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Attendees of the Western Performance Horse Sunrise Session at the 2003 American Association of Equine Practitioners' convention were greatly interested in lameness problems that plague Western performance horses. Moderators Jerry Black, DVM, past president of the AAEP and a senior partner of Pioneer Equine Hospital in Northern California; and Scott Taylor, DVM, from the Arizona Equine Medical and Surgical Center in Gilbert, Ariz.; fielded questions from the audience of veterinarians, technicians, and veterinary students in the informal discussion.
Common Lameness Problems
Tarsitis (hock inflammation) is a common problem for Western performance horses since they use their hind ends heavily during events such as reining and cutting. Black believes that a large percentage of high-performance Western performance horses have this problem. He said it is hard to keep these horses in training for futurity events since they are worked so hard.
Taylor agreed that hind limb problems, especially hock problems, are the majority of his cases, making up 60% of the lameness problems he sees. He said that another 20% turn out to be problems with the stifle, and other problems make up the other 20% of his cases.
Lameness in the Western performance horse can stem from many sources. "Don't think every horse has a hock problem," cautioned Black.
He said he sees a lot of minor suspensory apparatus problems and developmental orthopedic problems in forelegs. He said that over the past five to 10 years he has learned that this problem is seen more in young reiners and cutters versus roping horses.
"These horses undergo a lot of repetitive trauma for what they do," Black said. "After six to seven years, things have occurred to the suspensory ligament that do not look normal on ultrasound."
Black said that he has diagnosed suspensory lesions on futurity cutting horses which are at a grade four or five on the five-point lameness scale, believing that it would be a stress fracture at first. "The horse will be lame for several days, and finally one morning he might have sensitivity to palpation," he said. "Sometimes he won't give you very many clues."
Black will use ice, a poultice, and phenylbutazone (Bute) along with stall rest. Ten days out, the horse usually presents as a grade two lameness. Black said then he might use shock wave therapy, and he recommends lay-up for three weeks. Usually after all of this, the horse will be sound at the trot.
It is not a surprise that Western performance horses end up with suspensory ligament problems. "What I've noticed about cutting horses is that some stop so hard," Black said. "It depends on how they stop. Some have their cannon bone parallel to the ground, and when sliding, they will put one front leg out to stop, and one is planted. The toe is flipped up, and then they pivot. The forelimb suspensory problems are from hyperextension."
Treatments
One practitioner asked the moderators about therapeutic options for Quarter Horse foot problems.
"We still nerve horses if we can't get results any other way," Black said. "A neurectomy (cutting the palmar digital nerves that feed the navicular region) should never be the first line of defense. A neurectomy is not a permanent fix. The horse will re-innervate himself. I like to get three to six years out of it, then do it again."
Black also listed therapeutic shoeing, non-steroidal anti-inflammatories, and coffin joint injections as some of the treatments he often uses on a variety of problems.
Attendees were also interested in the efficacy of shock wave therapy (SWT). Black said he was happy with results when he has used it in soft tissue injuries, such as suspensory branch lesions. Taylor said that he has used SWT to treat problems in joints, such as the hock, commenting that it interrupts pain transmission, allowing horses to get back to competition; however, he said that it does not fix the problem.
Black has found SWT useful for advanced osteoarthritis.
One practitioner commented on the success of the drug tiludronate. Black said he uses this drug for navicular problems to stop bone remodeling and osteolysis (dissolving of bone). The veterinarian said that refractory cases (those not yielding to treatment) will go sound after treatment with tiludronate, and it seems to last for several years.
Back Problems
If a horse is experiencing lameness in the hind limbs, Taylor recommends checking the hind limbs first, but keeping in mind the problem might be related to the back. Taylor uses scintigraphy or oblique radiographs to diagnose a lesion. If a problem is found, he recommends checking the tack.
To treat back problems, Taylor will use anti-inflammatories along with rest. He prefers not to use too many therapies at once. "It's hard to tell what's working when you throw three to four things at them at once," he said.
Black has had a lot of success by injecting backs with anti-inflammatories where the horse demonstrates pain during palpation. He occasionally will team up with a chiropractor.
