John Victor Lacroix - Lameness of the Horse

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Transcriber's Note:

The original text was inconsistent in the use of accents and
hyphenation. These variants and a small number of typographical
errors were maintained in this transcription. A complete list
of the variant spellings is found at the end of the book along
with the list of typographical errors.

The Table of Contents lists the Authorities Cited section as
preceding the Index, but it was printed following the Index.
This order has been retained in this transcription.

Veterinary Practitioners' Series

No. 1

LAMENESS OF THE HORSE

by

J. V. Lacroix, D.V.S.

Professor of Surgery, The Kansas City Veterinary College
Author of "Animal Castration"

Illustrated

Chicago
American Journal Of Veterinary Medicine

1916

PREFACE

All that can be known on the subject of lameness, is founded on a
knowledge of anatomy and of the physiology of locomotion. Without such
knowledge, no one can master the principles of the diagnosis of
lameness. However, it must be assumed that the readers are informed on
these subjects, as it is impossible to include this fundamental
instruction in a work so brief as this one.

The technic of certain operative or corrective procedures, has been
described at length only where such methods are not generally employed.
Where there is no departure from the usual methods, treatment that is
essentially within the domain of surgery or practice is not given in
specific detail.

Realizing the need for a treatise in the English language dealing with
diagnosis and treatment of lameness, the author undertook the
preparation of this manuscript. That the difficulties of depicting by
means of word-pictures, the symptoms evinced in baffling cases of
lameness, presented themselves in due course of writing, it is needless
to say.

It is hoped that this volume will serve its readers to the end that the
handling of cases of lameness will become a more satisfactory and
successful part of their work; that both the practitioner and his
clients may profit thereby; and last but by no means least, that the
horse, which has given such incalculable service to mankind and is
deserving of a more concrete reward, will be benefited by the
application of the principles herein outlined.

In addition to the consultation of standard works bearing on various
phases of the subject of lameness, the author wishes to thankfully
acknowledge helpful advice and assistance received from the publisher,
Dr. D.M. Campbell; to appreciatively credit Drs. L.A. Merillat, A.
Trickett and F.F. Brown for valuable suggestions given from time to
time. Particular acknowledgment is made to Dr. Septimus Sisson, author,
and W.B. Saunders & Co., publishers of The Anatomy of Domestic Animals,
for permission to use a number of illustrations from that work.

J.V.L.

Chicago, Illinois, October, 1916.

_Justice shows a triumphant face at the works of humane practitioners,
who give serious thought and expend honest effort, for the alleviation
of animal suffering._

TABLE OF CONTENTS

Page
Illustrations 7
Introduction 11

SECTION I

Etiology and Occurrence 15
Affections of Bones 15
Rarefying Osteitis, or Degenerative Changes 16
Fractures 16
Affections of Ligaments 20
Luxations--Dislocations 21
Arthritis 22
Affections of Bursae and Thecae 27
Affections of Muscles and Tendons 28
Affections of Nerves 30
Affections of Blood Vessels 31
Affections of Lymph Vessels and Glands 32
Affections of the Feet 34

SECTION II

Diagnostic Principles 37
Anamnesis 38
Visual Examination 39
Attitude of the Subject 41
Examination by Palpation 43
Passive Movements 47
Observing the Character of the Gait 48
Special Methods of Examination 53

SECTION III
Lameness in the Fore Leg

Anatomo-Physiological Review of Parts of the Fore Leg 55
Shoulder Lameness 61
Fracture of the Scapula 62
Scapulohumeral Arthritis 65
Infectious Arthritis 66
Injuries 66
Wounds 67
Luxation of the Scapulohumeral Joint 67
Inflammation of the Bicipital Bursa 68
Contusions of the Triceps Brachii 71
Shoulder Atrophy (Sweeny) 73
Paralysis of the Suprascapular Nerve 75
Radial Paralysis 77
Thrombosis of the Brachial Artery 81
Fracture of the Humerus 82
Inflammation of the Elbow 84
Fracture of the Ulna 86
Fracture of the Radius 87
Wounds of the Anterior Brachial Region 90
Inflammation and Contraction of the Carpal Flexors 93
Fracture and Luxation of the Carpal Bones 96
Carpitis 98
Open Carpal Joint 100
Thecitis and Bursitis 104
Fracture of the Metacarpus 106
Splints 107
Open Fetlock Joint 110
Phalangeal Exostosis (Ringbone) 118
Open Sheath of the Flexors of the Phalanges 124
Luxation of the Fetlock Joint 125
Sesamoiditis 127
Fracture of the Proximal Sesamoids 128
Inflammation of the Posterior Ligaments of the Pastern
Proximal Interphalangeal Joint 129
Fracture of the First and Second Phalanges 131
Tendinitis (Inflammation of the Flexor Tendons) 135
Chronic Tendinitis and Contraction of the Flexor Tendons 137
Contracted Tendons of Foals 143
Rupture of the Flexor Tendons and Suspensory Ligament 146
Thecitis and Bursitis in the Fetlock Region 150
Arthritis of the Fetlock Joint 152
Ossification of the Cartilages of the Third Phalanx 155
Navicular Disease 157
Laminitis 160
Calk Wounds (Paronychia) 170
Corns 172
Quittor 174
Nail Punctures 178

