A randomized, controlled trial of the effects of resveratrol administration in performance horses with lameness localized to the distal tarsal joints.

OBJECTIVE To determine the effect of resveratrol administration in performance horses with lameness localized to the distal tarsal joints. DESIGN Randomized, blinded, placebo-controlled clinical trial. ANIMALS 45 client-owned horses with lameness localized to the distal tarsal joints. PROCEDURES All horses received injections of triamcinolone acetonide in the centrodistal and tarsometatarsal joints of both hind limbs. A placebo or a supplement containing resveratrol was fed twice daily by owners for 4 months. Primary outcomes were horse performance as determined by rider opinion (better, worse, or the same) and change in lameness severity from the enrollment examination. RESULTS Complete data were obtained for 21 horses that received resveratrol and 20 that received the placebo. Percentage of riders who reported that the horse's performance was better, compared with worse or the same, was significantly higher for the resveratrol group than for the placebo group after 2 (20/21 [95%] vs 14/20 [70%]) and 4 (18/21 [86%] vs 10/20 [50%]) months. The change in A1:A2 ratio between the enrollment and 4-month recheck examinations was significantly better for horses in the resveratrol versus placebo group. However, subjective lameness scores and degree of asymmetry of pelvis movement did not differ between groups. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in performance horses with lameness localized to the distal tarsal joints, injection of triamcinolone in the centrodistal and tarsometatarsal joints of both hind limbs followed by oral supplementation with resveratrol for 4 months resulted in reduced lameness, compared with triamcinolone injection and supplementation with a placebo.

Enthesopathy and desmitis of the medial collateral ligament of the cubital joint in 4 horses.

CASE DESCRIPTION: 4 horses with enthesopathy and desmitis of the medial collateral ligament of the cubital joint were examined. CLINICAL FINDINGS: All 4 horses had a history of acute, severe, unilateral forelimb lameness and had signs of pain during manipulation of the affected upper forelimb; 2 also had swelling in the axillary region. There was no improvement in lameness after diagnostic local analgesia below the carpal region, and 1 of 4 horses had mild improvement after cubital joint analgesia. Radiography revealed enthesophyte formation on the radial tuberosity and linear mineralization of the medial collateral ligament in 2 horses and periosteal reaction on the humeral condyle in all 4 horses. One horse had mild osteoarthritis of the cubital joint, and 3 had osteophytosis of the cranial aspect of the radius. Although all horses were initially examined because of an acute onset of lameness, all had chronic abnormalities visible on imaging. Ultrasonography revealed an irregular boney contour and enthesopathy at the insertion of the short medial collateral ligament to the radial tuberosity and desmitis of the short medial collateral ligament. Two horses had radiographic evidence of similar but less severe lesions of the contralateral cubital joint. TREATMENT AND OUTCOME: All horses received phenylbutazone and rest. All horses were free of lameness after a median of 3 months (range, 2 to 4 months) and returned to previous use after a median of 6 months (range, 3 to 8 months). CONCLUSIONS AND CLINICAL RELEVANCE: The results of the present report suggested that performance horses with enthesopathy and desmitis of the medial collateral ligament of the cubital joint may have a good prognosis for return to previous use following appropriate treatment.

Tendinitis of the proximal aspect of the superficial digital flexor tendon in horses: 12 cases (2000-2006).

OBJECTIVE: To determine clinical signs, ultrasonographic findings, and outcome of horses with tendinitis of the proximal portion of the superficial digital flexor tendon (SDFT; group A horses) and to compare signalment, horse use, and outcome in these horses with that of horses with tendinitis of the midmetacarpal region of the SDFT (group B horses). DESIGN: Retrospective case series. ANIMALS: 12 group A horses and 22 group B horses. PROCEDURES: Medical records were reviewed for signalment, horse use, and outcome information; data for group A horses also included severity of lameness, diagnostic results, and treatment. RESULTS: Most group A horses were aged (mean, 18 years; median, 17 years; range, 11 to 23 years) Quarter Horses (9/12 horses) and had a grade 3 or 4 (on a scale from 1 to 5) forelimb lameness. Most group A horses (8/12 horses) had positive reactions to carpal flexion and were (9/12 horses) sound following ulnar nerve blocks. Ultrasonographic evaluation revealed hypoechoic SDFT lesions (median echogenicity score, 3/4; median fiber alignment score, 3/3; and mean length, 9.75 cm). Group A horses were significantly older and had a poorer outcome for return to previous use (2/12 horses), compared with group B horses (median age, 5 years; 10/22 horses returned to previous use). Thirteen of 22 group B horses were Thoroughbreds. CONCLUSIONS AND CLINICAL RELEVANCE: Tendinitis of the proximal portion of the SDFT was a cause of lameness in aged performance horses; prognosis for return to previous use was poor.

