Horsey language needn t confuse you

Transcription

1 Vet Times The website for the veterinary profession Horsey language needn t confuse you Author : GRAHAM DUNCANSON Categories : Vets Date : March 2, 2009 GRAHAM DUNCANSON provides an A to Z guide to common conditions seen in horses and their corrective options IN my experience, horsey clients rarely actually understand the horsey terms they re using. The equine practitioner needs to be like Bradley Viner playing poker: never give away your ignorance (actually, it is usually theirs) and say little. If you are silent long enough, or ask the client to show you the problem, all will often be revealed. You will either find out his or her concern or lack of knowledge. I was standing with my senior partner many years ago while an owner lunged what, appeared to me, to be a perfectly normal horse. The owner kept saying: He s wrong behind. Sam Ellis, a superb horseman, who had obviously come to the same conclusion as myself, suddenly said: So, what is wrong behind? At the end of this article, I hope you will be less confused. Equally, I may well show how ignorant I am. Bucked knees This is not a common condition and is rarely more than a conformation defect of the suspensory apparatus. There is an anterior deviation of the carpus, which normally disappears after six months. If it is very severe, surgery may be an option. 1 / 14

2 Capped elbow Normally, trauma by the shoe on the hindleg causes this bursitis over the olecranon. It is a nasty condition to treat, particularly if the skin has been cut. The farrier can be of great help here by shortening the toes of the hindfeet, and leaving the horse without shoes until the skin has healed may be worthwhile. It is important to understand that this is a treatment and that it is not the case that the farrier has caused the condition in the animal by leaving its toes too long. Bandaging is extremely difficult and it is also very expensive, as a full Robert-Jones is the only suitable approach. If the skin is intact, then draining may be an option. However, referral, where the horse can be cross tied, would be my advice. Capped hock The cause of a capped hock (Figure 1) is likely to be from continual trauma when getting up on a hard surface. Ideally, the horse should be turned out. However, owners are likely to be reluctant, so a really good soft bed is vital. Just a thin rubber mat and some shavings are not sufficient. Once again, like the capped elbow, the area is not easy to bandage. The prognosis should be guarded. Curb This is a swelling just below the hock on the latero-plantar aspect. It is a thickening of the plantar ligament. Normally, it is a conformation defect and does not cause lameness. However, if it is caused by trauma from kicking out behind, then lameness may persist for several weeks. In my experience, given time, it will settle down, but some practitioners favour local steroid injections. Fistulous withers This condition was common when I was at veterinary college; perhaps ill-fitting saddles brought it about. My professor of surgery thought that it was a brucellosis infection, however that has not been proven. Whatever the cause, the bacteriological findings are a mixed infection of Staphylococcus and Streptococcus. The condition is difficult to treat, not because the organisms are resistant to antibiotics, but because there is very poor drainage from that area. Antibiotic treatment with penicillin, cephalosporin or potentiated sulphonamides needs to be prolonged. Obviously, the saddle should be checked and kept off the horse until full healing has occurred. Mercifully, it is a rare condition these days (Figure 2). Grease 2 / 14

3 Heavy horse owners use this rather unhelpful term to describe secondary bacterial infection on the lower legs usually as a result of chorioptic mange. Riding horse owners tend to use the term mud fever, which is neither a fever nor is it as a result of mud. A much better term, coined by Derek Knottenbelt, is pastern dermatitis. This multifactoral condition may follow Chorioptes equi or may even be photo aggravated. However, the bacteria involved are Dermatophilus, Streptococcus and Staphylococcus. The later infection is extremely painful. Light behind When I was newly qualified, I was asked to look at a mare, which, as I later found out, had varicose veins in the walls of her posterior vagina. The sign was frequent and small amounts of blood seen just below the vulva. I was told by the yard owner that she was light behind. She seemed not that well muscled on her gluteals, but I thought nothing more of it. I examined her with an old fashioned duck-billed speculum and applied a small silver nitrate pencil to the small bleeding point. On returning to the surgery, I asked Sam Ellis the meaning of light behind. Kicks like hell, was his ready reply. My reputation as a fearless horseman was made (Figure 3). Poll evil This condition is similar to fistulous withers, but has a different aetiology and is rare. A wound to the poll, usually self inflicted and that has become infected, causes it. Because drainage is poor, healing may be delayed. However, that has not been my experience and I have found that these wounds quickly repair. Quittor Owners often misuse this term when describing pus in the heel of a horse that has broken out above the coronary band. This is not a quittor. Specifically, a quittor is a deep-seated infection in the side bones better termed the collateral cartilages of the third phalanx. It is an osteomyleitis and is a very serious condition. Proper surgical debridement, establishing proper drainage, is required. There is even a specific quittor knife. It is not a quick fix, like releasing pus from a foot. Ringbone This term is often used by owners with no idea of the anatomy of the lower limb of the horse and should never be used by veterinary surgeons. It describes extra bone growth on the first and second phalanxes (Figure 4). A high ringbone is extra bone at the distal end of the first phalanx and the proximal end of the second phalanx. This can be felt. However, a low ringbone is extra bone at the distal end of the second phalanx and this can only be seen on radiographs. Neither condition causes lameness until it involves the joints. As the condition is progressive, it is likely to eventually cause lameness. The condition is caused by concussion and is common in cobs, but rare in 3 / 14

