choppy ❏ Palpation and flexion of the fetlock joint produce pain ❏ Careful examination reveals a soft, warm, sensitive swelling over the front and sometimes the side of the joint ❏ In the initial stages, no evidence of new bone formation – early condition ❏ termed “green osselets” ❏ Later, enthesopathy may be seen in the area of attachment of the fetlock joint capsule to the large metacarpal bone and first phalanx ❏ New bone or spur formation may break off and appear as “joint mice.”
- 51. Osselets ❏ Treatment ❏ Treatment– mild cases: ❏ Rest, PT, topical capsaicin or DMSO+cortisone ❏ Treatment – acute cases: ❏ Four to six weeks rest, cold hydrotherapy for 48 hours, followed by warm hydrotherapy ❏ topical capsaicin or DMSO+cortisone ❏ Treatment - unresolved acute cases: ❏ Intra-articular or systemic admin of sodium hyaluronate, followed by 3-4 days rest ❏ Treatment - chronic cases: ❏ Intra-articular or systemic sodium hyaluronate and systemic polysulfated glycosaminoglycans
- 52. 12. Splints ❏ Splints ❏Splints involve sprain or tear in the interosseous ligament between the large (third) and small (second) metacarpal bones ❏ Can also involve the metatarsal bones (less frequently) ❏ The condition is a periostitis with production of new bone (exostoses) along the involved splint bone ❏ Causes ❏ Trauma from concussion or injury ❏ Strain from excess training (especially in the immature horse) ❏ Faulty conformation ❏ Imbalanced or over-nutrition ❏ Improper shoeing
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- 54. Splints ❏ Treatment ❏ Completerest and anti-inflammatory therapy is indicated ❏ Intralesional corticosteroids may reduce inflammation and prevent excessive bone growth ❏ Corticisteroid use should be accompanied by counterpressure bandaging ❏ If the exostoses impinge against a ligament, surgical removal may be necessary
- 55. 13. Stringhalt ❏ Stringhalt ❏Stringhalt is a myoclonic affliction of one or both hind limbs seen as spasmodic overflexion of the joints ❏ The etiology is unknown, but lesions of a peripheral neuropathy have been identified in the sciatic, peroneal, and tibial nerves. ❏ Horses of any breed may be affected; it is rare in foals ❏ All degrees of hyperflexion are seen, from the mild, spasmodic lifting and grounding of the foot, to the extreme case in which the foot is drawn sharply up until it touches the belly and is then struck violently on the ground ❏ In severe cases, there is atrophy of the lateral thigh muscles
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- 57. Stringhalt ❏ Signs ❏ Mildstringhalt may be intermittent ❏ Signs are most obvious when the horse is sharply turned or backed ❏ In some cases, the condition is seen only on the first few steps after moving the horse out of its stall ❏ Signs are often less intense or even absent during warmer weather. ❏ Stringhalt is regarded as unsoundness, but may not materially hinder the horse’s ability to work, except in severe cases when the constant concussion gives rise to secondary complications
- 58. Stringhalt ❏ Diagnosis ❏ Diagnosisis based on clinical signs but can be confirmed by ❏ electromyography ❏ If the diagnosis is in doubt, the horse should be observed as it is backed out of the stall after hard work for 1-2 days ❏ False stringhalt sometimes appears as a result of some temporary irritation to the lower pastern area or even a painful lesion in the foot ❏ The occasional horse with momentary upward fixation of the patella may exhibit a stringhalt-like gait
- 59. Stringhalt ❏ Treatment ❏ Manyof these cases apparently recover spontaneously ❏ In chronic cases, tenectomy of the lateral extensor of the digit, including removal of a portion of the muscle, has given best results ❏ Improvement may not be evident until 2-3 wk after surgery ❏ Prognosis after surgery is guarded—not all cases respond ❏ Other methods of treatment include large doses of thiamine and phenytoin.
