It was two days after the 4th of July when I decided to take my horse Milagro for a ride alone on the trail. We live in an equestrian community with well-groomed bridle paths, and I planned to have him out for about an hour. We were only about half a block from home when it happened.

I heard a car coming down the street we had just turned off. One minute I heard the motor, and the next minute, a loud pop. Someone had thrown a firecracker out of the car window in our direction.

Milagro is solid on the trail—he’s my North American Trail Ride Conference (NATRC) competitive trail horse—but firecrackers are his nemesis. He bolted in terror, racing up the trail at a mad gallop, away from the sound.

In an effort to stop him, I turned his head and pushed him with my leg into a tight circle. But the bridle path that once seemed wide and safe was not big enough for a terrified, runaway horse.

As I turned him, his back hoof landed on the sloped driveway of one of the homes adjacent to the trail. I felt his back end going down. He scrambled and got his feet under him, but not before he let out a horrible scream.

I jumped off and examined his back legs. I didn’t see anything obvious, even as I led him home. His adrenaline was racing, and he was practically dragging me.

An hour later in his paddock, he had calmed down. It was then that I noticed he was dragging his left hind toe. I called out the vet, who examined him by lifting the affected leg and stretching it out behind him. Instead of bending at the hock, the leg extended straight out in a way that turned my stomach.

“He’s got a rupture of the peroneus tertius tendon,” my veterinarian said.

How Tendon Injuries Happen

Tendon injuries can occur in two ways: through chronic overuse, or through trauma. Because horses’ legs are made up of a number of tendons, they are prone to stress and injury.

“Tendon injuries result from sudden tears or ruptures from a single overloading event, or chronic strains from overuse,” says Annette McCoy, DVM, M.S., Ph.D., Dipl. ACVS, associate professor of Equine Surgery at the University of Illinois College of Veterinary Medicine.

“The former are usually recognized right away after an athletic episode, and usually have the hallmarks of heat, focal pain when touched, and obvious swelling,” she explains. “The latter can result in low-grade chronic lameness that can be difficult to diagnose.”

The most commonly injured tendons and collateral ligaments that support joint stability in non-racing horses are the suspensory ligament, deep digital flexor tendon, the check ligament and the superficial digital flexor tendon, according to Jennifer G. Barrett, DVM, Ph.D., DACVS-LA, DACVSMR-EQ, Theodora Ayer Randolph professor of Equine Surgery at Marion duPont Scott Equine Medical Center at the Virginia Maryland College of Veterinary Medicine.

Varied Treatment of Tendon Injuries

The way a tendon injury is handled right after it’s discovered can make a big difference in the ultimate outcome.

“Right after an injury happens, we are trying to combat inflammation and swelling,” says McCoy. “This is accomplished with a combination of cold therapy like icing or cold-hosing, compression with bandaging, systemic medications like a non-steroidal anti-inflammatory drug [NSAID] such as phenylbutazone [bute], and stall rest.”

Although scarring of the tendon as it heals cannot be prevented, making the scar tissue as functional as possible is the goal.

“Controlled exercise in a rehabilitation program helps us to do that,” says McCoy. “Periodic re-evaluation with ultrasound helps us determine the healing progress. A rehab program might need to be altered, depending on how the tendon is healing.”

A number of adjunct therapies can also be used to help tendons heal, including extracorporeal shock-wave therapy, therapeutic ultrasound, and low-level laser and magnetic therapy, although not all of these therapies have been studied in clinical research.

“Biological therapies such as platelet rich plasma [PRP], autologous conditioned serum, and mesenchymal stem cells injected directly into a tendon injury under ultrasound guidance have shown some promise at either speeding healing, improving the quality of the healed tissue, or helping to reduce the incidence of re-injury,” says McCoy.

“More work is needed to understand exactly how these treatments work, and what injuries are best addressed by using them,” she adds. “This is a very active area of ongoing research.”

There are some tendon and ligament injuries that can benefit from surgical treatment, according to Barrett.

“Examples include the suspensory ligament in hind limbs, the deep digital flexor tendon, and superficial digital flexor tendon when they are injured in a tendon sheath or bursa,” she says.

Slow Recovery

When a horse injures a tendon, the issue can require a temporary layup or permanent retirement.

