EC September/October, 2003

You’ve been campaigning a good horse all summer and he’s done very well.  Now you’re preparing for his most important show and you think he has a chance to beat all the competition.  But when you saddle him up this morning and head for the arena to make a few practice rounds, he seems to be favoring his right front foot.  You urge him into a jog, and sure enough, he’s lame.

Lameness can be the horseman’s worst nightmare when trying to make a winning season.  Some soreness problems are just minor things, and the horse is fine again after a few days’ layoff.  But other lamenesses can be signs of something more serious that might knock the horse out of competition for awhile.  Early diagnosis and treatment can be important in reducing the recovery time.

Dr. Joe Noble (an equine veterinarian who has been in practice in Texas and Oklahoma, now resident veterinarian at a ranch in Guthrie, Oklahoma) has comments about lamenesses most common in western pleasure horses.  “By AQHA definition, a western pleasure horse should be free flowing, balanced, and willing.  The horse should look fit and be a pleasure to ride, and should cover a reasonable amount of ground for the required gaits,” he says.

“I think it’s important for veterinarians to remember that these horses are ‘gaited’ horses.  The modern pleasure horse is no different than any other gaited horse.  They have a gait that has been changed by man.  There’s a lot of controversy about the way these horses move, but it’s probably not going to change any time soon,” says Noble.

“The desired walk is a four-beat, flat footed gait.  The rider shouldn’t have to cue the horse or rate its speed.  In all the western pleasure gaits, the horse should carry its head and neck level, or just above level–as compared to the withers.  There should not be excessive head or neck movement.  The horse should carry his nose slightly in front of a vertical line,” he says.

“The jog is a two-beat gait where diagonal legs move and hit the ground at the same time.  The horse should have an even length of stride between the front and hind legs.  He should be relaxed, with ears up.  A lot of western pleasure horses have an uneven stride in the hind legs in the jog.  Usually it’s the inside leg that’s a little shorter in stride, and this is not considered a lameness.  If it’s the outside leg that has the shortened stride, then you need to check and see if there’s a problem in that leg,” he says.

“The lope is the most difficult gait.  It’s a three-beat gait; in the left lead, the footfall is right hind, left hind and right front, then left front.  The horse has to carry a major portion of his weight on his hind legs.  The head and neck must be carried in relaxed position, without excessive movement.  The horse should have an even stride length, with engagement behind–which means he is driving his hind legs (hocks) directly underneath and uses the hindquarters and loin to elevate the front end.  This allows the front legs to be advanced with very little knee flexion (“flat knee”).  The horse must have a uniform, slow speed, showing that he’s well broke, and comfortable to ride,” says Noble.

In the left lead, the right hind is the driving leg, giving the most push.  In the right lead, the left hind gets the most stress.  “These horses have some knee flexion, but they must elevate the whole front end, using the hind legs and the loin.”

Another gait that might be used in a western pleasure class is the extended jog, with increased stride length and increased speed.  “When the judges call for this, they are usually trying to sort something out among the horses in that class, or are trying to send a message that the horses are moving too slowly,” says Noble.

When a horse is not performing well, the veterinarian should thoroughly examine the horse, and may use nerve blocks to determine whether the area of concern is actually the area of pain.  X-ray and ultrasound may also be needed to pinpoint the lameness.

HIND LEG PROBLEMS – “A lot of pleasure horses are presented to the veterinarian with the complaint of loping better in one lead than the other.  In the left lead, the right rear leg is the driving leg.  If a horse is bad-leaded to the left, and not showing any obvious lameness, there are ways to try to localize the problem.  With performance lamenesses, it’s best to have the trainer there, to ride the horse.  If the horse doesn’t show anything obvious on a physical exam, you need the trainer’s help to sort through the evaluation,” says Noble.

Noble usually starts an exam with hoof testers to see if the horse has a problem in the foot.  Next, he does flexion tests to see how the horse responds to having leg joints flexed for a minute–noting any evidence of pain immediately afterward when the horse moves off.  He then does a physical exam, with the horse trotting on hard ground.

