Ridden Horse Ethogram: New Sue Dyson study confirms viability of behavioral observation system to identify musculoskeletal pain in horses under saddle

This horse is demonstrating signs of musculoskeletal pain as described by the Ridden Horse Ethogram: 1) Ears are behind the vertical for more than five seconds; 2) Intense stare; 3) Mouth is open, exposing teeth for ten seconds; 4) Hindlimb toe drag.

As flight animals, horses instinctively remain silent in the face of pain, A new study, published earlier this month by Dr Sue Dyson in the peer-reviewed journal Equine Veterinary Education, shows that they however do have a "voice" if observers are trained to "listen".

Saddle Research Trust Conference: Dyson research focuses on pain-associated behavior in ridden horses

"Horse, rider, saddlery interactions: Welfare and performance" was the theme of a landmark conference held this weekend in England.

Dyson: Equine performance assessment tests veterinarians' ability to recognize pain-related behavior

Before the study horses were ridden, Association of Chartered Physiotherapists in Animal Therapy (ACPAT) physiotherapist Jo Spear assessed each one. (Saddle Research Trust photo)

Will veterinarians succeed in using Dr Sue Dyson's new "equine ethogram" system to identify behavioral signs of musculoskeletal pain in horses?

Research: Direct-Injection Gene Therapy Proven Successful for Soft Tissue Lameness Injuries in Horses

Two dressage horses recovered from suspensory ligament and superficial flexor tendon injuries following direct injection of enhanced equine DNA into the injury site. The research was published this week. (Photo: Catrin Rutland, Assistant Professor of Anatomy and Developmental Genetics, University of Nottingham School of Veterinary Medicine)

Can we use gene therapy to repair injuries? Specifically: Can genetic material (DNA) be injected directly into a soft tissue injury site and repair damaged tissue that is causing a performance or race horse to be lame?

An international group of British and Russian researchers believes that not only can it be done--they’ve done it. Twice. In a ground-breaking pair of case studies, Professor Albert Rizvanov (Kazan Federal University, Russia) and his group confirm that by injecting pure DNA into an injured horses' suspensory ligaments and superficial digital flexor tendons, they were able to completely restore the function in these vital areas.

The authors also stated that the horses presented at the clinic with naturally occurring injuries; the genetic treatment conformed with US Food and Drug Administration and EU standards. Similar treatments had been used experimentally in dogs and humans in tests by some of the team members.

The first case study was conducted on a successful 13-year-old dressage horse. The horse's clinical diagnosis was Grade 2 desmitis of the lateral branch of the suspensory ligament. A second treatment benefited a 9-year-old half-bred Trakehner, also used for dressage; he had been diagnosed with Grade 3 tendinitis of the superficial digital flexor tendon.

"We showed that gene therapy used within a period of 2–3 months after the injury resulted in the complete recovery of functions and full restoration of the severely damaged suspensory ligament and superficial digital flexor tendon," the authors state in the article.

The research also showed that the tissue within the limbs had fully recovered and that 12 months after the revolutionary treatment, the horses were completely fit, active and pain free.

No side effects or adverse reactions were seen in the horses.

The main advantage of gene therapy used in this study was the application of a combination of the pro-angiogenic growth factor gene VEGF164, enhancing growth of blood vessels, and bone morphogenetic protein 2 (BMP2), which plays an important role in the development of bone and cartilage.

To avoid undesirable immune reactions, both genes were derived from horses, thus resulting in biosynthesis of natural horse proteins in treated animals. Both recombinant genes were cloned into single plasmid DNA which is commonly regarded as non-immunogenic and a biologically safe gene therapy vector.

Since these injuries may affect not only horses but many other animals and humans, the study carries potential implications for the future direction of human and veterinary medicine, potentially with fewer relapses and shorter recovery times. Much more work will be needed to investigate safety and efficacy. A larger clinical trial has been started.

Professor Rizvanov formed a collaboration with scientists and clinicians within his laboratories at Kazan Federal University, Kazan, Russia and also with Moscow State Academy of Veterinary Medicine and Biotechnology, Russia and the School of Veterinary Medicine and Science, University of Nottingham, United Kingdom. Working together to heal ligament and tendon injuries has been the primary goal of the work.

Their work has now been published in the international journal Frontiers in Veterinary Science and is titled “Gene Therapy Using Plasmid DNA Encoding Vascular Endothelial Growth Factor 164 and Fibroblast Growth Factor 2 Genes for the Treatment of Horse Tendinitis and Desmitis: Case Reports.”

