Page 33 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

8 CHAPTER 1

VetBooks.ir the fetlock joint of the sound limb drops farther for 20–30 metres. A persistent increase in lameness
over baseline is positive. (Note that it may not be
when weight bearing than does the fetlock joint of
the lame limb. In some instances of more severe uni-
lame horses such as suspected fracture cases.)
lateral hindlimb lameness it may appear that the ipsi- appropriate to carry out flexion tests on severely
lateral forelimb is lame due to the horse shifting its Forelimb flexion tests may be divided into full,
weight forward in compensation. Digital recording distal/lower (Fig. 1.18), carpal and proximal/upper
of a lame horse in motion, on a video recorder or limb depending on the joints flexed:
smart phone, particularly when later evaluation of
the recording is made in slow motion, can provide a • A full forelimb flexion test aims to flex all the
good baseline for visualising lameness. joints by supporting the limb at the toe with the
Lameness is graded to indicate severity, com- cannon and radius parallel to the ground.
monly on a scale of 0–5 or 0–10, where 0 is sound • A distal forelimb flexion test aims to flex the foot
and 5 out of 5 or 10 out of 10 is non-weight bearing. and fetlock by supporting the limb at the toe
with the carpus at around 90° and with minimum
Manipulative tests flexion of the elbow and shoulder joints.
Once the lame limb and degree of lameness have • A carpal flexion test aims to flex mainly the carpus
been ascertained, identification of the site(s) of the by holding the cannon parallel to the ground and
lameness is carried out. Manipulative tests aim to allowing the distal joints to remain unflexed.
exacerbate temporarily the degree of lameness. • A proximal forelimb flexion test flexes mainly
Flexion tests should ideally be performed on all pairs the shoulder joint and involves holding the limb
of limbs for comparison, but lastly on the lame limb. at the radius and pulling the entire limb caudally
Any increase in severity is noted. The time and force and slightly proximally.
required to carry out flexion tests are personal but
should be consistent. Generally, 45–60 seconds with Similarly, hindlimb flexion tests can also be
mild force is used. The horse is trotted away from, divided in this way into full, distal/lower and
and back to, the examiner immediately after the test proximal/upper (also called hock or ‘spavin’ test).

1.18 1.19

Fig. 1.18 Right forelimb distal limb flexion test. Fig. 1.19 Full right hindlimb flexion test. Note
Note how the carpus is kept as minimally flexed as how all the joints are flexed, with the limb directly
possible. underneath the horse.