Page 430 - The Veterinary Care of the Horse

3–4 months depending on the clinical signs and healing which is monitored by taking X-

rays.
VetBooks.ir • Swimming allows a horse to keep fit without putting strain on the limbs.

Stage 3

There are two approaches to treatment of a stress fracture. Some can be screwed back in
place. This operation requires a general anaesthetic and may be combined with osteostixis

around the fracture site. The screw may be removed after 8 weeks or left in place. Return to
training may be possible from approximately 4 months after the surgery.

The alternative is conservative treatment which entails a period of rest with NSAIDs as
necessary. Horses with severe or multiple fractures are generally treated conservatively

because of the risk of a catastrophic break of the bone while recovering from general
anaesthesia.

Extracorporeal shock wave therapy is used for the treatment of metacarpal stress
fractures. In some cases this is combined with the use of bisphosphonates.

PREVENTION

Training

With careful planning of the training programme, sore shins should be preventable. Research
has shown that working at high speed subjects the dorsal surface of the third metacarpal bone

to compressive forces, whereas trotting puts it under tension. The bone remodels differently
for each of these gaits. In order for the bone to adapt to the stresses of racing, trotting should

be restricted to the warm-up period and not be used to increase fitness. By early introduction
of short, high-speed workouts into the training programme twice a week, the bone will adapt
to the stresses of racing. Galloping should be restricted to one mile. If training is interrupted

for any reason, it should recommence at slower speeds and shorter distances than those used
prior to the break in routine. Training on hard surfaces increases the likelihood of the disease.

Monitoring

The dorsal surface of the metacarpus should be palpated regularly and especially after racing
or hard training. If there is any soreness, the horse should not be raced and the training

programme should be modified.

PROGNOSIS

If appropriately managed, the prognosis for stage 1 is good. The prognosis for stages 2 and 3