To read the full article please go to: https://www.frontiersin.org/articles/10.3389/fvets.2017.00168/full

Full citation:
Kovac Milomir, Litvin Yaroslav A., Aliev Ruslan O., Zakirova Elena Yu, Rutland Catrin S., Kiyasov Andrey P., Rizvanov Albert A. (2017) Gene Therapy Using Plasmid DNA Encoding Vascular Endothelial Growth Factor 164 and Fibroblast Growth Factor 2 Genes for the Treatment of Horse Tendinitis and Desmitis: Case Reports. Frontiers in Veterinary Science. 4. DOI=10.3389/fvets.2017.00168.

For more information, contact Professor Albert Rizvanov: albert.rizvanov@kpfu.ru.

Dr. Rutland's imaging work was displayed on the cover of the September 2017 edition of HoofSearch. She assisted with the preparation of this article.

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is the news service for Hoofcare and Lameness Publishing. Please, no re-use of text or images on other sites or social media without permission--please link instead. (Please ask if you need help.) The Hoof Blog may be read online at the blog page, checked via RSS feed, or received via a headlines-link email (requires signup in box at top right of blog page). Use the little envelope symbol below to email this article to others. The "translator" tool in the right sidebar will convert this article (roughly) to the language of your choice. To share this article on Facebook and other social media, click on the small symbols below the labels. Be sure to "like" the Hoofcare and Lameness Facebook page and click on "get notifications" under the page's "like" button to keep up with the hoof news on Facebook. 

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Disclosure of Material Connection: The Hoof Blog (Hoofcare Publishing) has not received any direct compensation for writing this post. Hoofcare Publishing has no material connection to the brands, products, or services mentioned, other than products and services of Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Sue Dyson: Double video explanation of equine ethogram for recognizing lameness and pain

Bad behavior or signs of pain? All the facial expressions shown here are part of the ethogram developed by Dr. Sue Dyson's research team at the Animal Health Trust in England. In a continuation of the research, recognition of facial expressions in both ridden and unridden horses has been recommended as a way to identify potential lameness, not just "naughty" behavior, with larger welfare implications. (Photos courtesy of Sue Dyson)

Researchers at the Animal Health Trust (AHT) Centre for Equine Studies in England have produced a practical tool to help owners, riders, and professionals recognize signs of pain by observing a horse’s facial expressions. The second part of the study was published recently, along with a new video, with a focus on facial expressions relationship to lameness. Both videos are included in this article.

Thinking Outside the Flip Flop Box: Florida Farriers Find Flex-Step Free-Heel Hoof Pad Aids Problems in Sport, Racehorse Feet

Far from the racetrack, a warmblood show horse sports the new high-tech Flex Step free-heel pad. The shoe is cut to the widest part of the foot, and rabbit ear drainage holes have been opened to allow sand, footing and water to drain out. Attentive show grooms maintain the pads by inserting the hose nozzle between the pad and the heel bulbs to make sure the sole isn't packed. Two small holes in the heels accommodate studs for traction, if needed, on some models. Copper rivets on the inside of the shoe's web attach the pad to the unheeled shoe. Made by Polyflex, a company known for its glue-on shoes, the pad is designed to be partially attached to the foot with nails and requires no adhesive or hoof packing.

Sometimes you wonder where things came from. Who was that first Standardbred farrier in Europe who cut the heels off a horse’s shoe, put a plastic pad against the foot, and nailed it on? You can hear it now: the horse walking down the barn aisle with a clumsy sounding “flap flap flap flap” sound from the loose pad against the heels. The farrier probably never counted on the noise. The trainer took some teasing, without a doubt. But that horse must have won, because they’re still around.

And no one laughs at you when your horse is winning.

California Chrome’s Newmarket Souvenirs: Aluminum Bar Shoes with HammerHead Nails

Do racehorses have to go through customs and fill out those little declaration forms? If so, reigning Horse of the Year California Chrome had better think twice when he lands in Chicago on Tuesday, should he check off the “nothing to declare” box.

He’d better hope the customs agents don’t look at the bottom of his feet.

