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Yorik was admitted to the hospital for a
thorough clinical investigation. He was
examined initially for lameness, involving
walking, trotting and lunging in hand on soft
and hard surfaces. He was also assessed
whilst ridden and a number of problems
were very apparent. He had asymmetric
front feet both with very long toe low heel
conformation (Figure 1). He also had severe
mediolateral foot imbalances in all four feet
and had a very upright hindlimb conformation.
Yorik had a very rigid, tense back with a high
resting muscle tone and was noticeably
uncomfortable on palpation and reflex testing.
When trotted in a straight line he was slightly
lame on his left hindlimb and on his right
forelimb. When lunged on a soft surface,
lameness was observed in the outer hindlimb
in both directions and also the inside forelimb
in both directions. He was also occasionally
disunited with frequent bunny hopping when
asked to canter, on both reins. This lameness
pattern was replicated when he was examined
under ridden exercise but with a greater
reluctance to go forward and a high head
carriage noted. It was suspected at this stage
that Yorik was lame on all four legs and had a
sore back. An extensive lameness examination
was performed involving nerve and joint
blocks. Many x-rays were taken and ultrasound
scans performed where required.
Examination of Yorik’s front feet revealed that
he had pain in his heels and x-rays proved that
he had navicular disease in both his front feet
(Figure 2). Examination of his hindlimbs
demonstrated that he was suffering from
osteoarthritis of his distal tarsal joints (within
the hock). This is commonly known as ‘bone
spavin’ (Figure 3).
Anaesthetic and imaging techniques were used
to examine Yorik’s back and he was found to
have evidence of over-riding dorsal spinous
processes, commonly known as ‘kissing spines’
(Figure 4).
Treatment of such a complex case is often
difficult with a variety of different techniques
being used to try to improve his overall pain
levels and thus his ridden behaviour and
performance. Surgery was performed on his
back under standing sedation. This surgery is
called an ‘Interspinous ligament desmotomy’ and
involves cutting the ligaments between the spinous
processes where pain has been detected.
The hospital farrier trimmed and balanced all
four feet, applying egg bar shoes to the front
feet and normal shoes with length at the heels
to the hind feet. The breakover point was
pulled back in all four feet. His hock joints
were medicated with corticosteroids and a
tiludronic acid (Equidronate
®
) infusion was
administered. It has been shown that
Equidronate
®
is useful in navicular disease,
bone spavin and some back conditions. A
very strictly controlled rehabilitation programme
involving physiotherapy was also employed.
Yorik is now three months down the line in his
treatment programme and is back in ridden
work. His lameness grades have all improved
and he is tracking up much better. He appears,
at present, comfortable under saddle in light
ridden work.
We have many more techniques we can use in
cases such as this which we will employ if, alas,
poor Yorik should regress and struggle again.
POOR PERFORMANCE
Veterinary Surgeon
Graham Hunter
XLVets Equine Practice
Ardene House
Veterinary Practice
CASE STUDY...
Graham Hunter, BVM&S GPCert(EqP) CertEP CertAVP(ESO) MRCVS
Ardene House Veterinary Practice
Poor performance affecting
the musculoskeletal system
Poorly performing horses frequently have a number of possible underlying
causes, all contributing to some extent in the horse not working to previous,
or expected levels. Detailed below is the case of Yorik, an eight-year-old
novice dressage gelding who, since he was purchased one year ago, has
never really did his job happily. The owner now feels he is possibly ‘unlevel’.
Figure 1.
Yorik’s poorly balanced left fore foot
Figure 2.
X-ray of Yorik’s right fore foot
showing a diseased navicular bone
Figure 3.
X-ray of Yorik’s left hock showing
bone spavin pathology
Figure 4.
X-ray of Yorik’s back showing
kissing spines
7
EQUINE MATTERS