  SPRAINS AND INJURIES IN THE REGION OF THE SHOULDER.—Sprains and injuries of the structures in the shoulder region are more common in horses that are called on to do heavy work than among driving horses. The following causes may be mentioned: Ill-fitting collars, pulling heavy loads over uneven streets or soft ground, where the footing is not secure, and slipping are common causes. Young horses that do not know how to pull, or horses that are tired out by hard work, are predisposed to muscular strain, and are apt to suffer injury if forced to do heavy work. Sore shoulders, or an ignorant driver, may cause the animal to pull awkwardly and throw more strain on certain groups of muscles than they can stand. Rheumatism frequently causes shoulder lameness. The muscle usually affected by rheumatism is the large muscle extending from the region of the point of the shoulder to the summit of the head. [Illustration: FIG. 31.—Shoulder lameness.] The symptoms of shoulder lameness vary in the different cases. The horse may walk without going lame, but when made to trot lameness is quite noticeable. The animal may point with the foot of the diseased limb, holding it forward, but squarely on the floor. In severe strain, little weight is thrown on the limb and the lameness is marked (Fig. 31). In "shoulder slip" the head of the arm bone pushes outward every time the animal throws weight on the limb. This luxation can be noticed best when standing in front of the animal. Marked atrophy of the external shoulder muscles may occur. Such atrophy may appear and disappear quickly, and may result from an injury to the nerve supply of the muscle as well as from favoring the part. Atrophy of the shoulder may occur if the animal is lame in other regions of the limb, especially the feet. The outcome of shoulder lameness is favorable if the disease causing it is given prompt treatment. Rest is a very important part of the treatment. It may be advisable to restrict the horse's movements by placing it in a single stall, and tying the animal so that it can not lie down. This should be continued for at least one week. If the horse is restless, it should be given a box-stall or turned out in a small lot alone. It should be watered and fed in the quarters where confined. The local treatment consists in applying mild liniments or blisters to the shoulder. It is not advisable, however, to apply a blister if the muscles feel hot and tender. CAPPED ELBOW, "SHOE-BOIL."—Capped elbow is an inflammation of the bursa at the posterior surface of the elbow (Fig. 32). The swelling that results is usually sharply defined. It may feel abnormally warm and doughy, and it may be painful. Later, the enlargement may be well defined and hard. Sometimes the skin is indurated and lies in folds, or the shoe-boil shows abrasions on its surface and fistulous openings leading from abscess centres. The cystic or soft tumor is a common form. Such an enlargement fluctuates on pressure, and when opened, a blood-stained fluid escapes. All forms of capped elbow tend to become chronic. The treatment is both preventive and local. As capped elbow is caused by bruising the part with the hoof or heel of the shoe, the preventive treatment consists in hindering the animal from taking a position that may favor injury to the part. Confining the animal in a small stall and tying it with too short a halter strap favors a sternal position when lying down. A roomy stall that permits the animal to stretch or change position is an important preventive measure. Shoes that project beyond the quarters should be avoided. The elbow may be protected by placing a thick pad over the heels when the animal is in the stable. [Illustration: FIG. 32.—Shoe-boil.] Local treatment varies according to the character of the enlargement. Soft, doughy swellings may be treated by application of cold, iodine and blisters. The cystic form of tumor must be opened, the fluid removed and the lining membrane destroyed by the injection of tincture of iodine. Hard, indurated shoe-boils may be treated by completely removing the diseased tissue. The surgical treatment of capped elbow requires the service of an experienced veterinarian. His efforts may prove a complete failure, unless the irritation to the part by the shoe or hoof is prevented. INJURIES TO THE KNEE (BROKEN KNEE).—Horses frequently fall and bruise or lacerate the knee when moving at trot or canter. The injury varies according to the force of the fall, and the character of the road that the animal is travelling over. Some individuals are more liable to suffer from this class of injuries than others. Horses that are weak-kneed because of poor conformation, or knee-sprung, are inclined to stumble. Careless driving, especially if the animal is tired, predisposes it to this class of injury. Because of the predisposition toward stumbling on the part of some horses, scars on the front of the knee are termed broken knee, and the animal is considered unsound. The symptoms vary with the extent of the injury. Slight bruises or abrasions result in local swelling and soreness that disappear within a few days. Laceration of skin interferes with the movement of the knee and the animal may be quite lame. The part