12 minute read
Lameness and technology
ABOVE: ACCORDING TO RESEARCH, HORSES CARRY 60-65% OF THEIR WEIGHT ON THEIR FORELEGS.
SEARCHING FOR clues
LAMENESS CAN LIMIT THE DRESSAGE HORSE’S POTENTIAL OR END A CAREER, SO EARLY DIAGNOSIS AND ACCESS TO APPROPRIATE TREATMENT IS VITAL. A COMBINATION OF THE LATEST TECHNIQUES AND AN EXPERIENCED EYE CAN SHOW THE WAY FORWARD, REPORTS BARBARA YOUNG.
Defined as any alteration of the horse’s gait, minor lameness can manifest in many ways, including change in attitude and loss of performance.
While these abnormalities can be caused by pain and discomfort in the neck, withers, shoulders, back, hips, legs or feet, a vet evaluation can keep potentially small problems from becoming big ones.
According to research, horses carry 6065% of their body weight on their forelegs, (the site of most common lamenesses with 90% in or below the knee) with 80% of hind limb injuries occurring in the stifle and hock.
If your vet has cause for concern based on initial examination, they may recommend further tests, including diagnostic nerve or joint blocks, radiographs, nuclear scanning, ultrasound, arthroscopy or examination of blood, synovial fluid and tissue samples.
More recently, vets’ toolboxes have expanded to include new technology, including gait analysis and stem cell treatment.
According to Robert Oulton, senior veterinary surgeon at Scott Dunn’s Equine Clinic and support team vet for the British Equestrian Federation Podium Potential squads, the first step for diagnosis of lameness involves taking a thorough history on the individual horse from the rider.
He points out that questions such as ‘When were problems noted? What was the horse doing at the time? What does the horse find difficult to do typically in work?’ and ‘Has the horse had any issues or treatments in the past?’ can all help build a picture of which potential issues could be at play.
“This is followed by a thorough clinical examination, evaluating the horse’s musculature, limb placement, posture and general conformation. Palpation of limbs (tendons, joints), palpation of musculature for areas of tightness or tenderness, and evaluation of static foot balance can provide important clues.
“After this, the horse is evaluated in a straight line in walk and trot and flexion of each limb is performed. The horse is assessed to ascertain how it responds to passive flexion and how a brief period of holding the limb in
flexion affects its movement post -flexion.
“Next, the horse is lunged in walk and trot on a firm flat surface (briefly) and on a soft surface in walk, trot and canter. In some cases it is also useful to observe the horse ridden, particularly if the lameness is subtle or more an issue with performance rather than an overt lameness.
“Regional analgesia (nerve blocks and joint blocks) helps to locate the lameness, which involves placing a small amount of a local anaesthetic around different nerves or into joints starting with the lowest structures, until the lameness is resolved.”
According to Rob, various gait analysis systems are beginning to be used to assist with lameness.
“These can be very useful to help detect mild asymmetry in a horse’s movement but must be interpreted carefully. Some mild asymmetric patterns may be normal for a horse, but noticing a change in a typical pattern could be significant. If used to aid diagnosis of which limb is lame in a horse, repeating readings before and after blocking is crucial to note the change or effect the block has had. Overall experience is key.”
Rob highlights the importance of an accurate diagnosis which will allow optimum recovery plans to be made.
“This particularly depends on the injury or support the horse may need. I do not usually jump to the most expensive or newest treatment for the sake of it. Every situation is individual and requires thorough discussion about all options with your home team.
“I will happily turn horses away if I am comfortable it would not make an injury worse.
In some cases this is an excellent option, although it may take longer for an injury to heal and get back to full work. If the client is understanding of this fact, it is often a viable option to be discussed.”
Repetitive wear and tear coupled with the poor regenerative capacity of cartilage means that osteoarthritis is essentially managed rather than resolved. Treatment options range from anti-inflammatory medication given in feed to targeted medications injected into the joint.
Vets and scientists have worked to identify treatments that can address both the symptoms of osteoarthritis and the disease process itself to help ‘turn back the clock’.
STEM CELL TREATMENT
Recent research has studied the use of stem cells to try and achieve these goals. Stem cells have many properties, including the release of natural anti-inflammatory substances and their ability to ‘instruct’ the horse’s own cells to increase production of new tissues at the site of an injury. Stem cells have shown promise for use in equine joint disease but their production has involved lengthy, expensive and invasive procedures to harvest them from the patient’s own bone marrow and results have been variable.
