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What is Lameness Requiring Regional Anesthesia?

Regional anesthesia, or nerve block, is a tool that is generally used to diagnose various types of equine conditions.  Lameness is one of the most common maladies of which horses have suffered for centuries and the use of regional anesthesia or nerve blocks, aids the veterinary professional in pinpointing the cause of the lameness as well as its specific location. This is especially important when a thorough examination has not yielded enough information to establish the cause and location of the lameness.

Regional anesthesia, also known as “nerve block”, is defined as the injection of a local anesthetic directly into a nerve, joint or synovial cavity (joint cavity) in an attempt to desensitize areas associated with the nerve or joint for multiple purposes of diagnosis and pain treatment.

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Symptoms of Lameness Requiring Regional Anesthesia in Horses

The symptoms of lameness requiring regional anesthesia refer specifically to the numbness or lack of sensitivity of the areas below the injection site in the nerve involved.  As noted above, lameness is one of the most common maladies of which our equines will suffer and nerve blocks are a good tool for the diagnosis of the cause and location of the lameness.  Some of the symptoms you might note if your horse displays lameness:

  • Changes in normal gait especially at higher speeds
  • Refusal of horse to exercise or perform normal performance activities
  • Visual observation of the horse’s limbs for swelling, injuries or abrasions

Types 

There are two types of peripheral nerves which your vet may wish to utilize for nerve blocks in his diagnosis and treatment of your horse:

  • Sensory or afferent nerves - Are responsible for sending the brain and spinal cord information like pain, pressure and temperature
  • Motor or efferent nerves - Are responsible for sending the brain, spinal cord and the limbs information that enables the muscles to move the limbs

By using these regional anesthesia sites (nerve blocks), your vet can better determine the location of the cause of lameness in your horse, which will then allow him to provide treatment for the lameness.

Causes of Lameness Requiring Regional Anesthesia in Horses

The source or cause of lameness in your horse can emanate from several sources like skin, muscles, tendons, ligaments, blood vessels, nerves, joint structure and hoof.  The lameness can come from issues associated with any or combinations of these complex structures. Here are some of the causes of lameness in your horse:

  • Trauma like sprains, strains, fractures and other musculo-skeletal injuries
  • Arthritis, bone spavin and other degenerative joint diseases
  • Foot related injuries or diseases or infections
  • Diet related diseases like laminitis and developmental orthopedic diseases
  • Any limb deformities

These conditions can lead to lameness which can range from subtle to debilitating and can be noted when working at normal speeds or may not show up until after the horse has been worked awhile.

Diagnosis of Lameness Requiring Regional Anesthesia in Horses

Blood work may be needed to assess the possibility of infection and the presence of drugs which might mask pain in your horse which can sabotage the intent behind the physical exam.  He may need to obtain synovial fluid samples for evaluation as well.  Sometimes a thorough examination of the limbs of your horse doesn’t provide enough information for your veterinary professional to accurately diagnose and pinpoint the cause and the exact location of the lameness.  When this examination has not yielded sufficient information, your vet may wish to utilize regional anesthesia or nerve blocks to help isolate the area of concern for the lameness.  By utilizing Lidocaine or Mepivacaine in one or more of the most common nerve blocks, for example, Palmar digital nerve block, Abaxial Sesamoid nerve block, low Palmar nerve block, high Palmar nerve block or high Palmar nerve block at the accessory carpal bone, your vet will be able to desensitize painful areas below the nerve block to see if the lameness resolves under anesthesia, enabling him to gain more information about the source of the lameness.  

The information gleaned from these nerve blocks can help the vet focus other diagnostics (x-rays and ultrasounds) toward more specific areas to determine the cause of the lameness.  Arthroscopic examination is usually a later stage choice as it requires general anesthesia to accomplish.  Once the cause and location have been determined, an appropriate treatment plan can be developed and initiated.

Treatment of Lameness Requiring Regional Anesthesia in Horses

If the cause of the lameness is hoof related, the expertise of your farrier may be enlisted since he is very knowledgeable in the anatomy of the lower limbs and specializes in common hoof and foot problems. He can be utilized to achieve and maintain balance in the hooves and assure proper shoeing as well as monitor the hooves for any sign of infection or trauma.  The treatment plan or regimen that will ultimately be developed for your horse will be determined by the source or cause of the lameness as well as the location of it.  His goal will be to develop a plan that will treat the cause effectively and safely so that your horse can return to his normal routine as quickly as possible.  

This treatment may include antibiotics to treat infections which may be found, or it might include the use of non-steroidal anti-inflammatory medications to reduce the inflammation to promote healing. Additionally, it might include icing and resting the equine for a period of time or include changes in diet, exercise and work habits if continued episodes are expected.

Recovery of Lameness Requiring Regional Anesthesia in Horses

The recovery of your horse will depend on several things.  If the sources of the lameness are conditions which are expected to return periodically, your vet may recommend some changes in the horse’s feeding habits, diet, exercise and work routines to reduce the stress on the limb.  Recovery will definitely be dependent upon appropriate resting of the animal while the limb heals.  Adherence to your vet’s treatment plan for your horse’s lameness will assure the best possible recuperative effect for him.  Under most circumstances, you should be able to expect your horse to be able to return to most, if not all, of his previous activities.