Influence of the force applied and its period of application on the outcome of the flexion test of the distal forelimb of the horse.

The influence of the force applied and its period of application on the outcome of the flexion test of the distal forelimb was investigated in a group of eight sound horses. The degree of lameness after the flexion test was scored by a standard clinical classification, and by measuring the angle of maximum fetlock extension by means of the infrared light-based MacReflex gait analysis system. There was a good correlation between the clinical score and this electronically recorded kinematic parameter (r = 0.96). Both the force applied and the period of application affected the outcome of the test. Increasing the force applied by 25 per cent led to three horses being judged positive, instead of two when the normal force was applied. Doubling the time to 120 seconds resulted in four horses rather than two being classified as lame after the test. Reducing the force to 75 per cent or the time to 30 seconds resulted in all the horses being classified as sound. A flexion test lasting five minutes, either at 100 per cent force or at 75 per cent, classified six of the eight horses as lame. It is concluded that the flexion test should be defined more precisely in terms of these two factors in order to make its results more consistent and hence more useful.

Variations in the force applied to flexion tests of the distal limb of horses.

A pressure-sensitive device was developed to measure the force applied to flexion tests of the distal limb of horses. The mean force applied by a group of experienced clinicians was 150 N which results in a moment on the flexed fetlock joint of about 28.5 Nm. The coefficient of variation of the force applied by one experienced clinician was only about 12 per cent, but the coefficient of variation between clinicians was considerably higher (20 per cent), irrespective of whether the clinicians were considered to be experienced or not. The mean force applied by a group of women examiners (114 N) was significantly lower than that applied by the group of male examiners. It is concluded that the flexion test used in the clinical examination of the locomotor system of the horse should be better standardised.

[Inguinal and scrotal hernias in steers]. / Hernia inguinalis et scrotalis bij de stier.

A review of the bovine inguinal and scrotal hernia is given on the basis of two cases. One six year old Blonde d'Aquitaine bull had to be euthanised with severe muscle damage 13 days after surgical intervention, while the other patient, a five year old Meusse Rhine and Yssel bull recovered uneventfully after surgery. The literature is reviewed and the incidence, pathogenesis, clinical evaluation and surgical techniques are described.

The effect of the high palmar nerve block and the ulnar nerve block on lameness provoked by a collagenase-induced tendonitis of the lateral branch of the suspensory ligament.

Controversy exists with respect to the innervation of the suspensory ligament (SL) in the fore limb of the horse. It is uncertain whether this structure is exclusively innervated by branches of the ulnar nerve or also to some extent by median nerve branches. Ground Reaction Forces (GRF) were determined in horses before and after the induction of a tendonitis in the lateral branch of the SL by the injection of collagenase, and before and after a high palmar and an ulnar block respectively. The high palmar block succeeded in bringing all GRF variables back to their original values which the ulnar block did not. It is concluded that the SL is innervated by branches of both the ulnar and the median nerves, with the median nerve being relatively more important for the distal part of the SL.

The effect of diagnostic regional nerve blocks in the fore limb on the locomotion of clinically sound horses.

The practice of applying diagnostic nerve blocks relies on the assumption that the blocks in themselves do not alter the horse's gait. This assumption has recently been challenged. In the present paper a series of sequential nerve blocks (low palmar digital block, abaxial sesamoid block, high palmar block) was applied to clinically sound horses. Before and after each block the gait was clinically scored and Ground Reaction Forces (GRF) were measured. Clinical scoring did not change after any of the nerve blocks. None of the GRF variables changed significantly except for a slight alteration of the time at which the longitudinal GRF changed from a decelerative to a propulsive force. It is concluded that the basic assumption that diagnostic nerve blocks do not essentially alter the gait of a sound horse is correct.

Clinical and force plate evaluation of the effect of a high plantar nerve block in lameness caused by induced mid-metatarsal tendinitis.

To answer the question whether it is possible to differentiate, by means of a high plantar nerve block in the hind limb, flexor tendon lameness from a suspensory ligament lameness, mid-plantar tendinitis or desmitis was induced with collagenase in five Standardbred horses in two trials. Before the induction of lameness, and on the fourth (D4) and fourteenth day (D14) after the induction of lameness the horses were evaluated subjectively (clinical lameness score), objectively (ground reaction force (GRF) measurements), and ultrasonographically. Clinical evaluation and GRF measurements were also done on D4 and D14 after a high plantar nerve block. From the GRF measurements variables were selected and analysed and related to the clinical lameness score. The horses were significantly lame on D4; this lameness had decreased on D14. The clinical findings were supported by the GRF data. In the flexor tendon group, a high plantar nerve block resulted in soundness or lameness in the other hind limb, whereas in the suspensory ligament group the effect was less conclusive. The correlation between the subjective clinical lameness score and several objectively measured GRF variables proved to be moderate to high. The collagenase model proved to be useful to study the effect of a high plantar nerve block on lameness resulting from induced tendon/ligament lesion. However, a high plantar nerve block cannot be used to differentiate between flexor tendon and suspensory ligament lesions.