“Prognosis is entirely dependent on the severity and location of the injury, but typically ranges from fair to guarded for future athletic use,” says McCoy. “An owner should expect that their horse will be out of full work for nine to 12 months while the injury heals. Unfortunately, horses that have had a tendon injury are highly prone to re-injury.”

The way the layup and rehabilitation are handled can make a huge difference in whether the horse is able to return to his previous activity.

“The hardest thing for owners to understand is that healing takes a very long time for tendons and ligaments,” says Barrett. “Humans can rest by taking the weight off the limb completely. This is not possible for horses, so we rely on reducing exercise as much as possible during healing.”

Stall rest is the best we can do to limit trotting and overuse of a healing tendon, but stall rest is hard for owners, and is often seen as hard for horses too, according to Barrett.

“The same way you need to be on crutches to heal a tendon, horses need stall rest and very controlled exercise once your veterinarian determines it appropriate,” she says. “All of the difficult and expensive care your veterinarian provides [might] be wasted if the exercise recommendations are not followed.”

The length of stall rest and the limited exercise needed to help the horse recover depends on the injury. Extensive stall rest is usually prescribed early in recovery, with a gradual return to gentle exercise as the tendon heals.

“Early loading—exercise—of the tissue is the most essential aspect of healing, but we can’t load too much, otherwise it breaks again,” says Henk Offereins, DVM, of equinetendon.com, an Ireland-based equine management service specializing in the area of tendon injuries. “Getting that balance right [is the difference between] success and failure in rehabilitation.”

Update on Milagro

Milagro made a full recovery after rupturing his peroneus tertius tendon, but only after a one-year layup that required three straight months of stall rest with physical therapy on the affected leg. He eventually graduated to hand-walking, slowly building up the amount of time he could be walked over a period of months.

Today, he is back to trail riding around our community as well as competing in NATRC events. He is so sound these days, I often forget he ever suffered this horrible injury. I believe the long layup and following my veterinarian’s instructions on rehabilitation made all the difference.

Key Takeaway

Tendon injuries are as complicated as equine injuries come—and certainly time-consuming to recover from. Understanding treatment options and the recovery timeframe can help horse owners and caretakers to better manage any future tendon injuries.

Further Reading:
◆ Managing Horses with Tendon and Ligament Issues
◆ Taking Care of Your Horse’s Tendons

This article about equine tendon injuries appeared in the April 2024 issue of Horse Illustrated magazine. Click here to subscribe!

The post Treatment of Equine Tendon Injuries appeared first on Horse Illustrated Magazine.

“Dr. Chad Davis recommended that we use the Pro-Stride APS device to support CR’s joints, given the high level of work and impact that he sustains for training as well as competition,” shares Colleen Rutledge, whose horse Covert Rights – called CR – is a retired 5-star eventer. The 2006 gelding now competes in PSG dressage. CR has been on other treatments in the past but has now been on Pro-Stride APS for three years. “As most horse sports are a game of millimeters and seconds, anything that we can do to maximize comfort and minimize damage is always welcome. CR has always been very demonstrative when he doesn’t feel his best, and the Pro-Stride APS device helps him maintain his comfort.”

What is Pro-Stride APS and How Does it Help Horses with Joint Pain?

Pro-Stride APS – autologous protein solution – is a device that produces an all-natural concentrated injectable solution that uses your horse’s blood to help counteract the effects of osteoarthritis and musculoskeletal injuries. “The Pro-Stride device utilizes a combination of concentrated anti-inflammatory proteins, white blood cells and growth factors from platelets derived from the horse’s own blood,” explains Dr. Holly Helbig. “It works primarily by blocking interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-alpha) from binding to the cartilage surface. These are two major pro-inflammatory proteins that lead to degeneration of the joints.”

Your veterinarian can administer Pro-Stride APS stall-side in about 20-30 minutes. They will draw your horse’s blood and run it through a centrifuge in a two-step process. This creates a concentrated cell solution that contains your horse’s own anti-inflammatory cytokines and growth factors. When injected back into your horse, it helps to reduce inflammation and pain. “Not only does this therapy address inflammation, but it also promotes healing of the joint space,” explains Helbig. “Biological therapies continue to gain the attention of veterinarians and horse owners for corticosteroid-free management of osteoarthritis.”

