Lamenesses galore at BEH and a trip to the track

With the weather FINALLY warming up and the show season getting into full swing, that means that we have an abundance of lameness exams over the last couple of weeks.  We have had at least 4 lameness exams every day, and sometimes as many as 8!  From barrel racers and western pleasure horses, to pacers and pulling drafts, we have seen the many different ways a horse can be painful and lame.  Dr. Brown prefers to watch the horse trot in hand in a circle each direction on asphalt, and then in a straight line to and away.  During this time we try to determine two things: 1) Is the horse lame? (The answer is usually yes, otherwise they wouldn’t be here), and 2) In which leg (or legs) is the horse lame?  Once he has determined which leg he suspects is the problem he then asks the client for a history.  I like this method of determining lameness because it allows assessment of the horse without being biased by the history or palpation of abnormalities that may be a “red herring”.  After taking the history, Dr. Brown palpates the horse and then does a series of flexion tests to localize the lameness to a specific area.  The next steps vary depending on the horse and owner, but it usually involves a series of nerve blocks to further confirm the problem area, some sort of diagnostic imaging (usually radiographs and/or ultrasound depending on the type of tissues involved), and then the appropriate treatment depending on the type of injury.  One of the common methods of treatment is injection of the joints with hyaluronic acid (which simulates joint fluid) and/or corticosteroids. Last week I got to inject the tibio-tarsal joints on one of our patients!   Assessing and treating lamenesses is very methodical, but can also have a lot of variety that always keeps us on our toes. 

Injection of the tibiotarsal joint with hyaluronic acid and corticosteroids

This week I was also fortunate enough to be able to go over to the Standardbred racetrack nearby with Dr. Hackett to do a dynamic endoscopic exam.  We do endoscopies of horses regularly at BEH to look at their upper airways, but sometimes we can’t find a cause for what the trainer/driver/owner has noticed because we are examining the horse at rest as opposed to during extreme physical exertion.  The dynamic endoscope allows us to do just that.  A more rigid scope is inserted into the horse’s nostril and secured in place so that we can visualize (in this case) the larynx while the horse is exercising. The image is broadcasted to a remote screen as well recorded while the horse works and is then reviewed by the vet after the horse finishes exercising.  The horse we were examining had a history of making noise while working and some exercise intolerance.  Through the dynamic endoscopic exam, we were able to confirm that the horse was dorsally displacing his soft palate over his epiglottis.  This causes the horse to breath through his mouth as opposed to through his nose.  For humans this doesn’t seem like it would be much of a problem, but because horses are obligate nasal breathers, suddenly having to breath through their mouth can cause decreased air intake and poor athletic performance. Going to the track and helping with the dynamic endoscopic exam was something new and different, and it’s always interesting to see the ways technology allows vets to evaluate and treat our patients. 

The saddle pad holds the computer and other components of the endoscope

The endoscope runs from the saddle pad, up between the ears, into the nostril and allowed up to visualize the larynx

The endoscope records and transmits the images to a remote viewing screen.  If the screen was outside of the transmittable distance of the dynamic endoscope, we were unable to see the images in real time, so we had to review them afterwards
  

Our patient doing his job

Reviewing the video after our patient finished exercising

Until next time!