Lameness investigation – Orthopaedics

Lameness investigation

Lameness investigation consists of several separate examinations, all of which have to be carried out. As mentioned before, it is very important in any lameness investigation that the horse is carefully examined: the posture, the muscles , the way it is built and its condition. Touching the horse is another important source of information for our veterinarians.

After static research, we examine the horse in movement. We check out the different gaits, such as walk, trot, canter and gallop on different surfaces and, if necessary, while mounted or harnessed to a sulky. Flexion tests are also often executed. In order to pinpoint the painful spot, we use local anaesthetics.

When the cause of the pain is located, we make x-rays and / or an ultrasound. If these options do not give a decisive answer to the problem, using magnetic resonance imaging (MRI) is also a possibility.

Radiology

All radiology is digital and the images are directly visible on a screen. Our systems give razor sharp and crystal clear images with good possibilities to enlarge the pictures. Illnesses and handicaps such as arthrosis and fractures are straightforwardly diagnosed. Besides access to our permanent radiology installation, we also have two portable systems. We can come and make all the necessary x-rays in your stables.

Ultrasonography

In the past, only x-rays were used to diagnose whether a horse was lame or not. At that time ultrasound was only used on horses with tendon problems.

However, due to the broad development of ultrasound , we have discovered that most cases are not only due to a bone fracture, but often there are additional problems with the ligaments, tendons, musculature, cartilage or joints.

Ultrasound has enabled us to diagnose in a more precise manner, resulting in the best possible treatment and a thorough and precise prognosis.

There are many examples of horses which are lame or with back injuries that do not show up in x-rays but are apparent on an ultrasound image. Of course, the technique of echography complements x-rays, as it can be used to study abnormalities more effectively.

Ultrasound is also an important tool when making targeted injections into specific joints and structures. In these cases it enables the visualisation of the injection needle, and thus there is more certainty that the proper, targeted areas and structures are being injected. It goes without saying that in our clinic we always work with the latest technology and systems.

Magnetic Resonance Imaging (MRI)

We have a high quality Equine Magnetic Resonance Imaging (MRI) scanner at our disposal.This MRI enables us to get the best results in diagnostic imaging. With the aid of a MRI-scanner, we can make three dimensional images of the legs and the head. In this manner we can arrive at a diagnosis that is not available by other means. Even the bones, the tendons and the cartilage can be assessed. For the diagnosis and treatment of your horse it is crucial that no abnormality is overlooked. Having all of this crucial information at hand helps us make the proper diagnosis and prognosis for the fastest recovery of your horse.

Please check for more elaborate information: Equine MRI

Conservative therapy

After arriving at the proper diagnosis, it is time for the right treatment. Taking enough rest, using an adapted schedule for physical exercise and orthopaedic shoeing is always part of the treatment and rehabilitation.
Depending on the diagnosis, other treatments, such as anti-inflammatory agents and intra-articular treatments, can be prescribed. Food supplements can also be part of the treatment.

Regenerative medicine

We often use regenerative therapies which are processed in our laboratory. These treatments boost the recuperation of the horse. We use special anti-inflammatory proteins and cells that are produced from the horse’s own blood. Blood and stem cells are taken out of the horse. After a specific laboratory proces, these acquired horse-own products then will be injected at the exact spot of the injury.

These treatments have the benefit of being recognized by the horse’s body as its own blood and own cells. There are no unexpected side-effects, as may occur with other forms of treatment. Another benefit of using regenerative medivine is that the recovery of the tissue is stimulated, with reduced cicatrice formation.

Some examples of commonplace regenerative therapies:

  • IRAP: Interleukin 1 Receptor Antagonist Protein;
  • PRP: Platelet Rich Plasma (processing whole blood to obtain the blood fraction with the highest concentration of platelets)
  • Stem cells

Please contact our specialized equine veterinarians if you would like to obtain more information concerning the exact functioning and usage of these products.

Extra Corporeal Shock Wave Therapy (ESWT)

Extra Corporeal Shock Wave Therapy (ESWT) originally started out as a humane treatment for kidney and bladder stones, and later for orthopaedic problems such as heel spur and shoulder abnormalities. In the meantime, ESWT is also being used in other domains, such as for equine injuries.

ESWT is based on the usage of high-energy sound waves, generated via electromagnetic pulses, that increase pressure as they travel through the horse’s tissue. When these sound waves are fired repeatedly at a specific area, they stimulate blood flow and new blood vessel formation, and have the ability to eliminate calcifications.

ESWT is used for the treatment of musculoskeletal soft tissue pain and disorders near bone structures. It is proven that ESWT has the faculty to take away pain, to stimulate blood flow, and to enhance tissue regeneration. It also speeds up healing times and recovery.

ESWT is used for different sorts of problems, such as tendon injuries, injuries of the suspensory ligaments, calcification of the tendons, excess bone formation, back and spinal issues and in cases of arthrosis. We also offer radial mechanic shockwave therapy in the case of musculoskeletal soft tissue pain in, for example, the back area of your horse.

Surgery

Before surgery the horse will first be thoroughly examined. This pre-anaesthetic check is a general examination used to give an indication of the anaesthetic risks. The surgeon might decide that additional research is necessary if he has any doubt about the functioning of certain vital organs. Additional research can take several forms, such as, for example, an electrocardiogram (ECG), blood research and / or a worm egg count.

Unless emergency surgery is required, the horse owner is given the opportunity to insure the horse with a so called equine operation insurance. We work together with several specialized insurance companies in this field.

During surgical intervention under anaesthesia we always employ the so called monitored gas anaesthesia, where isoflurane, oxygen and an infusion pump are used. Monitoring of the patient throughout the surgery is constant, with parameters such as reflexes, gas exchange analysis, arterial blood gas analysis, tissue oxygenation, blood pressure, breathing- and heart rate continuously checked. Gas anaesthesia is a very safe and easily regulated procedure for both maintaining and recovering from anaesthesia.
After anaesthetics, assisted recovery is used in our recovery stall. During recovery horses have additional oxygen administered.

Every day sport and race horses are being operated on in our clinic.

With our orthopaedic surgery we cover a broad range of operations, such as:

  • Arthroscopy: a minimally invasive surgical procedure on a joint
  • Tenoscopy: a minimally invasive surgical procedure on the bursa
  • Osteosynthesis: a surgical procedure for the reduction and internal or external ixation of a bone fracture by implantable devices, usually made of metal

We frequently perform soft tissue surgery for upper airway disorders,-such as:

  • Tie Forward surgery: addressing the problem of dorsal displacement of the soft palate, causing a gurgling noise while the horse is at high speed. The soft palate is intermittent or persistently displaced over the epiglottis. This operation brings forward and pulls up the epiglottis.
  • Tie Backward surgery: surgery on horses with cornage (laryngeal hemiplegia).
  • Laser surgery of the throat
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