Lameness evaluations can range from being something as simple as a foot abscess to as complex as a complicated soft tissue or bone/joint injury. A typical lameness evaluation will begin with a good history and exam at rest, looking for any obvious swelling to joints or tendon/ligament structures. Hooftesters will be used to detect any foot related pain and each limb will be put through ranges of motion to to determine if adequate range of motion is still present and if any pain is elicited during the process. The horse will then be trotted in hand and/or on a lunge line to determine if an unsoundness is present and which limb(s) are affected. Once all these factors are combined a plan for diagnosis and treatment can be established. In situations where a limb is identified but the source of the lameness remains in question, a combination of of peripheral nerve blocks or intra-articular blocks will be performed to help localize the area of concern. Diagnostic modalities such as digital radiographs and ultrasound are the initial tools used most commonly to obtain images of bone, joint, ligament or tendon. At times, possibly due to location on the horse or lack of sufficient findings with radiographs or ultrasound, more advanced diagnostics are required to aid in a diagnosis. This is where bone scan, CT, and MRI are typically present to pursue a diagnosis.
Once a diagnosis is achieved treatment can range from a few days of stall rest to extended months of stall rest with rehab. Typically, if a joint(s) is of concern they can be injected and with a positive response there is minimal time off. Joints are typically injected with a combination of Hyaluronic Acid and steroids. Other options include IRAP or PRP if traditional injections are nontherapeutic. Soft tissue injuries can be much more severe. Extended stall rest with treatment of stem cells or PRP and shockwave are implemented.