LAMENESS OF THE HORSE VETERINARY PRACTITIONERS' SERIES, NO. 1 TEXT

narrow" or that have crooked legs are quite apt to interfere. Shoes that are put on a foot that is not level or applied in a twisted position, or shoes wide at the heel will often cause interfering and injury. Animals that are driven at fast work until they become nearly exhausted may be expected to interfere. Such cases are frequently observed in young horses that are driven over rough roads, particularly when so nearly exhausted or weakened from disease or inanition that the feet are dragged forward rather than picked up and advanced in the normal manner. Symptomatology.--Wounds inflicted by striking the extremities in this manner present various appearances and occasion dissimilar manifestations. The hind legs are almost as frequently affected as the front and the fetlock region is most often injured, though wounds may be inflicted to the coronet. In front, the carpus is sometimes the site of injury. When only an abrasion is caused, little if any lameness occurs, but where interfering is continued and nerves are involved or subfascial infection and extensive inflammation succeed such abrasions, marked lameness and evidence of great pain are manifested. Frequently, in chronic cases affecting the hind leg, the fetlock assumes large proportions, and at times during the course of every drive the subject strikes the inflamed part, immediately flexing and abducting the injured member, and the victim hops on the other leg until pain has somewhat subsided. Interfering is much more serious in animals that are used at fast work than in draft horses. In light-harness or saddle horses, it may render the subject practically valueless or unserviceable if the condition cannot be corrected. Treatment.--Wherever possible, cause is to be removed and if animals are properly used, ordinary interfering wounds will yield to treatment. If the shoeing is faulty, this should be corrected, the foot properly prepared and leveled before being shod and suitable shoes applied. In young animals that become "leg-weary" from constant overwork, rest and recuperation are necessary to enhance recovery. In such cases it will be found that very light shoes, frequently reset, will tend to prevent injury to the fetlock region such as characterizes these injuries of hind legs. Palliative measures of various kinds are employed where cause is not to be removed and a degree of success attends such effort. In draft horses or animals that are used at a slow pace, shields of various kinds are strapped to the extremity and protection is thus afforded. Or, large encircling pads of leather, variously constructed, serve to cause the subject to walk with the extremities apart. Interfering shoes of different types are of material benefit in many instances. Often the principle upon which corrective shoeing is based is that the mesial (inner) side of the foot is too low; the foot is consequently leveled and the inner branch of the shoe is made thicker than the outer, altering the position of the foot in this way. This is productive of desirable results. However, much depends upon the manner in which the foot in motion strikes the weight-bearing member as to the corrective measures that are indicated. This belongs to the domain of pathological shoeing and the reader is referred to works on this subject for further study of this phase of lameness. Lymphangitis. Excluding glanders, in the majority of instances, lymphangitis in the horse, such as frequently affects the hind legs, is due to the local introduction of infectious material into the tissues as a result of wounds. However, one may observe in some instances an acute lymphangitis which affects the pelvic limbs of horses and no evidence of infection exists. Consequently, lymphangitis may be considered as _infectious_ and _non-infectious_. INFECTIOUS LYMPHANGITIS. Etiology and Occurrence.