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Lameness Exams (AAEP article)
||* Written by
American Association of Equine Practitioners
Evaluating the Lame Horse
Stress, strain, or injury can
take a toll on any horse, even one with no obvious
conformation defects. When lameness occurs, you should
contact your veterinarian promptly. A prompt examination can
save you time, money and frustration by diagnosing and
treating the problem immediately, possibly preventing
further damage. The goal of such early examinations is to
keep small problems from becoming big ones.
Lameness evaluations are also routine in most purchase
examinations. When your veterinarian evaluates an animal you
are considering for purchase, you may be forewarned about
potential problems and should be able to make a more
Traditionally, lameness has been defined as any alteration
of the horse’s gait. In addition, lameness can manifest in
such ways as a change in attitude or performance. These
abnormalities can be caused by pain in the neck, withers,
shoulders, back, loin, hips, legs or feet. Identifying the
source of the problem is essential to proper treatment.
Veterinarians have specific systems for performing
examinations, depending on the reasons for the evaluation.
However, essential features of a thorough examination
include the following:
The medical history of the horse.
The veterinarian asks the owner questions relating to past
and present difficulties of the horse. He or she also
inquires about exercise or work requirements and any other
A visual appraisal of the horse at rest.
The veterinarian will study conformation, balance and weight
bearing, and look for any evidence of injury or stress.
A thorough hands-on exam.
The veterinarian palpates the horse, checking muscles,
joints, bones and tendons for evidence of pain, heat,
swelling or any other physical abnormalities.
Application of hoof testers to the feet.
This instrument allows the veterinarian to apply pressure to
the soles of the feet to check for undue sensitivity or
pain. Many practitioners will concentrate on the front feet,
as 60-65% of the horse’s weight will be supported by the
Evaluation of the horse in motion.
The veterinarian watches the horse walking and trotting.
Gait evaluation on different ground surfaces (soft to hard)
may give valuable information as to the nature of a
particular lameness. Observing the horse from the front,
back and both side views, the veterinarian notes any
deviations in gait (such as winging or paddling), failure to
land squarely on all four feet and the unnatural shifting of
weight from one limb to another. The horse also walks and
trots in circles, on a longe line, in a round pen, or under
saddle. The veterinarian looks for certain signs, such as
shortening of stride, irregular foot placement, head
bobbing, stiffness, weight shifting, etc.
Joint flexion tests.
The veterinarian holds the horse’s limbs in a flexed
position and then releases the leg. As the horse trots away,
the veterinarian watches for signs of pain, weight shifting
or irregular movement. Flexing the joints in this manner may
reveal problems that are not otherwise readily apparent.
Diagnostic procedures are often necessary to isolate the
specific location and cause of lameness. Lameness is best
treated with a specific diagnosis. If your veterinarian has
cause for concern based on initial examination, he may
recommend further tests, including diagnostic nerve or joint
blocks, radiographs, ultrasound, or examination of synovial
fluid and tissue samples.
Diagnostic nerve and joint blocks.
The analgesic techniques are perhaps the most important
tools used to identify the location of lameness. Working
systematically, the veterinarian temporarily deadens
sensation to specific segments of the limb, one joint at a
time, until the lameness disappears. This procedure isolates
the area of pain causing the lameness. Blocks can also help
determine whether the condition is treatable.
These are useful in identifying damage or changes to bony
tissues. They should be interpreted only by an experienced
and knowledgeable veterinarian, since not all changes are
cause for concern. Radiographs provide limited information
about soft tissue, such as tendons, ligaments or structures
inside the joints, which are often the source of lameness.
This procedure uses ultrasonic waves to image internal
Blood, synovial (joint) fluid and tissue samples.
These samples can be examined for infection, inflammation or
metabolic abnormalities (muscle biopsy). Such examinations
usually require laboratory testing.
AAEP Lameness Scale
Because each horse has unique performance characteristics,
evaluating lameness can be challenging. Experienced riders
may detect minor alterations in gait before they are
apparent to an observer. Lameness may appear as a subtle
shortening of the stride, or the condition may be so severe
that the horse will not bear weight on the affected limb.
