Page 579 - The Veterinary Care of the Horse

Rectal examination. The fracture or an associated haematoma may be felt on the inside of
• the pelvis. If the horse is asked to walk forwards slowly, or gently rocked from side to

VetBooks.ir • side, crepitus may be felt or heard.

Crepitus may also be heard by placing a stethoscope over the gluteal muscles and rocking
the horse gently from side to side.

• Palpation and manipulation of the bony landmarks and muscles of the pelvis which is
painful.

• Ultrasonography is very useful for diagnosing fractures of the ileal wing and shaft.

• Scintigraphy (a bone scan) is often used to diagnose a pelvic fracture. The increased bone
turnover at the fracture site causes increased uptake of the radioactive material. However,

this may not be evident for several days after the fracture has occurred.
• Radiography is not routinely used because the large amount of overlying muscle means

that poor images are obtained. The very powerful X-rays needed are hazardous to the
people helping with the procedure. Occasionally they are taken with the horse lying on its

back under general anaesthetic. This has the additional risk of further injury being caused
during the horse’s recovery from the anaesthetic.

Treatment

This involves the following.

• A minimum of 2–3 months box rest. If the shaft of the ilium is fractured, the horse is tied
up for the first month to reduce the risk of the iliac arteries being severed as the horse lies

down and gets up. Daily walking exercise is introduced as advised by the vet.
• Non-steroidal anti-inflammatory drugs, e.g. phenylbutazone, are administered to control

inflammation and pain.

• If the horse is non-weight-bearing on one hind limb, the supporting limb is at risk of
laminitis. If possible, a frog support should be fitted. If the horse is unable to stand on the
affected limb to allow this, the horse should be kept on a very deep, supportive bed;

wood shavings are preferable to straw which can wind around the legs and impede safe
movement around the box. A support bandage should be applied to the other limbs.

• If the horse is in distress and experiencing severe pain, a small dose of acepromazine

helps to relieve the anxiety.
• With a fracture of the tuber coxae, surgical removal of the bone fragment may be

necessary if it forms a sequestrum.
• Following the period of box rest, the horse should be turned out into a tiny paddock for at