Answered by, Brian MacNamara, DVM, MRCVS, New Bolton Center, University of Pennsylvania, College of Veterinary Medicine, Courtesy of AAEP
Question: My 10-year-old Quarter horse mare had a luxated or subluxated patella, which was put back by my veterinarian. She has been on stall rest for 3 months. She is using it a bit more although drags the leg from the side to underneath herself at times. Her leg is slightly turned out. Is there something more I could be doing for her? Exercises?
Answer: It is likely that your horse has an upward fixation of the patella rather than a true luxation. If this occurred for the first time when she was ten, you should start with a detailed clinical workup to try and determine the cause. You say that she drags the leg, but it is unclear if she is lame. I would probably start with local anesthesia of all three joints associated with the stifle to see if that alters her gait. Radiographs and ultrasonography may be beneficial in determining if there is any injury to the patellar ligaments or the patella itself. If she is dragging the leg, I would also be concerned about possible meniscal or cruciate ligament damage in the stifle joint. Diagnostic imaging would be useful in assessing those structures as well. I would not recommend any treatment or exercise until a more accurate diagnosis is obtained.
In cases of idiopathic upward fixation of the patella, local injection around the medial and middle patellar ligaments sometimes is helpful. There are also several surgical procedures aimed at shortening the ligament (or cutting it) that may alleviate that condition. If there is meniscal, cruciate ligament or patellar injury, there may be either surgical or medical treatment options: arthroscopy, shock wave therapy, platelet rich plasma, other joint injections. Again, however, you must try to get a more definitive diagnosis first.
Question: My Arabian gelding, has suffered for years from internal heat in all 4 hooves, which has caused him to be short-strided and “ouchy”. I can feel the heat with my hand, and he acts uncomfortable, but at least 3 vets have said it’s not founder and that it’s “normal”. But it isn’t. The horse is in pain. I feed him only timothy pellets and grass hay…and suspect I may have overfed him in the past. Do you have any idea what might be causing this heat? It is often located at the coronet, but can feel it radiating from inside the hoof. The heat is present in winter also. On bad days I give him a little bute.
Answer: If your horse is “ouchy” on all four feet and you consistently feel heat emanating from the hoof, it is likely that something is amiss.
Heat, along with pain, is usually a sign of inflammation. Inflammation is the body’s way of reacting to an abnormal insult. Common causes of heat and pain in the foot include abscesses and laminitis (founder).
It is unlikely, although not impossible, that your horse has abscesses in all four feet.
I recommend that you have a veterinarian perform a complete lameness workup. I am extremely suspicious of low grade laminitis, although there are other possibilities. Radiographs may be necessary to evaluate the foot completely. Sometimes there is little radiographic evidence of rotation or sinking in low grade chronic laminitis. You didn’t mention how old your horse is, but testing for PPID may be indicated.