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EQUINE MATTERS
A R T H R I T I S
Case Study:
Lameness - medical treatment
Veterinary Surgeon
Graham Hunter
XLVets Equine Practice
Ardene House
Our goals in treating arthritis should always
be to make an accurate and early diagnosis
and to implement accurate and early
treatment. Our ultimate aim being to reduce
pain and lameness, promote healing and
prevent any further damage. After diagnosis
of joint pain and inflammation our treatment
decisions are going to be based on
pathological factors, the use of the horse,
cooperation of the horse, sport rules and
regulations and economics.
Alfie is a nine year old Warmblood
gelding who is used regularly as a novice
showjumper. After a hard weekend
competing Alfie’s owner noticed him to be
lame on his right forelimb when she went
to bring him in from the field. She made
the assumption that he had been tearing
around the field in the wind and had
strained something. She decided to try ten
days of box rest and cold hosing the limb
to see if this resolved Alfie's complaint. After
the ten days he was improved but still quite
clearly lame so an appointment was made
for him to be seen at the clinic.
Alfie presented 2/10ths lame on his right
forelimb and it was noted that he had a
slightly warm and swollen fetlock joint.
It was particularly noted that there was
swelling of the fetlock joint capsule present
(joint effusion).
X-rays were taken of the fetlock joint and
this revealed no abnormalities of the bone
itself. An ultrasonographic examination was
carried out and this confirmed that there
was an increase in the amount of fluid in
the joint and that the inside synovial lining
was inflamed and thickened. It also
confirmed there was no serious damage
to any of the surrounding ligaments and
tendons. Local anaesthetic was injected
directly into the joint and ten minutes later
Alfie was seen to be much sounder when
he was trotted-up. This confirmed that there
was pain originating from the joint itself.
After discussion with Alfie’s owner it was
decided to treat this joint inflammation
with rest and a controlled exercise
programme and intra-articular medication.
In this particular case we chose a steroid
called Triamcinalone acetonide combined
with Hyaluronic acid. This mixture of drugs
was injected directly into his right front
fetlock joint.
Alfie was totally box rested for 14 days then
was started into a controlled programme
of in-hand walking, progressing to small
paddock rest. Alfie was examined at six
weeks and then again at 12 weeks after his
injury. At 12 weeks, he was completely
sound. Alfie started steadily back into
work and was back winning again eight
weeks after that.
Many cases like Alfie’s can be treated very
successfully using intra-articular medication.
It must never be forgotten however that
good farrier care along with rest, controlled
exercise and physiotherapy are also often
essential in resolving your horse’s lameness
problems and returning successfully to work.
Arthritis case treated by intra-articular medication
3. X-ray of Alfie's
fetlock from the side
(lateromedial view).
Again, no bony
changes evident.
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1. Alfie, a showjumper went lame
after competing
2. X-ray of Alfie's fetlock from the front
(dorsopalmar view), no bony
changes evident.
4. Ultrasound image taken from the front of
the fetlock joint showing the distended
joint capsule (arrow)
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5. Ultrasound image taken from the side of
the joint showing a normal collateral
ligament (1) and joint space (2) with
increased fluid in the joint (3).
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6. Injecting Hyaluronic acid and
corticosteroids into Alfie's fetlock joint.
Graham Hunter BVM&S CertEP MRCVS,
Ardene House Veterinary Practice
A
rthritis, or inflammation of a joint is very common in horses and frequently results in
lameness or loss of performance. This case report details the diagnosis and treatment
of Alfie the showjumper, a nine year old Warmblood gelding who developed a forelimb
lameness after a hard weekend competing.
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