The less than obvious lameness and the horse that travel unevenly #horsehealth

#horsesa #horse #horsehealth
Presentation at the Horse SA 'Northern Horse Forum' 2017 by Dr Olivier Simon, DMV Diplomate ECVS of the University of Adelaide Equine Health and Performance Centre, Roseworthy, South Australia
https://www.adelaide.edu.au/vetsci/centres/ehpc/

Hosted by Horse SA https//www.horsesa.asn.au a non-profit organisation working with and for horse owners on common topics. Why not join, sponsor or donate today https://www.horsesa.asn.au/join-sponsor-or-donate or visit our website for more events, webinars or download free resources.

Note: Horse SA has hosted this presentation only. It is up to individuals to seek their own advice. It is also the responsibility of individuals to familiarise themselves with laws relating to the provision of animal services which may fall under Acts or Regulations associated with veterinary services, animal welfare and related areas, which vary between Australian states, and in jurisdictions within different countries.

1. Olivier Simon, DMV Diplomate ECVS The less than obvious lameness and the horse that travel unevenly Northern Horse Forum – Roseworthy 20/04/2017

2. F acts Lameness is one of the major causes of poor perfomance in ( any level of) horse sport It has a major impact on finance and enjoyment Horses are not able to speak our language Not all lamenesses are foot abscesses 

3. What do we consider as lameness ? Any gait or stance abnormality resulting in asymmetry Includes : Shifting body weight - Head nodding Unloading - Hip hikes Relieve - Hip dips Alleviate Drifting Dragging Falling on one leg

4. What do we consider as lameness ? Any gait or stance abnormality resulting in asymmetry Includes : Shifting body weight - Head nodding Unloading - Hip hikes Relieve - Hip dips = LAMENESS Alleviate Drifting Dragging Falling on one leg

5. Semi-quantitative AAEP (5 grades) lameness scale Grade 0: not perceptible under any circumstances Grade 1: Difficult to observe and not consistently apparent regardless of the circumstances Grade 2: Difficult to observe at a walk or when trotting on straight line but consistently apparent under certain circumstances Grade 3: C onsistently observable at at trot under all circumstances Grade 4: Obvious at a walk Grade 5: minimal weight bearing in motion or at rest / complete inability to move

6. Semi-quantitative AAEP (5 grades) lameness scale Grade 0: not perceptible under any circumstances Grade 1: Difficult to observe and not consistently apparent regardless of the circumstances Grade 2: Difficult to observe at a walk or when trotting on straight line but consistently apparent under certain circumstances Grade 3: C onsistently observable at at trot under all circumstances Grade 4: Obvious at a walk Grade 5: minimal weight bearing in motion or at rest / complete inability to move

7. Semi-quantitative / subjective AAEP (5 grades) lameness scale Grade 0: not perceptible under any circumstances Grade 1: Difficult to observe and not consistently apparent regardless of the circumstances Grade 2: Difficult to observe at a walk or when trotting on straight line but consistently apparent under certain circumstances Grade 3: C onsistently observable at a trot under all circumstances Grade 4: Obvious at a walk Grade 5: minimal weight bearing in motion or at rest / complete inability to move

8. Other scales 1 to 8 (UK) 1 to 10 (F) Matter of subjectivity « Arts » of practice >>> variability and disagreement => risk of multi-consultations

9. Other classic complains around locomotor system Poor lateral translations Poor extensions Cross galloping Bunny hoping / poor dissociation at the gallop

10. Typical stages of a lameness examination Is the horse actually lame? From which leg (s) is the horse lame? Which segment of the localized leg (s) is the source of lameness ? What is the nature of the lesion of the particular region of the lame leg (s)? What is the treatment ? What is the prognosis ? What are the costs ?

11. Classic assessment Observation with naked eye

12. Classic assessment Observation with naked eye Qualitative

13. Classic assessment Observation with naked eye Qualitative Semi-quantitative ( scales )

14. Classic assessment Observation with naked eye Qualitative Semi-quantitative ( scales ) At a trot ( most of the time)

15. Why examining horses at a trot? Only symmetric natural gait of the horse Two symmetric impact « times » with an intermediate gliding (suspension) time Lameness is by definition asymmetry

16. Limitations of this classic approach Naked eye have a reduced sampling capacity about 10 samples /seconds vs min.200 s/s for videocamera recorder Multiple lamenesses Primary and secundary lameness Primary and compensatory lameness Hind limb lameness is always more difficult to assess What about gaited horses ? What about axial skelettal (« back ») injuries?

17. Limitations of «  naked eye  » exam Need of objective gait / lameness evaluation modalities No or less bias More sensitive : higher data sampling capacity Repeatable Quantitative

18. O bjective evaluation of lameness types Kinetic technique: study of the forces that produces or are produced by the movement Kinematic : descriptive analysis and quantification of the movement Electromyography : mesurement of the muscular activity during movement UC Davis, Ca

19. O bjective evaluation of lameness types Kinetic technique: Stationary force plate : measures vertical, horizontal and transverse forces Lameness generally => decrease in vertical forces UC Davis, Ca

20. O bjective evaluation of lameness types Kinetic technique alternatives: Pressure mats and « in- shoe  » systems Not durable not as repeatable as force plate Force measuring horse shoes None commercially available Force measuring treadmill One-of-a- kind U. Zurich

21. Kinematic Eadwaerd Muybridge 18th century

22. Eadwaerd Muybridge Sally Gardner at at Gallop 1878

23. Modern motion capture systems Qualisys AB, Göteborg Sweden

24. Combination of kinetic and kinematic

25. Body- mounted inertial sensors Giroscopic sensors (1 – 3 – 8 – 18) attached to the horse’s body and wireless transmitting datas to evaluator Multiple systems on the market allowing use in natural environment

26. Equimetrix ®

27. Equusys ®

28. Equinosys ® Lameness Locator®

29. Lameness Locator®

30. Clinical case 10 years old riding poney mare Pleasure riding Was operated 1 year before for OC RF fetlock Lost of condition Locking movement right hind downhill

31. Clinical case

32. Clinical case

33. Flexion test

34. Local anaesthesia DBLPN LH

35. Local a naesthesia DBLPN RH

36. Conclusion Subtle lameness evaluation can be very tricky Subjective qualitative evaluation alone is too limited Objective kinematic systems commercially available BUT have also some limits They can not substitute practitionner Bilateral symmetric lameness Back and neck problems