--Traumatisms of the legs frequently result in infection and when such injuries are near lymph glands, even though the degree of infection be slight, more or less disturbance of function of the muscles in the vicinity of such glands occurs and lameness follows. The prescapular, axillary and cubital lymph glands when in a state of inflammation, cause lameness of the front leg, and the superficial inguinal and deep inguinal lymph glands not infrequently become involved also. Because of the location of these lymph glands, they are subject to comparatively frequent injury and inflammation, causing lameness more often than other lymph-gland-affections. Small puncture wounds in the region of the elbow are often met with. These may be inflicted when horses lie down upon sharp stumps of vegetation or shoe-calk injuries may be the means of introducing contagium, and an infectious inflammation results. Abscess formation, the result of strangles or other infection in the prescapular glands, may be observed at times. Following castration, the inguinal lymph glands may become involved in an infectious inflammation and locomotion is impeded to a marked degree. Horses running at pasture sometimes become injured by trampling upon pieces of wood, causing one end of these or of various implements to become embedded in the soft earth and the other end to enter at the inguinal region and even penetrate the tissues to and through the skin and fascia just below the perineal region. Nail punctures resulting in infection frequently cause an infectious lymphangitis and a marked and painful swelling of the legs supervenes. [Illustration: Fig. 61--Chronic lymphangitis. Showing hypertrophy of the left hind leg, due to repeated inflammation.] Symptomatology.--Lameness, mixed or swinging-leg, signalizes the presence of acute lymphangitis. There is always more or less swelling present and manipulation of the affected parts gives pain to the subject. Depending upon the character of the infection and its extent, there is presented a varying degree of constitutional disturbance. There may be a rise in temperature of from two to five degrees, and in such instances there is an accelerated pulse. Where much intoxication is present, anorexia and dipsosis are to be noticed. Swelling may increase gradually and in time discharge of pus may take place spontaneously without drainage being provided for, if the character of the infection does not cause early death. In these cases lameness is pronounced and the cause of the disturbance is to be sought, particularly if the condition be due to a nail puncture. [Illustration: Fig. 62--Elephantiasis.] Treatment.--Location of the site of injury is advisable in all cases and in some instances provision for drainage, as in puncture wounds, is helpful. Locally, curettage and the application of suitable antiseptics are indicated. Hot fomentations are beneficial and should be continued for several days if necessary, to stimulate resolution. A brisk purge should be admintered at the onset and strychnin, because of its indirect stimulative effect upon the circulation together with its tonic effect upon the musculature, is beneficial. In all such cases rational treatment, good hygiene and careful nursing are the principal factors which stimulate recovery. Individual resistance or lowered vitality has a marked influence on the course of this affection. NON-INFECTIOUS LYMPHANGITIS. This type of lymphangitis is associated with, or the result of, a derangement of digestion. It affects heavy draft horses, rarely other types of animals, and involves one or both hind legs. Occurrence.--In healthy and well nourished horses irregularly used, this affection may suddenly manifest itself. It occurs in singular instances in mares that are in advanced pregnancy even when such animals are at pasture. Usually, however, this malady is found in heavy draft horses that have been kept stabled from one to three days. Symptomatology.