The Horse

JAN 2019

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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STEP BY STEP TheHorse.com/Step-By-Step NANCY S. LOVING, DVM TheHorse.com | The Horse January 2019 41 F or a horse to perform at his best, his musculoskeletal system must be strong and pain-free. Hooves are especially important parts of this equa- tion. Feet can be painful for a variety of reasons, from the simplest bruise or an abscess to more critical concerns such as issues with the navicular bone and associated structures, a condition now referred to as podotrochlosis, or laminitis, which is when the tissues supporting the coffin bone within the hoof wall become inflamed and potentially fail. What can an owner do to manage a horse's foot pain? We turned to two equine veterinarians that spend a lot of time managing horses' feet to find out. Localizing the Problem Rob Boswell, DVM, is president of Equine Sports Medicine Group, in Wel- lington, Florida. To track down the source of a potential hoof problem, he recom- mends having your veterinarian perform a comprehensive lameness evaluation that begins by watching the horse led straight on a level hard surface. Longeing in circles at the trot helps identify the af- fected limb(s). Then compare the horse's movement on a soft, packed surface, such as an arena, to movement on a hard surface, such as firm dirt or nonslippery asphalt. Flexion tests, thorough palpa- tion of all limb structures, and hoof testers further yield important diagnostic information. Based on his experience, Boswell says that in the lame limb with no apparent injury, 75% of the time the problem is likely in the hoof. "Swelling within hoof structures isn't visible due to a tough hoof capsule," he says. He adds that it is often difficult to pinpoint the various intricate parts of the hoof; the best way to do this is to use diagnostic nerve blocks systematically, starting at the bottom of the limb and working upward, keeping in mind that it's possible to have a concurrent leg problem that is causing soreness. Ted Vlahos, DVM, MS, Dipl. ABVP, Equine Regent ABVP, of Yellowstone Equine Hospital, in Cody, Wyoming, also stresses the importance of an accurate diagnosis: "I cannot emphasize enough the importance of a complete examina- tion that includes stress flexion tests, diagnostic anesthesia (nerve blocks), and a complete radiographic (X ray) study." Digital radiographs are important for identifying issues associated with the navicular bone, he says. However, he notes that even high-quality radiographs have their limitations, particularly when imaging soft tissues. If your veterinarian suspects a soft tissue injury affecting such structures as the deep digital flexor tendon (the DDFT, which connects to the coffin bone), the impar ligament (which connects the navicular bone to the coffin bone) or distal interphalangeal collateral ligaments (connecting the pastern and coffin bone), that's grounds for thorough imaging. MRI is the gold standard for docu- menting soft tissue pathology (disease or damage) in the foot and is the only way to evaluate these structures, says Kyla Ortved, DVM, PhD, Dipl. ACVS, ACVSMR, assistant professor of large animal surgery at the University of KEVIN THOMPSON/THE HORSE Managing Foot Pain Current ways veterinarians control pain associated with foot lameness It's crucial to have your veterinarian perform a complete lameness evaluation to pinpoint the problem before trying to treat it.

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