Texas Equine Veterinary Association

www.texasequineva.com • Page 11 positive response to anesthesia of the distal interphalangeal could implicate any structure within the foot as the site of pain causing lameness. In some cases, local anesthetic solution injected into the tarsometatarsal joint results in perineural anesthesia of the dorsal metatarsal and plantar metatarsal nerves. Resolution of lameness aer a tarsometatarsal joint block may, therefore, be erroneously interpreted as resolving pain within that joint when pain from the proximal portion of the suspensory ligament is the site of pain causing lameness because the plantar metatarsal nerves innervate the proximal portion of the suspensory ligament. e palmar outpouchings of the carpometacarpal joint capsule extend into the fibers of the proximal portion of the suspensory ligament, and therefore, local anesthetic solution injected into the intercarpal joint enters the carpometacarpal joint and anesthetizes the origin of the suspensory ligament. Conversely, a negative response to intrasynovial anesthesia does not always exclude intrasynovial pain as a cause of lameness. Intrasynovial anesthesia may not resolve lameness if disease of subchondral bone contributes to joint pain because subchondral bone is innervated by branches of nerves that enter the bone through its nutrient foramen. When using the lateral approach to ameliorate pain in the distal interphalangeal joint, the clinician should be aware that the navicular bursa or digital tendon sheath be entered inadvertently. Results of regional or intrasynovial analgesia can be misinterpreted if the lesion responsible for lameness is extraordinarily painful. Severe pain, such as that caused by a subsolar infection, is MEMBERSHIP RENEWAL BEGINS 12/1! 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First Person—Regular Annual Membership.................................................................................................$295 Second and ird Person—Regular Annual Membership............................................................................$275 Annual Intern or Resident Membership........................................................................................................$100 Annual Veterinary Student Membership (Includes First Two Years Aer Graduation)................................$25 Annual Retired Veterinarian Membership.....................................................................................................$50 Annual Veterinarian >65 Years of Age Membership.....................................................................................$150 Lifetime Membership....................................................................................................................................$2,500 Annual Group Practice Membership (4+ Veterinarians)...............................................................................$1,000 (Allows all members of a practice to attend meetings at member rates. You must include a listing of your entire professional staff on this registration form or an attached sheet, in order for them to be eligible for this membership. You must enroll four or more veterinarians to be eligible for the Group Practice Membership.) PAYMENT: Cash, checks, and credit cards are accepted. DOWNLOAD THE MEMBERSHIP FORM FROM OUR WEBSITE: WWW.TEXASEQUINEVA.COM BECOME A TEVA MEMBER TODAY! sometime difficult to diminish with regional analgesia. A clinician inexperienced in lameness evaluation may misinterpret the result of regional or intrasynovial analgesia if he or she fails to observe that the lameness has shied to the lame contralateral limb aer having improved or resolved in the limb that has received diagnostic analgesia. e results of a low, palmar nerve block can be misinterpreted if one palmar nerve is anesthetized proximal to the ramus communicans and the other is anesthetized distal to the ramus communicans because sensory fibers travel in both directions in the ramus communicans to connect the medial and lateral palmar nerves. When administering a low, palmar nerve block, both palmar nerves should be anesthetized distal or proximal to the ramus communicans to avoid leaving non-desensitized sensory nerve fibers travelling through this neural connection. Alternatively, local anesthetic solution could also be deposited adjacent to the ramus communicans when anesthetizing the palmar nerves. Because of all the pitfalls in interpreting the results of regional or intrasynovial analgesia, diagnostic analgesia should be interpreted with some degree of skepticism.

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