Lameness in the Racehorse Table Topic (AAEP 2011)

Attendees discussed hoof lameness, club feet, track surface’s effect on lameness, back and neck pain, and EPM.
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Malcolm J. Borthwick, VMD, practiced on Standardbreds in New Jersey and Pennsylvania for 30 years, and in his retirement continues to enjoy owning and driving racehorses. In his introduction to the Lameness in the Racehorse Table Topic presented at the 2011 American Association of Equine Practitioners Annual Meeting, held Nov. 18-22 in San Antonio, Texas, he emphasized the importance of the foot and felt that it is overlooked as a common seat of lameness in the racehorse. He also asserted the importance of the veterinarian having a good relationship with the trainer and groom, which facilitates reaching a diagnosis and ensures more effective follow-up care.

Melissa McKee, DVM, is a partner at McKee-Pownall Equine Services in Toronto, Canada. Her caseload is 70% Standardbred and 30% Thoroughbred/racing Quarter Horse, and she focuses primarily on lameness diagnosis and advanced imaging, including MRI. She also believes that a good relationship with the trainer and groom is vital, because a detailed history from those working closely with the animal provides important clues to the underlying problem. She also mentioned several subtle findings such as abrasions in the mouth, shoe wear, and various areas where a horse might interfere with himself while trotting or galloping, that are important details to notice during a workout. Both veterinarians agreed that a very thorough physical exam was essential before moving toward any type of imaging or treatment.

Attendees addressed several issues concerning the foot. Horses without a notable lameness or respiratory issue, but that were unwilling to pass other horses or finish the race strongly, often have bilateral (affecting both limbs) foot pain that saps their desire to be competitive on the track. Both Thoroughbred and Standardbred veterinarians in attendance commented on the long toe/low heel conformation as contributing to deep-seated foot soreness despite reasonably normal radiographs (X rays). All felt this was frequently related to soft tissue injuries within the hoof, particularly to the deep digital flexor tendon as it inserts on the bottom of the coffin bone. McKee confirmed she has noted that type of lesion on MRI scans of affected horses. All agreed this type of foot conformation was often acquired due to typical shoeing techniques encouraging a long toe, because it is erroneously assumed this will lengthen the horse’s stride. Unfortunately, crushed heels are a difficult problem to fix, and wedge pads will worsen the issue. Shortening the toe and trimming the crushed heel, while adding various types of pad to redistribute the weight, is often the best solution. Most veterinarians stated they would also perform injections or shockwave therapy to help treat local pain and inflammation.

Attendees discussed club feet and the question of whether to perform an inferior check desmotomy (cutting of the ligament) in a yearling with club feet. All agreed that a club foot in an older horse should not be corrected through shoeing, as dramatically lowering the heels would create lameness by altering the established limb mechanics. There was some debate over performing surgery on young horses, but most veterinarians felt the resulting adhesions could be quite problematic later on

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Melissa McKee, DVM, is a partner at McKee-Pownall Equine Services in Toronto, Canada.

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