If the horse doesn’t show anything in these tests, he has the trainer start riding the horse, and also starts using nerve blocks.  In an elusive performance lameness, Noble starts looking at hock joints.  “In pleasure horses, hocks are the most common source of a hind leg problem that doesn’t show an obvious lameness.”

The next step is to block the stifle joints, if nothing shows up in a hock.  Then (if he’s still looking) he concentrates on the hind pastern joints.  If there are no obvious abnormalities or swelling in those when he palpates them, he may then use regional anesthesia (rather than in the joint itself) and rule out anything from the fetlocks down, on both hind fetlocks.

“At this point, it’s a coin toss, whether you go to the right hock or the left hock or to the stifle.  In talking with 4 or 5 other veterinarians who look at pleasure horses, we all seem to go through the same basic line when sorting out the performance type lameness,” said Noble–the problems where a horse is not obviously lame, but just isn’t performing as well as it should or used to.

Sometimes the veterinarian will put corticosteroids into a joint (such as the hock), as a means of diagnostic therapy–to see if the horse improves.  Regarding this type of injection (for determining if a hock is sore), Noble says the veterinarian walks a fine line, always wondering if he is sorting these out properly, or over-diagnosing them.

“It puts a big question mark in the back of my head, when I have a trainer with an abnormal horse that has few or no clinical signs that I can determine, and I go ahead and inject the hocks, and then talk to them 7 to 10 days later and they tell me the horse is like a new horse.  It’s usually not a trainer who thinks the problem is better just because it’s been treated.  It’s usually a trainer you can trust and communicate with, and you know they are telling you the truth,” says Noble.

“The distal tarsal joints (in the hocks) more than any other joint, don’t always show radiographic changes even though there are clinical signs of a problem,” he says.  “You can’t always tell from an x-ray if there’s a problem; the x-ray may not show the problem, or a problem that appears on an x-ray may not affect the horse at all–there’s no lameness.

“One of the things we’ve run into in pleasure horses now is the way they’re having them lope while they are being shown.  They are starting to lope these horses on a diagnonal as they go down the rail.  They lope down the rail, facing the wall.  The hock is not made to flex that way, and it’s hard on the horse.  I’m not sure how the AQHA is going to address this.  They’ve had some discussions about it, but as long as this continues, there will be a higher incidence of hock inflammation that the veterinarians will have to deal with,” he says.  “If you watch these horses loping, it looks like they are going to run right into the wall, they way they move down the rail.”

Some joints in the hock (there are several) are hard to hit accurately when inserting a needle into them–espeically the distal tarsal joint.  “One summer I checked all the horses we injected at the clinic, and used a fluorescope to locate my needle after I had placed it, and it was definitely a humbling experience!  With a lot of practice, you can get to where you can hit it about 70 percent of the time, but for me, it’s tough to get a higher success rate than that,” he says.

“There are a small number of western performance horses that have significant lameness due to inflammation of the hind pastern joint.  A fair number of these horses are consistently lame (grade 2 to 3, out of 5) and always positive to flexion of the lower leg.”  When flexing the leg, he rotates the foot and pastern area, trying not to flex the rest of the leg.

“Some will show some discomfort when you rotate the foot, and a big percentage of them will jog off lame.  Most of those I see are horses I’ve misdiagnosed as fetlock joint lamenesses or foot abnormalities, treated them, and the owners have been nice enough to bring them back to me; then I start with inter-articular (into the joint) blocks, from the ground up, and sort them out,” he says.

“One of the horses I followed for 4 years doesn’t have any degenerative changes on radiographs.  There are 2 others I followed for 2 years, and they don’t have any changes either.  So I don’t think it’s an early ringbone.  Most of these horses only require 2 or 3 treatments to get them back to soundness.  It seems to happen more in the pleasure horses and reining horses, than any other discipline,” says Noble.

Regarding suspensory inflammation, he says this type of problem, in the hind legs, is uncommon in pleasure horses, but when it does occur it can be hard to diagnose.  “These horses do not show consistent response to hind limb flexion.  Some are negative, some are positive.  These can usually be diagnosed with nuclear scintigraphy (bone scan) and if you are lucky enough to detect them early, you’ll have much better results in treatment,” he says.

