Orthopaedics / Poor Performance

We offer a fully comprehensive referral service for the diagnosis and treatment of lameness, poor performance and other problems of the musculoskeletal and associated neurological systems.

Our staff have received specialist training in equine orthopaedics and diagnostic imaging, and have considerable experience, training and understanding in relation to competitive equestrian sports.

Our senior clinicians all hold an American, European or British Diploma, which requires at least five years of specialist training, and have international recognition for their expertise in this area.

Our orthopaedics clinicians

Dr Sue Dyson

Dr Sue Dyson

Head of Clinical Orthopaedics, Equine

Read Dr Sue Dyson's bio
Dr Rachel Murray

Dr Rachel Murray

Senior Orthopaedic Advisor, Equine

Read Dr Rachel Murray's bio
Dr Annamaria Nagy

Dr Annamaria Nagy

Senior Orthopaedic Clinician, Equine

Read Dr Annamaria Nagy's bio

Lameness workup

If there is a potential lameness problem, a detailed musculoskeletal examination will be undertaken, including palpation and mobilisation of the different structures, followed by a complete gait evaluation. A gait evaluation is likely to include examination in a straight line, on the lunge on both soft and hard surfaces, in trot and sometimes in canter. A ridden examination is very important, as many lameness or poor performance problems look different under saddle.

Lameness occurs when a horse is either experiencing pain during locomotion or there is a physical limitation to demonstrating a normal gait. For subtle lameness, the horse may only show a loss of performance or resentment of a particular type of activity. As horses are usually required to be an athlete in some capacity, many of the lameness problems that we see are subtle.

Equine back pain may be primary in nature or secondary to lameness or gait change, especially of the hind limbs. Clinical signs range from poor performance to resistance, rearing and bucking. These horses usually require diagnostic imaging including scintigraphy and computerised radiography if primary in nature. Secondary back pain may be alleviated by treatment and resolution of the primary issue, with concurrent physiotherapy treatment.

Nerve blocks are used to identify the site of pain either around a nerve (perineural analgesia) or into a joint (intra-articular analgesia). This can be useful for identifying where a horse is painful if a lameness is eliminated following a specific nerve block.

Poor Performance

Ridden evaluation is crucial in horses presenting with poor performance. The main objectives for seeing a horse ridden are for subtle lameness, back pain and poor performance evaluation; which may include problems such as resistance, lack of impulsion or loss of rhythm. These problems may be the result of pain, or they could be training related, a physical limitation of the horse, or rider related.

For these types of problems, the horse is often ridden at the initial evaluation, which may be by the owner or an AHT rider. The response to diagnostic tests can be assessed by riding particular movements that show up a problem and assess whether there is a significant improvement. If the horse stays for further evaluation or management, then one of the skilled AHT riders is available for riding.

The horse may exhibit some of the following;

  • Not want to bend to the left, resist to the right?
  • Lose rhythm in lateral work?
  • Change late behind
  • Refuse to go forward?
  • Have an unsteady head?
  • Lose freedom in his shoulder?
  • Find difficulty with piaffe?
  • Get 7s when he used to get 9s?
  • Come above the bit?
  • Lose impulsion?
  • Go unlevel?
  • Refuse?
  • Breathe harder than expected at exercise and recover slowly?

Referring a Patient

We aim to provide a friendly, personable service that supports your clinical evaluation, and to communicate with you as rapidly as possible. If you have any queries about a potential equine referral or wish to discuss a horse that you have referred, do not hesitate to contact us.

The reception for referral booking is open Monday to Friday, from 8.30 a.m. to 5.30 p.m. After you have contacted us about a referral, we are happy to contact the client directly to organise appointment times and details.

If you have any queries, you are welcome to contact the Equine Centre during office hours for an update. After discussion with you, a final report will be sent to you and copied to the owner. In the case of direct referrals for imaging, the diagnostic imaging findings will be discussed with you as soon as possible and a written report with accompanying images will be provided.

We can provide copies of any scintigraphic or MR images in a format suitable for you to use. We welcome feedback on progress of cases.

Direct Referral Service for Imaging only

A direct referral service for imaging only is available, including electronic referrals; please talk to us about your requirements.

Pre Purchase Examinations

Equine pre-purchase evaluations can be carried out on an out patient basis. We need to know as much as possible about the horse, its age and intended use, whether or not the purchaser has any reservations about the horse and if it is to be insured for either all risks of mortality or loss of use prior to the examination. We also need to know whether examinations additional to the standard 5 stage pre-purchase examination are required. For example are radiographs required and if so, of what areas? Is an endoscopic evaluation of the upper airways required? Is it necessary to perform an ultrasonographic examination of the tendons or ligaments? Should a blood sample be collected for either storage or immediate testing for the presence of drugs, either for commonly used anti-inflammatory drugs or a whole screen?

It is helpful if both the vendor and purchaser can be present for the evaluation. We ideally require the vendor to sign a declaration relating to the horse’s previous medical history, work status and management history. The vendor or their agent also has to give permission for collection of blood or sedation. If any unexpected findings materialise these can be discussed with the purchaser if they are present and, if appropriate, the vendor. Failing this, we need a contact telephone number for the purchaser so that we can speak with them if examination is necessary.

The horse will be required to be ridden for the examination. We can provide a skilled rider if necessary. If the horse undergoes radiography it will need to be sedated. If radiographs of the front feet are required the shoes will be removed. If we know in advance, it may be possible to arrange for the horse to be reshod.

We can also provide interpretation of radiographs or other images obtained elsewhere as part of an equine pre-purchase examination. The standard x-ray protocol varies between countries and we can provide a list of the views that we consider necessary. You are advised to contact us in advance.