becomes swollen and painful. In injuries involving the sheaths of the tendons and the synovial membrane, the pain is severe and the accompanying inflammation may take on a serious form. The preventive treatment should not be overlooked. Horses should be trained to carry the head at a proper height when moving. The driver should handle the reins properly and keep his attention on the horse or horses that he is driving. Superficial bruises require no special treatment other than rest. Laceration of the skin and underlying tissue requires complete rest and careful removal of any particles, of dirt and gravel that may be present in the wound. Shreds of tissue that may take no part in the healing should be cut away. The hair in the region of the wound should be trimmed short. Careful and repeated dressings with antiseptics are necessary until the inflammation has largely disappeared and healing is rapidly taking place. It may be advisable to tie the horse in the stall so that it can not lie down. DISTENDED SYNOVIAL SACS, JOINT SHEATHS AND BURSAE, "GALLS."—Soft enlargements may occur in the region of the knee and fetlock. They are commonly termed "galls," "wind-galls," or "road-puffs." They are usually due to the sheaths surrounding the tendons becoming distended with synovia. "Galls" are caused by strains, direct injury to the part and severe, continuous work. Certain individuals may develop this class of blemishes without being subject to any unusual conditions. This condition is seldom accompanied by lameness. The treatment may vary in the different cases. If the distended sheath, or bursal enlargement, is caused by a direct injury or strain, cold bandages should be applied and the part given as complete rest as possible. "Wind-galls" may be removed by a surgical operation. It is not advisable to attempt the removal of "road-puffs." Rest, stimulating leg washes and bandages may temporarily remove the latter. SPRUNG KNEES (BUCK KNEES).—This condition of the knee is characterized by the partly flexed condition of the region. It is best observed by standing to one side of the horse (Fig. 33). Instead of the forearm and cannon regions appearing perpendicular or in line, they are directed forward. This condition may exist in varying degrees. Some individuals show it to a slight degree, the condition being accompanied by a weakness or shakiness of the knee when standing at rest. Sometimes, but one knee is involved. The causes of this unsoundness are hereditary and accidental. Weak knees due to faulty conformation seldom escape becoming sprung in animals that are given hard work. Severe and continuous driving is a common factor in the production of this condition. Strains of the flexor muscles of the region may cause it. The retraction of the flexor muscles and their tendons and the aponeurosis of the antibrachial region occurs in this disorder and prevents the animal from extending the knee. The region is greatly weakened by this condition and the animal may be unfitted for active work. For this reason the value of the animal is greatly diminished. Treatment is unsatisfactory. The preventive treatment consists in not breeding animals that have poorly conformed knees and using the proper judgment in working young horses and when driving or riding horses. Certain cases may be greatly benefited by sectioning the tendons of the external and middle flexors of the metacarpi. To insure a successful outcome in any case that is operated on, a long period of rest is required. [Illustration: FIG. 33.—Sprung knees.] [Illustration: FIG. 34.—Splints.] SPLINTS.—A splint is a bony enlargement situated along the line of articulation between the splint and cannon bones (Fig. 34). This blemish is due to an inflammation of the periosteum. It is a very common blemish and is generally located along the splint bones of the forefeet, especially the internal ones. Splints are caused by strains and rupture of the ligament that binds the splint bone to the cannon bone. The result is an inflammation of the periosteum. Slipping, or an unbalanced condition of the foot, may cause this injury by distributing the weight unequally on the splint bones. Faulty action and bad shoeing may cause the horse to strike and bruise the region. Symptoms of lameness are not always present. A high splint involving the articulation between the lower row of carpal, splint and cannon bones may be considered an unsoundness, because of the persistent character of the lameness. The animal may show little or no lameness when walked, but if moved at a trot, especially over a hard roadway, it may show marked lameness. The local inflammation is characterized by a small swelling lying along the splint bone, that feels hot and may pit on pressure. After a time the inflammation disappears and is replaced by a hard, bony enlargement. When this occurs the lameness disappears. The preventive treatment consists in keeping the feet of young horses in proper balance by frequent trimming and proper shoeing. This attention is very necessary in young colts that are running in pasture. It is very advisable to rest the animal during the period of inflammation. Cold bandages should be applied. As soon as the inflammation has subsided mild counterirritants and absorbents may be used. In. case the lameness persists, more severe counterirritation is indicated. INFLAMMATION OF THE FLEXOR TENDONS OF THE DIGIT.