The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
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YOUR GUIDE TO THE 2017 AAEP CONVENTION A20 TheHorse.com/AAEP2017 AAEP Wrap-Up THE HORSE March 2018 Warmblood horses diagnosed with sagit- tal groove injury and concurrent osteoar- thritis is poor," she said. She advised veterinarians to always evaluate the fetlock when clinical work- up, imaging, and treatment do not produce desired results, as fetlock injury can cause similar signs. She also said to consider adding advanced imaging (such as MRI) to exams to allow for earlier diagnosis and treatment if no other lame- ness causes are identified. Rear Hoof Imbalance and Lameness Historically, veterinarians and farri- ers have spent far more time evaluating and adjusting front hoof balance than rear hoof balance. This is because front imbalances typically manifest as obvious foot pain. Rear limb imbalances are less obvious but just as critical to monitor, however, because they can cause pain higher up in the limb and body. "I've spent the majority of my career talking about front feet," said Tracy Turner, DVM, MS, Dipl. ACVS, ACVSMR, of Turner Equine Sports Medicine and Surgery, in Stillwater, Minnesota. "I started looking and realized that rear hoof imbalance has been largely ignored. But rear hoof imbalance might have more effect on the upper body due to its direct attachment to the axial skeleton (the ver- tebrae, skull, ribs, and sternum)." The hind leg attaches directly to the pel- vis, which attaches to the sacroiliac joint, which attaches to the vertebrae. "You can't move those parts until the foot leaves the ground," said Turner. "There's a lot more effect on all those joints." The horse can move and adjust his front limbs more eas- ily, without affecting his upper body. When the horse lifts his hind foot off the ground, he must contract his stifle, hamstring, hip, and gluteal muscles to propel forward. Any imbalance in the hooves is going to alter these biomechan- ics and can lead to lameness, said Turner. He then described three of the most common rear hoof imbalances: Broken Hoof-Pastern Axis In any foot the front (dorsal) hoof wall should align with the pastern. In the rear feet this axis can change for many reasons, said Turner, but often because of age-related suspensory ligament weakness in older horses with hyperextended fetlock joints. It can also occur if the horse is placing his hind feet farther under his body to compensate for painful or underrun front feet, thus overloading his rear heels. Most commonly, Turner said, farriers and vets encounter a broken-back hoof- pastern axis, in which the hoof wall angle is lower than the pastern's. In the rear feet, "this imbalance causes the hoof to stay on the ground longer than normal," he said. "The strain on the deep flexor tendon will be markedly increased over normal before heel lift. This can lead to many lameness issues, the most serious of which is teno- synovitis (inflammation of the membrane surrounding the tendon sheath)."