A breakthrough came in 2019 when the first stem cells that could be isolated, grown in a laboratory and licensed as a veterinary medicine became available. Modern techniques meant that these medicines could be produced to a consistent standard and subjected to clinical trials to demonstrate safety and efficacy.
These veterinary medicines are now available to treat appropriate cases, where lameness associated with osteoarthritis needs to be resolved but the longevity of treatment is also important.
Rob Oulton sees stem cells as another tool to help in the fight to maintain joint health.
“With continued research these treatments will no doubt continue to advance and give us greater longevity for maintenance of performance in our competition horses, particularly when issues can be detected at an early stage.
“Regular assessment of competition horses instead of waiting for a lameness is one method to allow for early intervention, alongside regular monitoring of joint health with radiographs and even MRI. When joint disease does begin to affect joints, and in particular when cartilage degeneration is likely advanced within a joint, reducing inflammation with other methods (including corticosteroids) helps to maintain comfort and function for performance. Reducing
ABOVE: EVALUATION OF THE HORSE IN A STRAIGHT LINE AT WALK AND TROT IS A KEY ELEMENT OF DIAGNOSING LAMENESS. BELOW: STEM CELL TREATMENT HAS SHOWN PROMISE FOR USE IN EQUINE JOINT DISEASE.
ABOVE: GAIT ANALYSIS CAN BE USEFUL FOR REGULAR ASSESSMENT OF COMPETITION HORSES AS WELL AS IN DIAGNOSIS OF LAMENESS.
inflammation in itself will help to slow disease advancement as well.
“Overall, the more tools we can have to not only treat current disease (which often may be subclinical and more of a performance limiting issue in dressage horses) but allow for early intervention to hopefully prevent or stall joint disease, will give better outcomes long term.”
ARE YOU COVERED?
When it comes to knowing which lameness diagnostic tools are likely to be covered in policies, Shearwater Insurance points out that as long as it is a valid claim (not for a pre-existing condition) it would include all lameness diagnostics.
“We do ask that clients discuss the more costly diagnostic tools, such as MRI, CT and bone scans, with us prior to authorising these with their vets. Some policies may have restrictions or limitations on some of the more costly diagnostics,” explains Kirsty Law, Assistant Equine Manager. “Generally, in order for diagnostics to be fully covered, a client would require full veterinary cover. We do have some policies that offer a more limited cover such as external accidental injury or catastrophe, both of these policies
would have restricted cover on lameness diagnosis. “However, if the horse had a hindlimb exclusion, any diagnostics carried out on the forelimbs would be covered if they were also REGULAR not excluded.” ASSESSMENT OF Be aware that costs can escalate quickly if the COMPETITION cause of the lameness is not straightforward. HORSES INSTEAD “An example of this is if the horse needs an OF WAITING FOR MRI scan after previous A LAMENESS IS diagnostics already carried out and nothing found. ONE METHOD TO Unfortunately, once the veterinary limit is reached ALLOW FOR EARLY on a claim, the client must settle any further costs INTERVENTION themselves. At Shearwater we offer an enhanced vets fees limit and can offer up to £7,500 worth of cover, giving owners increased peace of mind. Lameness exclusions are reviewed on a caseby-case basis, so if it was a small injury and no further issues have occurred, underwriters may remove the exclusions after 1-2 years. “Our recommendation would be for an owner to take full vets fees cover and read all the policy wording prior to taking out the cover to ensure they are aware of any restrictions.” Owned by the Thurman-Baker family since 2009, Highcliffe Apollo has competed to international level with Samantha and Joanna Thurman-Baker, as well as Juliette Lindsay, who also partnered him in Young Riders. The 19-year-old gelding will soon be out with Junior rider Scarlett John in Junior FEI classes.
“Apollo thrives on work and is as fit as a fiddle because we follow the guidance and knowledge of our vet Rob Oulton,” explains Joanna. “We look for prevention rather than cure and do not allow him to go lame through negligence of not receiving the required veterinary treatments.
“As we run a busy yard with multiple horses and also breed, Rob visits on a regular basis. He has worked with Apollo for more than five years and is in tune with how he moves. Building a trusting relationship with your vet is vital - Rob trusts our judgment to know when Apollo needs an assessment, which happens twice a year when Apollo needs his coffin and hock joints re-medicating, using Triamcinalone and sodium hyluronate.
“When I was on the World Class and Youth programmes, Apollo was assessed by a full team of vet, physio and farrier (both our home team and respective teams) several times throughout the year. This is a great practice to get into - I will often try to schedule in a day where the farrier, physio and vet are all here so they can discuss their respective knowledge for a particular horse.
