Mission:

 To provide excellent Equine Veterinary care and service through the support of the Doctors, the Staff, and the Customers.

We also strive to bring new services for the benefit and
advancement of Equine health,
and continually work to provide a local resource for education of the public and equine professionals in matters of the health and welfare of horses.

                                                               JANUARY
                   CASE OF THE MONTH

  
                                                             RINGBONE


                                                                 What is ringbone?

Ringbone refers to new bone growth on the last three bones in a horse’s leg.
“High” ringbone involves the pastern joint and “low” ringbone involves the coffin joint.


                                          

Ringbone got its name because extra bone (osteophytes) formation appears as a ring around the two joints.


What causes ringbone?

Conformation problems: If pastern and foot are aligned correctly one should be able to draw a line directly through the middle of the pastern and through the middle of the toe. (Fig. 2)

Improper trimming: If the heels are too short and toes too long or one heel longer than the other there will be extra forces on various areas between the joints. Anytime a horse is trimmed in a way that goes against its natural anatomy problems like ringbone or navicular disease could result.

Working horses on hard surfaces (concussion between joints): Horses with upright pasterns are more at risk because the joints take a direct, up and down pounding when the hoof meets the ground. Ringbone most often affects the front hooves since they support approximately 60 % of the horses weight and absorb the majority of the pounding forces.

Trauma: Any trauma such as sprains, kicks, lacerations, or infections in the pastern area can also create enough inflammation to get the formation of ringbone started.

How is a diagnosis made?

Early cases may or may not show any signs of lameness. Minimal swelling may be evident first. A thorough lameness exam (with possible nerve blocks) is necessary to localize the problem. Then radiographs ( X-rays) will be used to show the extent of the problem.

Is there treatment for this disease?

Treatment centers around reducing the stresses on the joints and preventing any further inflammation from occurring.

Proper trimming and shoeing
Rest
Anti-inflammatory drugs
Cold water hosing
Joint injections of hyaluronic acid (Adequan)
IV injections of hyaluronate sodium (Legend)
Injections in the muscle of hyaluronic acid (Adequan)
Oral nutraceuticals ( Cosequin)_
Topical anti-inflammatory creams (Surpass)

What is the prognosis?

Ringbone around the pastern joint has a slightly better prognosis since there is less motion around the joint compared to the coffin joint. However, ringbone can not be reversed so the best chance for full soundness is early diagnosis and treatment.

January Case Study

Signalment: Ten year old Appalosa gelding.

History: Horse was used for pleasure riding and kept out on pasture with three other horses. The horse was trimmed 3-4 times per year as needed. There was no history of trauma or precipitating lameness event. The horse had been lame at a trot for about one month. The lameness on the right front was gradually getting worse. After being shod improperly the horse started to rock back on its heel when walking.

Physical exam: The horse was bright and alert with its temperature, pulse and respiration within normal limits. The horse did not appear lame at a walk but would rock back on its heel consistently. The lameness was apparent at a trot in a straight line. Flexion tests on the pastern joint magnified the lameness problem.

Diagnosis: Radiographs were taken to confirm the diagnosis of high ringbone. (See Pictures)

 

 

Treatment: A farrier was brought in to correctly trim and shoe the horse. An IV loading dose of phenylbutazone was administered. Injections of hyaluronic acid along with an oral nutraceutical were also recommended.

Follow-up: The horse was started on a reducing dose of phenylbutazone over a coarse of two weeks. Stall rest was also recommended to prevent further inflammation while on the phenylbutazone. Return to exercise was to be introduced slowly. Amount of exercise was dependent on the horses comfort level.

Prognosis: This case carries a guarded prognosis due to the fact that this is an ongoing condition. However, the horse has been sound after the treatment described above was performed. Radiographs at some later date would be recommended to track the progression of ringbone.