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Diagnosing Foot Lameness in Horses: Take a Systematic Approach

Diagnosing Foot Lameness in Horses: Take a Systematic Approach
A systematic approach to examining the equine foot can help veterinarians identify causes of lameness more quickly and accurately. To help other practitioners understand the process, Tracy Turner, DVM, MS, Dipl. ACVS, ACVSMR, outlined the steps he’s developed to identify hoof-related pain and imbalances at the 2018 American Association of Equine Practitioners Convention, held Dec. 1-5 in San Francisco, California.
Turner operates Turner Equine Sports Medicine and Surgery, in Stillwater, Minnesota, and has served as an Olympic, World Equestrian, and Pan American games veterinarian over his career.
 
“During your exam, ask every question three times,” he said. “You will get six different answers, so it’s important to find out before you begin what the goal of your exam is.”
 
Also, the veterinarian should collect a complete history from the horse’s owner. With an established goal (i.e., why is the vet examining the hoof, and what is he or she trying to find?), Turner described for practitioners his approach to examining cases of equine foot lameness.
 
Physical Examination
 
Start at the pastern, assessing the digital pulses, located at the back of the fetlock or pastern region of all four feet. They should be palpable but not bounding like the feeling when you slam your thumb in a car door. The coronet should feel spongy and have a smooth hairline. Appreciate the thickness and density of the collateral cartilages—structures projecting from the coffin bone at the back of the inside and outside of the foot that can become bony (a condition called sidebone). Inspect the hoof wall for cracks, fissures, bulges, uneven growth, heat, or breakage.
 
“There is always a reason for any observed abnormalities,” said Turner.
 
For example, the sole should be concave, giving ample clearance between it and the ground; a convex frog might indicate weak and underrun heels. If the frog is receded, it could be because of upright/narrow feet.
 
Objective Examination
 
This requires measuring the horse and his foot to assess hoof balance. Collect hoof measurements, including hoof length, heel length, frog length, hoof angle, and frog ratio.
 
Assess Pain
 
Watch the horse in motion, Turner said, and see whether his feet land flat or toe-, heel- or quarter- first.
 
Then, move on to the following tests:
  • A systematic hoof tester examination. A positive response should be repeatable, said Turner—so, if the horse reacts to the hoof testers in a single spot once, he should react every time the practitioner applies pressure. “Using your hoof tests will determine whether there is pain between the prongs or not,” he said. “If so, what’s between those prongs causing the pain? Hoof wall, bone, soft tissues?”
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