- 60. 14. Uper fixationof patella ❏ Some horses show a very mild flexion of the hock during walking, whereas others show a marked jerking of the foot toward the abdomen. ❏ The signs are usually exaggerated when the horse is backed ❏ Surgery is medial patellar desmotomy in which medial patellar ligament cut down
- 61. 15. Bog spavin ❏Bog spavin ❏ Bog spavin is a chronic synovitis of the tibiotarsal joint characterized by distention of the joint capsule ❏ Faulty conformation leads to weakness of the hock joint and increased production of synovia ❏ In such cases, both limbs are affected ❏ The unilateral case is more likely to be a sequela of a sprain or some underlying problem within the joint (eg, osteochondrosis)
- 62. Bog spavin ❏ Treatment ❏The excess fluid within the joint capsule can be aspirated ❏ Intra-articular corticosteroids provide variable and transient relief ❏ Repeat procedure in three weeks, if necessary ❏ Arthroscopy should be done when osteochondral involvement is suspected ❏ Bog spavin tends to recur, especially if poor conformation is a factor.
- 63. 16. Bone spavin ❏Bone spavin ❏ Bone spavin is osteoarthritis or osteitis of the hock joint, usually the distal intertarsal and tarsometatarsal articulations, and occasionally the proximal intertarsal joint ❏ Lesions involve degenerative joint disease, particularly on the craniomedial aspect of the hock with periarticular new bone proliferation, which eventually leads to ankylosis ❏ Causes ❏ Theories to explain this condition include faulty hock conformation, excessive concussion, and mineral imbalance ❏ All breeds can be affected, but it is most prevalent in Standardbreds and Quarter Horses.
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- 65. Bone spavin ❏ Signs ❏The lame horse tends to drag the toe ❏ The forward flight of the hoof is shortened, and hock action is decreased ❏ The heel may become elongated ❏ Standardbreds develop soreness in the gluteal musculature (so-called trochanteric bursitis - secondary to spavin. ❏ In advanced cases, the bony proliferation may be visible on the distal ❏ craniomedial aspect of the hock ❏ When standing, the horse may rest the toe on the ground with the heel slightly raised ❏ Lameness often disappears with exercise and returns after rest.
- 66. Bone spavin ❏ Treatment ❏The disease is self-limiting, ending with spontaneous ankylosis of the affected joint(s) and a return to soundness ❏ In the early stages, intra-articular injection of corticosteroids or sodium hyaluronate (or both) may be beneficial ❏ NSAIDs (phenylbutazone) eliminate or reduce the clinical signs ❏ Working the horse after this treatment is aimed at accelerating ankylosis and resolution of lameness ❏ Surgical arthrodesis - another means to accelerate ankylosis of the joint ❏ Corrective shoeing - raising the heels and rolling the toe - may help but is unlikely ❏ to eliminate lameness on its own.
- 67. 17. Capped hock ❏Capped hock ❏ Capped elbow and hock are inflammatory swellings of the subcutaneous bursae located over the tuber calcaneus ❏ Causes ❏ Trauma from lying on poorly bedded hard floors, kicks, falls,, iron shoes projecting beyond the heels, and prolonged recumbency are frequent causes. ❏ sign ❏ Circumscribed swelling develops over and around the affected bursa. ❏ Lameness is rare. ❏ Bursa may be fluctuating and soft at first but, in a short time, a firm fibrous capsule forms ❏ Initial bursal swellings may be hardly noticeable or quite sizable. ❏ Chronic cases may progress to abscessation.