Dr. William Moyer Retires from Texas A&M College of Veterinary Medicine

Dr. William Moyer retired last month after 22 years of service to the Texas A&M College of Veterinary Medicine. His writing and speaking on the subject of equine lameness in sport and racehorses, and in particular his interest in the equine foot have made him a frequent subject of Hoofcare and Lameness articles since early days. (TAMU photo)

Texas A&M University in College Station, Texas recently honored William Moyer, DVM with a retirement party. The Hoof Blog pairs some photos from the party with the University's official farewell to Dr. Moyer, who also recently served as president of the American Association of Equine Practitioners and is a popular lecturer on equine lameness.

New Statistics: Lameness Most Critical Health Problem for British Horses; Laminitis Increased in 2014

A new study published today in Great Britain sorts out what is likely to send horses to vets and farriers for treatment there, and you have to look pretty far down to find hoof-related problems (other than laminitis) on the list. 

Great Britain's National Equine Health Survey (NEHS), held annually every May, has confirmed for the second year that lameness is the most common syndrome affecting the UK’s horses and ponies. This year’s top results, compiled in this report, have also revealed an apparent increase in laminitis compared with previous years.

Research Update: Laminitis and Lameness Project Funding Announced by Grayson-Jockey Club Research Foundation

Grayson-Jockey Club Research Foundation’s board of directors has announced a slate of 19 research projects which the Foundation will fund for a total of $1,003,580 in 2014. The list includes eleven new projects and five which are in their second year, as well as three Storm Cat Career Development Awards.

Lameness Evaluation: American Sensor System Tests Successfully in British Research

Flexion testing, using the sensor-based system, at the University of Glasgow's School of Veterinary Medicine

For many years, opinions on the value of flexion tests in assessing equine lameness have been divided. Now, however, new research looks set to turn what has always been regarded as a subjective process into a wholly objective one. 

A comprehensive study, published in a November 2012 supplement to the Equine Veterinary Journal (EVJ) in partnership with the American Association of Equine Practitioners, showed that a wireless, inertial sensor-based system can effectively measure the horse’s response to a flexion test.

Hallmarq Standing MRI: Hoof Conformation from the Inside Out

 

This sponsored blog post is the latest in a series produced in partnership with Hallmarq Veterinary Imaging. Thanks to Hallmarq for their support of The Hoof Blog. This video explains the process known as "Standing MRI" of the equine foot using a Hallmarq system. The units are in use around the world.

Which came first: the chicken or the egg? 

Forget everything you “know” or think you know, about the relationship between foot shape and lameness. What matters in this age of evidence-based veterinary medicine is 1) what can be demonstrated and measured; 2) reliably repeating what was demonstrated; and 3) documenting the data of the measures.

If some hoof research makes you yawn and seems to be proving what is already obvious to you, remember that building a better tower of knowledge means that we know we can count on the blocks at the bottom of the tower. They must be proven before we can move on.

Hoof science is shy a few blocks. The tower is still on the drawing board. In order to document what you "know"via the scientific process, it is necessary to approach it from different angles so that it can be measured.

The deep digital flexor tendon (DDFT) is the most common site of damage in the foot identified by standing MRI scanning of sport horses. As you know, this tendon runs down the leg and attaches to the bottom of the coffin bone (P3). The three arrows added to this scan are directing the eye to the portion of the DDFT which, in this Irish horse, has a lesion that looks like a split. Normally tendon would be solid black. The recent study in England looked at a group of horses with similar injuries of the DDFT and measured for similarities in the conformation of foot structures. (Photo courtesy of Troytown Equine Hospital, Co. Kildare, Ireland.)

When researchers at Great Britain’s Royal Veterinary College wanted to get to the bottom of this age-old conformation to lameness relativity issue, they used Hallmarq standing MRI images to collect data that could be measured. The group of investigators worked under the direction of Renate Weller Dr Med.Vet, PhD, MRCVS, FHEA, senior lecturer in diagnostic imaging and locomotor biomechanics, at the RVC's Structure and Motion Laboratory.

Tim Mair, BVSc, PhD, DEIM, DESTS, DipECEIM, MRVCS is an author of the paper and a partner in England's Bell Equine Veterinary Clinic, where Hallmarq Standing MRI scans were sourced by Hallmarq's Nick Bolas. Also from the private sector, and a recent RVC graduate, Jonathon Dixon BVetMed MRCVS of Rainbow Equine Clinic was involved with the study.

The premise of the study is an inside-out refinement of hoof confomration. Instead of measuring the circumference of the hoof capsule and the contour of the coronet, they measured or calculated characteristics of the structures inside the foot. The availability of real-world lameness cases' standing MRI scans meant that the researchers had the luxury of a library of almost 200 images of injured or lame feet that met the study's criteria.