SECTION IV
Lameness in the Hind Leg

Anatomo-Physiological Consideration of the Pelvic Limbs 185
Hip Lameness 195
Fractures of the Pelvic Bones 196
Fractures of the Femur 199
Luxation of the Femur 201
Gluteal Tendo-Synovitis 203
Paralysis of the Hind Leg 204
Paralysis of the Femoral (Crural) Nerve 204
Paralysis of the Obturator Nerve 206
Paralysis of the Sciatic Nerve 208
Iliac Thrombosis 209
Fracture of the Patella 212
Luxation of the Patella 213
Chronic Gonitis 217
Open Stifle Joint 220
Fracture of the Tibia 222
Rupture and Wounds of the Tendo Achillis 224
Spring-Halt (String-Halt) 225
Open Tarsal Joint 229
Fracture of the Fibular Tarsal Bone (Calcaneum) 230
Tarsal Sprains 232
Curb 233
Spavin (Bone Spavin) 235
Distension of the Tarsal Joint Capsule (Bog Spavin) 242
Distension of the Tarsal Sheath of the Deep Digital Flexor
(Thoroughpin) 246
Capped Hock 251
Rupture and Division of the Long Digital Extensor (Extensor
Pedis) 253
Wounds from Interfering 255
Lymphangitis 257
Authorities Cited 265
Index 267

ILLUSTRATIONS

Page
Fig. 1--Hoof Testers 53
Fig. 2--Muscles of Left Thoracic Limb, Lateral View 56
Fig. 3--Muscles of Left Thoracic Limb, Medial View 57
Fig. 4--Sagital Section of Digit and Distal Part of
Metacarpus 59
Fig. 5--Ordinary Type of Heavy Sling 62
Fig. 6--A Sling Made in Two Parts 63
Fig. 7--Paralysis of the Suprascapular Nerve of Left
Shoulder 76
Fig. 8--Radial Paralysis 78
Fig. 9--Merillat's Method of Fixing Carpus in Radial
Paralysis 79
Fig. 10--Contraction of Carpal Flexors, "Knee Sprung" 95
Fig. 11--Pericarpal Inflammation and Enlargement Due to
Injury 99
Fig. 12--Hygromatous Condition of the Right Carpus 100
Fig. 13--Carpal Exostosis in Aged Horse 101
Fig. 14--Exostosis of Carpus Resultant from Carpitis 102
Fig. 15--Distal End of Radius, Illustrating Effects of
Carpitis 102
Fig. 16--Posterior View of Radius, Illustrating Effects of
Splint 108
Fig. 17--Phalangeal Exosteses 120
Fig. 18--Rarefying Osteitis in Chronic Ringbone 121
Fig. 19--Phalangeal Exostoses in Chronic Ringbone 122
Fig. 20--Contraction of Superficial Digital Flexor Tendon
Due to Tendinitis 138
Fig. 21--Contraction of Deep Flexor Tendon Due to
Tendinitis 139
Fig. 22--Chronic Case of Contraction of Both Flexor Tendons
of the Phalanges 140
Fig. 23--Contraction of Superficial and Deep Flexor
Tendons 141
Fig. 24--Contraction of Superficial Digital Flexor and
Slight Contraction of Deep Flexor Tendon 142
Fig. 25--"Fish Knees" 145
Fig. 26--Extreme Dorsal Flexion 146
Fig. 27--A Good Style of Shoe for Bracing the Fetlock 148
Fig. 28--The Roberts Brace in Operation 149
Fig. 29--Distension of Theca of Extensor of the Digit 151
Fig. 30--Rarefying Osteitis Wherein Articular Cartilage
Was Destroyed 153
Fig. 31--Ringbone and Sidebone 156
Fig. 32--Position Assumed by Horse Having Unilateral
Navicular Disease 159
Fig. 33--The Hoof in Chronic Laminitis 165
Fig. 34--Effects of Laminitis 166
Fig. 35--Cochran Shoe, Inferior Surface 168
Fig. 36--Cochran Shoe, Superior Surface 169
Fig. 37--Hyperplasia of Eight Forefoot Due to Chronic
Quittor 176
Fig. 38--Chronic Quittor, Left Hind Foot 177
Fig. 39--Skiagraph of Foot 179
Fig. 40--Sagital Section of Eight Hock 186
Fig. 41--Muscles of Right Leg; Front View 187
Fig. 42--Muscles of Lower Part of Thigh, Leg and Foot 189
Fig. 43--Right Stifle Joint; Lateral View 190
Fig. 44--Left Stifle Joint; Medial View 191
Fig. 45--Left Stifle Joint; Front View 193
Fig. 46--Oblique Fracture of the Femur 200
Fig. 47--Fracture of Femur After Six Months' Treatment 201
Fig. 48--Aorta and Its Branches Showing Location of
Thrombi 210
Fig. 49--Thrombosis of the Aorta, Iliacs and Branches 211
Fig. 50--Chronic Gonitis 218
Fig. 51--Position Assumed in Gonitis 219
Fig. 52--Spring-halt 226
Fig. 53--Lateral View of Tarsus Showing Effects of Tarsitis 228
Fig. 54--Right Hock Joint 231
Fig. 55--Spavin 235
Fig. 56--Bog Spavin 243
Fig. 57--Thoroughpin 247
Fig. 58--Fibrosity of Tarsus in Chronic Thoroughpin 248
Fig. 59--Another View of Case Shown in Fig. 58 249
Fig. 60--"Capped Hock" 252
Fig. 61--Chronic Lymphangitis 258
Fig. 62--Elephantiasis 259

