Lameness – Thoughts on how can you be better prepared to help your Veterinarian diagnose and treat your horse

Lameness – Thoughts on how can you be better prepared to help your Veterinarian diagnose and treat your horse

By: Mike Guerini, B.S., M.S., Ph.D.

Lameness can be defined in many ways. One of my favorite definitions comes from a course I took that was taught by Dr. Carrie Schlachter (DVM) who defined lameness as – “a loss of balanced and fluid motion through a variety of movements, any alteration in a horse’s gait which creates asymmetrical movement, any change in performance level or pattern, any weakness that alters the normal performance level of a horse.”

In a lameness examination, the veterinarian will often proceed through these five steps:

  • Learn the history of the horse and the complaint about what is wrong with the movement.
    1. In this — it is important to be able to explain when you last felt or saw what is normal for the horse. Owners and Riders and Trainers often disagree on when normal was last seen so it is important to get input from everyone.
  • Perform a visual and physical examination – often referred to as a static exam.
    1. Touch and sight to see where the horse may have bumps, bruises, asymmetry, etc.
  • Perform a movement exam
    1. Visual and/or with diagnostic tools that are on the horse to measure the movement.
  • Further examination components to identify the diagnosis
    1. Can include nerve blocking and imaging (ultrasound, radiology, MRI, CT scan, nuclear scintigraphy)
  • Development of a treatment plan (which in some cases may also include a veterinarian recommended rehab plan)

Note: — As owners, trainers, and coaches …we can all be challenged at times with determining what leg is responsible for the lameness. One way to identify the responsible leg in the front end of the horse — is to remember, “down on the sound,” which is a way to remember that the horse’s head goes down when the sound leg is on the ground.

Those of us who see a horse each and every day can be regarded as experts on how a horse moves normally … but when things are not normal … we are often challenged to explain what the abnormality is in the movement of the horse. As we ride, we may feel something not right – again – it is the rider that understands the feel but it is sometimes difficult to explain what is off in the feeling of how the horse is moving.

Being prepared to explain what is normal for your horse:

This can be a challenge because not all of us use the same words to explain what we see or feel. Also, when anxiety creeps in when we have a lame horse … it can be difficult to remember everything we have felt or seen with this horse in the past days or weeks.

So how do we overcome this challenge of explaining normal – video can save the day. You can record (high quality video camera or your cell phone) and easily show your veterinarian what is normal. Many veterinarians are willing to look at a quick video (please have these videos easy to find and share) to help him/her see what your horse looks like normally.

With a focused protocol (such as this one recommended here) we can have a library (on our phone) of how our horse(s) moves normally. In all of these guidelines — make sure that you keep the entire horse in the view screen

  • Video horse at Walk and Trot in a straight line filmed from behind (coming and going).
    1. 1 walk line of about 100 feet coming and going.
    2. 3 Trot lines of about 100 feet coming and going.
  • Video horse at Walk and Trot in a straight line filmed from the side.
    1. 1 walk line of about 100 feet.
    2. 3 Trot lines of about 100 feet.
  • Video horse at Walk and Trot in a circle (film from inside or from outside the circle … just be consistent on position from where you film and make sure to capture the whole horse). These circles can be 10 to 30 feet in diameter.
    1. 1 circle at walk to the left.
    2. 3 Trot circles to the left.
    3. 1 circle at walk to the right.
    4. 3 trot circles to the right.
  • Capture the above straight lines and circles on both hard ground (packed dirt is okay) and on soft ground.
  • The above can be done in-hand (on the halter) and it is also a great idea to do these same videos with the normal rider on the back.
    1. When lameness is seen with the rider and not (or not as easily) with the horse moving in hand … there can be rider/tack related issues that are creating or enhancing the lameness.
      1. Some of these rider/tack issues can include saddle fit, rider balance, rein contact (rein lameness) …and maybe a few other issues that also need to be corrected while the horse is treated/in rehab.

The above protocol for capturing video is really helpful to use when you want to explain normal. You can capture video yearly, semi-annually, or quarterly (or more often if you wish).

For the suggestion of recording this video with the rider – this focused protocol is better than capturing video of a horse in a class/test at a show because at the show you do not have total control of the distance traveled, number of circles ridden or the aspect from which to video.

Other benefits of these videos include:  being able to see rider changes in position or balance, see rider changes in rein contact, and evaluate the progressive development of your horse in hand verses under saddle.

I know this blog gives you some guidance on how to be better prepared for a possible lameness in your horse.  You are welcome to share this blog post and thank you for reading.

—————–

Dr. Mike Guerini is a scientist, author, and horsemanship Coach in Gilroy California.  Mike is focused on balanced horsemanship that takes into account the mental, physical, spiritual, and emotional well-being of the horse.  Mike is also the co-inventor of the Equine Hydro-T.  You can learn more about Dr. Mike at www.dunmovinranch.com.

