Undiagnosed Equine Lameness
ABSTRACT
Eli was lame on right front for five months. Initially sound after nerve block to the foot, sensitive to hoof testers at the time so suspected an abscess. That seemed to get a little better and then got worse again, but not positive to hoof testers anymore and nothing seen on x-rays. Restricted in medial pastern/ coffin and pastern. Collateral ligament injury to the distal limb was the assumed diagnosis. Stall rest for 2 months did not improve the lameness. Beginning on November 2nd, pharmaceutical carbon dioxide was used as a primary treatment and the lameness was improving within 2 weeks. The lameness was resolved within 30 days after rehab, rest, and transdermal carbon dioxide.
Clinician: Ann-Marie Hancock, DVM
Client Information: Eli, 10-Year-Old Quarter Horse
CASE HISTORY AND CLINICAL SIGNS
10-25 8:35:07pm
Basic exam - has been lame on right front for a couple months. Initially sound after nerve block to the foot, sensitive to hoof testers at the time so suspected an abscess. That seemed to get a little better and then got worse again, but not positive to hoof testers anymore and nothing seen on x-rays. Has been stall rested for last two months, but no improvement in the lameness.
11-20 4:55:44pm
Lameness is improving on right front. Sound at the walk, still grade 2/ 5 - lame at the trot, but improving!
Body work – some restrictions in shoulder, TMJ and carpus on the right side. Worked to mobilize these areas and get better balance in the whole body.
Plan to go to every other day CO2 therapy, start turn out in small pen on flat hard ground and start small amounts of hand walking.
TREATMENT
Transdermal treatments with pharmaceutical carbon dioxide began on November 2nd and the owner performed 12 treatments over a three-week period. The first five treatments were performed consecutively followed by a two day break. Then treatments were continued every other day.
SUMMARY
Eli was one of those cases where you struggle with what to do. He had a medial/lateral imbalance in the foot, and he wasn’t improving with rest or corrective shoeing. These cases can be so difficult to get to turn around. Resting, laser therapy, shock wave, injections… sometimes they work, sometimes they don’t. This was a case where we needed to try some way to improve the microcirculation to the foot to help heal all the soft tissue structures that weren’t responding to conventional therapy.
One of the most interesting sequelae that happened in this case was how the feet began to grow after doing transdermal carbon dioxide therapy. Although only one foot was treated, all 4 hooves began to grow and push out large bars and buttresses to support new hoof growth with concavity and better, stronger feet. We were impressed with the change in the feet and we think this contributed to his overall improvement in movement.
Eli was sound on a straight line, with some sensitivity still in a tight pivot on November 29th. He looked sound at the walk and trot and in tight circles at recheck on December 23rd.