Thanks to advances in equine sports medicine, we're exiting the days when bute, Banamine, and the common X-ray were our only weapons for battling lameness. While those tools are still useful, recent options are proving valuable for finding and fighting lameness problems.
Three of them are attracting a fair share of attention: fluoroscopy, a video form of X-ray; digital radiography, which is to X-rays what the digital camera is to photography; and extracorporeal shock wave therapy (ESWT)--also known as lithotripsy--which emits high-energy shock waves to stimulate healing at a targeted site, and is used primarily to treat bony and soft-tissue injuries. (For information on how each of these options work, why they help your horse, and how much they might cost, see Horse & Rider, July 2003.)
Here's a case history for each of these lameness-fighting methods, from two veterinarians who regularly use them in their performance-horse practices: Alan D. Donnell, DVM, and Jack Snyder, DVM, PhD. (See "Our Experts.")
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Lameness Case history #1: A fluoroscope find. "A few years ago, my ex-wife was looking at a yearling in Oklahoma," recalls Dr. Donnell. "Instead of bringing the horse to my clinic for fluoroscopy, we opted to drive up and evaluate it using standard radiography, which includes four views of each hock. When I developed the film, I didn't see any problems. She bought the horse, brought it home, and later broke it to ride. The horse came up lame. When I fluoroscoped it, I found a large bone spur with significant degenerative joint disease I'd missed with the standard X-ray views. (ep)"I've had the same experience with spurs and chips in the fetlock joints in my referral practice," Dr. Donnell adds. "I commonly find problems that have gone undetected on X-rays, because I can move the fluorosccope all around the joint."
Lameness Case history #2: A digital discovery. "A horse was brought to me with an intermittent short stride on his left foreleg," says Dr. Donnell. "Upon examining him, a large medial splint was apparent. At the time, we were at a horse show in Arizona, where I didn't have my digital X-ray equipment. A fluoroscope of the splint revealed some remodeling and calcium deposits. I suggested the owner treat the horse with shock-wave therapy two times, at a 10-day interval, which she did. When she brought the horse to me for a follow-up exam, he was much improved from a lameness standpoint. Still, to be sure we were on the right treatment track, I took a single digital X-ray view of the splint bone. With it, I could see very clearly a hairline fracture of the bone--which the fluoroscope hadn't revealed. While it didn't affect the course of treatment in this specific case, it did confirm that we were on the right track."
Lameness Case history #3: An ESWT suspensory success story. "The first horse I ever treated with shock-wave therapy was a grand-prix jumper that had a hind-leg suspensory-origin injury," recalls Dr. Snyder. "We'd used every procedure available over about a four-year-period on him, but nothing worked. Finally, the owners gave up and retired him. He'd been turned out for a year when we received the shock-wave machine. I remembered the horse, tracked down his owners, and had him shipped to the University of California-Davis. The horse was as lame as he was the first day we examined him. I treated him for free. Eight months later, he was back to work; within a year, he was jumping again. Maybe he would've gotten better anyway, but I doubt it."
Alan D. Donnell, DVM, focuses on performance-horse lameness, using fluoroscopy, digital radiography, and ESWT at his La Mesa Veterinary Clinic in Pilot Point, Texas. He also takes a mobile veterinary clinic to horse shows around the country. Dr. Donnell is FEI-certified in reining, and was named USET reining veterinarian for the 2002 World Equestrian Games in Jerez, Spain, where the United States team won the gold medal.
Jack Snyder, DVM, PhD, is Professor and Chief of Equine Surgery in the veterinary school at the University of California-Davis. With his wife, Sharon Spier, DVM, PhD, he's headed the veterinary staff at the Olympic Hospital for the countries where the Olympics have been held since 1988. He's used ESWT in treating more than 300 cases. He and Dr. Spier took a shock-wave machine to the Sydney Olympics and used it to treat 28 horses there.