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EQUINE VETERINARY EDUCATION / AE / SEPTEMBER 2017
Discussion
Can this evidence be applied to the clinical scenario? Lameness that improves with a PDNB can arise from sites other than the heel. The experimental evidence indicates that a PDNB can ameliorate lameness arising from the DIP joint and the sole. The clinical evidence strongly suggests that this block can improve lameness arising from the fetlock joint and likely can improve lameness arising from structures distal to the fetlock also. It is probable that using larger volumes of LA, placing needles at greater distances proximal to the collateral heel cartilage and allowing more time to elapse between blocking and assessment, all increase the likelihood of desensitising structures above the foot.
Author’s declaration of interests No conflicts of interests have been declared.
References
Contino, E.K., Werpy, M.N., Morton, A. and McIlwraith, C.W. (2012) Metacarpophalangeal joint lesions identified on magnetic
resonance imaging with lameness that resolves using palmar digital nerve and intra-articular analgesia. Proc. Am. Ass. Equine Practnrs. 58, 534.
Dyson, S.J. and Murray, R.C. (2007) Lameness and diagnostic imaging in the sports horse: recent advances related to the digit. Proc. Am. Ass. Equine Practnrs. 53, 262-274.
Easter, J.L., Watkins, J.P., Stephens, S.L., Carter, G.K., Hague, B.A., Dutton, D.W. and Honnas, C.M. (2000) Effects of regional anesthesia on experimentally induced coffin joint synovitis. Proc. Am. Ass. Equine Practnrs. 46, 214.
Nagy, A. and Malton, R. (2015) Diffusion of radiodense contrast medium after perineural injection of the palmar digital nerves. Equine Vet. Educ. 27, 648-654.
Ross, M.W. (1998) Observations in horses with lameness abolished by palmar digital analgesia. Proc. Am. Ass. Equine Practnrs. 44, 230-232.
Schumacher, J., Steiger, R., Schumacher, J., de Graves, F., Schramme, M., Smith, R. and Coker, M. (2000) Effects of analgesia of the distal interphalangeal joint or palmar digital nerves on lameness caused by solar pain in horses. Vet. Surg. 29, 54-58.
Schumacher, J., Livesey, L., DeGraves, F.J., Schumacher, J., Schramme, M.C., Hathcock, J., Taintor, J. and Gomez, J. (2004) Effect of anaesthesia of the palmar digital nerves on proximal interphalangeal joint pain in the horse. Equine Vet. J. 36, 409-414.
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