Musculoskeletal problems associated with lameness and poor performance among horses used for barrel racing: 118 cases (2000-2003).

OBJECTIVE: To identify types of musculoskeletal problems associated with lameness or poor performance in horses used for barrel racing. DESIGN: Retrospective case series. ANIMALS: 118 horses. PROCEDURE: Medical records were reviewed for information on signalment, history, physical and lameness examination findings, diagnostic tests performed, diagnosis, and treatment. RESULTS: Most horses were examined because of lameness (n = 72 [61%]) rather than poor performance (46 [39%]), but owner complaint was not significantly associated with age or body weight of the horse. The most common performance change was refusal or failure to turn properly around the first barrel (19/46 [41%]). The right forelimb (n = 57 [48%]) was most commonly affected, followed by the left forelimb (51 [43%]), the left hind limb (31 [26%]), and the right hind limb (25 [21%]). In 31 horses (26%), both forelimbs were affected, and in 6 (5%), both hind limbs were affected. The most common musculoskeletal problems were forelimb foot pain only (n = 39 [33%]), osteoarthritis of the distal tarsal joints (17 [14%]), suspensory ligament desmitis (15 [13%]), forelimb foot pain with distal tarsal joint osteoarthritis (11 [9%]), and bruised feet (10 [8.5%]). In 81 (69%) horses, the affected joint was treated with intra-articular medications. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in horses used for barrel racing that are examined because of lameness or poor performance, the forelimbs are more likely to be affected than the hind limbs, with forelimb foot pain and osteoarthritis of the distal tarsal joints being the most common underlying abnormalities.

Lameness and poor performance in horses used for team roping: 118 cases (2000-2003).

OBJECTIVE: To determine the types of musculoskeletal problems that result in lameness or poor performance in horses used for team roping and determine whether these problems are different in horses used for heading versus heeling. DESIGN: Retrospective study. ANIMALS: 118 horses. PROCEDURE: Medical records of team roping horses that were evaluated because of lameness or poor performance were reviewed to obtain information regarding signalment, primary use (ie, head horse or heel horse), history, results of physical and lameness examinations, diagnostic tests performed, final diagnosis, and treatment. RESULTS: Among horses evaluated by lameness clinicians, the proportion with lameness or poor performance was significantly greater in horses used for heading (74/118) and lower in horses used for heeling (44/118) than would be expected under the null hypothesis. Most horses examined for poor performance were lame. A significantly greater proportion of horses used for heading had right forelimb lameness (26/74 [35%]), compared with horses used for heeling (7/44 [16%]). Horses used for heading had more bilateral forelimb lameness (18/74 [24%]), compared with horses used for heeling (4/44 [9%]). Horses used for heeling had more bilateral hind limb lameness (3/44 [7%]), compared with horses used for heading (0%). The most common musculoskeletal problems in horses used for heading were signs of pain limited to the distal sesamoid (navicular) area, signs of pain in the navicular area plus osteoarthritis of the distal tarsal joints, and soft tissue injury in the forelimb proximal phalangeal (pastern) region. Heeling horses most commonly had signs of pain in the navicular area, osteoarthritis of the metatarsophalangeal joints, and osteoarthritis of the distal tarsal joints. CONCLUSIONS AND CLINICAL RELEVANCE: Horses used for heading were most commonly affected by lameness in the right forelimb. Horses used for heeling had more bilateral hind limb lameness than horses used for heading.

Gracilis muscle injury as a cause of lameness in two horses.

