Q:I have a 12-year-old Tennessee Walker who weaves. I recently noticed lameness in the right front leg. I had radiographs and testing done to rule out the really bad causes, such as laminitis, navicular, and founder. The radiographs were normal except for slight arthritic changes. I did not, however, have the veterinarian look at the shoulder. The horse does not always appear lame. How does weaving affect the lameness, and what treatments can I do to stop or decrease the lameness? He is an excellent trail horse and I'd like to improve his quality of life. Would steroid injections help?  

Donna Faulkner, Tenn.

A:From my experience and from the horse's history you have provided, I feel it is most likely not in the shoulder. Most front limb lameness is isolated to the foot by the use of nerve blocks starting with the PD (palmar digital) nerve. This block desensitizes the heel and approximately a third of the way around the lateral (outer) and medial (inner) walls of the hoof. We use this block to rule in or out navicular or caudal heel syndrome.

If this did not make your horse sound the next block to be done is the abaxial nerve block. This is done on the lateral and medial sides of the sesamoids and desensitizes the entire hoof from approximately below the fetlock joint down. The abaxial nerve block does not alleviate true bone pain and, as you have stated, there were some arthritic changes on the X rays. If this does not make your horse sound the next block to be done is a coffin joint block.

I would suggest that if you have not had the coffin joint blocked, ask for this to be done. Many horses that have front limb lameness that do not respond to the other nerve blocks do become sound with a coffin joint block. If this does not make your horse sound then I would recommend an origin of the suspensory block, then, if that does not make him sound I would start to look higher up.

If the coffin joint block makes him sound, then intra-articular injections of steroids and Hylartin V (sodium hyaluronate) would greatly help your horse, as well as starting on a loading dose of Adequan (polysulfated glycosaminoglycan) and continuing on a once-a-month injection. If your horse becomes sound after the abaxial nerve block, this could indicate some soft tissue, tendon, or ligament damage, and an MRI would show the damage and extent of the injury.

Further treatment modalities, depending on the results of the blocks, could include oral supplements of glucosamine/chondroitin, acupuncture, or extracorporeal shock wave therapy treatments.

As for his weaving, it can exacerbate any lameness or injury that is there and compound any treatment modalities that are needed. But by putting excessive stopping and starting motion and side-to-side stress on the joints and ligaments of the foot, he may have created this injury. Your goal with him should be to alleviate the weaving or to keep it to a minimum. I am sure he learned this behavior as a way to cope with the boredom or stress of his previous housing/situation.

About the Author

Heather Heiderich, DVM

Heather Heiderich, DVM, is an associate veterinarian for Florida Equine Veterinary Services Inc., based in Clermont, Fla., where she has special interests in acupuncture, reproduction, and sports medicine. She is an avid hunter/jumper rider and breeds Belgian Warmbloods.

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