Outcome of medical treatment for horses with foot pain: 56 cases

Reasons for performing study: Currently, there are limited dataregarding the long-term outcome of horses with foot paintreated with corrective shoeing, rest and rehabilitation, andintrasynovial anti-inflammatory medication to target lesionsdetected with MRI.Objective: To report the long-term (≥12 months) outcome ofhorses with foot lesions following medical therapy.Hypotheses: 1) There is no association between clinicalparameters considered and a poor response to therapy. 2)Horses with a deep digital flexor tendinopathy are less likelyto respond to medical therapy than horses without a deepdigital flexor tendinopathy.Methods: The medical records of horses with foot painsubjected to MRI examination and medical therapy (2005-2007) were evaluated retrospectively. Data collected includedhistory, signalment, occupation, duration and severity oflameness at the time of MRI, radiological and MRIabnormalities. Number of treatments, complications andlong-term response to treatment were obtained by detailedtelephone questionnaires. Association between clinical andMRI findings and long-term lameness were investigated.Results: Frequent abnormal structures included the navicularbone, the deep digital flexor tendon, the navicular bursa andthe distal interphalangeal joint. Thirty-four of 56 horses(60.7%) failed to return to previous level of exercise due topersistent or recurrent lameness or owners' decision todecrease the horse's athletic level; however, 11 horses (32.3%)were being used for light riding. Prognosis for horses withconcurrent deep digital flexor tendon, navicular bone andnavicular bursa lesions was worse than horses with individuallesions. Deep digital flexor tendinopathy was stronglyassociated with persistent or recurrent lameness.Conclusions: Horses with multiple foot lesions managed withconservative therapy have a guarded prognosis for long-termsoundness. Deep digital flexor tendinopathies negativelyinfluence prognosis.