4 thoroughbreds. Seedy toe In my experience, this is rarely a primary condition, but normally a sequel to laminitis. Initially, dirt and then infection, usually by anaerobes, enter between the hoof wall laminae and the pedal bone laminae, thus causing pain and lameness in the animal. Radical foot paring is required. Often, a shoe has to be applied to allow the wall to heal and spread the weight load. Shivering This is a strange condition of involuntary movement of the hindlimbs and tail. It is usually more pronounced when the horse is pushed backwards. Aetiology is unknown and there is no treatment. Sadly, the condition does seem to be progressive and makes farriery very difficult. Sore shins My main experience with this condition is in young standardbreds in Australia. However, I know it is common in young thoroughbreds worldwide. It is a periostitis of the anterior aspect of the cannon bones on both the front and hindlegs. The cause is likely to be concussion affecting rapidly growing bones. Certainly, the front cannons are more often affected. There is heat and pain in the affected area so diagnosis is not a problem. Treatment, on the other hand, is very contentious. Rest is important and cooling methods may be worthwhile in the acute phase. There is obviously inflammation, so any treatment causing more inflammation seems to me to be idiotic. Any sort of counterirritant must be contraindicated. However, the most ludicrous treatment of all must be radiation therapy, which I was asked to do in Australia. Spavin I am uncertain as to the derivation of this term. It has certainly caused considerable problems in the past and I am the worst offender. The normal scenario, when I reflect on my bad practice, is in the cob-type riding horse, which has bilateral hindleg lameness. This lameness, on both hindlegs, is made worse with flexion. Usually, the owner has no money and the animal is not insured. Referral is not an option, but scintigraphy would be helpful. The temperament of the horse does not lend itself to multiple nerve blocks in the hindlimbs. Basically, I am faced with a lame horse and no diagnosis. I perform a bute test. This involves giving three grams of phenylbutazone daily for five 4 / 14

5 days. If the animal improves, I consider this as positive. I then suggest the owner continues to use the horse on the lowest dose of phenylbutazone, which will keep it sound. The theory behind this is that natural fusion of the metatarsal tarsal joint will occur. Hopefully, the horse will be able to be taken off the pain relief medication in four to six months. Work during that time needs to be regular trotting work. No jumping is allowed, and any cantering needs to be very controlled. If the owner is not happy with this very low-tech approach then radiography is suggested. A quote is given for light sedation and four radiographic views of each hock. I am aware many equine veterinary surgeons will be annoyed by this approach. I have no defence, but cannot think of any other course of action. I am sure readers would be very interested in better protocols to guide them. Stringhalt This condition, which is an involuntary flexion of the hock during forward movement, is disastrous in driving horses, as the high movement may involve the tack. However, it is a condition that can be tolerated in riding horses. The aetiology is unknown, but there are plenty of theories (Figure 5). When vetting horses I would advise the handler to push the horse backwards and then snatch it forward, as the condition is likely to be more obvious in this circumstance. Sadly, there is no effective reliable treatment. Sectioning of the lateral digital extensor as it passes over the hock has been suggested, but this practitioner has not tried this surgery. Sweeney I have not heard an owner use this term; however, I understand from a fourth-year veterinary student, that he was asked the meaning of this term in an exam, and no one knew the answer. Forty years ago, I suspect I would not have known either. The term sweeney actually means an atrophy of a muscle and it has come to mean an atrophy of the supraspinatus and infraspinatus muscles. The cause is nerve damage to the supraspinatus nerve as it crosses the point of the shoulder. In my experience, the horse is not lame and the muscles continue wasted. However, some consider that muscle bulk will return after nine months. It should always be mentioned on a vetting certificate. Thoroughpin Owners are always concerned about these benign swellings of the deep digital tendon sheath at the level of the hock (Figure 6). The diagnosis is easy, as the swelling can be pushed medially or laterally from its position cranial to the tendon. 5 / 14

6 They do not appear to cause problems, but, they must be recorded on a vetting form. Unlevel This is a very silly term used by horsey folk. It is used to indicate a slight lameness, when they don t want to say the horse is lame. The correct veterinary terminology would be one-tenth lame. Wind galls I use this term to describe the common synovial swellings seen on the plantar medial and plantar lateral aspects of the fetlocks. They are normally not a problem. However, I think they should be mentioned on the vetting form of a young horse in case they become very enlarged with strenuous jumping work. They are uncommon on the palmar aspects of the fetlocks. Summary As veterinary surgery becomes more scientific and less of an art, I am sure these terms will disappear from the veterinary literature. However, I notice in human medicine that they still refer to syndromes named after the first recorder. I am always on the look out for a new syndrome. 6 / 14

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8 Figure 1. Horse displaying a small capped hock. 8 / 14

9 Figure 2. This horse has fistulous withers. 9 / 14

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11 Figure 3. She may have the look of an angel, but she is definitely light behind. 11 / 14

12 Figure 4. A cob with ringbone in both front legs. 12 / 14

13 Figure 5. Similar in appearance to stringhalt is an upward fixation of the patella, as displayed in this horse. 13 / 14

14 Figure 6. Thoroughpin on the right hind. 14 / 14 Powered by TCPDF (