 

 

Early Detection of Equine Lameness

By Dr. Mike Guerini (www.dunmovinranch.com)

Recently I have found myself working with people who have some lame horses and this got me thinking about how we detect lameness.  Concurrently, I have been reading books by Natalie Keller Reinert and MaryAnn Myers, both of whom write horse racing fiction.  Now wait a minute you ask — how does horse racing fiction help with detecting Equine Lameness.  Well — the fiction has some great stories about life around the racetrack and these well written works relay real life details of what race track trainers do each and every day — they study the horse for any and all weaknesses. After some great conversations with LaurenMichele Mcgarry of Red Horse Equine Arts I decided to pen this article — with some homemade ideas about how we can detect lameness.

Before I begin let me please remind all of you that when you have any question about the health of your horse, you need to consult equine health care professionals.  These professionals can be either a veterinarian, farrier, chiropractor, acupuncture specialist, or other professional.

So what is my point here?  We as horse owners, riders, trainers, breeders, and enthusiasts have the opportunity for early detection of a minor injury or “catch in the horse’s get along.”  Of course we all know what “dead lame” or “three-legged lame” means — time to call the veterinarian.  But what do we do to monitor our horse each and every day — well we follow some of what they do on the racetrack — we study our horses.

1) Learn the length of your horses stride.  If you have a pretty good idea (within an inch or two) of the normal length of your horse’s stride at the walk…and that changes — you may be seeing some early signs of a problem.

2) Study the footfalls of your horse.  Know how your horse places his/her foot on the ground.  Is it straight, is there a slight twist, does the foot roll, etc?  There are many things to look for and each horse is unique — so time to study the footfalls of your horse.

3) Know the movements of the joints. Is the pastern motion fluid, are the hocks fluid, is there and hesitation in the movement of the joints?  By learning the motion of the joints of your horse, you can see when changes are happening….then you can look for issues.

4) Watch how your horse stands around.  If he/she is normally quiet and then you start to see him/her fidget (and it is not flies or insects or being in heat), he/she may be uncomfortable standing on all four hooves or one in particular. Does your horse try to stand up or down hill — maybe he/she is trying to remove pressure from a part of the body.

5) Is the rhythm of the gait changing?  Rhythm is movement of strong and weak elements.  Does your horse seem to have more weak or strong elements than normal — it may be a sign of something changing.

6) Do you feel heat or swelling?  Rub down those legs and know how they normally feel.  Any slight change in temp or size might be an indicator of something changing or a lameness issue developing.

7) Do you notice stumbling or tripping?  This might be a sign that the horse has an issue.  Many times we sum these up as a bad riding day, clumsy horse, or a lazy horse.  These might be an early sign of a problem.

8) Is there an attitude change?  Without any other causes do you notice your horse getting grumpy or unwilling?  These might be the first signs of a skeletal-muscle issue developing in your horse.

Quite a few of these we can do while on the back of a horse during our ride.  Use fence posts to mark distance being covered and when you ask for a gait, if it takes longer, your horse might not be striding correctly.  Feel the legs move beneath you and understand your horse’s normal movement — so that you can detect that “hitch” that may be an early warning sign.

My point is not to scare you or get you to be overly worried about every little movement your horse makes.  What I hope that you will think about after reading this article is how you can become more in tune with your horse and detect issues when they are minor.  When we use rest, hydrotherapy, corrective trimming, massage, acupuncture, or chiropractic along with input from our veterinarian early on to deal with these issues when they are still minor and this might just save money and frustration later on.

Please share your thoughts and I welcome you sharing this article.

Dr. Mike Guerini is a clinician, author of multiple Horsemanship books, co-inventor of the Equine Hydro-T and specializes in western performance based instruction and you can learn more about Dr. Mike and his 6 C’s of Horsemanship at www.dunmovinranch.com. Dun Movin Ranch is also home to the Equine Hydro-T (www.hydrot.com).

Setting the Pivot Foot — What is all this fuss about?

            Recently I was asked to study up on scientific research relating to the “damaging effects” of setting a pivot foot in some of the western riding disciplines.  The goal of this article is to share information so that horseman and horsewoman can engage in further conversation and thought about this topic.

            Often times when questions arise, it is because someone does not fully comprehend the terms in use or what actually happens.  First, we should refresh everyone’s memory as to what we mean by “setting a pivot foot” in the western disciplines.  Setting a pivot foot has become synonymous (incorrectly so) with a turn on the haunches (TOH) of up to 360 degrees where the horse has to keep a rear pivot foot “stationary.”  In truth, keeping the foot stationary is anatomically impossible for a complete 360-degree turn.  Truthfully, what happens in good western horsemanship is that the hind pivot foot remains in “essentially the same location” throughout the turn, and the horse will pick it up and put it down in almost the same location as it turns on the haunches.  Western riders know that the pick up and put back down is to reposition the foot and leg/joints to eliminate potential strain/stress.