The MRI would have been originally made to assist in a definitive diagnosis on a lame horse. The clinician noted that the MRI showed a lesion in the deep digital flexor tendon or injury to the navicular bone, etc.

The researchers from the Royal Veterinary College undertook the project of evaluating these standing MRI scans not in the context of a single lame horse, but in the hopes that they would find other similarities in the feet of horses that had received the same diagnosis.

Once again: don’t assume anything, but see what the MRIs had to say.

If you overlaid a dozen images of the same type of injury from a dozen horses’ hooves, would the hoof capsules line up and show similar characteristics?

The researchers found that there indeed was similarity in the measurements of feet with the same diagnosed injuries.

What type of horses and lameness?

The mean age of horses in the study was between ten and eleven years; the average grade of lameness was approximately a “3” on a scale of 1 to 10. Breeds included 37 Warmbloods, 51 Thoroughbreds and Thoroughbred crosses, 22 Irish sport horses, 15 Irish draft horses and Irish draft crosses, 11 Cobs and 43 horses of other various breeds.

The horses had been diagnosed with many types of injuries, including lesions of their deep digital flexor tendon (DDFT), navicular bone (NB), collateral ligaments of the distal interphalangeal joints and

25 other structures.

What was measured? C, sole angle; D, toe angle; H, heel angle; N, deep digital flexor tendon angle; PL1, plumb line 1;  PL2, plumb line 2;  MA1, proximal moment arm; MA2, distal moment arm; SI, distal phalanx length; LC, toe length.

Sole angle

Sole angle is a relatively new term in the lexicon of foot anatomy. It is not the angle formed where the sole meets the wall, as documented in some studies. Its number is not describing the sole at all, in fact, rather the concavity of the coffin bone.

Dr. Weller took the time to explain it for Hoof Blog readers as the concave sole surface of the coffin bone to horizontal angle. Check the diagram to see the point on the mid-sagittal MRI scan where this angle is measured.

Dr Weller explained: "The issue we have in practice is that the sole angle we measure on radiographs does not correspond to the angle at which the DDFT actually attaches, but (rather we measure) the lateral and medial coffin bone borders.

"This (angle of the coffin bone) can be taken as an approximation at best, since the concavity of the coffin bone differs between horses. So some may have little concavity and in those horses the radiographic measurement will correspond quite well to the insertion angle of the DDFT, (however) some horses may have (a) very concave coffin bone and in these the radiographic measurements will not represent the DDFT insertion angle.

"The reason we care about this angle is that it is strongly related to the strain the DDFT experiences and hence the pressure this tendon exerts on the navicular bone," she concluded.

Measurement results

• A larger sole angle was associated with combined deep digital flexor tendon (DDFT) and navicular bone (NB) lesions, but not with NB lesions alone.
• A more acute angle of the DDFT around the NB was associated with DDFT and NB lesions.
• A lower heel height index was linked with DDFT injury.
• The larger the sole angle, the smaller the likelihood of a DDFT or NB lesion.
• Measurements of the feet in the study contradicted findings of other studies.

Why is this study important?

Taking measurements from diagnostic images is not a new idea, so why is this study newsworthy? 

Previous studies have shown that certain conformational traits--sole angle in particular--increase forces acting on the DDFT and NB in sound horses. This study supports these findings by showing that conformational parameters are associated with DDFT and NB lesions in lame horses.

Standing MRI is done with the horse
bearing weight on the injured limb

The researchers noted that while this study shows an association between certain conformation parameters and foot lesions, foot conformation cannot be identified as causative factor of lameness. "Foot conformation may change as a consequence of lameness," they concluded.

Which brings us back to the chicken and the egg.

Future studies at the RVC will focus on dynamic conformation by investigating foot-surface interaction in lame versus sound horses, which may eventually open a preventative and/or therapeutic window for horses in the process of developing specific lesions within the foot.

Relevance of this study

The study's findings emphasize the deep digital flexor tendon's influence on the conformation of the foot and that it plays a leading role in many foot lameness problems. The DDFT's angle within the foot and the relative concavity of the distal phalanx (P3) (as measured by sole angle) may become routinely documented in the future.

