What are Bursitis?
True bursitis, also called natural bursitis, is found in the conventional areas within the legs or withers, mostly centered on the joints. True bursitis is generally easy to diagnose and treat.
Acquired bursitis will develop subcutaneously in direct response to friction or pressure. A tear within the subcutaneous tissue allows fluid to build up and become trapped in the fibrous tissue surrounding it.
Bursitis is extremely common in horses. It is inflammation within the bursa and can be classified as either true or acquired. The bursa is a sac that is filled with fluid found between tissues of muscles, skin, tendons and bone. The fluid provides lubrication reducing rubbing, friction or irritation within the leg.
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Symptoms of Bursitis in Horses
Bursitis, no matter its form, can be severe if not treated immediately. If you notice any change in your horse’s behavior or see any physical changes, contact your veterinarian right away for an assessment.
- Localized heat
- Limited movement within the leg or shoulder
- Not eating or drinking
- Refusal to walk
- Behavior changes
There are several different types of bursitis. Once your veterinarian has diagnosed your horse with bursitis, they will then be able to pinpoint which type and choose the best treatment plan for that particular type. Any of these types of bursitis can become septic, or have an infection begin if a bacterium has been introduced into the body.
This is classified as acquired bursitis and is caused by direct trauma to the knee. It usually occurs from lying on hard ground, hitting the knee against a hard surface, excessive and hard pawing or a fall. There will be severe swelling on the front of the knee, restricting the flexion of the knee.
Also known as capped elbow, it is very similar to carpal hygroma. It is classified as acquired bursitis and is caused by trauma, usually from a shoe hitting the elbow when running or when lying down.
Also known as capped hock, it is classified as acquired bursitis. There is fluid buildup with the tissues causing possible lameness. Kicking a wall or gate is usually the cause of capped hock.
It is classified as true bursitis. This is mainly associated with an underlying condition called tarsitis. Tarsitis is inflammation within the lower hock joints, called the tarsal. Lameness generally occurs.
Classified as true bursitis, it can be considered a part of navicular disease. Lameness generally does occur and can have severe consequences if not treated immediately. The frog and navicular bursa are affected when a foreign object punctures the area and can cause infection.
Classified as true bursitis, it is generally caused by an injury to the shoulder. Lameness is usually associated with bicipital bursitis. It may be from an injury to the bicipital tendon or from bone fragments that have broken from the shoulder.
This is not common and is an infection of the bursa that overlays the withers. It causes swelling, drainage tracts and severe discomfort. Brucellosis can occur from fistulous withers.
Causes of Bursitis in Horses
True bursitis usually develops from direct trauma or the stress of performance training. Acquired bursitis will develop from inflammation within a bursa or from excessive build up of fluid within the subcutaneous bursa. An injury such as a puncture wound can cause a form of acquired bursitis along with a severe infection.
Diagnosis of Bursitis in Horses
Your veterinarian will do a thorough physical examination of your horse. During the physical examination, provide as much background information as possible including exercise routines and when you first noticed any oddities or symptoms.
After an initial examination, further testing may be required. A radiograph will confirm swelling and located any fluid buildup within the soft tissues. An ultrasound may also be used to see the extent of the fluid buildup and how much of the leg or shoulder is affected.
Once the presence of fluid has been determined, your veterinarian may take a biopsy or sample of the fluid. By examining the fluid, your veterinarian will be able to properly treat your horse if there is an infection present. Septic bursitis requires aggressive treatments.
Treatment of Bursitis in Horses
Your veterinarian will create an appropriate treatment plan for your horse depending on the affected bursa and the severity of the condition. Always follow treatment plans exactly as given and any changes within your horse’s condition should be immediately reported to your veterinarian.
Rest will most likely be advised. Stall rest is always best with a thick layer of dry bedding for a cushion should your horse prefer to lie down. Pressure bandages or splints to help immobilize the affected leg may be used. Cold applications to the affected area will help reduce swelling. Cold applications work best in the early stages of acute bursitis.
Corticosteroid and anti-inflammatory medications may be used to help reduce swelling and eliminate pain. In cases of septic bursitis, aggressive antibiotics are needed to treat the infection. Surgical drains may need to be implanted if the fluid buildup is excessive. In some cases, removal of the bursa or closing the puncture is needed.
Recovery of Bursitis in Horses
In cases of true bursitis, the prognosis is good. For acquired bursitis, the prognosis is more guarded. Horses that are diagnosed with any form of septic bursitis may not recover even if treatment is begun immediately.
Always follow your veterinarian’s set treatment plan for your horse. If you notice any changes or you are concerned that your horse is not responding to treatments, contact your veterinarian for additional assessments. Be sure to schedule all recommended follow-up visits so your veterinarian can closely monitor your horse’s progress.
Bursitis Questions and Advice from Veterinary Professionals
My otherwise sound 27 yr. old horse jammed his shoulder about five years ago in a 20x20 paddock, and was very lame at the walk. Vet ultrasound diagnosed bursitis and we rehabed him nicely after about three months; however, after all this time, it seems to return once in a while and has never completely gone away. The COLD of the winters helps it (like an ice pack!) but after mild arena work, I can detect it slightly at the trot when he's carrying my weight. Otherwise it's not noticeable in the round pen. I am giving him Cosequin as a preventive, and Bute-Less for pain management. Is there anything else you can recommend that might help? Because it's his shoulder, it's hard to wrap an ice pack in that area which I believe would help! Thoughts?
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I have a horse that was treated for navicular bursitis & inflammation of the deep flexor tendon, over a year ago. He has been injected a few times & only showed no lameness for about a month. We’ve even tried 2 different types of corrective showing. First one seemed to work relieved lameness but made him heal sore.
Before this vet he was treated with antibiotics & anti-inflammatory & he showed improvement from a grade 4 to a 2 in lameness. We have not been able to keep him fully sound for very long at all. So we’ve turned him out.
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I recently bought a 3yo thoroughbred who came out of a paddock. He moved in a week and a half ago and his new pipe corral was extremely hard and rocky. We had sand put in a few days ago. He has squired a bit of a puffy knee on the right. Nothing extreme. I noticed that he had rubbed on the knees from lying out in paddock but with his winter coat I’m unsure if that knee has always been a bit swollen. He’s completely sound on it and shows no signs of soreness, lameness or sensitivity. It may have gone down a little since the sand was added but not a ton. Trying to decide my best route.
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My horse is 20 he has large hard lump on inside of his knee that was once believed to be a bursa but has became hardened , he isn't slightly lame in trot. Just curious as to what the best thing to do for him is he is not able to stay in his stable due to becoming stressed
It sounds like a carpal hygroma which can feel quite solid and firm. They are usually nothing to worry about and don’t cause any pain or other issues, just keep an eye on it. I have added a link below. Regards Dr Callum Turner DVM
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