While continuing on this path of trying to find answers about injuries related to setting a pivot foot, some conversations led me to ask — why do people believe this is detrimental (in fact some people have uttered the words — do that once and you have ruined the horse).  How does the Western Turn on Haunches differ from the Classical Dressage TOH?  It depends on who you might ask…some will say, not much difference while others will say it is a huge difference. So we continue on with the question of whether or not the Western TOH with a pivot foot, that lifts and repositions in nearly the same location, causes everlasting damage.

Where to begin.  After a search of numerous online databases including PubMed, Agricola, and Google Scholar with a variety of search terms I was unable to find scientific papers discussing injury in relation to setting a pivot foot.  From the literature search I went on to ask numerous veterinarians, University Professors, and conduct a broader online search.

Dennis Sigler from Texas A&M University responded to my request for further information “Michael:  Dr. Gibbs has forwarded your request for information concerning rate of injury due to setting a pivot foot during a turn around.  I am not aware, nor is any of the other faculty in the Horse Section in Animal Science aware of any scientific studies in regard to this subject.  My general observation is that turns on the inside pivot foot as in many of our classes such as western horsemanship are mild in comparison to the stops and turns that  cutting and reining horses are exposed to.  There is no doubt that these types of repetitive activities are extremely hard on the joints, especially the hock joint.  However, many other factors also contribute to the rate of injury including conformation of the horse and the type of ground or footing they are working on.  The reason there are few controlled studies on this subject is that this would be very tedious long-term (several years) study and funding for this type of horse research is seldom available.”

If we take a moment to think about the conformation of the horse, we might be able to better understand the concern about “proper execution of a TOH”.  Horses with long cannon bones (when I say long, I am referring to long with repect to the rest of the leg, in other words not proportioned optimally) are not as suited for rollbacks and getting low in the rear.  These horses can succeed, but there is an added degree of strain on the joints of this type of horse.  These horses with long cannon bones will have some difficulty staying balanced when asked to do a pivot/rollback at higher speeds.  Many (but not all) of today’s modern/successful western performance horses do have correctly proportioned cannon bones for the work/competition they are being asked to perform.  So conformation is something we seriously need to consider BEFORE we ask a horse to perform.  There is no shame in not doing something if you and the horse are not emotionally, physically, and mentally prepared.

Dr. Sigler shared some good information about why these studies have not been conducted and what factors contribute to injuries associated with setting a pivot foot.  Dr. Rob Keene, veterinary consultant for the Equine Hydro-T gave a similar response.  Dr. Mandi Holland of Performance Equine Specialists could not immediately find any scientific studies on the effects of setting a pivot foot.

In answer to the question I was asked — at this time there does not appear to be any publicly available scientific evidence that proves setting a pivot foot has long lasting and damaging effects.

BUT WAIT — THERE IS MORE!

These experts I have mentioned, and a few others who asked not to be named, suggested that many of the activities we do with our horses these days can cause injury.  While conducting this research, I came across many articles and ideas that I think are very important to share with everyone concerned about performance horse activities.  Torzewski and Mihaly (2009) discussed the fact that “Distal tarsal joints (hocks and knees) are joints with a small range of movement” and these researchers went on to claim that with some western performance horses exposed to high torsion forces on joints it is not a question of “if it will happen” but rather “when injury/inflammation” will occur.  Veterinarians from the American Association of Equine Practitioners (AAEP) have presented numerous papers on Lameness seen in a variety of western performance horses (cutting, reining, barrel racing, etc), Hunter/Jumper events, and Dressage … yes Dressage activities can cause equine leg injuries at the same rates as other disciplines.  Dr. Jackman presented a paper in 2001 on Common Lameness in the Cutting and Reining Horse.  Dr. Sue Dyson presented on Lameness and Performance in the Sport Horse: Dressage.

Equine Medical Service (EMS) of Northern Colorado was willing to direct me to their website and share information on what they find as the greatest causes of musculoskeletal stressers in the equine athlete.  EMS shared the following — The ten most common lameness conditions in the dressage horse (and by extension through the rest of the article, western performance horses as well) are as follows:

  • Proximal suspensory inflammation of the both fore and hind legs
  • Suspensory branch lesions
  • Joint problems of the two lowest joints in the fore legs
  • Inflammation of the accessory ligament of the deep flexor tendons on fore legs
  • Osteoarthritis of the two lower joints of the hock joints
  • Inflammation of the middle carpal (knee) joints
  • Joint problems in both fore and hind fetlocks
  • Inflammation of the ligaments surrounding the fetlocks and the tendons that are in that area
  • Stress fractures of the front cannon bones
  • Lower back pain.