In his experience, the horses that have suffered from hind limb suspensory problems have all been exceptional athletes.  “It seems to occur in the hind limb–in the horses that I’ve looked at–more often in pleasure horses and reining horses than in the cutting horses,” he says.

FRONT LEGS – Noble thinks veterinarians often overlook front foot lameness in pleasure horses.  “We ask farriers to nail more shoes and pads on these horses.  Along with that, we dress off the clinches, and all of the periople (outer waxy covering) on these feet.  We get them as smooth as the kitchen counter, then dress them up with hoof black so they look absolutely perfect–and these horses aren’t exactly programmed to have the best feet.  For the last 20 years we have not been selecting for good feet in western performance horses,” says Noble.

“Along with that, we reset pleasure horses’ shoes all too often, trying to change the way they move.  We drive way too many nails into the marginal hoof wall that they have.  I don’t want to criticize farriers.  I think veterinarians and trainers make the farriers’ job almost impossible,” he says.

“There’s a large number of horses that come to major events, that may have been acupunctured for back soreness, and have their acupuncture points injected with B vitamins.  They may have had their hocks injected with hyaluronic acid, and all of this happens in the morning, and in the afternoon they suddenly have a foot abscess coming on.”  The problem was in the foot, but it was misconstrued as a back problem or hock problem.

“To me, the foot is the place to sort out, to begin with, on most of these problems with pleasure horses, mainly because we dress those feet so severely, and they start out with a poor foot to begin with,” says Noble.

“Heel pain syndrome is a problem in all of the performance horses.  It’s common in pleasure horses because some of them aren’t as athletic and can’t carry the majority of their weight with their hind limb and their loin.”  The weight and concussion falls too heavily on the front feet.

“Those horses pound their front ends tremendously in the gaits that we demand of them.  When you go to a horse show, you see the makeup pens, and there’s been hundreds of horses pounding on those pens all day long.  The horse show management rarely makes the footing a priority in these pens.  Everyone is out there working their horses, pounding on hard packed clay,” he says.

“One thing I tell my clients is to not ride their horses across the concrete and asphalt.  I remind them how their own feet feel after they’ve been at the horse show for 7 to 10 days, walking on asphalt the whole time.  If they can get off the horse and walk the horse to the pen, it’s easier on the horse.  Those horses are there for 10 to 14 days at these big horse shows, and they’re not used to pounding around–those distances–on that hard ground.”

“When these horses have heel pain, they can’t trot or lope with the “flat” knee action that western pleasure enthusiasts want,” says Noble.  “They’ll look like a mix-master, up front.  A fair number of these horses have some coffin joint inflammation (inside the foot) and after blocking them, we usually end up treating them with some kind of anti-inflammatory compound,” he says.

A lot of western performance horses–and pleasure horses in general–have a slight conformational deformity, with a toe-out stance in front.  This leads to excessive concussion on the inside heel as they trot or lope.  For whatever reason, whether improper trimming, or decreased hoof wall growth due to the concussion on that side of the foot, these horses do not grow enough foot on the inside.  “If you stand both front feet on the blocks, and take a flat view, you will see a lopsided foot,” he says.

In giving advice to veterinarians regarding their treatment of western pleasure horses, Noble warns against overdiagnosing hock disease.  He recommends using plenty of local, regional and into-the-joint nerve blocks for sorting out the hind limb lameness, and tells them to concentrate on the front feet.  He feels this will take care of diagnosing routine problems.  “These horses are not much different from the other western performance horses, but they do have unusual gaits.  If you get to the horse show and watch them, and develop a relationship with the farrier, and the trainer, working with western pleasure horses can be very rewarding.”

His advice to riders and trainers is to have a good “feel” for how the horse is doing.  Even if a problem does not show up as an obvious lameness, a drop in performance level (the horse not doing his best) can be a sign that something isn’t right.  When in doubt, check it out.  Early diagnosis and treatment can keep a small problem from turning into a bigger one–and get the horse back into top form more quickly.

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