In a 2014 study published in the American Journal of Veterinary Research, client-owned horses who were evaluated for lameness and then treated with Pro-Stride APS showed significant improvement in lameness grade up to a year later, and in some cases longer, after just one injection.¹

How long effects last will vary from horse to horse, depending on many factors including type of injury or condition being treated. Helbig explains that after one treatment, your veterinarian will assess your horse’s response and create a plan from there. In her experience, Helbig says, “We evaluate the horse’s response to see if the Pro-Stride device improved lameness approximately 4-6 weeks post injection.”

An Alternative Treatment to Steroids for Horses with Joint Pain

While corticosteroids are the norm for treating osteoarthritis and musculoskeletal injuries, Pro-Stride APS may be a better alternative. Steroids are known for being fairly fast-acting, reducing pain quickly, but does not address the healing process like Pro-Stried does. Additionally, there are potential negative side effects to repeated and long-term use. “High doses of corticosteroids as well as repeated use has more recently been associated with degradation of articular cartilage, leading to potential further damage to a horse’s joints,” explains Helbig. This means that the treatment you are using may eventually make the problem you are trying to solve worse.

While all injections have a small risk of complication including localized pain, swelling or infection at the injection site, Pro-Stride APS will not degenerate the joint further like steroids. “The Pro-Stride APS device has safety and efficacy studies showing a strong safety profile and efficacy up to 12 months post-injection,” she adds.

Nonsteroidal anti-inflammatory drugs – NSAIDS – are also common systemic treatment for pain in horses with osteoarthritis and musculoskeletal injuries. However, NSAIDS have negative side effects from prolonged use as well, including papillary necrosis, equine gastric ulcer syndrome and right dorsal colitis, according to “Non-Steroidal Anti-Inflammatory Drugs and Associated Toxicities in Horses” published in 2022.

With Pro-Strides APS, you may be able to ditch the NSAIDS too. “It depends on the condition that we’re treating or managing,” explains Dr. Chad Davis, when asked about stopping NSAIDS with regenerative therapy like Pro-Stride APS. “In our practice, it’s uncommon to keep horses on chronic NSAID therapy or treatment. Rather, we would look to medical devices like Pro-Stride APS to allow for a more comprehensive response and better outcome than using NSAID therapy alone. Our thought process when using orthobiologic devices and therapies is to condition and train the injured location and associated cells to be less inflammatory in response to an injury or disease, and more reparative and regenerative in nature. Inflammation control is key, but how you address inflammation is the science behind the treatments and therapies.”

Can I Compete with Pro-Strides APS on Board My Horse?

A big question with any treatment we use on our horses is whether it’s legal for competition. So can you use Pro-Stride APS before a competition? “There are no drugs, medicines or additives in a Pro-Stride device since it’s a byproduct of the horse’s own blood,” answers Helbig. “Speak with your veterinarian to ensure that your horse is fit for competition, and if lame, has an appropriate diagnosis and plan to ensure timing of the injection. Most equine organizations have a minimum number of days between injection and competition times. Check with your veterinarian or governing body for appropriate rules and regulations.”

“As for using the Pro-Stride APS device before a big event, the short answer is yes,” adds Davis. “The extended answer is to ensure you have enough recovery time after the therapy to achieve the maximal responses. We see many orthobiologic therapies and devices, not only as point-of-care medicine but also as preventive medicine. Preventive medicine ensures optimal performance and predictable outcomes and is a focus at our practice with the Virginia Equine Rehabilitation and Performance Center.”

We all want to keep our horses happy, healthy and pain-free. Pro-Stride APS uses your horse’s amazing power of self-healing to ease discomfort and possibly regenerate the joints. Learn more about Pro-Stride APS at the Zoetis website and ask your vet if it may be right for your horse.

¹ Bertone AL, Ishihara A, Zekas LJ, et al. Evaluation of a single intra-articular injection of autologous protein solution for treatment of osteoarthritis in horses. Am J Vet Res. 2014;75(2):141-151. doi: 10.2460/ajvr.75.2.141.

This article is a web exclusive for Horse Illustrated magazine. Click here to subscribe!

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Soaking the hoof several times a day will eventually cause an abscess to erupt and drain. However, some vets now advise against frequent soaking as it may weaken the hoof wall. Some horse owners instead choose to apply drawing agents, such as ichthamol or Epsom salts, directly to the hoof under a bandage.

The goal in the treatment of a horse’s hoof abscess is to draw out the infection and keep the area clean to prevent reinfection while the hoof heals. Once you have confirmed the diagnosis with your vet, follow the steps below to put your horse on the road to recovery.

