G. Kent Carter

Diagnosis, treatment, and farriery for horses with chronic heel pain

In conclusion, horses with heel or navicular area pain vary, and no one treatment option is suitable for all horses. Each horse must be evaluated individually to determine which structure in the palmar aspect of the foot is injured, severity of disease, horse and hoof conformation, and horse use and level of performance expectation before a treatment plan can be developed. Overall, there are many treatment options to help these horses to perform their intended athletic event.

MANAGEMENT OF A KERATOMA IN A HORSE: A case report

Summary An 8-year-old Thoroughbred gelding presented with chronic intermittent lameness of the left forelimb. Keratoma was diagnosed based on history, clinical signs and the radiographic evidence of a radiolucent concavity of the third phalanx. The keratoma was removed by hoof wall resection and the foot was immobilized using a bar shoe with clips and a dorsal hoof wall plate positioned across the hoof wall defect. The hoof wall defect was completely filled with new hoof wall by 9 months postoperatively. The horse returned to normal athletic function and is performing successfully 18 months later.

Tendinitis of the proximal aspect of the superficial digital flexor tendon in horses: 12 cases (2000-2006).

OBJECTIVE To determine clinical signs, ultrasonographic findings, and outcome of horses with tendinitis of the proximal portion of the superficial digital flexor tendon (SDFT; group A horses) and to compare signalment, horse use, and outcome in these horses with that of horses with tendinitis of the midmetacarpal region of the SDFT (group B horses). DESIGN Retrospective case series. ANIMALS 12 group A horses and 22 group B horses. PROCEDURES Medical records were reviewed for signalment, horse use, and outcome information; data for group A horses also included severity of lameness, diagnostic results, and treatment. RESULTS Most group A horses were aged (mean, 18 years; median, 17 years; range, 11 to 23 years) Quarter Horses (9/12 horses) and had a grade 3 or 4 (on a scale from 1 to 5) forelimb lameness. Most group A horses (8/12 horses) had positive reactions to carpal flexion and were (9/12 horses) sound following ulnar nerve blocks. Ultrasonographic evaluation revealed hypoechoic SDFT lesions (median echogenicity score, 3/4; median fiber alignment score, 3/3; and mean length, 9.75 cm). Group A horses were significantly older and had a poorer outcome for return to previous use (2/12 horses), compared with group B horses (median age, 5 years; 10/22 horses returned to previous use). Thirteen of 22 group B horses were Thoroughbreds. CONCLUSIONS AND CLINICAL RELEVANCE Tendinitis of the proximal portion of the SDFT was a cause of lameness in aged performance horses; prognosis for return to previous use was poor.

A randomized, controlled trial of the effects of resveratrol administration in performance horses with lameness localized to the distal tarsal joints.

OBJECTIVE To determine the effect of resveratrol administration in performance horses with lameness localized to the distal tarsal joints. DESIGN Randomized, blinded, placebo-controlled clinical trial. ANIMALS 45 client-owned horses with lameness localized to the distal tarsal joints. PROCEDURES All horses received injections of triamcinolone acetonide in the centrodistal and tarsometatarsal joints of both hind limbs. A placebo or a supplement containing resveratrol was fed twice daily by owners for 4 months. Primary outcomes were horse performance as determined by rider opinion (better, worse, or the same) and change in lameness severity from the enrollment examination. RESULTS Complete data were obtained for 21 horses that received resveratrol and 20 that received the placebo. Percentage of riders who reported that the horses performance was better, compared with worse or the same, was significantly higher for the resveratrol group than for the placebo group after 2 (20/21 [95%] vs 14/20 [70%]) and 4 (18/21 [86%] vs 10/20 [50%]) months. The change in A1:A2 ratio between the enrollment and 4-month recheck examinations was significantly better for horses in the resveratrol versus placebo group. However, subjective lameness scores and degree of asymmetry of pelvis movement did not differ between groups. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in performance horses with lameness localized to the distal tarsal joints, injection of triamcinolone in the centrodistal and tarsometatarsal joints of both hind limbs followed by oral supplementation with resveratrol for 4 months resulted in reduced lameness, compared with triamcinolone injection and supplementation with a placebo.

Enthesopathy and desmitis of the medial collateral ligament of the cubital joint in 4 horses

CASE DESCRIPTION 4 horses with enthesopathy and desmitis of the medial collateral ligament of the cubital joint were examined. CLINICAL FINDINGS All 4 horses had a history of acute, severe, unilateral forelimb lameness and had signs of pain during manipulation of the affected upper forelimb; 2 also had swelling in the axillary region. There was no improvement in lameness after diagnostic local analgesia below the carpal region, and 1 of 4 horses had mild improvement after cubital joint analgesia. Radiography revealed enthesophyte formation on the radial tuberosity and linear mineralization of the medial collateral ligament in 2 horses and periosteal reaction on the humeral condyle in all 4 horses. One horse had mild osteoarthritis of the cubital joint, and 3 had osteophytosis of the cranial aspect of the radius. Although all horses were initially examined because of an acute onset of lameness, all had chronic abnormalities visible on imaging. Ultrasonography revealed an irregular boney contour and enthesopathy at the insertion of the short medial collateral ligament to the radial tuberosity and desmitis of the short medial collateral ligament. Two horses had radiographic evidence of similar but less severe lesions of the contralateral cubital joint. TREATMENT AND OUTCOME All horses received phenylbutazone and rest. All horses were free of lameness after a median of 3 months (range, 2 to 4 months) and returned to previous use after a median of 6 months (range, 3 to 8 months). CONCLUSIONS AND CLINICAL RELEVANCE The results of the present report suggested that performance horses with enthesopathy and desmitis of the medial collateral ligament of the cubital joint may have a good prognosis for return to previous use following appropriate treatment.