Taylor has started using acupuncture within the past year. Black commented that with regular acupuncture sessions, there should be results. Taylor said that a lot of owners are turning to acupuncture over medications.
With chronic back problems, specialty ultrasound and transrectal ultrasound might be needed to diagnose osteoarthritis.
Common Lameness Problems
Tarsitis (hock inflammation) is a common problem for Western performance horses since they use their hind ends heavily during events such as reining and cutting. Black believes that a large percentage of high-performance Western performance horses have this problem. He said it is hard to keep these horses in training for futurity events since they are worked so hard.
Taylor agreed that hind limb problems, especially hock problems, are the majority of his cases, making up 60% of the lameness problems he sees. He said that another 20% turn out to be problems with the stifle, and other problems make up the other 20% of his cases.
Lameness in the Western performance horse can stem from many sources. "Don't think every horse has a hock problem," cautioned Black.
He said he sees a lot of minor suspensory apparatus problems and developmental orthopedic problems in forelegs. He said that over the past five to 10 years he has learned that this problem is seen more in young reiners and cutters versus roping horses.
"These horses undergo a lot of repetitive trauma for what they do," Black said. "After six to seven years, things have occurred to the suspensory ligament that do not look normal on ultrasound."
Black said that he has diagnosed suspensory lesions on futurity cutting horses which are at a grade four or five on the five-point lameness scale, believing that it would be a stress fracture at first. "The horse will be lame for several days, and finally one morning he might have sensitivity to palpation," he said. "Sometimes he won't give you very many clues."
Black will use ice, a poultice, and phenylbutazone (Bute) along with stall rest. Ten days out, the horse usually presents as a grade two lameness. Black said then he might use shock wave therapy, and he recommends lay-up for three weeks. Usually after all of this, the horse will be sound at the trot.
It is not a surprise that Western performance horses end up with suspensory ligament problems. "What I've noticed about cutting horses is that some stop so hard," Black said. "It depends on how they stop. Some have their cannon bone parallel to the ground, and when sliding, they will put one front leg out to stop, and one is planted. The toe is flipped up, and then they pivot. The forelimb suspensory problems are from hyperextension."
Treatments
One practitioner asked the moderators about therapeutic options for Quarter Horse foot problems.
"We still nerve horses if we can't get results any other way," Black said. "A neurectomy (cutting the palmar digital nerves that feed the navicular region) should never be the first line of defense. A neurectomy is not a permanent fix. The horse will re-innervate himself. I like to get three to six years out of it, then do it again."
Black also listed therapeutic shoeing, non-steroidal anti-inflammatories, and coffin joint injections as some of the treatments he often uses on a variety of problems.
Attendees were also interested in the efficacy of shock wave therapy (SWT). Black said he was happy with results when he has used it in soft tissue injuries, such as suspensory branch lesions. Taylor said that he has used SWT to treat problems in joints, such as the hock, commenting that it interrupts pain transmission, allowing horses to get back to competition; however, he said that it does not fix the problem.
Black has found SWT useful for advanced osteoarthritis.
One practitioner commented on the success of the drug tiludronate. Black said he uses this drug for navicular problems to stop bone remodeling and osteolysis (dissolving of bone). The veterinarian said that refractory cases (those not yielding to treatment) will go sound after treatment with tiludronate, and it seems to last for several years.
Back Problems
If a horse is experiencing lameness in the hind limbs, Taylor recommends checking the hind limbs first, but keeping in mind the problem might be related to the back. Taylor uses scintigraphy or oblique radiographs to diagnose a lesion. If a problem is found, he recommends checking the tack.
To treat back problems, Taylor will use anti-inflammatories along with rest. He prefers not to use too many therapies at once. "It's hard to tell what's working when you throw three to four things at them at once," he said.
Black has had a lot of success by injecting backs with anti-inflammatories where the horse demonstrates pain during palpation. He occasionally will team up with a chiropractor.
Taylor has started using acupuncture within the past year. Black commented that with regular acupuncture sessions, there should be results. Taylor said that a lot of owners are turning to acupuncture over medications.
With chronic back problems, specialty ultrasound and transrectal ultrasound might be needed to diagnose osteoarthritis.