Undiagnosed Lameness In A Horse

Ava Flores
• Monday, 08 March, 2021
• 7 min read

Equine lameness can be difficult to detect, but a study from England confirms the reliability of a relatively new tool for identifying subtle signs of musculoskeletal pain in horses. Developed at the Animal Health Trust in Newmarket in 2018, the Ridden Horse Pain Attogram (Rope) is a compilation of 24 behaviors, such as “head tilting,” “tail swishing” and “spontaneous changes of gait,” that have been proven to correlate with musculoskeletal pain (see “A System for Identifying Lameness, ” below).

horse hoefsmid horses hoof conformation toeing shoeing farrier gait changes trimming zoek goede paard mijn ik voor een patterns understanding
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If a horse exhibits eight or more of the behaviors, chances are good he is lame. Undiagnosedlameness has a far-reaching impact on the lives of horses and their riders, says Sue Dyson, Vet MB, PhD.

“One of the reasons I was incentivized to develop a Rope was I had become so dispirited by seeing so many horses who clearly had pain-related problems that had been ignored for far too long,” she explains. Longer whips, spurs, tighter nose bands, ‘stronger’ bits were being employed.

Moreover, veterinarians did not understand what they were looking at either---if an enlightened owner sought advice, and there was no obvious lameness seen in hand, they were told that the horse had behavioral problems.” The behaviors that had the strongest statistical correlation with lameness were ears being pinned back for five seconds or more, an intense stare for five seconds or more and repeated stumbling or dragging of both hind toes.

The average age of the horses was 11, and they were used in a variety of English disciplines. At the beginning of the study period, the horses were examined by a physiotherapist for signs of back pain.

A master saddle fitter than checked the fit of each horse’s tack to determine if it could be a source of pain. Each horse was then ridden by his usual rider through a dressage-type test that included walking, trotting, cantering and circling in both directions.

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An experienced veterinarian observed each ridden test and evaluated the horse for lameness, assigning a score on a 0-to-8 scale. Next, a second researcher, unfamiliar with each horse’s lameness score, analyzed the videotapes, documenting any instances of the behaviors listed in the Rope.

The behaviors that had the strongest statistical correlation with lameness were ears being pinned back for five seconds or more, an intense stare for five seconds or more and repeated stumbling or dragging of both hind toes. The researchers also found that almost three-quarters of the horses (73 percent) that were assumed to be sound by their owners actually had some degree of lameness.

An even higher pro-portion (82 percent) of the study’s lesson horses were found to be lame by the researchers, who noted that this group also had the highest median Rope scores. “One of the reasons that some of these horses are so safe for beginners is that they don’t want to go quickly; they hold their backs stiffly to compensate for lameness and minimize their discomfort, making them easier to ride.

The Ridden Horse Pain Attogram (Rope) was developed by Sue Dyson, Vet MB, PhD, in 2018 to help detect lameness. If a horse exhibits eight or more of the following 24 behaviors, it is likely that he is experiencing musculoskeletal pain.

With the free weekly EQUUS newsletter, you'll get the latest horse health information delivered right to your in basket! Lameness is a term used to describe a horse’s change in gait, usually in response to pain somewhere in a limb, but also possibly as a result of a mechanical restriction on movement.

equine massage therapy
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Lameness affects individual horses of all kinds and all levels, from subtle, reduced performance to loss of use, to chronic severe pain resulting in euthanasia. Sadly, many horses are asked to perform when they are in pain because of riders’ failure to recognize lameness.

As a horse owner, you are faced with a universe of well-advertised but completely unproven “miracle cure” products which claim to address every ailment. What is missing from the equation is a proper diagnosis, which only a trained and experienced veterinarian can provide.

Know the most common lameness conditions that affect horses of YOUR breed, type, conformation, and discipline. The most important are conditioning and fitness; matching of conformation to use, hoof care and shoeing, and nutrition.

Understand the value of a pre-purchase exam, whereby an equine veterinarian assesses lameness and conformation issues, as well as the health of the whole horse, before purchase. • BREEDING: Understanding basic equine form and function allows breeders to select horses that are of superior conformation and thus less likely to become lame.

The scar shortens the hamstring muscle unit, and causes a characteristically abnormal gait, irrespective of pain. Lameness results from pain coming from any part of a limb that contains nerve endings.

lameness horses detect
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Pain from skin wounds, connective tissue bruising, muscle pain, arthritis (joint inflammation), tendon sheath and burial inflammation, tendon and ligament injury, and bone injury can all result in lameness that cannot be differentiated by observing the horse’s gait. Certain breeds and disciplines are more commonly predisposed to developing specific lameness conditions.

It’s important to know that the site and nature of the injury cannot necessarily be determined based on the appearance of the lameness or the way a horse moves. The mechanics of the forelimb causes lameness to usually be more consistent and more obvious to the untrained eye.

The diagnosis and treatment plan is derived from a synthesis of findings from all the above parts of the lameness exam. Information gathered about the horse includes breed, age, and prior use all of which provide clues to the problem.

This is followed by a more careful visual examination and palpation of specific anatomic structures for swelling, heat, and pain. Examination often includes trotting in hand in straight lines, and circles to both directions.

The result, which is the change in severity of lameness following flexion, provides additional information regarding the origin of the pain. As with many parts of the exam, flexion tests are subjective, and the vet must interpret them in light of what is considered normal for that specific horse.

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As with flexion exams, the key to accurate interpretation of hoof tester examination is knowledge of what constitutes a normal response. This can only be gained through a methodical approach, and lots of experience with different types of horses and hooves.

If there is not, the process is continued on specific nerves progressing up the limb until the lameness is visibly lessened. Blocks into a joint or tendon sheath require surgical cleanliness and technique to prevent infection of these structures.

Limitations of blocking include spread of local anesthetics to adjacent regions, clouding the interpretation of the results. More difficult studies on larger body parts are often better performed in a clinic setting.

Examples of diagnoses that could be made via radiographic interpretation are chronic arthritis and fractures. An example of a diagnosis that could be made via ultrasound is a tear or strain of a specific ligament or tendon.

Arthroscopic surgical exploration is an important and commonly used diagnostic that allows direct visualization of the inside of joints. All the above steps, when performed properly and assembled and interpreted correctly, help to provide an accurate diagnosis and form the basis for a treatment program.

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These are generally classed as “regenerative therapies” wherein the body is manipulated in some way to heal itself without externally derived medications. Complementary therapies like acupuncture, chiropractic, massage and other treatments may have additional value in some cases but are not a substitute for a thorough lameness evaluation.

While lameness in horses cannot be prevented, it can be minimized through your understanding of the factors involved in its development. Educate yourself, and work with your trusted equine veterinarian to diagnose problems early on.

In this way, appropriate and effective treatments can be used, alleviating pain and slowing progression of problems, and enabling horses to get back to comfortable, sustainable work. While new imaging techniques add a great deal to our understanding, a methodical clinical veterinary exam will always be the cornerstone of lameness diagnosis and should precede use of this diagnostics.

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