• Lameness in Horses

  • Lameness can range from a subtle, performance limiting problem or very obvious, severe lameness.  Interestingly, 95% of forelimb lamenesses will be caused by a problem below the knee level – elbow and shoulder problems are rare.  The causes of hindlimb lameness are more varied and investigation of these cases can be more time-consuming.  

    Usually the first examination of lameness is at your yard.  In cases of severe lameness, we will usually only need to see a few steps of movement from the horse; however, in subtle lamenesses, we will need to see the horse walked and trotted, perform flexion tests, lunge them or possibly even see them ridden.  If you do not have suitable facilities at home, Ashbrook Equine Hospital has all the facilities required for full lameness investigation (pic level trot up, firm non-slip lunge).  The benefit of clinic based lameness investigations is that all the equipment is to hand, rather than requiring repeated trips to your yard to investigate, nerve block, x-ray or ultrasound scan your horse.  This should hopefully provide a quicker route to diagnosis and treatment.

  • Isolating the Problem

    Once the lame leg is established and if there are no obvious symptoms, we will usually require nerve blocks to establish the area causing lameness.  Nerve blocks (pic of nerve block) are small injections of local anaesthetic round nerves in the leg.  After the injections, the lameness examination is repeated and if the horse has improved sufficiently, we can be sure the lameness originates from the area that has been 'numbed out' by local anaesthetic.  If further specificity is required, we can then return later that day, or the following day, once the nerve block has worn off and put local anaesthetic directly into any joints or synovial structures in the area previously isolated.

  • Radiographs


    Once we have established the area causing lameness, we can then image the area to provide a diagnosis, a treatment plan and a prognosis.  Usually radiographs (x-rays) are taken using our in-house digital radiography machine (pic of radiograph machine).  This allows assessment of the bony structures in the area.  Our x-ray machine is ceiling mounted and has enough power to provide great images of necks, spines and upper limb joints.  We also have a portable x-ray machine that can be taken to yards for radiographic examinations.

  • Ultrasound Scanning

    Often, ultrasound scanning will also be useful as it enables us to assess for tendon
    or ligament damage or even damage to the surface of bones.  We have two ultrasound
    scanners – the machine in hospital provides superior quality images and we also have one which can be transported for yard-based investigations.
  • Treatment Plan


    If we require further investigation of a lameness using gamma scintigraphy (bone scan) or magnetic resonance imaging (MRI), we have a good working relationship with two different providers within an hour of Ashbrook EquineHospital.
    Nerve and joint blocks, together with imaging results allows us to formulate a treatment plan. This can be medical or surgical. Medical treatment of lameness involves many different treatments and often we use a combination of these to provide the best result for you and your horse.Lameness problems that require surgical intervention can be operated on in our surgical suite.

    Lameness Treatment Options

    Medical treatment of lameness provides many different options to chose from. Some of these treatments are only suitable for certain conditions and some of the more costly options will be reserved for cases that have not responded to conventional treatments. We will also consider the whole horse and as such, can recommend remedial farriery, manipulative therapy and joint supplements as required. We will always try to incorporate your wishes, your horses' requirements, competition rules and any financial constraints into the treatment plan.


    Non Steroidal Anti Inflamatory Drugs


    Although 'bute or danilon seem very old fashioned treatments, they are immensely beneficial to reduce swelling and pain while a simple injury heals. They may be used as a stand-alone treatment or until other treatments have a chance to improve the lameness.

    Conventional Joint Medications


    If a lameness has been isolated to a specific joint, we will often inject medications directly into that joint. This form of treatment can be very effective in a very short period of time.


    Corticosteroid Medication


    We have 2 different types of corticosteroid medication that are commonly used in joint medication. In high-motion joints, like fetlocks and coffin joints, we use a short acting steroid which has less negative effects on the cartilage joint surfaces. In low-motion joints, such as small hock joint pain associated with bone spavin, we will often use a longer acting steroid. This will have some degenerative effects on the cartilage but this can be beneficial as often, once the cartilage is destroyed, the lameness will resolve. We will usually seen a dramatic improvement in lameness within 10-14 days, allowing the horse to quickly return to his normal job.

    Hyaluronic Acid


    This is a component of normal joint fluid and by medicating joints with this, you can improve the quality of joint fluid and it also provides some anti-inflammatory action. This is often used in conjunction with corticosteroids to provide the maximum benefit to the affected joint.

    Equidronate (formerly tildren)


    This drug acts on the damaged bone at the surfaces of arthritic joints by reducing the bone resorption associated with arthritis. It is licensed for bone spavin (hock osteoarthritis) yet has been shown to have great benefits in a multitude of other conditions. This drug is given as an intravenous infusion and usually takes about 6-7 weeks to show its maximum benefit. If the improvement has only been partial, then it can be repeated at this stage. After that, it should only require repetition at 6-18 monthly intervals.

    Extracorporeal Shockwave Therapy


    This treatment uses pulsed waves of energy focussed over the area of damaged tissue to stimulate healing and also provide some degree of pain relief. It is most commonly used for proximal suspensory desmitis of the hindlimbs. Most horses do require some sedation for the procedure and it is usually repeated 3 times over during a 6 week period.

    Biological Treatments

    At Ashbrook Equine Hospital we are also able to offer all the latest biological therapeutics available for lameness treatment.