Evaluating the equine athlete for lameness and poor performance (Proceedings)
Lameness problems and decreased performance are common in the equine athlete, and comprises a large part of performance horse veterinary medicine. Every equine sport or disciple has its own set of common disorders, so a basic knowledge of the sport and training techniques is very useful in both finding the problem and communicating with the people involved. However, the basic skills and knowledge necessary is the same for all equine disciplines.
Examining lame horses requires time and dedication. It is important to remember that not all lameness or performance evaluations can be completed in one day. Additionally, a trained staff and adequate facilities are essential. Ideally, areas where horses can be evaluated on hard and soft surfaces should be available, as well as an area where a horse can be examined under saddle.
The basic lameness exam begins with a thorough history of the presenting problem. The essential information that I like to obtain prior to looking at the horse includes the primary complaint of the owner or trainer, duration of the problem, prior treatment and any response to treatment, and expectations for the horse including future show schedule. It is important to remember that many times the presenting complaint may be simply a decrease in performance rather than a specific lameness issue. I rely a lot on what the trainer is seeing and feeling in the saddle. Often times a decrease in performance can be related to a lameness, however soreness in an area not bad enough to cause an obvious lameness can be highly significant in reducing the quality of performance of the horse. Other potential problems not related to lameness that are commonly seen in athletic horses are equine protozoal myelitis, gastric ulceration, and dental disease.Whatever pattern of examination you choose should be based on individual preference, but I believe that a systematic approach should be taken to evaluate the entire animal. Once you are comfortable with your system, it can be used for every horse that you evaluate. This is a good way to pick up any subtle abnormalities that can help streamline your examination. This basic lameness or performance evaluation also serves as the basis for my pre-purchase examination.
Once I have obtained a history on the nature of the problem, I like to evaluate the horse in motion. A lot can be ascertained simply by watching the horse unload off of the trailer. Any obvious asymmetry in musculature or abnormal swellings can be seen. Many horses with bilateral rear limb soreness may have a hard time backing off of a step up trailer, and can even fall or go down while backing. As my unloading area is on gravel, I can observe how the horse behaves while walking. Horses that are sore in the feet may show an obvious lameness while walking or turning on the gravel.
After the horse is unloaded, I will observe the horse at a walk in-hand on the hard surface (asphalt). Once the horse is accustomed to the handler and surroundings I systematically evaluate the horse walking and jogging in both directions of the circle. It is important to have a handler that you work with every day and a set routine to the sequence of the evaluation. I always begin with the horse in a left circle and then proceed to the right. A lot can be ascertained during this initial examination even prior to laying your hands on the horse. While examining the horse on the circle, both the front and hind end can be evaluated at the same time. Occasionally I may examine the horse in a straight line, however the front and rear limbs can only be evaluated independently in this manner. If the lameness is very subtle or if the horse is not amenable to jogging in hand, I may observe the horse on a lunge line. Many horses in my practice are never taught to lunge, so this may be difficult and can carry some liability if the horse injures itself. If the problem is not clear during these manipulations, I may watch the horse move in a sand arena in hand or under saddle. Many very subtle problems are made much more apparent when the horse is worked under saddle by an experienced rider. For some horses with decreased performance, it may be necessary to watch the horse performing their discipline to ascertain if there is a problem