Studies like this one are changing the way that foot structures are evaluated and measured. Standing MRI scanning provided three-dimensional evaluation of the foot, expanding the diagnostic field for the most precise possible examination of foot tissues and for the most accurate measurement protocols for scientific relevance. 

But Weller’s team’s emerging protocols for evidence-based hoof evaluation provide the sport horse and racing worlds with a basic building block that could one day be used on important studies to answer questions on equine welfare, prevent pain and increase a horse’s useful years. The hoof is one of the last frontiers of equine science, and the Royal Veterinary College is dedicated to learning more about it.

Research can’t be any more relevant than that.

To read the full paper: Kate Holroyd, Jonathan J. Dixon, Tim Mair, Nick Bolas, David M. Bolt, Frederic David and Renate Weller; Foot conformation in lame horses with different foot lesions diagnosed, published online in The Veterinary Journal, September 2012.

 To learn more about Hallmarq Veterinary Imaging and standing MRI technology for horses:

• "Like" Hallmarq Equine MRI Facebook page;
• Follow @HallmarqMRI on Twitter;
• Subscribe to the hallmarqvetimaging channel on YouTube.com;
• Watch for a growing equine distal limb Hallmarq MRI image gallery on Flickr.com.
• Visit the Hallmarq.net web site. (Plan to spend some time there!) 

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

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Disclosure of Material Connection: Hoofcare Publishing contracted to receive compensation for compiling this post but the veterinary expertise and opinions in the article were provided by John Peloso DVM and Hallmarq Veterinary Imaging.  The information contained in this article is for informational purposes only, and should not be used to replace professional veterinary advice for your horse. Visitors to the website are responsible for how they choose to utilize this content. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Book Review: Horses, Owners, Vets, Farriers and Therapists All Live Happily Ever After In New Book "Back to Work"

I wish you could fold me up like a bookmark and store me inside this book.

The lovely volume "Back to Work" arrived from the printer this week and I eagerly sat down for a critical review of the fat (389 pages!) hardcover about rehabbing horses from colic surgery, laminitis and soft-tissue injuries.

The first thing I noticed was how many friends of Hoofcare and Lameness Journal are featured in this book. Farrier Paul Goodness, vets Ric Redden, Cooper Williams, Bruce Lyle and Liz Maloney...the names jump off the page. It's like old-home week.

But the stars of this book are the owners. The author judiciously profiled each one--riding level, job and time and budget constraints, personality flaws and all, as she analyzed the techniques and timelines used to bring each horse back to performance.

And that's no mean feat. These injuries are severe but each horse's story that I read had a happy ending. Every vet and every farrier was a hero. The horses all eventually seem to have recovered, and some even surpassed their pre-injury level of performance. Each owner overcomes the challenges to handwalk their horses through the depths of winter and somehow manage to afford ACell treatments, chiropractics, heart monitors, magnetic blankets, and serial ultrasounds and radiographs. Vet clinics like Fairfield Equine in Connecticut and Palm Beach Equine in Florida and consultants like Ric Redden are in the budgets of these riders: lucky horses!

I admit to being mesmerized as I read the tales. After the first few, I started to realize that the horses were not going to even come close to pasture-ornament status, let alone see the dreaded "Entering New Holland" sign. And each of these dedicated owners kept the horse, obviously feeling a lifetime bond with it after the ordeal of hands-on rehab. I'd like to live in this world.

What's disturbing about this book is the lack of illustrations. Each horse and rider are pictured together, often during competition. Everyone looks happy. What we don't see are the horses themselves during rehab. No ratty stable blankets, no knotted manes, no soiled bell boots. We read about the therapies, but we don't see any treatments. There are no closeup images of bulging bows or abscessing soles. No radiographs, no ultrasounds. Everyone's smiling. Life is good.

Authors of technical chapters include veterinarians Mary Brennan, Barb Crabbe, Bob Grisel, Nancy Loving, Richard Markell, David Ramey, W. Rich Redding, Jeanne Waldron, Cooper Williams. Massage therapy section by Richard Valdez, human psychology by Janet Sasson Edgette. Each rider lists veterinarians and therapists who assisted.

One criticism: It's hard to understand how farriery as a subject could be left out of this book, but Texas farrier Ron Marshall and Hoofcare and Lameness consulting editor Paul Goodness are mentioned as individuals who played roles in helping foundered horses.

The story of Karen O'Connor's plagued-with-injuries event horse Upstage was a highlight of the book for me. She competed on him at the Rolex 4* in Kentucky last month. After seeing his medical history, that is nothing short of a miracle.