—The large tendons posterior to the foot and the suspensory ligament that separates them from the cannon bone frequently become inflamed. Sometimes complete rupture of one or more of these structures occurs. The lighter breeds of horses are the most frequent sufferers. Because of the greater strain thrown on the tendons of the forefeet, inflammation of these tendons is far more common than it is in the hindfoot. Diseased conditions of the hind tendons are usually due to other causes than strain. The following predisposing and accidental causes should be considered: Weak flexor tendons and heavy bodies predispose animals to inflammation of the tendons and suspensory ligament; quality, not size, is the factor to consider when judging the strength of a tendon; long, slender pasterns increase the strain on these structures, and this mechanical strain is further increased by low heels and long toes; the character of the work and the condition of the road that the animal travels over are important factors to consider; trotting and running horses more often suffer from injuries to tendons and ligaments than draft horses; travelling at a high rate of speed over an uneven road, slipping and catching the foot in a rut or car track, are common causes; bruises and wounds may result in the tendons becoming inflamed; inflammation of the tendinous sheaths and the tendons as well sometimes occurs in influenza. Lameness is a prominent symptom. The pastern is held in a more upright position than normal. When the animal is standing, the foot is rested on the toe, and it may take advantage of any uneven place on which to rest the heel. In severe strains the local symptoms are quite prominent. The tendons may be hot and swollen. Pressure may cause the animal pain. In chronic tendinitis the tendon may be thickened and rough or knotty. Pain is not a prominent symptom in this class of cases. Shortening of the inflamed tendon may occur, causing the animal to knuckle over. Rupture of one or more of the tendons and the suspensory ligament can be recognized by the abnormal extension of the pastern. If the ruptured tendon heals, it always results in a thickening at the point of the rupture that gives the tendons a bowed appearance. This is termed bowed-tendon. The lameness resulting from an inflammation of tendons resembles that resulting from strains and injuries to the fetlock joint, especially in the region of the sesamoid bones. INFLAMMATION OF THE SESAMOID BONES differs slightly from the former. Pressure over the posterior region of the fetlock may cause the animal pain. The lameness shows a tendency to disappear with rest and reappear when the animal is again worked. Lameness is most prominent in some cases when the animal is first moved out. There may be a lack of local symptoms, such as heat and swelling. It is not uncommon for a bony enlargement to form on the sesamoid bone after a few months or a year. The following treatment is recommended. Horses that have a poor quality of tendon and weak fetlocks and pasterns should not be used for breeding purposes. Careful driving would prevent a large percentage of injuries to tendons. The most important treatment for all injuries due to strains is rest. In all cases of severe strain to the structures in this region, it is very advisable to apply a plaster bandage. This should be left on for at least two weeks. When the acute inflammation has subsided, counterirritants may be applied. Either cold or hot applications are recommended. Cold applications are to be preferred at the beginning of the inflammation. Covering the tendons with a cold bandage, or with a heavy layer of antiphlogistin, is recommended. The horse should not be worked until after the tendons have had an opportunity to completely recover from the inflammation. CONTRACTED TENDONS, KNUCKLING-OVER.—New-born foals are sometimes unable to stand on their front feet because of the excessive knuckling-over. The colt may walk on the front of the pastern and fetlock. This sometimes results in severe injury to the skin and the underlying tissues. Knuckling-over in the mature horse is not always due to contracted tendons. It may occur as a symptom of inflammation of the flexor tendons, ligaments of the fetlock joint and the articulation as well. It may be noticed in animals that have ring-bone, or coffin-joint lameness. The most common cause for this unsoundness is inflammation of the muscles and tendons of the flexors of the digit. As a result of long standing or severe inflammation, shortening of these structures occurs in consequence of the contraction of the inflammatory or cicatricial tissue. Knuckling-over in the newborn colt is commonly caused by a weakness or lack of innervation of the extensor muscle of the digit. Judging from the quick recovery that usually occurs, other causes for this condition are seldom present. The treatment recommended for the new-born colt is supporting the fetlock with a light plaster bandage. This should be applied very soon after birth in order to prevent bruising