The correlation between the dose and distribution of intratendinous fluid injections in the flexor tendons/ligaments of the horse.

An in vitro study was carried out to define the correlation between the dose and distribution of intratendinous fluid injections in the different flexor tendons/ligaments of the palmar/plantar, metacarpal/metatarsal region of the horse. Injection of 0.1-0.2 ml resulted in a local intratendinous fluid depot showing minimal abaxial spreading and more extensive proximodistal expansion. If 0.3-0.5 ml was injected the abaxial spreading remained minimal but the proximodistal expansion increased significantly, the depots in the axial proximal, mid and distal region flowing together. Also minimal peritendinous fluid accumulation was visible. Increasing the dose from 0.5 to 2 ml resulted in extensive abaxial spreading and peritendinous accumulation. These findings indicate that the 2 ml injection recommended in the veterinary literature probably represents an oversized dose. If a small lesion is present a 0.1-0.2 ml intratendinous injection should be adequate. The injection should preferably be guided by ultrasonography to allow precise deposition of the drug into the lesion. In larger local defects a depot of 0.3-0.5 ml apparently is sufficient. If a very large portion of the tendon is injured, several depots of 0.3-0.5 ml approximately 5 cm apart is preferred to cover the full proximodistal extension of the lesion.

The effect of regional nerve blocks on the lameness caused by collagenase induced tendonitis in the midmetacarpal region of the horse: a study using gait analysis, and ultrasonography to determine tendon healing.

The influence of regional nerve blocks on lameness resulting from tendon injury was studied in six horses. Tendonitis was induced in the midmetacarpal region of the Superficial Digital Flexor Tendon (SDF), Deep Digital Flexor Tendon (DDF) and the Suspensory Ligament (SL) through collagenase injections. The results were evaluated through sequential clinical examinations, ultrasonographic imaging and kinetic gait analysis (force plate) during a period of 144 days post injury and subsequently compared with gross and microscopic findings. The lameness corresponding to the SDF and DDF tendon lesions was completely abolished by a high palmar nerve block. The SL desmitis was partly abolished by high palmar nerve block and completely blocked with an additional ulnar nerve block. The ultrasonic evaluations showed the lesions, expanding until approximately 30 days post injection (p.i.) and subsequently decreasing. The texture of the lesion also improved markedly after 30 days p.i. The post-mortem macro- and microscopic evaluation revealed still considerable abnormalities at 145 days p.i. At that time the tendon lesions were no longer detectable ultrasonographically.

Ultrasonographic evaluation of fetlock annular ligament constriction in the horse.

The diagnosis of restriction of free movement of the flexor tendons through the fetlock canal usually rests on the characteristic clinical appearance of this condition, or airtendography. In a series of seven normal Warmblood horses and 16 diseased horses of various breeds, the efficacy of ultrasonography in the diagnosis of this condition was determined. In normal limbs, the annular ligament is a very thin structure usually not visible on sonograms. In diseased limbs, ultrasonography outlined flexor tendon injury, distension and thickening of the digital sheath, peritendovaginal tissue proliferation and thickening of the annular ligament. Four different types of constriction syndrome were noticed. The first type (nine cases), was characterised by thickening of the annular ligament and distension of the digital sheath; the second type (three cases) was dominated by distension of the digital sheath; the third type (three cases) was characterised by superficial digital flexor tendon injury and thickening of the annular ligament and in the fourth type (one case), the constriction resulted from distension of the digital sheath and extensive peritendovaginal tissue proliferation.

[Modification of wound healing with ultraviolet rays. Review of the literature]. / Beïnvloeding van wondgenezing met behulp van ultraviolette stralen. Een literatuuroverzicht.

This article describes the physical aspects and biological effects of UV radiation. The clinical effects of UV waves on wound healing are discussed separately. Indications for treatment using UV waves are presented, as well as suggestions as to the best way in which treatment can be effected, and the risks which must be considered.