health ‘n’ wellbeing Seven equine only vets led by Andrew McDiarmid BVM&S Cert ES (Orth) MRCVS


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Bent Limbs in Foals


by Susan Donaldson BVMS MRCVS


Foals can either be born with bent limbs or these may develop over the first few months of life, often being caused by other developmental problems. In this article, we will look at the significance of these bent limbs, what kinds of deformities occur and how these can be treated.


Why are bent limbs a problem? Any deviation from a straight leg can alter the foal's foot placement and therefore lead to uneven pressure being placed on the joints. Once the foal has stopped growing, any bend in the limb will be permanent and the uneven strain on joints can influence future soundness for athletic performance.


Bent limbs can be divided into angular deformities and flexural deformities.


Flexural deformities are identified by assessing the foal's limbs from the side. The most common of these is 'contracted tendons' where the


tendons which run down the back of the limb are too tight meaning the limb cannot be


straightened. Forelimbs are most commonly affected. If the foal is able to move and feed from the mare, then mild cases often simply require careful


monitoring and no specific treatment. In severe cases, treatment includes intravenous injections of


oxytetracycline; which is an antibiotic but has the useful side effect of relaxing tendons and ligaments; and


bandaging and splinting of the limbs to attempt to straighten the leg, allowing the foal to move around and the tendons stretch. In older foals, tendons


may become contracted after a period of rapid


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Septic Joints


Foal with severe flexural deformity of forelimbs. Photo by Luanne Hunt. to stretch and by use of anti-


inflammatory drugs. If the tendons do not relax, the foal's foot will begin to take on a 'boxy' or 'club foot' appearance. In such cases, surgical intervention may be indicated. Where surgery is performed, normally the accessory ligament of the deep digital flexor tendon (ALDDFT) or 'inferior check ligament'


joint, most commonly the knee (carpus), but the fetlock, hock or even a


combination of joints can be affected. We can also describe the direction the leg is deviated in: deviation to the outside (laterally) is described as valgus, whilst deviation to the inside (medially) is described as varus.


which attaches the deep We can divide ALD into problems which digital flexor tendon to the back of the knee is cut.


The other kind of flexural deformity which is seen in young foals is laxity of the tendons. Hindlimbs and specifically hind fetlocks are most


commonly affected, with foals often being


described as being 'down' on their fetlocks. In general, affected foals require little or no


treatment, unless the deformity is so severe that the heels and


fetlocks make contact with the ground and therefore require


protection by bandaging. Glue-on shoes can also be used.


Carpal Valgus. Photo by Luanne Hunt.


growth and initially these foals can be treated by restricting their exercise, trimming of the heels to help the tendons


Angular limb deformities (ALD) can be defined as a deviation of the leg


from a straight line when the limb is looked at from the front or back. The


Joint infections occur most commonly through a wound, either due to a kick or from being caught in a wire fence. Rarely, infection can be induced via a needle when joints are being medicated. In foals the most common source of joint sepsis is via the blood (haematogenous spread); this occurs more commonly when the foal has not had enough colostrum in the first few hours of life.


the foal is born with and those which occur during growth, usually in the first six months of life. Those noticed at birth or soon after are perinatal deformities and those developing during growth are acquired deformities. It is very common for foals to be born with a mild carpal valgus where both forelegs are slightly deviated to the outside from the knee and a slight toed-out conformation; as these foals grow and their chests widen these problems often self-correct. In premature foals, the small bones in the knee and hock may not have calcified properly and therefore are softer meaning that they can be 'crushed' when the foal is moving, leading to bent legs and in time, if untreated, arthritis in the affected joints. These bones are best assessed by x-rays. If the foal is only mildly affected, bandaging or splinting and box rest can be used while the bones become more calcified.


Acquired ALD is likely to have a number of contributing factors, including injury, overfeeding or nutritional imbalances, and inflammation of the growth plate in the cannon (physitis).


So how can ALD be treated? deviation can be centred over one specific X-rays of a bent leg will allow the


Immediately following a penetrating wound, particles of hair and grit enter the joint along with bacteria. The horse’s immune system mounts an immediate acute response, however this is unfortunately quickly overcome and the bacteria reproduce in the joint. The presence of bacteria and foreign material in the joint activates various mediators, stimulating an influx of white blood cells into the joint. The white cells rapidly start to release destructive enzymes which damage the articular cartilage. If left untreated, osteomyelitis (infection of the adjacent bone) quickly sets in.


Horses tend to present as being incredibly sore on the affected limb, often unwilling to weight bear. The joint will frequently be distended and joint fluid may be seen coming from the wound.


To aid with our diagnosis, if joint fluid is seen coming from the wound, then the diagnosis is simple. If there is no obvious fluid coming from the wound, a needle can be placed into the joint, distant from the wound and sterile saline injected we then monitor the wound to see if the fluid comes out. We can also acquire a sample of the fluid which can be analysed- this is the most accurate way of diagnosing joint infection. Occasionally radiography and ultrasonography can aid in the diagnosis.


Equine Page 8 www.farmnequine.co.uk


by Alison Pender BVMS MRCVS


Infections in the joints and tendon sheaths of horses, ponies and donkeys is an all too common finding for equine vets. When these infections occur, prompt treatment is imperative, because if such infections are not brought under control rapidly, the horse may not be fit to return to his previous athletic function or in the most severe cases, may need to be put to sleep.


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