Texas Equine Veterinary Association

www.teva-online.org • Page 13 JOHN C. JANICEK, DVM, MS, DACVS Brazos Valley Equine Hospital L A m e n e S S I N F o A L S Injury to the musculoskeletal system is a commonly encountered crisis in foals and can occur immediately after birth and or at any time during development. The foals' immature immune system coupled with a fragile musculoskeletal unit will produce varying degrees of lameness when either is compromised. Lameness in foals should be differentiated between infectious and non- infectious etiologies. More often than not, the progression of lameness in foals is rapid and contains potentially life-threatening consequences; therefore, timely recognition, accurate diagnosis, and appropriate treatment are imperative for a positive outcome. The "hide, wait, and watch" approach to foal lameness often yields unforgiving results. The lameness examination in foals is similar to that of adults with minor modifications. Patience is important when examining foals because behavioral characteristics of foals can make lameness examinations more challenging and confusing. Isolation of the lame limb can be difficult if subtle, but foals will usually display the lameness in a dramatic fashion and/or exaggerate their effort to unload the affected limb. The gait should be observed while walking and also at a slow trot; most foals are observed unrestrained while following the mare. A routine physical examination and extensive digital palpation of the affected and contralateral limbs are key to isolating the origin of the lameness. Compression of the foot to assess for pain may be made with the hands and fingers on young foals rather than hoof testers. Close attention should be given to the foal's stance and to any sensitive areas, swellings, or joint effusion. Complete blood count and fibrinogen are routinely performed. Routine ancillary diagnostic aids include peri-neural anesthesia, radiographs, ultrasonography, synoviocentesis, and magnetic resonance imaging. Diagnostic peri-neural anesthesia should not be performed if a fracture is suspected. non-InfectIous cAuses of LAmeness Distal Phalanx fractures Distal phalangeal fractures are predominantly seen between two weeks and five months of age. These fractures almost always involve the lateral wing of the distal phalanx (Figure 1). Factors attributable to these types of fractures include hard or soft surfaces or application of external hoof acrylics. Clinical signs of wing fractures include an acute lameness that may be intermittent in nature, increased digital pulses, painful response when pressure is applied across the heels/quarters, and occasionally a gait alternation characterized by landing on the medial aspect of the foot is noted. Abaxial peri-neural anesthesia should eliminate the lameness. Treatment of wing fractures in the distal phalanx is conservative and consists of stall confinement or small pen turnout for four to six weeks; external coaptation or a glue on shoe is contraindicated. These foals generally have a good prognosis. When diffuse pain is noted during foot compression in conjunction with an increased foot temperature, subsolar abscessation should be considered. Long Bone fractures Long bone fractures in foals usually occur from external trauma such as a kick, being stepped on, or having the limb pinned beneath an object while rolling (Figure 2). The fractured region is typically recognizable; however, some fractures do not yield excessive swelling or lameness. Regardless, radiographs are necessary to determine fracture configuration, develop a plan, and provide a prognosis. Prognosis is dependent upon bone involved, fracture configuration (ie. closed vs open, complete Figure 1. Lateral wing fracture of the distal phalanx.

• Cover