Page 441 - The Veterinary Care of the Horse

These include some of the following.

• There may be a loss of performance before lameness is apparent. The horse may shorten
VetBooks.ir its stride and move in a more upright fashion as extension of the fetlock pulls the

ligaments and is painful.
• Variable degrees of lameness. It can occur as an acute injury with severe lameness or as a

chronic progressive condition with low-grade lameness.
• The lameness may be most evident at the start of exercise and on hard surfaces.

• Heat over the outside edge of the sesamoid bones.

• Pain on palpation of the sesamoid bones and attached ligaments.

• Soft-tissue swelling or thickening at the back of the fetlock.

• Flexion of the fetlock may be painful and increase the degree of lameness.
• The condition improves after a period of rest.

DIAGNOSIS

This is made on:

• the clinical signs

• nerve blocks; the lameness should be abolished by a low four-point nerve block;
however, this is not specific for this condition and does not rule out pain coming from

other areas such as the fetlock joint
• radiography; possible radiographic changes include:

– new bone (enthesiophytes) laid down at the site of ligament attachments

– calcium deposits within the suspensory ligament

– decrease in bone density

– an increase in the size and number of vascular channels within the bone.

With the exception of a fracture, the X-ray changes are unlikely to be seen until
approximately 3 weeks after the injury has occurred. Early changes can be detected using

scintigraphy. Ultrasound examination of the surrounding soft tissues is routine as they may
also be very painful and it is important to try to confirm the primary site of pain as treatment

may vary, depending on the structures involved.

TREATMENT

• In the acute stages, cold treatment and support bandaging are beneficial.

• Non-steroidal anti-inflammatory drugs, e.g. phenylbutazone, help to reduce the