--At the outset in severe cases, there is elevation of temperature, labored breathing, accelerated pulse, anorexia and more or less swelling of the affected members. Swelling is very painful and when the affected legs are palpated, pain is manifested by flinching. The inguinal lymph glands are often swollen but in some cases they are not affected in any perceptible degree. In the average case suppuration does not occur and when conditions are favorable, resolution is complete within ten days. The extent of the involvement and the intensity of the affection vary materially in different cases and a chronic lymphangitis may succeed the acute attacks and finally in some instances, elephantiasis results. Treatment.--An active purgative should be given at once and in the ordinary case, stimulants are indicated. If marked distress is present, morphin is given and where there is much rise of temperature, cold drinking water is offered in abundance and catharsis is enhanced by enemata. Locally, hot applications are of benefit. Hot towels or cotton held in position by bandages and kept soaked with warm water will relieve pain and stimulate resolution. Diuretics may be of benefit and anodyne applications are to be employed with profit in some cases. Walking exercise, if not indulged in to excess, is helpful as soon as acute inflammation has subsided. By giving careful attention to the regimen and providing regular exercise for susceptible subjects, this type of lymphangitis is often forestalled. FOOTNOTES: [Footnote 34: Manual of Veterinary Physiology. Page 610.] [Footnote 35: Manual of Veterinary Physiology, page 601.] [Footnote 36: Case report at meeting of the Iowa State Veterinary Medical Association, Jan., 1904, by Dr. S.H. Bauman, Birmingham, Ia.] [Footnote 37: Regional Veterinary Surgery and Operative Technique, by John A.W. Dollar, M.R.C.V.S., F.R.S.E., M.R.I., page 733.] [Footnote 38: As quoted by A. Liautard, M.D., V.M., American Veterinary Review, Vol. 37, page 667.] [Footnote 39: Quoted by Prof. Liautard, American Veterinary Review, Vol. 33, page 190.] [Footnote 40: Traite de Thérapeutique Chirurgical des Animaux Domestique par P.J. Cadiot et J. Almy, Tome second, page 460.] [Footnote 41: Traite de Thérapeutique Chirurgical, Tome second, page 465.] [Footnote 42: Luxation of the Femur, by Wm. V. Lusk, Veterinary Surgeon, U.S. Cavalry, American Veterinary Review, Vol. 21, page 254.] [Footnote 43: Because of the intimacy of the psoas major (p. magnus) and the iliacus they are sometimes called iliopsoas.] [Footnote 44: Dr. John Scott, Peoria, Ill., in The American Veterinary Review, Vol. 16, page 16.] [Footnote 45: Annotation on Surgical Items, by Drs. L.A. and Edward Merillat, American Veterinary Review, Vol. 31, page 358.] [Footnote 46: W.L. Williams in American Veterinary Review, Vol. 21, page 452.] [Footnote 47: Geo. H. Berns, D.V.S., report, American Veterinary Medical Association, 1912, page 238.] [Footnote 48: Joseph Hughes, M.R.C.V.S., in the Chicago Veterinary College Quarterly Bulletin, Vol. 10, page 15.] [Footnote 49: Traite de Therap. Chir. Cadiot et Almy, Tome second, page 480.] [Footnote 50: E. Wallis Hoare, F.R.C.V.S., American Veterinary Review, Vol. 27, page 1189.] [Footnote 51: Discussions on paper entitled "The Spavin Group of Lamenesses," by W.L. Williams, Carl W. Fisher and D.H. Udall, Proceedings of American Veterinary Medical Association, 1905.] [Footnote 52: "Hock-Joint Lameness," by Dr. James McDonough, Proceedings of the A.V.M.A., 1913, page 545.] INDEX A Acetabulum, 185 Acute arthritis, 65 Acute laminitis, 162 Acute tendinitis, 135 Affections of blood vessels, 31 Affections of bursae and thecae, 27 Affections of the feet, 34 Affections of ligaments, 20 Affections of lymph vessels and glands, 32 Affections of muscles and tendons, 28 Affections of nerves, 30 Anamnesis, 38 Anatomo-physiological review of parts of fore leg, 