1 Lameness diagnostic in the horse Dr. Tóth Péter Lameness diagnostic in the horse Dr. Tóth Péter SZIU, Faculty of Veterinary Sciences, Large Animal Clinic Definition of lameness (claudication) Definition of lameness (claudication) •Structural or functional disorder in one or more limbs and related structures Functional anatomy Functional anatomy •Hoof, navicular region •Tendons, ligaments, • tendon sheath, bursae Phases of the stride Phases of the stride •Supporting phase • landing • loading • Stance • Breakover • heel lift • toe pivot • Swinging phase Phases of the stride -Swing Phases of the stride -Swing •Swinging phase •Flexion (caudal) •Extension (cranial)
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Lameness diagnostic in the horseDr. Tóth Péter
Lameness diagnostic in the horseDr. Tóth Péter
SZIU, Faculty of Veterinary Sciences, Large Animal Clinic
Definition of lameness(claudication)
Definition of lameness(claudication)
• Structural or functional disorder in one or
more limbs and related structures
Functional anatomyFunctional anatomy
• Hoof, navicular region
• Tendons, ligaments,
• tendon sheath, bursae
Phases of the stridePhases of the stride
• Supporting phase
• landing
• loading
• Stance
• Breakover • heel lift
• toe pivot
• Swinging phase
Phases of the stride -SwingPhases of the stride -Swing
• Swinging phase
• Flexion (caudal)
• Extension (cranial)
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Normal gait (by Sue Dyson)Normal gait (by Sue Dyson) Overextension in the fetlock jointOverextension in the fetlock joint
Overextension in the coffin jointOverextension in the coffin joint Mechanism of the hoofMechanism of the hoof
Arc of foot flightArc of foot flight
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Plaiting hind limb(bilateral ilial stress fracture)Plaiting hind limb
(bilateral ilial stress fracture)Interference forms at the trotInterference forms at the trot
• A: front limb to front limb
• B: ipsilateral front to hind
• /C: pacer (diagonal limbs)/
• D: ipsilateral hind to front
I. Causes of lameness 1.I. Causes of lameness 1.
Trauma
I. Causes of lameness 2. I. Causes of lameness 2.
Congenital
I. Causes of lameness 3.I. Causes of lameness 3.
Acquired
I. Causes of lameness 4.I. Causes of lameness 4.
Infection
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I. Causes of lameness 5.I. Causes of lameness 5.
Metabolic disturbances
I. Causes of lameness 6.I. Causes of lameness 6.
Circulatory disorders
Aortoiliac thrombosisAortoiliac thrombosisI. Causes of lameness 7.I. Causes of lameness 7.
Nervous system
??
II. Causes of lamenessII. Causes of lameness
• Pain
• Mechanical
• Paralytic disorders
Classification of lamenessClassification of lameness
• Supporting limb lameness
• Swinging limb lameness
• Mixed lameness
• Complementary lameness
• Untipical lameness
• Special lameness
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Supporting limb lamenessSupporting limb lameness
• Cranial phase is longer
• Head and neck movement
• The problem is usually lower
• Worse in inside circle
Swinging limb lamenessSwinging limb lameness
• Cranial phase is shortened
• It is evident during motion
• Usually the problem is higher
• Worse in outside circle
Swinging limb lameness-(bicipital bursitis)
Swinging limb lameness-(bicipital bursitis)
Mixed lamenessMixed lameness• Disturbance in function of different structures
involved in supporting and swinging phase
Compensatory lamenessCompensatory lamenessUneven distribution of weight on another limb
Severe left hind limb lameness(med. femorotibial osteoarthritis)
Severe left hind limb lameness(med. femorotibial osteoarthritis)
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Untipical lamenessUntipical lameness
• When more than one limb is effected
Concurrent left hind right front limb lameness
Concurrent left hind right front limb lameness
Special lamenessSpecial lameness
• E.g. rupture of peroneus tertius
• Upward fixation of the patella
• DDFT rupture
Patella fixationPatella fixation
3 primary causes of upward patellar fixation:
1, Lack of fitness: Lack of quadriceps and/or biceps femoris muscle tone results in an inability to quickly pull the patella up and off of the medial
femoral trochlea.2, Straight or upright pelvic limb conformation: This places the medial
femoral trochlea further distad in closer proximity with the patella, facilitating patellar fixation.
3, Excessive distal patellar ligament length: This places the patella proximad in closer proximity with the medial femoral trochlea, where it
• Remember• Subcarpal analgesia and middle carpal joint analgesia
may block the same structures
• Clinical findings may help to differentiate
N. ulnaris analgesiaN. ulnaris analgesia
N. medianus
N. ulnaris
N. palm.lat
• 18g 4cm needle
• 10-15ml anaesthetic
• 10 cm prox from accessory carpal bone
N. medianus analgesiaN. medianus analgesia
N. medianus analgesiaN. medianus analgesia
• 5 cm below elbow joint, medial side
• caudomedial surface of radius
• jusst cranial from m. flex. carpi radialis
• 10 ml loc anaesthetic
•A. and v. is locaated caudally from it
•Fals positive response because of elbow joint
•possible
N. musculocutaneus analgesiaN. musculocutaneus analgesia
• Branch for skin
• Seldom necessary
• 4x3 ml
• V. cephalica cran. caud.
• V. ceph. access. cran. caud.
v. cephalica
v. cephalica acc.
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Elbow analgesiaElbow analgesia
• Cranial or Caudal pouch
• 19g 9cm needle • 25ml anaesthetic
• NB radial nerve• Lat ulnar bursa not adviced (communicates just in 37%)•• Cran approach: signs of radial paresis • Method: infront of collat lig 2/3 distance between
humerus epicondyle and tub radii in cranial diretion
• Caud method: infront of olecranon caud fron epicondyle long needle, may need skin loc anaesthesia