During my studies, I had the privilege of speaking with Lester Sellnow who has written a few articles and books on Equine Lameness. While speaking with Lester he suggested that if we take some time to watch horse activities in the wild, we will not see very many horses try to jump a five-foot high obstacle, some will, but most will look for the easier way around unless forced over the object by a predator.  He reminded me that we often ask horses to accomplish tasks in the arena that are rather unnatural.  In 2001, Lester wrote an article for The Horse.com and as of our conversation in 2013, he felt the article was still accurate and relevant.  The article by Lester included information from a conversation he had with Jerry Black, DVM.  For those who do not know, Dr. Black has long been held in high regard by horsemen/women and veterinarians for his knowledge relating to equine legs/lameness and injury.

In the article, this discussion is very relevant to the topic at hand — “Causes of Joint Problems — ‘Horses have joint problems because we often ask them to do things they weren’t designed to do’, says Jerry Black, DVM, (former senior partner and past president of the Pioneer Equine Hospital in Oakdale, Calif., and former president of the American Association of Equine Practitioners).  After domesticating the horse, man designed competitions for him that put a great deal of additional stress on his joints.  Think, for example, of the concussive force on joints of the front legs when a 1,200-pound horse sails over a six-foot jump and lands on his front feet.  … Dressage seems like a fairly benign competition as far as placing stress on joints is concerned, but that isn’t true.  The advanced dressage horse is required to move his center of gravity more to the rear, putting more stress on the hind limbs. Some of the lateral movements, such as the shoulder-in and half-pass, cause high joint stress particularly on the hock. The types of disease and injury that can afflict dressage horses include degenerative joint disease of the hocks, inflammation and degenerative joint disease of the front pasterns, inflammation of the middle knee joint, and degenerative joint disease and inflammation of the fetlock. … Western horses also are stressed with competition. There is a lot of torque on the rear joints when a cutting horse drops its hindquarters toward the ground and spins a split second before accelerating to stop the movement of the calf it is seeking to hold away from the herd. Some cutting horses are susceptible to injuries and disease involving the hock and stifle joints. … The reining horse is asked to run down an arena at speed, slide to a stop, and spin in a circle, with the rear end anchored in place. This produces a great deal of torque on the hind limbs, especially the hocks. … Western pleasure horses which travel sedately and slowly around the ring might also be prone to joint disease because of their conformation, Black explains. To accentuate a chosen way of going, he says, many Western pleasure horses have been bred and selected to have straighter shoulders and more upright pasterns than horses which perform at speed. This type of conformation can set the stage for poor shock absorption and thus joint disease.”

Much more was presented in the article by Lester Sellnow and I encourage you to follow the link and read the work in its entirety.  The take home message from this and many other sources I read for this article can simply be summed as follows — anything in excess, without balance of the horse and rider and done without preparation and attention to detail can lead to injury.

A colleague of mine, Nettie Barr of Canadian Natural Horsemanship, reminded me that there are so many things that influence the athletic capabilities of the horse.  These influences come from the horse, rider, and the environment.  Training, conformation, warm-up exercises, number of repetitive actions, rider balance, arena footing, hoof care, health care, and nutrition are all-important.  But maybe the most important is as Nettie says “When we are able to ride in harmony and balance with a horse and know the footfalls of the horse, we are able to ask at the correct time to set the horse up for success to plant the desired hind foot and to properly shift his/her weight to perform the maneuver in balance.  We must understand that in order to perform such maneuvers, a solid foundation of the basics need to be in place to build to refinement.”

Let us review the information presented in this article.  1) No scientific study available that proves “setting a pivot foot is detrimental/harmful”, 2) balance, balance, balance is the key to any discipline because a balanced horse and rider can perform some pretty amazing maneuvers, and finally the most important of all, 3) KNOWING, FEELING, AND CONTROLLING THE FOOTFALLS is the key to success and longevity of the horse and rider.

As classical/traditional dressage and western performance riders continue to dialog and the discipline of Western Dressage grows, let us hope we all take the opportunity to ask questions of one another, search for and provide proof of things we say, be open and receptive to new/different ideas, and always remember that the horse is what is important in this relationship.

Dr. Michael Guerini, author of this article holds a Ph.D. in Veterinary Molecular Biology, taught numerous biotechnology students who have gone on to be successful equine veterinarians, published >30 scientific research papers on various topics, works with veterinarians on successful equine product designs, and coaches horsemanship (http://www.dunmovinranch.com).