55 Anatomo-physiological consideration of the pelvic limbs, 185 Anatomy of the joint capsule, 220 Annular ligament, 58 Antea-spinatus muscle, 65 Anterior brachial region, wounds of, 90 Anterior digital extensor muscle, 193 Arteritis, 209 Artery (brachial), thrombosis of the, 81 Arthritis, 22, 84 Arthritis, acute, 65 Arthritis, chronic, 65 Arthritis, infectious, 66 Arthritis, metastatic, 25 Arthritis of the fetlock joint, 152 Arthritis, rheumatic, 26 Arthritis, scapulohumeral, 65 Arthritis, tarsal, 225 Arthritis, traumatic, 22 Articular ringbone, 121 Articulation, femeropelvic, 185 Articulation, metacarpophalangeal, 58 Articulation, scapulohumeral, 55 Aspiration-and-injection treatment of bog spavin, 244 Aspiration-and-injection treatment of capped hock, 252 Aspiration-and-injection treatment of thoroughpin, 250 Astragalus, 190 Astragalus, fracture of the, 230 Attitude of the subject, 41 Atrophy of the quadriceps muscles, 205 Atrophy, shoulder, 73 B Biceps brachii, 58, 65, 68, 69 Bicipital bursa, inflammation of, 68 Blood vessels, affections of, 31 Bog spavin, 242 Bog spavin, aspiration-and-injection treatment of, 244 Bog spavin, line firing for, 246 Bog spavin, vesication for, 246 Bone spavin, 235 Bones, degenerative changes in, 16 Bones, tarsal, 190 Bossi's double tarsal neurectomy, 242 Brachial artery, thrombosis of the, 81 Brachial paralysis, 77 Bursa intertubercularis, 62, 69 Bursa podotrochlearis, inflammation of the, 157 Bursae, affections of, 27 Bursitis, 27, 104 Bursitis, infectious, 28 Bursitis in the fetlock region, 150 Bursitis intertubercularis, 68 Bursitis, noninfectious, 28 C Calcaneo-cuboid ligaments, 190 Calcaneo-metatarsal ligaments, 190 Calcaneum, fracture of the, 230 Calk wounds, 170 Capped hock, 251 Capped hock, aspiration-and-injection treatment of, 252 Capsular ligament, 190 Caput muscles, 71 Carpal bones, fracture of the, 96 Carpal bones, luxation of the, 96 Carpal flexors, contraction of the, 93 Carpal flexors, inflammation of the, 93 Carpal joint, 58 Carpal joint, open, 100 Carpitis, 98 Carpus, inflammation of the, 98 Cartilage, lateral, inflammation of, 174 Cartilages of the third phalanx, ossification of the, 155 Chronic arthritis, 65 Chronic gonitis, 217 Chronic laminitis, 164 Chronic tendinitis, 137 Cochran shoe for dropped soles, 169 Collateral ligaments, 190 Comminuted fractures, 17 Compound fractures, 17 Contracted tendons of foals, 143 Contraction of the carpal flexors, 93 Contraction of the flexor tendons, 137 Contusions of the triceps brachii, 71 Contusive wounds, 85 Coracoradialis, 58 Corns, 172 Coronary region, wounds of the, 170 Corpora oryzoidea, 218 Cotyloid ligament, 185 Courbe, 233 Crepitation, false, 48 Crepitation, true, 47 Crucial ligaments, 188 Crural nerve, paralysis of the, 204 Cunean bursa, 237 Cunean tenotomy, 242 Cuneiform magnum, 191 Cuneiform medium, 191 Curb, 233 D Deep digital flexor, distension of the tarsal sheath of, 246 Deep flexor tendon (perforans), 60 Degenerative changes in bones, 16 Diagnosis by exclusion, 53 Diagnosis by use of the X-ray, 179 Diagnostic principles, 37 Disease, navicular, 157 Dislocations, 21 Distension of the tarsal joint capsule, 242 Distension of the tarsal sheath of the deep digital flexor, 246 Division of long digital extensor, 253 Dorsal ligaments, 190 Dropped elbow, 71, 80 Dropped soles, shoe for, 169 Dropped stifle, 205 Dry spavin, 225 E Elbow, dropped, 71, 80 Elbow, inflammation of the, 84 Elbow joint, 58 Elephantiasis, 34 Etiology, general discussion of, 15 Examination by palpation, 43 Examination, special methods of, 53 Examination, visual, 39 Exclusion, diagnosis by, 53 Exostosis of splint bones, 107 Exostosis, phalangeal, 118 Extensor (long digital) rupture and division of, 253 Extensor of the digit, rupture of, 145 Extensor pedis, 60 Extensor pedis, rupture of, 145 Extensor pedis, rupture and division of, 253 F False crepitation, 48 Feet, affection of the, 34 Femoral