Large Animal Sx- Lameness Diagnosis 1

untimely's version from 2015-09-19 20:24


Question Answer
what is "lameness"?A condition of the horse that renders it unwilling or incapable of utilizing the locomotor system to stand or move normally.
Lameness is The most common cause of loss of use in which horses?pleasure horses
what's "ARFE"ain't racin' fast enough
******THREE MAJOR CAUSES OF GAIT DISTURBANCE?(1) pain (2) Neuromuscular disease (Peripheral nervous system, Central nervous system, Metabolic disorders) (3) Mechanical abnormalities (ex: adhesions)
what's the problem in Sweeny?suprascapular nerve is damaged
examples of NEUROMUSCULAR DISEASES which can cause lameness?Nerve damage (sweeny), Glycogen muscle storage diseases, EPM (equine protozoal myelitis (myeloencephalitis) ), Wobblers, rabies, HYPP (Equine Hyperkalemic Periodic Paralysis Disease)
examples of mechanical reasons for lameness?Fibrotic myopathy, UFP (upward fixation of the patella-- doesn't hurt them, but they can't use their leg well), chronic laminitis leading to "sled runners" (their hoofs have grown out really long)
What is a lead?when a horse is galloping, one front leg comes off the ground first, that's the lead leg. Supposed to lead with leg on inside of track. so lead is when gait is proper. so if going left and not taking a left lead, prolly hurting. when horses are subtly lame can exaggerate by circling toward suspect lame leg. so circle both ways to see how well the legs are.
to do a complete exam of the foot, what must you do?remove the shoe!
why does he pick up the right foot first if he thinks the horse is lame on the left?the first thing you do is hurt the horse first, they don't like you. so touch not painful leg to show horse to trust you (and you can look to compare too)
head nod-- head goes down when?down on sound. Up on lame.
which part of the limb is most commonly affected by lameness?lower part of limbs
when do you palpate the tendons and ligaments?when the leg is picked up
does a flexion test change a AAEP lameness grade?NO
are there half grades for the AAEP lameness grades?NO
****AAEP Lameness Grade----> Grade 1?Difficult to observe, and not consistent regardless of circumstances
****AAEP Lameness Grade----> Grade 2?Difficult to observe at trot in a straight line, consistent under certain circumstances
****AAEP Lameness Grade----> Grade 3?Consistently observable at the trot
****AAEP Lameness Grade----> Grade 4?Obvious lameness, marked nodding or hiking (lameness seen at walk)
****AAEP Lameness Grade----> Grade 5?Minimal weight bearing
AGE to consider--> Yearling might be lame bc? Old horse?Yearling: osteochondrosis dissicans. Old horse: osteoarthritis, navicular dz
BREED to consider--> pony prone to what? Quarter horse prone to what?Pony: founders (aka laminitis). Quarter horse: navicular dz, HYPP
USE of horse to consider--> dressage prone to what? Thoroughbred racing prone to?Dressage: hock problems. TB: fractures, disease of fetlock and carpus
why might you want to ask about last shod for a history of a lame horse?quicked, hot nail, tight nail
what is hot nail/tight nail/quickened?cut a nail too close to the sentitisve structures
history questions to ask owner?Length of ownership, Onset of lameness, Duration, Previous lameness, Previous treatments and current medication, Last shod, Effect of exercise on lameness, Recent rest, What is abnormal about gait, Owner’s opinion as to cause (What do think is wrong?)
3 reasons there might be dropped elbow?(1) radial n damage (2) olecranon fracture (so triceps detached) (3) fracture humerus (what wraps around back of humerus? Radial n)
what is the classic laminitis posture?"camped out" aka feet in front of them (dont wanna be on toes bc hurt)
chronic laminitis will make the hoof look like what?start to grow out instead of down (rings of growth should not be moving outward diagonally)

specific exam stuff

Question Answer
Passive Examination of lameness involves what kinda stuff?Palpation, Manipulation of limbs and trunk, Hoof testing
2 kinds of blocks he mentioned?can be intrasynovial or perineural
if you get a positive response with the hoof testers, what should you do?test again!!! need to replicate response, since some horses just don't like the pressure. Also always test the opposite hoof for comparison
you want to use varied surfaces with lameness testing. Which probs are worse on hard surfaces, and which are worse on soft surfaces?laminitis worse on hard surface. Soft tissue probs worse in deep footing/bedding
head nod indicates lameness where?FRONT limbs
when does head drop and lift with head nod?down on sound, up on lame leg (when the leg hits the ground)
Sacral rise indicates lameness where?HIND limbs
when does the sacral rise occur? when does it go down?rises on lame limb- down on sound limb.
what's the lameness locator?Computerized Gait Analysis System
how does the lameness locator work?Objectively measures body movement and detects asymmetry.
What can the lameness locator do/ see?Gives measurements of severity, Can detect subtle changes not evident to the human eye, Detects multiple site lameness, May detect lameness which cannot be seen but can be felt by rider, Useful for evaluating response to flexion tests and diagnostic blocks
Pros and Cons of lameness locator?PRO: Portable and Field Usable. Can detect subtle changes not evident to the human eye. Determines Which Limb Is Lame. **CONS: Does not pinpoint exact location of lameness, Does not determine the significance of a lameness, Does not detect back soreness not associated with head or pelvis asymmetry
you are looking at a lame horse and you notice that one of the fetlocks drops down more on the walk. Is this the lame or sound leg?sound limbs fetlock drops more, because there more weight on it due to the compensation
if you are looking for a sacral rise, where do you look?gotta look over top of horse.
What is "the law of sides"? if a horse has R rear lameness, might see a R front lameness too that's secondary (artifact) at the trot
How does the lameness locator work?It measures head nods and sacral rises! (put sensors on the points it wants to gauge)
Applications of Lameness LocatorHorses with mild lameness, Horses with apparent multiple limb lameness, Horses with apparent compensatory lameness, Quantifying the effectiveness of nerve and joint blocks, Confirming the incidental nature of equivocal imaging abnormalities, Developing a further diagnostic approach based on type of lameness (impact, pushoff) exhibited, Documenting soundness in pre-purchase evaluations, Evaluating horses with poor performance (NRFE)
what are the 3 Provocative Tests of Joint Flexion?Distal limb flexion, Carpal flexion, Hock flexion (full limb flexion)
what are the 2 Provocative Tests of the Hoof?Reverse hoof wedge, Heel block
what should you keep in mind if you get a positive Distal Limb Flexion Test?Can be positive in normal horses
what are you looking for with a Distal limb flexion test?Look for asymmetry of response
is the distal limb flexion test specific?not very specific
what does distal limb flexion test look like in the front limb?
what does distal limb flexion test look like in the hind limb?
what is an alternate approach to the distal limb flexion test? why would you do this?reduces stress on the coffin joint
is the carpal flexion test specific?Reasonably specific for carpus
how do you do the carpal flexion test?
Full Rear Limb Flexion Test (FLFT) is aka?Known as spavin test and hock flexion test
which joints does the Full Rear limb flexion test stress?Stresses all joints in upper limb- Hip, Stifle, Hock (Stresses joints in lower limbs to lesser degree)
how do you do a Full rear limb flexion test?
doing a hoof test with this type of block is to look at what? puts pressure on the frog
doing a hoof test with this type of wedge is to look at what? stretches the deep digital flexor tendon

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