For treatment of a horse’s hoof abscess, you will need a flexible bucket or tub, Epsom salts and poultice pads or iodine. Bandaging materials include sheet cotton or a diaper, elastic bandage and duct tape.

Step 1:  Mix Epsom salts in a bucket of warm water.  Use enough salts to reach the point of saturation, where no more will dissolve.

Step 2:  Submerge the entire hoof up to the coronary band and soak for 10 minutes.  This will help draw out the infection and will encourage the abscess to erupt if it has not already been opened and drained.

Step 3:  Soak a poultice pad in hot water.

Place the pad over the sole of the hoof.

If you do not have any poultice pads, you can make a poultice with Epsom salts and iodine.

Pack the paste into the hoof so it covers the entire sole.

Step 4:  Wrap the hoof in a diaper or sheet cotton.  Secure the diaper by tightly wrapping it with elastic bandage. Cover the entire bandage with duct tape for durability. If your horse will be turned out or is prone to destroying bandages, you may want to use a hoof boot.   Click here for step-by-step instructions on bandaging a hoof.

Your horse may be sound in as little as a couple of days.  Once the abscess has drained, keeping the hoof protected from dirt and debris is the best way to avoid complications or reinfection.  And of course, always consult your vet to help you decide the best course of action. 

Further Reading on Treatment of Hoof Abscesses in Horses

◆ Hoof Abscesses and Puncture Wounds
◆ How to Manage and Treat a Hoof Abscess
◆ Causes of Equine Lameness: Foot Abscess

This article about treatment of hoof abscesses first appeared in Horse Illustrated magazine. Click here to subscribe!

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Don’t let the optimistic array of new research findings, therapeutic products, and expert opinions deter you from the basics of helping your horse avoid or survive the disease that has broken so many owners’ hearts.

What you have seen of this too-common disease has probably shocked you. You’ve watched owners soaking and bandaging and gingerly hand-walking their stiff-legged, laminitic horses. You’ve seen hooves crusted with growth rings, scarred by abscesses, and shod with pricey designer horseshoes or boots.

Every horse is at risk of laminitis. It’s a disease with different forms, multiple causes, varying severity, and an impact like no other. Some horses recover to gallop again, some spend months on stall rest, and others live with low-grade chronic lameness, helped by a special diet, conscientious hoof trimming and medication for the rest of their lives.

For advice, we turned to a respected source on the subject. The Animal Health Foundation (AHF) funds laminitis research all over the world. The charity’s founder, Donald Walsh, DVM, is optimistic about how horse owners can prevent and manage the disease.

What is Laminitis?

Most people think laminitis is a horse foot disease, but it is more than that. The AHF defines laminitis as the breakdown of the internal supporting structures (“laminae”) between the outer hoof wall and the coffin bone inside the hoof. This breakdown can also damage the delicate circulation in the horse’s foot and cause great pain.

Laminitis commonly affects horses’ feet when hormone production is disrupted, but it is also caused by retained placentas in mares after foaling, or when an injured horse bears weight excessively on its good foot. Body-wide inflammation, such as a complication after surgery, severe diarrhea, or diseases like Potomac horse fever are other pathways. Horses may also develop laminitis when exposed to stable bedding made from black walnut trees.

The most classic laminitis is direct carbohydrate overload, caused when a horse gorges on grain. He may not look sick, but his feet can be damaged by a situation that could have been prevented.

Laminitis research focuses on any one of these causes of the disease. Researchers look at aged horses at risk for the hormonal disease pituitary pars intermedia dysfunction (PPID, or Cushing’s disease), which alters pituitary hormones. They also research how efficiently horses regulate the hormone insulin, how they handle stress, or how seasonal or gender-related hormones affect them.

The most familiar form of laminitis is the sore-footed aftermath of grazing on rich spring grass. Many of these horses have what is called equine metabolic syndrome, rooted in insulin dysregulation, and frequently are overweight with obvious cresty necks or fatty areas around the tail base, sheath and shoulders.

Signs of Laminitis in Horses

Laminitic horses are usually lame in both front feet and sometimes in all four feet. Laminitic horses take shorter, more tentative steps than usual, and will toss their heads when turning at the end of a walkway. They may stand with their hind feet tucked forward under their bellies, and their front feet strutted out in front.

