Investigations on a lame or under performing horse are often in depth and take several hours to complete. Most horses go home on the same day, but sometime we want to keep them overnight for further tests. Many owners like to stay for the initial assessment, and then leave the horse at the clinic while investigations take place.
We will always start with detailed questions about the exact problem, how long it has been present and if there was any incident which set it off. We will then palpate the horse’s legs and body looking for any areas of heat, pain or swelling and assess the flexibility of the joints and body. The horse’s movement will then be assessed, usually involving walking and trotting in a straight line as well as trotting and cantering on the lunge.
Trotting on the lunge is often done on both hard and soft surfaces to allow us to assess the effect of different levels of concussion on the horse’s legs. Flexion tests, where we hold a horse’s leg up for about 30 seconds then ask them to trot away, may be performed.
Finally you may be asked to ride your horse on our ménage. This is most often necessary when there is no obvious lameness, rather the horse just doesn’t feel quite right. With this in mind it is always a good idea to bring saddle and bridle with you when coming to the clinic.
Once the base line problem has been established, we may have a fair idea what is going on and proceed straight to x-rays or scans, alternatively we may want to localise the source of pain by performing nerve blocks. This is where we inject local anaesthetic around specific nerves or into a particular joint to numb a region of the horse’s leg or body. A few minutes later we watch the horse exercise again to determine if the problem has improved. For instance, if a lame horse becomes sound when his hock is numbed, we know that his pain is coming from that joint.
If there is no obvious cause for the problem, and nerve blocks have not helped us we may perform nuclear scintigraphy (bone scan). Here we can look at a horse’s entire skeleton in a single investigation, and it is particularly useful for back and pelvis problems. Once we know where the pain is coming from, we will then perform x-rays, scans or sometimes we refer for an MRI scan to find the cause of the problem.
Having made a diagnosis we can then advise you on the best treatment options and the prognosis.