NEW INNOVATIONS IN THE DIAGNOSIS AND TREATMENT OF LAMENESS


stages, but many horses with acetabular rim frac- tures can become quite comfortable and pasture- sound. Many horses with severe lameness in the acute phase of injury will show gradual improve- ment in their degree of lameness. It can be tempt- ing to base the decision for euthanasia on the initial severity of lameness. Euthanasia should be consid- ered if the degree of pain or lameness becomes un- manageable. In the authors’ experience, this is most often seen in horses with a complete fracture through the acetabulum but may also be seen in horses with proximal femoral fractures. Sacral fracture should also be considered because it can produce severe pain and neurologic signs. Several horses were managed with ultrasound-


guided therapeutic injections. Some treated horses with acetabular rim fractures were able to eventu- ally become sound enough to ride. Injections were typically performed 6 to 12 months after diagnosis. Although horses seldom became completely sound afterward, some owners reported that they were serviceably sound to be ridden at low levels after a long convalescence. Multiple horses with sublux- ation were also managed with single or repeated therapeutic injections to improve their comfort level while at pasture. Although these horses never be- came rideable, owners were often pleased with the results, and some horses were maintained for 1 to 3 years after diagnosis. Therapeutic effect was often reduced with each injection. In summary, ultrasound of the coxofemoral joint


can be very rewarding given adequate training and experience. Although it remains a challenging structure to evaluate, the use of the clock technique should help motivated practitioners improve their comfort level in evaluating the coxofemoral joint. Ultrasound can diagnose many types of coxofemoral abnormalities, although accurate configuration of fractures should not be expected in most cases.


Acknowledgments


Declaration of Ethics The Authors declare that they have adhered to the Principles of Veterinary Medical Ethics of the AVMA.


Conflict of Interest The Authors declare no conflicts of interest.


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354 2015  Vol. 61  AAEP PROCEEDINGS


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