EquiSearch's Ask the Vet: Diagnosing Lameness

In this EquiSearch.com Ask the Vet, Dr. Joyce Harman outlines the diagnostic steps to follow if your horse has a mysterious lameness.
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In this EquiSearch.com Ask the Vet, Dr. Joyce Harman outlines the diagnostic steps to follow if your horse has a mysterious lameness.

Question 1: My pony went lame about two years ago. He started jumping this year but now he is lame again. No vet can give me an answer. They've scanned him but can't find anything wrong. He has a funny lameness. He lifts his back leg to the outside and seems to have a problem lowering it again.

Question 2: I have a 4-year-old Quarter Horse mare. She has been ridden moderately this summer, nothing really hard, but enough to keep her in shape. About two weeks ago, I noticed she was riding a little differently, nothing major, but I could tell she was off somewhere. I then took her to an open show, and I noticed her right leg moves "snappier." It doesn't pop or anything, just quicker. She also started resting the right hind more than the left. I felt for heat, swelling and tenderness, but I didn't find anything. I also checked her hooves and saw no problems. I have noticed while riding her that she wants to be heavy on the front and drag her toes in the back.

Question 3: Our 4-month-old Friesian colt was running, rearing and playing when he slid on the damp grass and fell. When he got up he was limping slightly on his right rear leg. He walked off the limp, but now he appears to occasionally hitch up at the stifle on that leg.

Answer: These emails have been grouped together because they are similar in nature. All are also equally difficult to sort out what is happening over an email or web discussion. However, there are some things that can be learned from the group.

Many horses are injured slightly in the line of work and also in play. Often the initial injury will heal well, but the horse is now "not quite right." Or there may be no apparent injury, you just have a horse who was doing well and is not going well now. Or there is a mysterious irregularity in the gait without any known history of trauma.

The first thing to do is really try to remember if there has even been an injury. Sometimes if we really think about it, we remember a time when the horse came in from the field covered in mud, when that horse usually does not get covered in mud. Or we remember that we took a good fall over a jump or a log on the trail, or fell down while trotting on the road. The horse seemed fine at the time but even an accident several years ago can leave its mark.

In human accidents it is very possible to be injured, heal quickly from the initial bruising and stiffness, yet acquire headaches and back pain one or two years later that increase in severity as the years go by. The horse is no different.

Horses also have a number of neurologic diseases that cause a mysterious lameness or gait irregularity.

A veterinarian uses hoof testers to check for soreness. | ? Stacey Nedrow-Wigmore

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In all cases with unexplained lameness, the first thing to do is have a veterinarian perform a lameness examination and, if he/she feels it is needed, a neurologic examination. Veterinarians trained in acupuncture and/or chiropractic generally have a broader background to help diagnose subtle lameness problems (see Alternative Healthcare Organization Links). These individuals may or may not also do a conventional examination with nerve blocks, X-rays or other diagnostic tests, but they can refer you to a clinic or your regular veterinarian if needed.

Many of the gait irregularities, such as those described by all the letters here, come from tightness or tension in the back or neck muscles, which then leads to a loss of proper motion in the joints of the spine. This loss of motion leads to pain and sometimes partially interferes with the nerve supply in the legs so the horse does not gait normally. Or there may be restricted motion in a joint such as the stifle or hip causing pain. There are a number of techniques that can help restore motion to the spine and relieve pain, including chiropractic, osteopathy, spinal manipulation and acupuncture as well as massage and stretching.

Your horse may need a complete work-up to find the source of the problem. There are many fancy diagnostic tests available, often at a great expense, so it is important to proceed a step at a time especially if you are on a budget. Sometimes we forget the old fashioned nerve blocks in our hurry to use the latest imaging techniques, but the nerve block really does help isolate the exact location in many cases. Then the diagnosis and treatment can be more focused.

There is no need to inject or treat multiple joints unless the problem has been located in all those joints. Certainly a joint that has been previously X-rayed and is sore again to a flexion test can be injected without X-rays, but generally it is a good idea to complete the exam before starting treatment. Ultrasound can be very useful when an injury to a joint such as the stifle is suspected, since the ligaments do not show on X-ray. The same is true of the foot and lower parts of the leg.

Treatments will depend on the nature of the injury. The horse with loss of motion in the spine may improve significantly in a few treatments with chiropractic or a related therapy. A horse with a degenerative joint from years of working hard may need joint supplements, injections of the joint and a physical therapy program to restore his gait. A horse with a neurologic problem may need medical therapy along with a rehab program designed to help the nervous system such as Linda Tellington-Jones' TTEAM Training. My website has one of my favorite TTEAM books to help with useful exercises, Improve Your Horse's Well-Being.

Dr. Joyce Harman is a veterinarian and respected saddle-fitting expert certified in veterinary acupuncture and veterinary chiropractic; she is also trained in homeopathy and herbal medicine. Her Harmany Equine Clinic is in northern Virginia. Visit her online shop.

Have you had a similar experience? Chat about it in the EquiSearch.com forum.

Do you have a veterinary or saddle-fit question for Dr. Harman? Send it to asktheexperts@equinetwork.com. Check back for her answers on EquiSearch.com.