Apollo also has acupuncture from Rob as and when required. All of this is vital to ensuring he stays fit and healthy. The body is a machine - it must be kept in top condition to avoid breakdown.
“If you have an older horse that is presenting slight lameness, listen to your vet’s advice. Also get a second opinion from a top vet within your field and get your entire team discussing it to weigh up the pros and cons.
FMBS THERAPY
SYSTEMS provides superior Dead Sea salt and purified oxygen therapy for enhanced performance and recovery, helping to improve respiratory and skin function, cell function and concentration, oxygen uptake, immune system response and physical and mental resilience. Available for installation in yards, lorries or trailers and show pop-ups.
RRP: FROM £5,250 | fmbs.co.uk
THE VITAFLOOR VIBRATING FLOOR
LAMENESS PRODUCT WATCH TECHNOLOGY
SYSTEM is a whole-body vibration therapy solution designed exclusively for horses. The fully automated vibration plate can be used as a stand-alone platform or integrated into a stable for a non-invasive, low impact and high performing therapy for a daily routine and can offer increased circulation, improved bone density and hoof growth and the relief of joint and muscle soreness.
RRP: SEE WEBSITE | equinehealthcentre.com
EQUISSAGE is an easy to use and scientifically proven therapy to aid both horse and rider. Created by Niagara Health Care, Equissage uses the same technology as that used in spinal and rehabilitation units across the NHS. Equissage Pulse has been developed to provide medical grade versatile therapy that offers unrivalled equine health and recovery benefits. Equissage therapy increases circulation and localised blood flow stimulating fresh, nutrient and oxygen-rich blood to areas needing repair. Aids improve lymphatic drainage to help flush out toxins to support speedier effective recovery.
RRP: £600 | niagaraequissage.com
SUSSEX EQUINE HOSPITAL makes
use of advanced imaging modalities to diagnose the cause of lameness. Following a comprehensive clinical examination and nerve block evaluation, digital radiography and ultrasonography can be performed at the yard or in the clinic. If indicated, scintigraphy, standing MRI and standing CT are available in a Tier 3 Royal College of Veterinary Surgeons-accredited hospital.
RRP: SEE WEBSITE | sussexequinehospital.co.uk
GOT 60 SECONDS? That’s all it takes to capture 3D image sets with Hallmarq’s new Standing Equine Leg CT. Designed to help fully evaluate and diagnose bony disease in the equine distal limb, the standing sedated horse is imaged on an open platform to capture 3D image sets in just 60 seconds.
RRP: SEE WEBSITE | hallmarq.net
From the first steps of rehab to getting you back on the road - FMBs caters for all!
REDUCE THE SEVERITY OF THE INITIAL INJURY
Ice Horse Boots – easy to use Ice Horse wraps provide uniform compression and superior cold coverage to reduce in ammation and heat in soft tissue and joints. Available in various wraps to cover the majority of the limbs and back.
Cold Salt Water Spa – the cold salt therapy provided by the spa helps to reduce the risk of injury after exercise, but also brings rapid relief from pain, bruising, swelling and recent tissue damage as it decreases blood ow to reduce in ammation.
FITNESS & STRENGTH BUILDING
Water treadmill - our Water Treadmills can be used for rehabilitation and as part of training to improve overall suppleness, stride length, muscle tone and strength for performance and reducing risk of injury.
Dry treadmills and Salt and Oxygen therapy – also available to help support everyday tness, health and ultimately performance.
Here at FMBs...
we can support you through the whole process of getting your equines back on the road after injury. What’s more, our equipment is available to hire to enable you to maximise on the healing potential they can o er.
PROMOTING HEALING OF CELLS
Low Level Laser – our cluster is a powerful combination of 24 infrared and 24 red diodes together with an inbuilt PEMF spool. Ideal for directly targeting the problem area whether soft tissue, bruising, wound or arthritis.
Leg Wraps – our legs wraps can be used in conjunction with our Combi Pro rug, or on their own for direct PEMF to the lower limbs. Sold in pairs and come in two styles, front and hind leg wraps.
Combi Floor – our Combi Floor is a state of the art equine therapy plate, and the only one on the market that combines controlled vibration with Pulsed Electromagnetic Field Therapy. It can be used pre warm up, and post exercise for both recovery and rehabilitation.
To nd out more about any of the above therapy products, please visit www.fmbs.co.uk, email info@fmbs.co.uk or call 01494 883433