INTRODUCTION

Lameness is a symptom of an ailment or affection and is not to be
considered in itself as an anomalous condition. It is the manifestation
of a structural or functional disorder of some part of the locomotory
apparatus, characterized by a limping or halting gait. Therefore, any
affection causing a sensation and sign of pain which is increased by the
bearing of weight upon the affected member, or by the moving of such a
distressed part, results in an irregularity in locomotion, which is
known as lameness or claudication. A halting gait may also be produced
by the abnormal development of a member, or by the shortening of the leg
occasioned by the loss of a shoe.

For descriptive purposes lameness may be classified as _true_ and
_false_. _True lameness_ is such as is occasioned by structural or
functional defects of some part of the apparatus of locomotion, such as
would be caused by spavin, ring-bone, or tendinitis. _False lameness_ is
an impediment in the gait not caused by structural or functional
disturbances, but is brought on by conditions such as may result from
the too rapid driving of an unbridle-wise colt over an irregular road
surface, or by urging a horse to trot at a pace exceeding the normal
gait of the animal's capacity, causing it to "crow-hop" or to lose
balance in the stride. The latter manifestation might, to the
inexperienced eye, simulate _true lameness_ of the hind legs, but in
reality, is merely the result of the animal having been forced to assume
an abnormal pace and a lack of balance in locomotion is the consequence.

The degree of lameness, though variable in different instances, is in
most cases proportionate to the causative factor, and this fact serves
as a helpful indicator in the matter of establishing a diagnosis and
giving the prognosis, especially in cases of somewhat unusual character.
An animal may be slightly lame and the exhibition of lameness be such as
to render the cause bafflingly obscure. Cases of this nature are
sometimes quite difficult to classify and in occasional instances a
positive diagnosis is impossible. Subjects of this kind may not be
sufficiently inconvenienced to warrant their being taken out of
service, yet a lame horse, no matter how slightly affected, should not
be continued in service unless it can be positively established that the
degree of discomfort occasioned by the claudication is small and the
work to be done by the animal, of the sort that will not aggravate the
condition.

Subjects that are very lame--so lame that little weight is borne by the
affected member--are, of course, unfit for service and as a rule are not
difficult of diagnosis. For instance, a fracture of the second phalanx
would cause much more lameness than an injury to the lateral ligament of
the coronary joint wherein there had occurred only a slight sprain, and
though crepitation is not recognized, the diagnostician is not justified
in excluding the possibility of fracture, if the lameness seems
disproportionate to the apparent first cause.

The course taken by cases of lameness is as variable as the degree of
its manifestation, and no one can definitely predict the duration of any
given cause of claudication.

Because of the fact that horses are not often good self-nurses at best,
and that it is difficult to enforce proper care for the parts affected,
one can not wisely state that resolution will promptly follow in an
acute involvement, nor can he predict that the case will or will not
become chronic. Experience has proved that complete or partial recovery
may result, or again, that no change may occur in any given case, and
that in some instances even where rational treatment is early
administered, a decided aggravation of the condition may follow
unaccountably.

