Lameness Examination in Horses

Foundational Requirements & Preparation:

Facilities: Requires standardized areas, including a level, firm, nonslip surface for walking/trotting and a soft support area for lunging/riding.
Examiner Expertise: Knowledge of equine anatomy, normal conformation, gaits, regional anesthesia, and imaging techniques is essential.
Goal: A systematic investigation to recognize and localize lameness when the cause is not obvious.

Comprehensive Medical History:

Core Factors: Age, type of horse, training regimen, time since onset, and interim management.
Influence of Activity: Note whether the lameness improves with rest or exercise.
Maintenance & Meds: Interval since last shoeing and previous response to anti-inflammatory or analgesic medications.
Lab Work: Hematologic and biochemical analyses may identify infections, metabolic disturbances, or electrolyte imbalances.

Physical Evaluation (Standing):

Visual Inspection: Check conformation, symmetry, swellings, muscle loss, and abnormal stance.
Palpation:
- Assess limbs in both weightbearing and non-weightbearing positions.
- Check for heat, pain, swellings, and joint effusion.
- Compare findings with the contralateral (opposite) limb as a control.
Joint Function: Evaluate the range of motion during flexion and extension of all joints.
Back and Neck: Thorough examination for mobility and pain using consistent techniques.

Detailed Foot Examination:

Hoof Testers: Used to compress the walls and sole to identify localized pain.
Wear Patterns: Observe how the shoes and feet are wearing down.
Conformation Abnormalities: Identify mismatched hoof angles, abnormal hoof/pastern axis, sheared heels, or disproportionate hoof size,

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.

Lameness Examination in Horses

Foundational Requirements & Preparation:

Facilities: Requires standardized areas, including a level, firm, nonslip surface for walking/trotting and a soft support area for lunging/riding.

Examiner Expertise: Knowledge of equine anatomy, normal conformation, gaits, regional anesthesia, and imaging techniques is essential.

Goal: A systematic investigation to recognize and localize lameness when the cause is not obvious.

Comprehensive Medical History:

Core Factors: Age, type of horse, training regimen, time since onset, and interim management.

Influence of Activity: Note whether the lameness improves with rest or exercise.

Maintenance & Meds: Interval since last shoeing and previous response to anti-inflammatory or analgesic medications.

Lab Work: Hematologic and biochemical analyses may identify infections, metabolic disturbances, or electrolyte imbalances.

Physical Evaluation (Standing):

Visual Inspection: Check conformation, symmetry, swellings, muscle loss, and abnormal stance.

Palpation:

Assess limbs in both weightbearing and non-weightbearing positions.

Check for heat, pain, swellings, and joint effusion.

Compare findings with the contralateral (opposite) limb as a control.

Joint Function: Evaluate the range of motion during flexion and extension of all joints.

Back and Neck: Thorough examination for mobility and pain using consistent techniques.

Detailed Foot Examination:

Hoof Testers: Used to compress the walls and sole to identify localized pain.

Wear Patterns: Observe how the shoes and feet are wearing down.

Conformation Abnormalities: Identify mismatched hoof angles, abnormal hoof/pastern axis, sheared heels, or disproportionate hoof size,

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.