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Lameness

Lameness Seminar July 14(copy)










The Franklin Vets Equine team recently held a very popular seminar evening covering lameness in horses.


Any horse owner will understand the struggle that a lameness can bring, and we hope this will arm our clients with extra knowledge and an ability to pick up on a lameness which may have previously been unnoticed.  Here we have a summary of the main points covered by each speaker.

Andrea Ritmeester is a Massey graduate who spent time in America specialising in equine surgery, returning to New Zealand to become the first registered specialist in equine surgery in the country.  She is now based at Matamata Vets but known to the Franklin area after spending several years as a surgeon for a local clinic.  Franklin Vets are proud to have a close relationship with Matamata Vets, and this is our first choice for referring patients & where we seek specialist advise on tricky cases from.  Andrea discussed joint disease and her main points were:
  • Joints are highly intricate structures with many components.  The bony surfaces are lined with cartilage which contributes to the production of joint fluid.  If the cartilage becomes damaged, as a result of an injury or arthritis, the integrity of the joint lining is compromised and more fluid is created.  This results in a characteristic puffy joint.
  • It is important to feel your horse’s joints daily.  By getting to know normal, you will quickly pick up the abnormal.  Ask one of our equine vets to show you how to effectively and safely palpate joints.
There are 3 main imaging modalities used for joint disease
  • Radiography to show up bony changes.  These changes take weeks to be visible so radiographs must be carefully timed.
  • Ultrasound to investigate soft tissues and joints.  Ultrasound is a very useful diagnostic tool when used correctly, and can be used immediately after an injury.
  • Nuclear scintigraphy (bone scan) uses radioactive substances and scans the entire body. Anywhere that has increased bone cell activity related to inflammation from injury, will show up as a ‘hot-spot’.  Bone scan indicates the site of lameness however does not diagnose the cause, so needs to be used in conjunction with examination and other imaging.  Your vet can arrange referral if this specialist technique is advised for your horse’s problems.
Joint medication has 3 routes:
  • Injected directly into the joint:  Medication such as corticosteroids and hyonate are injected directly into the joint for localised effect.  This is only useful if the exact problem joint has been identified.  Hyonate helps repair the cartilage while corticosteroids reduce inflammation which causes the pain and drives the degeneration process.  However, steroids are not recommended for long term repeated use as can be detrimental to cartilage health.
  • Injected into the horse, either into the vein or muscle: Pentosan is the most common of these medications.  By injecting into the horse, the product has the ability to circulate around the entire body and target several joints.  These products are best for low-grade arthritis or lameness issues.
  • Oral medications:  Oral supplements are highly popular and can provide several of the necessary building blocks for healthy cartilage and joints.  It is important to note that there is no regulation on oral supplements so you may not be buying what you think.  Speak to one of our vets for recommended supplements.
  • Joint damage has many treatment options with varying efficacy.  The gold standard for assessment and to aid initiation of healing is ‘keyhole’ surgery, in which a camera is inserted into the joint for a thorough assessment of cartilage and other structures such as ligaments.  Our equine team is more than happy to refer suitable cases to Andrea for this highly specialised procedure.
 
Kara Watson is a member of the Franklin Vets Equine team who qualified from Washington University and has spent several years since practicing as an equine vet around Pukekohe.  Kara’s main interests lie not only in stud medicine, but also sport’s horse medicine, particularly lameness. She has taken much time, including training courses, to become highly skilled at diagnostics and treatment of with lameness cases; in particular tendon injuries and rehabilitation which she discussed on the evening.  Her main points were:
  • Tendon injuries are frustrating and have a long recovery period.  It is important to remember that even once recovered, the tendon will never return to how it was before the injury
  • A strict controlled exercise programme (CEP) is key to success.  The tendon requires movement to ensure the fibres heal in the correct pattern and with enough elasticity to be functional, however too much too soon and the tendon will become re-damaged.  It is essential to discuss the correct plan with your vet
  • There are exciting new treatment options coming up on the horizon.  Treatment such as stem cells and PRP which are injected into the injury have had some success.  However no treatment will work if not combined with a CEP
  • Feel your horse’s tendons regularly.  The earlier you can catch a tendon injury, the greater the chance of recovery.  Any heat or swelling in a tendon is definitely an indication for a vet visit.  Don’t wait until your horse goes lame on it because it may be too late
Guest speaker Claire McGowan is highly regarded as one of New Zealand’s best equine physios.  She has extensive training under the guide of the world’s first dedicated equine physiotherapist whilst in the UK and a vast  base of experience ensures she can offer patients highly specialised care and attention.   Claire also works training standardbred racers & has previously worked with Olympic standard eventers and gallopers so is used to many angles and needs of differing horses.  Franklin Vets work closely with Claire and she is often a key compenent of our lameness rehabilitation plans.  Claire had a very interactive talk and opened the floor to audience questions.  Her main points were:
  • Horses are dynamic, and if one area causes pain then the rest of the body will adapt to manage it.  A sore muscle often isn’t the primary problem - it can indicate pain somewhere else in the body. 
  • Take time when you are grooming and listen to your horse.  If they object to you touching one site in particular, investigate as it may be pointing out another problem.
    • For example, ’girthy’ behaviour or sensitivity around the belly may indicate a gut problem and should be discussed with a vet.
  • Horses adapt to surface types and make subtle changes in their stride.  Working on the incorrect surface reduces performance and makes them predisposed to injury.  Take note of what surface your horse performs best on and stick with that, even if it means scratching from a show because it rained a few days earlier or not competing over summer.  Not only will you preserve your horse’s performance and confidence, you will minimise the risk of injury as well.
  • Following on from the previous point, train on the surface you aim to compete on.  Research has shown even bone strength can be detrimentally changed if training is not reflective of competition.If the majority of your shows are on grass, get out of the arena when possible and work in a paddock.  If the arenas you compete on are generally soft, ensure your arena is soft as well.  A little bit of extra planning can mean hugely improved performance and a longer competitive life.