of the fetlock. A light cheese-cloth bandage should be applied to the limb from the hoof to the knee. The colt is laid on its side, the toe extended as much as possible, and the plaster bandage applied. This should be removed in about one week and fresh bandages applied. In about two weeks the young animal is usually able to walk on the toe. As soon as it is able to do this a bandage is unnecessary. It is not advisable to turn the colt outside if there is any chance for the bandages to become wet. Knuckling-over due to faulty conformation is difficult to correct. Light work and careful shoeing are the most valuable preventive measures in young horses. Sprains and injuries to the region of the fetlock should receive the necessary treatment. The treatment for contracted tendon is largely surgical and consists in sectioning it. INJURIES CAUSED BY INTERFERING.—Horses that have faulty action may strike the opposite fetlock with the moving foot, the inside of the opposite limb in the region of the knee, and the quarters of the front foot with the shoe of the hindfoot. It is very common for horses to "brush" the inside of the hind fetlock with the opposite foot when trotting, especially if tired. Interfering in the front feet is less common. Striking the inside of the region of the knee with the opposite foot or "speedy cutting" occurs in driving and speed horses. Both of the latter forms of interfering may be considered unsoundnesses. The most common cause of interfering is faulty conformation, such as narrowness of the chest or pelvis, faulty conformation of the limbs and irregularity in the action of the joints. Shoeing and the condition of the feet are also important factors. Animals that have a narrow chest or pelvis interfere because the legs are placed too closely together. Turning in of the knees or "knock-kneed," winging in or out of the feet, or any other defective conformation of the limbs that tends to prevent the animal from moving the feet in line, lead to serious interfering. A wide-spreading hoof, an unbalanced condition of the foot and improper fitting of the shoes are common causes for interfering in horses that would otherwise move the feet in line. Debility from disease and overwork may cause the animal to interfere temporarily. An unbalanced gait and shortness of the body are the common causes for injuries to the quarters. All degrees of injury to the part struck by the shoe or wall of the foot may be noted. Horses that interfere lightly, wear the hair off and produce slight abrasions of the skin on the inside of the fetlock. Sometimes the skin is bruised, inflamed or scarred. Injuries to the inside of the knee and quarter are the most serious. Lameness, inflammation of the periosteum and bony enlargement may result from "speedy cutting." Deep wounds in the region of the heel or quarter may occur when a horse strikes this part with the shoe of the hindfoot in moving at a high rate of speed. The treatment is largely preventive. No doubt many cases of interfering could be prevented by careful training and balancing of the foot when the animal is growing and developing. The feet of colts should be trimmed every three or four weeks. Interfering in the hindfeet may be stopped by noting the character of the animal's gait and the portion of the wall that strikes the part, and by practising intelligent methods of shoeing. Slight injuries should be treated by the application of antiseptic powders. The treatment for injuries to the periosteum is the same as that recommended for splints. As a last resort boots and button rings may be used for the purpose of preventing serious injury to that part which is struck by the foot. RING-BONE.—Chronic inflammation of the articulation between the first and second bones of the digit is termed ring-bone (Fig. 35). Not all ring-bones involve the articular surfaces. The periarticular, or false ring-bone, is a chronic inflammation of the bone near the articular surface. The bony enlargement varies in size. It may form a ring encircling the part, or it may be limited to the lateral surface of the joint. The bony enlargement may be so small as to be detected only by a careful examination. Ring-bone may occur on any of the feet, but it is said to be more common in the front feet. [Illustration: FIG. 35.—Bones of digit, showing side bones and ring-bones, and normal bones of digit.] The predisposing cause of ring-bone is faulty conformation. Long, weak pasterns that are predisposed to strains, upright pasterns, especially if small, and exposed to concussion and jarring, and crooked feet that distribute the weight on the part irregularly are important factors in the production of ring-bones. The external causes are sprains or any injury to the region. Lameness is nearly always present. The degree of lameness varies, and does not depend altogether on the size of the bony enlargement. Large ring-bones interfere with the movement of the tendon. Lameness is most pronounced when weight is thrown on one foot, the later phase of the step being shortened and the pastern more upright. Some cases improve with rest, but the lameness returns when the animal is given hard work. |
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