This is particularly true when assessing a horse with bilateral hindlimb lameness, or loss of hindlimb power. It is always important that the rider rides the horse after the nerve blocks so that he can assess whether it is performing as it used to. Sometimes it is necessary to block both front feet simultaneously before any change in the horse’s action can be appreciated. The horse can then move with much greater freedom.Īlthough you might expect this to happen with any horse with bilateral (left and right) foot pain, curiously, it doesn’t always. This lameness may also be abolished by nerve blocks of the foot. If the horse shows a shortened forelimb stride but no obvious lameness, it is possible that by desensitising one front foot using nerve blocks and thus relieving pain, lameness may become apparent in the other leg. It is helpful to be aware of the conditions that often cause pain in both limbs simultaneously, such as the many causes of front foot pain, osteoarthritis of the lower hock joints or proximal suspensory desmitis in hindlimbs. Only then can you proceed with further investigation, such as X-rays or ultrasound scans. The vet’s first priority is to try to determine the sources of pain. Seeing the horse ridden in small figures of eight may reveal hindleg unlevelness as it changes direction. With bilateral hindlimb lameness, toe drag or lameness may become evident on the lunge, especially on a softer surface. Physiotherapy treatment may relieve the back pain, but, unless the primary problem is identified and treated, the improvement will be short-lived. Affected horses often have some secondary back muscle soreness, but that is not the primary cause of the performance problem. The signs are rather non-specific, and are often erroneously attributed to back pain. The clinical signs may be gradual in onset and it could be some time before the rider appreciates that there is a problem. Dressage horses may become resistant or even appear nappy. A jumping horse may lose power and find it hard to jump large spreads. If asked to push more from behind, a horse might prefer to break into canter. The horse may be unwilling to work properly on the bit and some hindlimb unlevelness might be seen in medium and extended trot. It may work more on the forehand and appear to hold its back stiffly. If both hindlimbs are affected, the horse will show loss of engagement and impulsion.
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