With such extremes of lameness possible, a lameness grading
system has been developed by the AAEP to aid both
communication and record keeping. The scale ranges from zero
to five, with zero being no perceptible lameness, and five
being the most extreme.
Grading system explained:
Lameness not perceptible under any circumstances.
1: Lameness is difficult to observe and is not consistently
apparent, regardless of circumstances (e.g. under saddle,
circling, inclines, hard surface, etc.)
2: Lameness is difficult to observe at a walk or when
trotting in a straight line, but consistently apparent under
certain circumstances (e.g. weight carrying, circling,
inclines, hard surface, etc.)
3: Lameness is consistently observable at a trot under all
4: Lameness is obvious at a walk.
5: Lameness produces minimal weight bearing in motion and/or
at rest or in complete inability to move.
More about Observing the Horse in Motion
The veterinarian should observe the horse both on soft and
hard surfaces, since different types of lameness may become
apparent with different footing. In addition, lameness may
only be apparent when the horse is under saddle, or it may
manifest only at liberty or on a longe line when the horse
can be evaluated without the influence of the rider.
A horse’s walk and trot may be especially revealing. The
slower gait of the walk makes it easier to observe slight
deviations that aren’t readily apparent at a faster pace.
However, the trot is perhaps most useful for evaluating
lameness because it is the simplest gait, consisting of a
two beat stride pattern, and because the horse’s weight is
distributed evenly between diagonal pairs of legs. In some
cases, the speed and concussion of a faster pace (i.e.
canter, gallop) is needed to help demonstrate the lameness.
Lameness Evaluations in Relation to Purchase Exams
Evaluation for the presence of lameness should be part of
every purchase evaluation. While it is impossible to predict
a horse’s actual performance, the veterinarian can provide
information regarding lameness or potential lameness by
evaluating conformation, movement, medical history, past
performance and existing medical conditions. The extent of
the exam will be determined by the buyer and veterinarian.
Value, intended use and long-term goals may be factors in
selecting certain exam procedures. For example, radiographs,
sonograms and other diagnostic tests provide comprehensive
pictures of the horse’s condition, but they also add to the
exam’s cost. Remember, your veterinarian cannot tell you
whether to buy a horse or not, he can simply assist you in
finding current or potential problems.
The most important question your veterinarian will ask is:
What will you be doing with this horse? Your veterinarian
will then weigh conformation movement and medical
considerations against the type and level of performance
expected. A horse that is fine for a daily pleasure ride may
not hold up under more strenuous activities.
In the purchase lameness exam, the veterinarian will try to
determine two things:
1.) Is the horse lame at the present time, or are there
existing conditions that deserve a closer look?
2.) What is the likelihood that the horse will remain
serviceable for its intended use? Age, health, expected
level of activity, conformation and past use will be
considered. The veterinarian will inform the buyer of the
relevant facts and risks, and the buyer can then decide
whether to purchase the horse.
Limitations of Purchase Exams
It is important to remember that even a favorable report
following a lameness exam is not a guarantee there are no
problems. Many factors can affect a horse’s short –and
long-term ability to perform. Factors in the lameness
equation include many variables, such as:
o Hoof Care
o Use of protective leg gear
o Fitting and conditioning of the horse
o Degree and manner of training
o Type and level of performance
o Skill balance and experience of the rider
o Type or condition of the ground on which the horse
o Disease or injury
o Genetic predisposition
for your veterinarian to evaluate a horse fairly, the animal
should be fit, conditioned and in training for its intended
use. A horse that has been laid off for an extended time
will be difficult to evaluate for lameness. One option may
be to ask that the horse be returned to training and then
re-examined after 30-60 days. Depending on the horse’s
value, such a request may be reasonable. Ask your
Lameness is a complicated condition, with many possible
causes. Be a conscientious observer. If you suspect a
problem, discontinue riding your horse and seek advice from
your veterinarian promptly. By identifying even minor
lameness and acting swiftly to correct it, you will minimize
the risk of injury to the horse and yourself, and you will
be rewarded by better performance and a longer, more useful
life from your horse.