But laminitis caused by hormonal problems may have been sending you warning signals for months by gradually altering the shape of the horse’s feet. Hoof wall ridges are common, but the Animal Health Foundation suggests that it is farriers who see it first; they will remark that the sole is flattening out or bruised, and that the white line around the border of the sole is stretching and flecked with hemorrhage even if the horse isn’t noticeably lame.

The Mechanics of Laminitis

When the inner lamina tissue are damaged by laminitis, the bone partially detaches from the hoof wall. If you’ve ever torn one of your fingernails loose, you know how much damaged lamina hurt. Now imagine bearing your weight on that ripped nail: That’s how a horse feels when standing on laminitic hooves.

Sometimes the lamina are mildly damaged; other times the damage is focused on a portion of the foot. Commonly, the toe region is the worst affected. In severe cases, the bone becomes unstable inside the foot.

According to AHF, founder is the painful, crippling result of a foot’s bond damaged by laminitis. When a horse founders, the unstable coffin bone rotates or even sinks, putting pressure on the sole of the foot, sometimes even puncturing it.

Veterinarians take X-rays to evaluate the rotation factor, and also may take a venogram to get a picture of how badly the circulation is damaged.

What can you do to reduce your horse’s risk of laminitis or founder, and what makes a laminitis emergency? Click here to continue reading about treating laminitis.

This article originally appeared in the April 2019 issue of Horse Illustrated magazine. Click here to subscribe!

The post An Overview of Laminitis appeared first on Horse Illustrated Magazine.

“In my experience, horses almost never say no,” says Steve Allday, DVM, an equine lameness specialist with more than 35 years’ experience caring for an impressive list of equine athletes. “Horses can talk, and it is our job to learn how to speak their language and above all, to listen and be their advocate.”

Allday has been the lameness specialist for equine legends that include Triple Crown race winners, 29 Breeders’ Cup race winners, and five Thoroughbred Horses of the Year—including legendary racehorses A.P. Indy and Cigar—among other elites, such as World Equestrian Games jumpers. In addition to being a top sport horse veterinarian, Allday has also founded and developed a line of joint supplements.

1. What is equine osteoarthritis?

Sometimes hidden and other times obvious, equine osteoarthritis (OA) is a condition that impacts horses regardless of age, breed or discipline. It’s estimated that OA is responsible for up to 60 percent of all lameness in horses, according to the American Association of Equine Practitioners (AAEP).

Also referred to as equine degenerative joint disease, OA is a chronic disease-causing degeneration of the joints and resulting in pain, inflammation and reduced flexibility and range of motion. To understand OA, it’s important to understand the three different types of joints horses have:

1. Synovial joints: These allow different degrees of movement and rotation, acting as a hinge for the primary mode of flexion and extension. Examples include fetlocks, knees and hocks.

2. Fibrous joints: These do not allow for movement between the bones, such as the joints between bones of the skull.

3. Cartilaginous joints: These connect bones with cartilage, allowing limited movement and shock absorption, like the joints between the vertebrae of your horse’s spine.

Osteoarthritis can occur in synovial and cartilaginous joints, and it’s a common condition horses can experience.

“Osteoarthritis is ubiquitous in all mammals, and progressive as a rule,” says Allday. “It can occur anywhere on the horse: in their hips, hocks, stifles, knees, fetlocks and other joints.”

2. What causes equine osteoarthritis?

You may have wondered if different equine sports affect specific joints. Although any horse in any discipline can be affected by OA, there are common themes and joint problems that occur in the varying equine sports.

For instance, cutting and reining have greater impact on the hocks and stifles, causing horses to have heightened OA risk to these joints. And jumpers are more likely to have front-limb lameness in the coffin or fetlock joints. The bottom line is that any joint that is more significantly used on a horse increases its likelihood for developing OA.

3. Can osteoarthritis be prevented?

To help avoid joint health problems, you need to get ahead of what problems can—and unfortunately, likely will—arise due to a horse’s conformation flaws, stabling or training environments and everyday injury risks.

“Whether a racehorse, dressage horse, cutting horse or a barrel horse, by maintaining things preventatively and staying a step ahead of potential problems before they become a major issue, you can help ensure your equine partner’s performance,” says Allday.