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- 69. Capped hock Treatment ❏ Acuteearly cases may respond well to applications of cold water… ❏ Followed in a few days by aseptic aspiration and injection of a corticosteroid. ❏ Bursa may also be reduced in size by application of a counterirritant or by ultrasonic or radiation therapy ❏ Older encapsulated bursae are more refractory ❏ Surgical treatment (usually curettage and drainage) is recommended for advanced chronic cases or for those that become infected ❏ A shoe-boil roll should be used to prevent recurrence of a capped elbow if the condition has been caused by the heel or the shoe
- 70. 18. Sweeney ❏ Sweeney ❏Shoulder atrophy or slipped shoulder ❏ Sweeney is either disuse atrophy or neurogenic atrophy of the supraspinatus and infraspinatus muscles ❏ Disuse atrophy, sometimes involving the triceps also, follows any lesion of the limb or foot that leads to prolonged diminished limb use ❏ Neurogenic atrophy is due to damage to the suprascapular nerve, which supplies the supraspinatus and infraspinatus muscles ❏ Polo ponies are occasionally affected because of collision during competition
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- 72. Sweeney ❏ If thetrauma is not evident, pain may be absent, and lameness may not occur until atrophy develops ❏ If injury is evident, there may be some difficulty in extending the shoulder ❏ As atrophy progresses, there is a noticeable hollowing on each side of the spine of the scapula, especially in the infraspinous area, resulting in prominence of the spine ❏ Because the tendons of insertion of the two affected muscles act as lateral collateral ligaments to the humeroscapular joint, atrophy of the muscles leads to a looseness in the shoulder joint ❏ In severe cases, this is sometimes erroneously diagnosed as a dislocation
- 73. Sweeney ❏ Treatment ❏ Treatmentfor disuse atrophy consists of removing the cause of the failure to use the limb ❏ For neurogenic atrophy, massage with stimulating liniments or by an electrical vibrator may be of benefit. ❏ Rhythmic muscular contractions by faradism have maintained muscle bulk until the nerve regenerates ❏ Surgical release of the suprascapular nerve from scar tissue impingement, by “notching out” the rostral border of the scapula, has also been recommended
- 74. 19. Rhabdomyolysis ❏ Rhabdomyolysis ❏It is multifactorial myopathy affecting mainly draft horses and less frequently the race horses. ❏ The disease is a metabolic muscular disorder of horses characterized clinically by ❏ Stiffness in gait, ❏ Lameness and swelling and ❏ Hardening of massive muscles ❏ Biochemically: the presence of myoglobin pigments in urine (myoglobinuria).
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- 76. Rhabdomyolysis ❏ Etiology a. Carbohydrateoverload b. Local hypoxia c. Thiamine deficiency d. Vitamin E and Selenium Deficiency e. Hormonal disturbance f. Electrolyte imbalance
- 77. Rhabdomyolysis ❏ Clinical sign ❏In very mild cases that receive little amount of exercise, only poor performance is observed. ❏ In mild cases, stiffness in gait are observed. ❏ In severe cases, which receive excessive exercise ❏ Profuse sweating, stiffness in gait and reluctance to move. ❏ Then the horse assumes a dog-sitting position followed by lateral recumbency, laying down and repeated attempts to rise. ❏ Accelerated weak pulse, rapid respiration and temp. may rise up to 40.5°C ❏ Hard board – like muscles particularly of hind legs (gluteal and quadriceps femoris) ❏ The horse voided dark – red brown urine (Hburia)
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- 79. Rhabdomyolysis ❏ Treatment Medicinal treatment 1.I/M chloral hydrate narcosis particularly if horse attempt to rise to avoid self-injury. 2. I/M injection of 0.5gm thiamine HCL (Nevramin®)daily to increase lactic acid metabolism 3. NSAIDs Flunixin @1.1mg/kg Phenylbutazone @4.4mg/kg to control the pain. 4. Acepromazine to relieve mussel spasm 5. Avil 6. Vitamin E and Selenium Supportive treatment 1. Hot application 2. 1 liter Na bicarbonate solution to resolve acidosis 3. .I/V injection of large quantities of fluids and electrolytes to maintain high rate of urine flow to avoid renal tubule blockage and subsequent uraemia.
- 80. Lameness Examination ❏ LamenessExamination ❏ Helps to differentiate among the many types of lameness problems in the horse. The objectives of a lameness examination are to determine: ❏ Objectives ❏ Whether the horse is lame ❏ Which limb or limbs are involved ❏ The site or sites of the problem ❏ The specific cause of the problem ❏ The appropriate treatment ❏ The prognosis for recovery
- 81. Lameness Examination ❏ Routineor traditional lameness Examination 1. Complete history including signalment and use 2. Visual exam of the horse at rest 3. Palpation of the musculoskeletal system including hoof tester examination of the feet 4. Observation of the horse in motion (usually at a straight walk and trot/lope followed by circling) 5. Observation of the horse under saddle or in work if necessary 6. Manipulative tests such as flexion tests 7. Diagnostic anesthesia if necessary 8. Diagnostic imaging
- 82. Refrances ★ Manual ofEquine Lameness ★ Adams and Stashak's Lameness in Horses ★ Msd Vet Manual