The Horse

FEB 2018

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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23 February 2018 THE HORSE The first step, after ruling out farriery issues, is deciding if it's a neurologic or orthopedic problem. Veterinarians base this determination on history, along with lameness and neurologic exams. However, lameness exams can be tricky with stumbling cases, says Dyson. Veterinarians often use local anesthesia to block the pain that would cause lameness—the idea being that when the horse is pain-free, the lameness disappears temporarily. But that local anesthesia could back- fire in a stumbling exam. "Local anesthesia reduces proprio- ception," Dyson says, adding that this is particularly evident with hind-limb issues. "We have observed that hind- limb nerve blocks may not abolish a lameness-induced toe drag and … may sometimes accentuate a toe drag. Stumbling and tripping behind may be accentuated, despite improve- ment in baseline lameness by diagnostic analgesia." If the nerve block evaluation fails, veterinarians might use video to better assess the gait and foot placement "to determine why and how the limb lacks stability," she says. During a neurologic evaluation, the veterinarian must consider all neurologic pathways, from the brain to the spinal cord to limb muscles, says Johnson. "Most of the horses I work up have a spinal cord problem that is interfering with the transfer of information from the brain to the leg and back again, which is causing them to misstep or misplace their feet," she says. "But sometimes they've injured either the nerves traveling down the limb or the muscles of the limb such that the nerve muscle connection is interrupted." Infectious diseases such as equine protozoal myeloencephalitis (EPM) can also cause ataxia-related stum- bling, she adds. "The appropriate diagnostic proce- dures for a suspected neurologic case that stumbles with the front limbs would include doing radiographs (X rays) of the neck and a spinal tap to look for evidence of EPM (protozoal infection), and maybe more advanced imaging like myelography or CT scans," she says. Stopping the Stumble With the proper early treatment there's hope for resolving many orthopedic issues, says Dyson, depending on the Walking over ground poles might help improve your clumsy horse's proprioception. DUSTY PERIN

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