You can help prevent equine joint health problems by:
◆ Offering quality nutrition for strong bones and healthy cartilage.
◆ Prioritizing hoof care and keeping horses on a regular trim schedule.
◆ Keeping horses at optimum weight and avoiding obesity, which stresses the joints.
◆ Riding on softer footing and limiting work on hard surfaces.
◆ Incorporating joint supplements to help maintain their joints and cartilage.

4. How is osteoarthritis diagnosed?

Allday assures us that as the No. 1 human in your horse’s life, you are the best diagnostician of any changes in your horse’s joint health.

“This is simply because you know your horse,” he says. “I don’t have a crystal ball. When I go look at a horse, I’m taking a snapshot of that moment, while you have known the horse for days and years—sometimes, his entire life—before I got there that day.”

Every time you’re grooming or tacking up for a ride, check your horse for symmetry: If you fear one side is larger than the other, you can just compare it to his opposite side.

Give your horse a proper once-over: Rub his back and palpate it, checking for soreness.

When you pick up his hind leg, check the hock for any fluid. This daily interaction with your horse, coupled with knowledge of his particular history, will be invaluable to your veterinarian when diagnosing any joint problems.

Should your veterinarian suspect joint problems, it’s likely he or she will perform a routine lameness evaluation. According to the American Association of Equine Practitioners, this includes summarizing the horse’s medical history; a visual appraisal of the horse at rest; a thorough, hands-on examination, including palpating the horse’s muscles, joints, bones and tendons for any heat or swelling; an evaluation of your horse’s three gaits in motion; and a joint flexion test.

“Every horse deserves a full and thorough veterinary examination,” says Allday. “It’s not just a choice—it’s a necessity to help maintain these equine athletes and keep them at their best.”

In addition to lameness evaluations, diagnosis of OA can also involve diagnostics such as:
◆ Radiographs
◆ Fluoroscopy
◆ Nuclear scintigraphy
◆ CT
◆ MRI
◆ Nerve and joint blocks
◆ Ultrasound
◆ Thermography

5. Is equine osteoarthritis curable?

While there is, unfortunately, no definitive cure for OA in horses, the pain and inflammation associated with it can be treated. Prevention, along with early diagnosis and treatment, is critical to keep the condition from progressing.

“OA isn’t the end of their career, but it’s certainly something you have to be on top of, address rapidly and maintain routinely,” says Allday. “You have to remember that osteoarthritis is progressive, and as it gets worse as the horse gets older, you’ll need to be very proactive. You may even have to go to anti-inflammatories to maintain a horse’s athletic career.”

6. What are treatment options?

Treatment for equine OA focuses on alleviating pain and inflammation in the joint, allowing horses to have improved mobility. For horses diagnosed with osteoarthritis, veterinarians may recommend prescription medications, like Equioxx, Adequan I.M., Legend or Surpass Topical.

Should OA be diagnosed, your veterinarian will work closely with you on joint health supplements to prevent further progression of joint damage, as well as anti-inflammatory treatments available to manage the pain and inflammation associated with osteoarthritis.

Allday recalls a conversation he had with Allen Paulson, founder of Gulfstream Aerospace and renowned owner of more than 100 graded stakes race winners. Paulson’s horse was the favorite for the Kentucky Derby, but due to a joint injury, he was scratched.

“I told him, ‘A horse isn’t like the planes you build—you have to go with the original equipment.’ And it’s true—you can’t put a horse up on a rack and switch in a new part. Taking care of their original equipment is the epitome of how you can preventatively maintain your horse throughout his career.”

The post Answering 6 Questions About Equine Osteoarthritis appeared first on Horse Illustrated Magazine.

The elderly gray Appaloosa craned her neck to watch me as I gently ran my hand over the hard swelling on her hind leg. I didn’t like the fact that the large mass was right on the outside of the stifle joint. I also didn’t like the fact that the swelling had been present for over a month, and Gregg had just now asked me to come see it.

“Is she lame?” I asked.

“Nope, seems fine,” replied the man holding Ellen’s lead rope. “But she does favor it.”
Now in my world, when a horse favors a leg it means that the leg hurts and that the horse is limping, which technically means that the horse is lame. For reasons I don’t understand, the word “lame” seems to reliably cause horse owners to become defensive, so I’ve learned to settle for the term “favoring it.”

Looking for Answers

I asked Gregg if he’d jog Ellen for me. She was lame at the trot but took an almost normal stride at the walk.

