Services
Lameness & Orthopaedics
A methodical route from “something is not right” to an answer you can act on.
The problem
Lameness is a question, not a diagnosis
“Lame in front” tells you almost nothing. The horse may be compensating for a hind limb. The head nod may be the consequence of the problem rather than its location. Two horses with identical gaits can have entirely different pathology, and the treatment for one would do nothing for the other.
The only reliable way through is to localise the pain before imaging anything — and then to image the region the horse has pointed you towards, rather than the region you expected.
The workup
What a full investigation involves
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History and static examination
How the horse works, what has changed and when, shoeing and surfaces, previous injuries and treatments. Then a hands-on examination: palpation, joint effusions, hoof testers, limb and back assessment.
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Dynamic examination
Walk and trot in hand on a hard surface, lunged on both reins on hard and soft going, flexion tests, and ridden assessment where the problem only appears under saddle.
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Diagnostic analgesia
Nerve and joint blocks worked from the foot upwards, re-assessing between each one. This is the step that turns an opinion into a location, and it is worth doing properly.
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Imaging
Digital radiography for bone and joint, ultrasound for tendon, ligament and soft tissue — directed at the region the blocks identified.
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Diagnosis and plan
What is wrong, what can be done, what it is likely to cost, and what a realistic return to work looks like. In writing where it matters.
Treatment
Orthopaedic treatment and rehabilitation
A diagnosis is only useful if something follows from it. Treatment is chosen for the horse in front of you and the job it needs to go back to.
- Intra-articular medication, including corticosteroid and hyaluronan
- Regenerative therapies for tendon and ligament injury
- Extracorporeal shockwave therapy where indicated
- Remedial farriery, planned with your farrier rather than around them
- Structured rehabilitation programmes with review points built in
- Referral for advanced imaging or surgery when a case needs it
Rehabilitation is where a great many good diagnoses come undone. Programmes are written to be followed on a real yard, by real people, with the time and facilities actually available.
Common questions
Lameness questions
How long does a lameness workup take?
Allow at least half a day. A straightforward case may be quicker, but blocking works in sequence and each block needs time to take effect before the horse is reassessed. Rushing that sequence is the fastest way to reach the wrong conclusion.
Does my horse need to be shod or unshod?
Leave the horse as it normally works unless you are told otherwise. If shoes need removing for radiographs it can usually be arranged on the day, and it is worth mentioning your farrier’s schedule when you book so the visit can be timed sensibly.
What do I need to have ready for the visit?
A hard, level surface to trot up on, somewhere safe to lunge on both a hard and a soft surface, and a competent handler. Power and shelter are helpful for imaging. If the horse is only lame when ridden, have the rider and tack available too.
Should I give bute before the vet arrives?
No — not without being asked to. Pain relief masks exactly what the examination is trying to measure. If the horse is on medication already, say so when you book so the visit can be planned around it.
Can you treat the horse on the same visit?
Often, yes. Where a diagnosis is reached and treatment is straightforward, it can usually be carried out there and then. Some treatments are better planned for a separate visit, and that will always be discussed with you first.
Can I ask a veterinary question through the website?
The enquiry form is for general questions — registering, availability, arranging a visit and accounts. Clinical questions need a conversation, and the inbox is not monitored around the clock, so anything concerning your horse’s health should come by telephone.
How do I register as a new client?
Send an enquiry through the contact page or telephone the practice. You will be asked for your details, your yard, and a little about your horses so the right amount of time can be set aside for a first visit.
Concerned about a horse?
Lameness cases are best discussed by telephone, so the right amount of time can be booked for the visit.