"Hey Doc, my horse has been lame for two weeks. I think he needs an X-ray of his shoulder.” We hear things like this often at the clinic, but this is not the starting point for a lameness evaluation.
Lameness is a clinical sign; it is a term used to describe a gait abnormality which can have a wide range of causes. Often, the underlying cause is pain, but it can also be due to a mechanical restriction on normal range of motion or movement. When we think of a lame horse, we think of one that has an obvious limp, but lameness can be more subtle, causing a slight gait change or sometimes a decreased ability or willingness to perform.
There are multiple steps for a thorough lameness evaluation. First, a detailed medical history is taken. Next, the horse will be examined at rest. The conformation will be assessed. Is the horse balanced and does it bear weight evenly on all four limbs? Is there any obvious evidence of an injury? A thorough hands-on exam follows. The limbs and body are palpated, and joints manipulated to assess for signs of inflammation, pain or any other abnormalities. Hoof testers are applied to feet to check for any sensitivity by placing pressure on the soles and hoof walls.
Then, we get to the motion exam. Your veterinarian will watch the horse at both the walk and the trot; evaluating the gait from the front, rear and sides observing for abnormal movements and identifying which limb(s) appear to be affected. We are looking for things like head bobbing, hip hiking, shortened stride, irregular foot placement, stiffness, winging or paddling feet, etc. Next, flexion tests are performed. This involves holding the horse’s joints in a flexed position for a set length of time and then releasing them and sending them off in a trot to observe for signs of pain, abnormal movement or weight shifting. Flexion tests can make an issue more obvious, or even reveal problems that are otherwise not readily apparent.
Depending on the findings from the history, standing and in-motion exams, further diagnostics may be required to isolate the specific location and cause of the lameness. This may include diagnostic nerve or joint blocks, radiographs (x-rays) and ultrasound. If more advanced imaging, like an MRI, is required, then a referral to an equine specialist may be recommended.
Treatment options and prognosis will vary depending on the reason for the lameness, which is why it’s best to have a diagnosis for the underlying cause if possible. There are things that you can do as an owner to help your horse. If you suspect a problem, discontinue riding and consult with your veterinarian promptly. Ensure your horse is conditioned properly prior to asking them to perform at a certain level. Match a horse’s conformation to its intended use. Ensure that their feet are well maintained and that they have appropriate nutrition.
Dr. Kim Jones joined the North Peace Veterinary Clinic care team in 2009 after graduating with distinction from the Western College of Veterinary Medicine.