I palpated the stifle joint more carefully. All external ligaments were intact, but I couldn’t feel the lateral aspect of the joint because of the large amount of swelling. If it was an infection and affected part of the stifle joint, Ellen could be in big trouble.
I sedated her lightly and scrubbed the area with a chlorhexidine-based surgical soap. Gregg blanched as I held up a large bore needle.

“What are you going to do with that, Doc? Needles give me the spins!”

“You don’t have to watch, Gregg,” I said. “I’m going to try to tap into this swelling and see what is in there.”

Gregg visibly paled, turned his back to me and started humming loudly, and I leaned forward and popped the thick needle straight into the center of the mass on the mare’s leg. I gave the needle a quick twist with my fingers, and suddenly there was a rush of yellowish fluid, some of which hung from the needle hub like mucus.

I quickly caught some of it in a test tube, then connected a large syringe to the needle and proceeded to suck out almost 170 ml of the same cloudy, syrupy fluid. Not knowing exactly what I was trying to treat, I injected a Hail Mary dose of a steroid back into the area and pulled the big needle out.

It was either a seroma, which is basically the aftermath of blood leaking under the skin after trauma of some sort, or an infected joint. I knew I would be euthanizing Ellen if it were the latter, as a month-old infected joint basically had a hopeless prognosis.

Steroids are contraindicated when infection is present, but they would at least help make the pony more comfortable until I had a diagnosis.

Gregg was still humming loudly, and I announced that he could turn around. He braved a glance in my direction but blanched as I held up the full syringe triumphantly. The mare’s leg was considerably deflated, and I started her on some medicine and went home to analyze the fluid.

Mystery Solved

Gregg called as I was about halfway home.

“What did you find out, Dr. Diehl?”

“My fuel mileage is terrible.” I replied. “Oh, and it looks like it might rain.”

“No, about Ellen!”

I sighed. “Gregg, I’m not even home yet! I promise I will call you immediately when I know something.”

Since I was no clinical pathology expert, the odds of me having to send the fluid out for analysis were fairly high, but I gave it my best shot. I made several thin smears of the fluid on a microscope slide, air dried them, then used a special stain that would highlight things like white blood cells and bacteria. I couldn’t find many cells in the fluid and could only identify a few pieces of fibrin, a protein that forms when blood clots.

Infection seemed less likely, but I couldn’t risk making the wrong call. The fluid was cloudy, and usually seromas produced clear fluid, so I sent the sample off to the lab. Their bacterial culture was negative, and the pathologist just reported the same fibrin on the cytology report, which meant that a seroma was indeed more likely.

I called Gregg back and explained the lab’s findings and got his permission to X-ray the leg. When I looked at the images, there was a lesion on the tibia consistent with a nasty bone bruise, and I knew we’d found the explanation for the angry fluid and the lameness.
Gregg’s eyes were wide as he studied the X-rays.

“I bet old Dobbin did that to her, Doc! He’s a mean one when there’s food around!” He shook a finger at an ancient chestnut gelding that meandered around a corner. “You bad horse! I’ll turn you into glue if you do that again!”

Dobbin reached for the carrot that Gregg had produced, and the man stroked the old gelding’s neck.

Another Horse Favors a Leg

Ellen went on stall rest for another four weeks, and the swelling gradually improved, as did the lameness. Gregg spread the hay piles out further and peace seemed to be restored.

About a month later, Gregg asked me to take a look at Dobbin, who had a swelling on his hind leg and a perfect imprint of a hoof embedded on his rear end, accompanied by some bite marks. Ellen was calmly munching from the nearby hay pile, but when Dobbin dared a glance in her direction, she pinned her ears flat and advanced towards him very slightly.
Gregg chuckled, then pointed at Dobbin. “And it serves you right, Glue!”

He thumped the old horse on the neck affectionately. “Now, what do you make of this leg, Doc? He’s not lame, but he is favoring it.”

This article about what to do when a horse favors a leg originally appeared in the September 2021 issue of Horse Illustrated magazine. Click here to subscribe!

The post Vet Adventures: When a Horse Favors a Leg appeared first on Horse Illustrated Magazine.

Lameness brings out many emotions, including fear and frustration, particularly when its cause is a mystery and the horse doesn’t heal. Those are just some of the emotions that Barb Robinson, an avid trail rider from Aston, Penn., felt when her partner, an 18-year-old Icelandic gelding named Ari, went mysteriously lame.

