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How to assess lameness on multiple limbs
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Recognition of multiple limb lameness requires knowledge of how a normal horse of that type should move and how the gait may be modified by pain, bearing in mind that shortening the steps and stiffening the thoracolumbosacral region can conceal overt lameness. A head nod may reflect either forelimb lameness or hindlimb lameness. Forelimb lameness can influence hindlimb gait, inducing asymmetry. If hindlimb lameness is mild but there is an obvious head nod when the diagonal forelimb is bearing weight this is most likely to reflect a primary forelimb lameness, whereas if hindlimb lameness is moderate or severe then a head nod may reflect the hindlimb lameness. If the hindlimb lameness is unchanged on a circle whereas the head nod deteriorates this is more likely to reflect concurrent forelimb lameness. Of course, hindlimb lameness inducing a head nod and forelimb lameness may coexist.
In order to determine which are the lame limbs a comprehensive clinical examination at rest, followed by assessment in hand, flexion tests and evaluation on the lunge are required. Since many lamenesses are only apparent when ridden, I believe that when possible ridden exercise should also be performed unless the horse is too lame to be ridden. It must be borne in mind the many ways in which a rider may influence the horse’s performance either positively or negatively (Dyson 2013). [...]
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