Lameness and Neurological investigations at Athletic Equine
Explanatory Notes for Owners
My experience means that referral level investigations including nerve and joint blocks, digital radiography and ultrasound scans can be done where the horse is kept. This is obviously convenient for the owner and can enable better detection of subtle problems by avoiding the high adrenaline levels created by going to a different environment. If facilities at home are lacking it is also possible to bring the horse to a convenient location in Palmerston North, Hawkes Bay or Feilding by arrangement.
When your horse is undergoing investigation of a lameness problem it is important that you read these notes to understand the process. They explain why we do certain things and some of the things you can do to help us optimise the benefit from each visit and achieve an accurate diagnosis.
The Principles of a lameness investigation.
A thorough history taken and an examination at rest will be performed to determine if there are any indications to the cause of the lameness.
The horse will then be examined at walk and trot on a straight line and on the lunge on a firm level surface.A flat, straight and hard area for trotting the horse up is therefore needed,a quiet road is fine however an arena surface is too soft. We may also lunge the horse in an arena and on a firm surface. If the problem occurs mainly under saddle we will need to see it ridden. A competent horse person will need to be available to hold horse, trot, lunge and ride horse if required.
Each of the limbs will then be flexed to see if this exacerbates any lameness seen as this may help us locate an area of pain.
If lameness is apparent in one or more limbs we will try to localise it to a region of the limb and then more specifically to a joint or soft tissue structure of the limb using nerve blocks. Generally lameness is due to pain. Nerve blocks involve numbing the nerves to an area and assessing whether this reduces the lameness, if it does we know the pain is in the region we have just numbed.
We may repeat nerve blocks that your vet has performed because we have to identify the site of pain on the day we examine the horse to be able to make a diagnosis.
Some causes of lameness may not be suitable for nerve blocks e.g. stress fractures, certain horses. In these cases we may recommend going directly for radiographs, ultrasound examination or referral for a bone scan.
Some causes of lameness do not respond to any of the nerve blocks e.g. back or pelvis problems again we may recommend a bone scan.
Some apparent lameness problems are actually due to an underlying neurological problem e.g. mild wobblers can look like mild lamenesses. If we suspect this we will undertake a neurological examination of the horse and discuss the findings with you.
Radiographs (xrays) and or ultrasound examination may be indicated to determine the cause of the lameness once we have localised the site of pain. They are useful in determining treatment and prognosis for certain conditions.
Bone scans do not detect all causes of lameness and are not required to diagnose most common lameness problems therefore we only recommend them in certain cases.
Optimising the investigation
It is important to obtain a clear and exact diagnosis as much as is possible so we can optimise both our treatment and or advice regarding the prognosis for recovery. There are a few things that you can do to help us achieve this.
If you are not travelling to the appointment with the horse please contact Athletic Equine so we can get a complete and thorough history from you. Some details you may not think to mention initially often come up in discussion and are of interest and importance.
Horses that are overdue for shoeing, have been shod in the last week or have no shoes on when used to being shod will all exhibit a degree of foot pain. Also a loose or missing shoe on one limb will affect the gait of the horse. It is therefore important that the horse is well trimmed and shod when presented for investigation. If horses arrive with shoes missing we will not continue with the investigation until the shoes have been replaced and this will be at your expense.
Horses with a low grade lameness should be worked for a minimum of 20 minutes trotting daily unless your vet advises against this. Please discuss with Athletic Equine the vet if you are concerned or unable to work your horse prior to your appointment.
Some lameness or poor performance problems are only exhibited or are exacerbated when ridden. Therefore please arrange for tack and a rider to be present at the initial examination.
When horses are referred to us by another veterinary practice, we normally discuss the results with the referring vet before full discussion with the client. This is because your vet will need to be fully involved with the treatment plan for the horse.
Fees for an investigation are $300/hr inc GST and cover a thorough assessment of the history, your horse and production of a report on my findings. It does not include travel, sedation, nerve blocks and consumables. It can take a surprisingly long time to get to the bottom of problems, especially if subtle, long standing problems or those involving multiple limbs. We are happy to discuss costs before and during workups and will have a better idea of what will be involved once we have obtained a thorough history.Remember I am always happy to discuss individual cases and provide an estimate.
Should you wish to discuss any aspects of this, please contact us.