Ari was performing well in the months leading up to his lameness. Uncertain but considering possible causes, Robinson relayed that she had taken him on a 10-day trail riding trip to Hocking Hills, Ohio. When she arrived, she found the conditions less than ideal. “It was a deep, slogging mud,” she says. “But he came out fine.”

She rode Ari all summer and fall without issue, even taking part in the League of Maryland Horsemen’s Fall Roundup in November 2019. “His gaiting was awesome!” she adds.

After the Roundup, she began to notice small changes. “He started resting his left hind leg [while in crossties] here and there,” says Robinson. “He never did that before. He used to always stand square.”

He was also laying down more than usual. Still, she was able to continue riding without issue, including the day after Christmas with a friend. It was on this ride that she noticed that Ari felt a little off while she was posting. Then, bringing him in from the pasture the next day, he was off at the walk and on turns while being led. Robinson called her veterinarian out to investigate.

“I was convinced it was the left hind,” Robinson says. “He flexed positive in the left stifle and the hock.”

Ari was placed on a COX-2 inhibitor for several weeks, and Robinson stopped riding, but unfortunately she didn’t see any improvement. Her next step was to have an osteopath visit. “The osteopath felt the right stifle was sticky,” she continues. ” She got it working properly.”

The osteopath also gave her the green light to start riding again. “But when I rode him, he really didn’t want to put weight on the left hind.”

Because of its prevalence it was at this stage that she had her veterinarian also test for Lyme disease. It was negative. By this time, Ari was exhibiting a level five lameness on the American Association of Equine Practitioners’ scale, meaning that he was minimally weight-bearing whether in motion or at rest. At her wits end, Robinson began appealing to others for help.

Healing Hands for a Mystery Lameness

“One of our associates reached out to me about a fellow Icelandic Horse owner having trouble with a mystery lameness,” said Heather Wallace, ESMT, CCMT, an equine and canine sports massage therapist.

Wallace owns Animal Bodywork and Aromatherapy based in Red Bank, New Jersey, and has partnered with human and animal chiropractor, Madelyn Rauch, DC, AVCA.

“She called me up and asked if there was something, we could do to help,” says Wallace, and she and Robinson were able to make the connection. “That was in January of this year.”

On their initial visit, Wallace and Rauch (who is known as Dr. Madi) took thermal images. “We could immediately see that there was a lot of heat in the left stifle and hip,” Wallace says. “There was some compensation in the front as well. Once I got my hands on him, he had a knot the size of a grapefruit in his groin. I started to unlock it.”

The team’s efforts are a true partnership. It starts with Wallace loosening and adjusting the muscles, a benefit in and of itself. Then Rauch removes the interference to the central nervous system, which is housed within the spine and accessory osseous (bone) structures, to create more ease in the skeletal system.

“I’m looking at the way the horse’s body moves,” says Rauch. “If it is locked and not moving the body cannot get messages to that area as efficiently.

She then works to remove any interference. “I was able to get more motion into all of these segments, so that they would fall back into alignment and start progressing,” she adds.

Rauch uses a specialized technique, Bio-Geometric Integration (BGI), which is largely fascial-based (related to the tissue covering the muscles). This technique minimalizes the effort that it takes to move a bone. Coupled with Wallace’ s massage, the combined treatments make for a gentle but effective adjustment.

Wallace and Rauch worked on Ari for a total of three sessions at one and three weeks apart after the initial visit. “We started seeing results immediately,” Wallace said.

Ari was still lame, but he was able to stretch the leg and bear weight. The lameness was reduced by 60% after the first visit.

The team pointed out that it’s important to note that Ari’s other caregivers were not wrong. “There was definitely something going on in the right stifle, because he was compensating and putting so much pressure on that right stifle, because he physically could not put weight on and stretch that left hind leg,” said Rauch.

Ari’s long-term prognosis is very good, and his owner is thrilled. He’s currently 100% sound and back to trail riding. He’s now on a maintenance plan with Wallace and Rauch to ensure his future soundness, which both recommend for all horses as a preventative measure.

Sometimes it is more about adding other members to a horse’s healthcare team so that issues can be evaluated from a variety of perspectives.

Have you ever had a health issue with your horse that required a team of experts to work together? If so, please share your story in the comments below.

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