nerve, paralysis of the, 204 Femeropatella ligaments, 188 Femeropelvic articulation, 185 Femur, 185, 192 Femur, fracture of the, 199 Femur, luxation of the, 201 Fetlock joint, 58 Fetlock joint, arthritis of the, 152 Fetlock joint, luxation of the, 125 Fetlock joint, open, 110 Fetlock region, thecitis and bursitis in, 148 Fetlock, shoe for bracing the, 181 Fibular tarsal bone, fracture of the, 230 Firing, treatment of ringbone by, 123 First phalanx, 59 "Fish knees", 145 Fixed luxations, 21 Fixed patellar disarticulation, 213 Flexor brachii, 58, 68, 69 Flexor carpiradialis, 93 Flexor carpiulnaris, 93 Flexor metacarpi externus, 94 Flexor metacarpi internus, 93 Flexor metacarpi medius, 93 Flexor metatarsi, 193 Flexor, superficial digital, 194 Flexor tendons, contraction of the, 137 Flexor tendons, inflammation of the, 135 Flexor tendons, rupture of, 146 Flexors of phalanges, open sheath of, 124 Foals, contracted tendons of, 143 Forearm, wounds of, 90 Fore leg, lameness in the, 55 Fracture of the carpal bones, 96 Fracture of the femur, 199 Fracture of the fibular tarsal bone, 230 Fracture of first and second phalanges, 131 Fracture of humerus, 82 Fracture of the ilium, 198 Fracture of the ischial tuberosity, 199 Fracture of the metacarpus, 106 Fracture of the patella, 212 Fractures of the pelvic bones, 196 Fracture of the proximal sesamoids, 128 Fracture of the pubis, 197 Fracture of the radius, 87 Fracture of the scapula, 62 Fracture of the tibia, 222 Fracture of the tibial tarsal bone, 230 Fracture of the ulna, 86 Fractures, 16 Fractures, comminuted, 17 Fractures, compound, 17 Fractures, green stick, 18 Fractures, impacted, 19 Fractures, longitudinal, 18 Fractures, multiple, 18 Fractures, multiple longitudinal, 19 Fractures, oblique, 18 Fractures, simple, 17 Fractures, simple transverse, 18 Fractures, transverse, 18 Fragilitas, 199 Fragilitas osseum, 128 G Gait, observing character of, 48 Gastrocnemius, 194 Gluteal tendo-synovitis, 203 Gluteus medius muscle, 192, 203 Gonitis, chronic, 217 Green stick fractures, 18 H Hind leg, lameness in the, 185 Hind leg, paralysis of the, 204 Hip lameness, 195 Hip swinney, 205 Hock, capped, 251 Hock joint, 188 Hoof testers, 53 Humeroradioulnar joint, 58 Humerus, fracture of, 82 I Iliac thrombosis, 209 Iliopsoas, 204 Ilium, fracture of the, 198 Impacted fractures, 19 Infectious arthritis, 66 Infectious bursitis, 28 Infectious inflammation of the lateral cartilage, 173 Infectious lymphangitis, 257 Infectious synovitis, 124 Inflammation of the bicipital bursa, 68 Inflammation of the bursa podotrochlearis, 157 Inflammation of the carpal flexors, 93 Inflammation of the carpus, 98 Inflammation of the elbow, 84 Inflammation of the flexor tendons, 135 Inflammation of posterior ligaments of pastern, 129 Inflammation of proximal sesamoid bones, 127 Inflammation of third sesamoid and deep flexor tendon, 157 Inflammation of the trochanteric bursa, 204 Infraspinatus muscle, 65 Injection of fluids for quittor, 177 Injuries to scapulohumeral joint, 66 Interfering, shoeing for, 256 Interfering, wounds from, 255 Ischial tuberosity, fracture of the, 199 J Joint capsule, anatomy of the, 220 Joint, carpal, 58 Joint, elbow, 58 Joint, fetlock, 58 Joint capsule, tarsal, distension of the, 242 Joint, fetlock, arthritis of the, 152 Joint, fetlock, luxation of, 125 Joint, hock, 188 Joint, humeroradioulnar, 58 Joint, open, 67 Joint, open carpal, 100 Joint, open fetlock, 110 Joint, pastern proximal interphalangeal, 129 Joint, shoulder, 55 Joint, stifle, open, 220 Joint, tarsal, open, 229 L Lameness, hip, 195 Lameness, mixed, 49 Lameness in the fore leg, 55 Lameness in the hind leg, 185 Lameness, shoulder, 61 Lameness, supporting-leg, 49 Lameness, swinging-leg, 49 Laminitis, 160 Laminitis, acute, 162 Laminitis, chronic, 164 Lateral cartilage, infectious inflammation of the, 174 Lateral cartilages, ossification of, 155 Ligaments, affections of, 20 Ligament, capsular, 190