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Is the horse lame? (History- signlament, use, time frame, owners idea of…
Is the horse lame?
History- signlament, use, time frame, owners idea of problem
Acute mild
Chronic
Acute- severe
Yes
Severity of lameness
** GRADE SYSTEM
Which limb is lame
Hindlimb (oscillation of the tuber coxae, lowest and greatest vertical displacement on lame side)
Hoof testers is there a response
Diffuse
Local/ focal area of response
Check for signs of underun sole/ bruising or abscess
NO response
Nerve blocks but different names
Forelimb (determined my head oscillation, Down on the sound limb, up on the lame limb)
Hoof testers is there a response
Diffuse
Localised
no
BOTH
refereed lamness
No
return to physical exam and history
Do you suspect a fracture
Yes-
Do no do nerve block
Go to diagnostic imaging
No
Nerve blocks- start from as distal as possible, looking for improvement (doesn't have to be 100%)
PDNB
Castro/wheat nerve block
ASNB
High4NB
LOW4NB
Median/Ulnar Nerve block
Localised to different areas
diagnostic imaging
Ultrasound
Soft tissue changes
CT
MRI
scintigraphy
Radiology
Changes
Increased radiopacity
Sclerosis
decreased radiopacity
Osteopetrosis
Fractures
Periosteal reaction
Change in size or contour
Change in trabecular pattern
No changes rereadiography in 7-10 days
Specific localisation-joint blocks but need to wait 6-8 hours