However, because of the economic element to be reckoned with, it is of
some value to be able to give a fairly accurate prognosis in the
handling of cases of lameness, as in the majority of instances the
treatment and manner of after-care are determined largely by the expense
that any prescribed line of attention will occasion.

A case of acute bone spavin in a horse of little value is not generally
treated in a manner that will incur an expense equivalent to one-half
the value of the subject. The fact is always to be considered in such
cases, that even where ideal conditions favor proper treatment, the
outcome is uncertain. Where less than six weeks of rest can be allowed
the animal, one affected with bone spavin would therefore not be treated
with the expectation of obtaining good results, as six weeks' time, at
least, is necessary for a successful outcome. If the cost attending the
enforced idleness of an animal of this kind is considered prohibitive
for the employment of proper measures to affect a cure, and if lameness
is slight, the animal should be given suitable work, but in cases of
articular spavin in aged subjects, they should be humanely destroyed and
not subjected to prolonged misery.

A thorough knowledge of the structure and functions of the affected
parts is necessary to proceed in cases of lameness; likewise, the age,
conformation and temperament of the subject need to be taken into
consideration; the presence or absence of complications demand the
attention; the kind of care the subject will probably receive directly
influences the outcome; and the character of service expected of the
subject, too, needs to be carefully considered before the ultimate
outcome may reasonably be foretold.

The practitioner is often confronted with the problem of how best to
handle certain cases. Will they do better under conditions where
absolute quiet is enforced, or is it preferable to allow exercise at
will? The temperament of the animal must be considered in such cases,
and if a lame horse is too active and playful when given his freedom,
exercise must be restricted or prevented, as the case may require. In
cases of strains of tendons, during the acute stage, immobilization of
the affected parts is in order. In certain sub-acute inflammatory
processes or in instances of paralytic disturbance where convalescence
is in progress, moderate exercise is highly beneficial.

Consequently, each case in itself presents an individual problem to be
judged and handled in the manner experience has taught to be most
effective, appropriate and practical, and the veterinarian should give
due consideration to the comfort and welfare of the crippled animal as
well as to the interests of the owner.

SECTION I.

ETIOLOGY AND OCCURRENCE.

In discussions of pathological conditions contributing to lameness in
the horse, cause is generally classified under two heads--_predisposing_
and _exciting_. It becomes necessary, however, to adopt a more general
and comprehensive method of classification, herein, which will enable
the reader to obtain a better conception of the subject and to more
clearly associate the parts so grouped descriptively.

Though _predisposing_ factors, such as faulty conformation, are often to
be reckoned with, _exciting_ causes predominate more frequently in any
given number of cases. The noble tendency of the horse to serve its
master under the stress of pain, even to the point of complete
exhaustion and sudden death, should win for these willing servants a
deeper consideration of their welfare. Too frequently are their
manifestations of discomfort allowed to pass unheeded by careless,
incompetent drivers lacking in a sense of compassion. Symptoms of
malaise should never be ignored in any case; the humane and economic
features should be realized by any owner of animals.

In the consideration of group causes, lameness may be said to originate
from affections of bones, ligaments, thecae and bursae, muscles and
tendons, nerves, lymph vessels and glands, and blood vessels, and may
also result from an involvement of one or several of the aforementioned
tissues, caused by rheumatism. Further, affections of the feet merit
separate consideration, and, finally, a miscellaneous grouping of
various dissimilar ailments, which for the most part, do not directly
involve the locomotory apparatus but do, by their nature, impede normal
movement.

AFFECTIONS OF BONES.

The bony column serving as the framework and support of the legs,
probably constitutes the most vital element having to do with weight
bearing and locomotion, and therefore during the acute and painful stage
of bone affections, the pain becomes more intense in the process and
pressure of standing than when the member is swung or advanced.

Certain bones are so well protected by muscular structures that they are
not frequently injured except as a result of violence which may produce
fracture. However, there are certain bones which receive the constant
shock of concussion when the animal is subjected to daily, rapid work on
hard road surfaces. Splints, ringbones and spavins are the most general
examples produced by these conditions.

Varying pathological developments often result from concussion,
contusion or other violent shocks to the bony structures. In such cases
there either follows a simple periostitis which may resolve
spontaneously with no obvious outward symptom, or osteitis, which may
occur with tissue changes, as in exostosis; or the case may produce any
degree of reaction between these two possible extremes.

Rarefying Osteitis, or Degenerative Changes.

Certain bone affections, such as osteomalacia or osteoporosis, are in
the main, responsible for distortions and morphological changes of bone,
causing lameness, permanent blemish and even resulting in death of the
affected animal. The climatic conditions in some localities favor these
occurrences but they may also be ascribed to improper food constituents
and to possible infective agencies.

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