Equine Sports Medicine & Performance Lameness in Madison, Georgia & Beyond
Performance Evaluations
Performance evaluations are often used for athletes that are not necessarily having a lameness problem but perhaps is not performing as he has been previously (e.g., a barrel horse off his usual time, a jumper hitting rails at a height he’s been jumping easily in the past). Performance evaluations look for musculoskeletal causes of poor performance (muscle fatigue, sore joints, etc.) as well as non-musculoskeletal causes such as respiratory disease (often structural or inflammatory) or gastrointestinal (e.g., stomach ulcers, etc).
Lameness Exams
Whether your horse is an active competitor (in any discipline) or your trusty pleasure/trail horse, we perform lameness exams both at the clinic and in the field to diagnose the problem and implement treatment.
Lameness exams consist mostly of observing the horse move on a lunge line and on a straight line without a rider. Horses are observed at the walk, trot, and canter as different gaits will commonly exacerbate different types and degrees of lameness. After observing the gaits, flexion tests will often be performed. By flexing the limb(s), increased pressure is placed on specific joints for a few seconds before trotting the horse on a straight line and evaluating if the degree of lameness changed in any way, often revealing the areas of concern. The hooves will also be examined with hooftesters which apply pressure in specific locations of the hoof and sole, revealing any areas of discomfort/pain.
In specific cases, a mounted (ridden) lameness exam may be needed for the horse to demonstrate the issue. This will be requested by the veterinarian if necessary.
Diagnostic Nerve & Joint Blocks
After observing the horse and localizing the lameness to a specific limb, we then determine the region of the limb causing the pain by using local anesthesia as nerve and/or joint blocks. By making a specific region or structure on the limb numb, we can rule that region or structure in or out as being the source of the lameness.
Imaging
Once we have localized a lameness to a specific structure or region on a leg, we will often then move on to imaging the region.
- Radiography: Appropriate for imaging bone
- Ultrasound: Appropriate for imaging soft tissue (tendons, ligaments, bursae, etc.)
Joint Injections
Joint injections are a common way to treat lameness originating from a specific joint (e.g., arthritis in the fetlock). While there is some variability in what is used in a joint injection, there is a consistency between all of the veterinarians at Piedmont Equine Associates.
All joint injections are performed in sterile technique after aseptic preparation of the area. The horse is then typically sedated and often has a nose twitch applied to prevent the horse from moving (and thus potential contamination) as much as possible.
Joint injections are often a combination of multiple components:
- Corticosteroid: This is responsible for decreasing the inflammation and improving comfort level.
- Hyaluronic acid (H.A.): This is also mildly anti-inflammatory and encourages the joint tissue to produce its own hyaluronic acid.
- Amikacin: This is an antibiotic to further prevent infection.
- Other: Polyacrylamide gel products (Noltrex, Arthramid), etc.
Regenerative Therapies
There are a host of other products used as an “injection” either directly into the joint or into a lesion within a tendon or ligament or tendon sheath/bursa to combat inflammation.
The following are products that are developed from blood or other tissue collected from the patient himself:
- IRAP (Interleukin-1 Receptor Antagonist Protein)
- PRP (Platelet-Rich Plasma)
- Alpha-2 macroglobuline
- Prostride
- Renovo
- Stem Cells (mesenchymal, from adipose or marrow origin)
Shockwave Therapy
Extracorporeal Shockwave Therapy is commonly used in treating lameness issues, especially injuries to tendons and ligaments. We have portable shockwave units that can be used in the clinic and in the field.
Podiatry & Farrier Consultation
Hoof and foot health is imperative for not only performance but comfort in everyday life for a horse. We are happy to provide consultations for/with farriers for therapeutic trimming and shoeing.
We also perform some therapeutic trimming and application of a variety of therapeutic shoes and devices to the hooves such as EVA shoes, quarter crack laces, etc.