Injury to the gracilis muscle can cause acute, severe lameness in horses. Two female Quarter Horses that were used for barrel racing sustained gracilis muscle tear injuries. The site of injury was localized by direct infiltration of the area with mepivacaine. The extent of muscle tearing and seroma formation was determined via ultrasonographic evaluation. One horse developed fibrotic myopathy approximately 3 months after the original injury and underwent surgery to transect a palpable fibrous band at the previous injury site. Both horses returned to barrel racing 5 to 6 months after the injury These results suggest that horses sustaining a gracilis muscle injury have a good prognosis for returning to athletic use after an adequate period of muscle healing; however, fibrotic myopathy or muscle atrophy could be a complication of the injury resulting in persistent gait deficits.

Injection of corticosteroids, hyaluronate, and amikacin into the navicular bursa in horses with signs of navicular area pain unresponsive to other treatments: 25 cases (1999-2002).

OBJECTIVE: To determine history, clinical and radiographic abnormalities, and outcome in horses with signs of navicular area pain unresponsive to corrective shoeing and systemic nonsteroidal anti-inflammatory drug administration that were treated with an injection of corticosteroids, sodium hyaluronate, and amikacin into the navicular bursa. DESIGN: Retrospective study. ANIMALS: 25 horses. PROCEDURE: Data collected from the medical records included signalment, history, horse use, severity and duration of lameness, shoeing regimen, results of diagnostic anesthesia, radiographic abnormalities, and outcome. RESULTS: 17 horses had bilateral forelimb lameness, 7 had unilateral forelimb lameness, and 1 had unilateral hind limb lameness. Mean duration of lameness was 9.2 months. All horses had been treated with corrective shoeing and nonsteroidal anti-inflammatory drugs for at least 6 months; 18 had previously been treated by injection of corticosteroids and sodium hyaluronate into the distal interphalangeal joint. Fourteen horses had mismatched front feet, and 21 horses had signs of pain in response to application of pressure over the central aspect of the frog. Palmar digital nerve anesthesia resulted in substantial improvement in or resolution of the lameness in all horses. Twenty horses (80%) were sound and returned to intended activities 2 weeks after navicular bursa treatment; mean duration of soundness was 4.6 months. Two horses that received numerous navicular bursa injections had a rupture of the deep digital flexor tendon at the level of the pastern region. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that navicular bursa treatment may provide temporary improvement in horses with signs of chronic navicular area pain that fail to respond to other treatments.

Diagnosis, treatment, and farriery for horses with chronic heel pain.

In conclusion, horses with heel or navicular area pain vary, and no one treatment option is suitable for all horses. Each horse must be evaluated individually to determine which structure in the palmar aspect of the foot is injured, severity of disease, horse and hoof conformation, and horse use and level of performance expectation before a treatment plan can be developed. Overall, there are many treatment options to help these horses to perform their intended athletic event.

Osteomyelitis secondary to trauma involving the proximal end of the radius in horses: five cases (1987-2001).

OBJECTIVE: To determine clinical, radiographic, and scintigraphic abnormalities in and treatment and outcome of horses with trauma-induced osteomyelitis of the proximal aspect of the radius. DESIGN: Retrospective study. ANIMALS: 5 horses. PROCEDURE: Data collected from the medical records included signalment; history; horse use; degree of lameness; radiographic, ultrasonographic, and scintigraphic findings; treatment; and outcome. RESULTS: Duration of lameness prior to referral ranged from 14 to 60 days. Mean severity of lameness was grade 3 of 5, and all horses had a single limb affected. All horses had signs of pain during elbow joint manipulation and digital palpation over the lateral aspect of the proximal end of the radius. Radiographic lesions consisted of periosteal proliferation, osteolysis, and subchondral bone lysis. Scintigraphy in 3 horses revealed intense pharmaceutical uptake diffusely involving the proximal end of the radius. Two horses had sepsis of the elbow joint. All horses were treated with antimicrobials long-term; 1 horse was also treated by local perfusion of the radial medullary cavity through an indwelling cannulated screw. At follow-up, all horses had returned to their previous function. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that osteomyelitis of the proximal end of the radius can result from a traumatic injury to the antebrachium. Because lesions may be an extension of septic arthritis, a thorough examination of the wound area and elbow joint is recommended. Prolonged systemic antimicrobial treatment can result in a successful outcome.