Shoe Management: Shoes should remain on initially to prevent foot-soreness from interfering with the exam; remove only after lameness is localized to the foot.
Examination During Exercise:
Safety Warning: Exercise and regional anesthesia should not be performed if a fracture is suspected to avoid catastrophic breakdown.
Standard Procedures:
Walk and jog in hand with a loose lead line.
Trot on a straight, firm line to listen to footfall and observe gait.
Lunge in circles on both soft and firm footing to accentuate subtle lameness.
Visual Indicators:
Forelimb: Identified by a head nod (head rises when the lame limb hits the ground).
Hindlimb: Identified by a sacral rise (hip hike) when the lame limb strikes the ground.
Ridden Assessment: May be necessary to observe subtle issues or multiple-limb lameness that only appear under saddle.
Specialized Diagnostic Tests:
Flexion Tests: Passive flexion followed by immediate trotting to assess response; must be consistent and compared to sound limbs.
Diagnostic Regional Anesthesia: Used to pinpoint the area of pain once lameness is localized to a specific limb.
Medication Trials: Using therapeutic levels of anti-inflammatories (e.g., phenylbutazone) to see if performance improves.
Neurologic Exam: Performed if no painful or mechanical cause is found; evaluates cranial nerves, motor function, and proprioception through tasks like backing and tight circles.
Technological Aids: Gait analysis systems using video capture or inertial sensors can augment visual detection.