Vets, therapists, and farriers may not have the patience to read this book from cover to cover but the index is helpful in locating information buried in the text and it might be worthwhile to gain the author's insight into what sorts of owners are willing to go the distance to bring their horses back from injury and illness. Each horse's story has a timetable outlining how and when medical and therapeutic treatments progressed.

This book would make a superb gift to inspire an owner who is undertaking a suspensory rehab or a bowed tendon or whose horse needs to recover from colic surgery or laminitis.

Favorite quote from the book, attributed to David Ramey DVM on laminitis therapy: "If someone tells you that if he or she had started their particular approach to rehabilitation 'in time', your horse would be much better, you're either dealing with a charlatan, an egomaniac, or a fool. Laminitis is a humbling disease and anyone who claims universal success simply hasn't treated enough horses."

Contact Hoofcare Publishing anytime:
tel 978 281 3222 email hoofblog@gmail.com

New Lameness Treatments: IRAP™ Therapy

One of several new high-tech treatments for equine lameness is the creation of an enriched serum injection for horses with potential joint damage. "IRAP" is not a new hip-hop group; it's a therapy that has quickly made its own place at the table of equine therapy, especially for sport horses and racehorses whose owners expect a return to the previous level of soundness and performance...in the shortest possible length of time.

Interleukin-1 Receptor Antagonist Protein (IRAP™) therapy works like this: the veterinarian, often a surgeon or lameness specialist, injects a horse’s affected joint with serum that contains anti-inflammatory proteins that block the harmful effects of Interleukin-1 (IL-1), an inflammatory cytokine that has been shown to accelerate destruction of cartilage during osteoarthritis. (A cytokine is a chemical secreted by the immune system to attack infections and damaged or dying cells.)

What makes the process a little complicated is that Interleukin-1 (IL-1) is a quite normal part of the horse's inflammatory response but it can sometimes be detrimental to a horse's joints and accelerate damage to cartilage there. IRAP™ creates a barrier that prevents IL-1 from having its damaging effect.

Since the serum sample is derived from the horse’s own blood, there is minimal risk of an adverse reaction. The incubated serum also does not contain any drugs.

The treatment process consists of drawing a blood sample using a special syringe containing glass beads. The blood is incubated for 24 hours and a centrifuge separates the serum from the red blood cells. The serum, now enriched with Interleukin-1 receptor antagonist protein, is divided into three or four doses. The horse receives one dose injected into the affected joint once weekly for three to five weeks.

A quick check around the web found that quite a few vet clinics are promoting IRAP therapy. Here are some comments from veterinarians:

Dr. Laura Werner of The Equine Center in San Luis Obispo, California: "The reason IRAP is so exciting is its potential for a long-term effect on battling osteoarthritis. Whereas some of the therapies might only have short-term effect, IRAP has the potential to stop the cartilage matrix from being degraded and increase healing. IRAP has the ability to stop the inflammation cycle and bring comfort to your horse. The research on IRAP is ongoing but the results have been very encouraging."

Dr. Laurie Tyrrell of Virginia Equine Imaging: "IRAP can also be used as maintenance therapy throughout a competition season to reduce the amount of steroid use. IRAP therapy is not for every horse. There are some factors that make a horse a less successful candidate; however the therapy shows great promise for horses that have become refractory to traditional management of osteoarthritis, as well as offering an alternative therapy for those worried about excessive use of corticosteroids."

According to the web site of Steinbeck Country Equine Clinic in Salinas, California: "Coffin joints and stifles that don’t respond well to steroid injections seem to be the most popular condition to treat (with IRAP therapy). Reactions are uncommon largely due to the fact that it is the patient’s own serum."

IRAP is one of the many therapies and treatments that will be on the program of the 4th International Equine Conference on Laminitis and Diseases of the Foot to be held in West Palm Beach, Florida, from November 2-4.

Denoix, Dyson and those tricky ligaments

Collateral ligament injury (black arrow) on a case diagnosis by Dr. Sue Dyson at the Animal Health Trust in Newmarket, England

One of the many popular topics covered by Hoofcare & Lameness is the importance of the collateral ligaments of the coffin (distal interphalangeal, DIP) joint. Sue Dyson, lameness veterinarian of the Animal Health Trust in England, has written a super article on injuries to the ligaments and how to identify them.

We pair this with a compelling discussion of the movement of the coffin (distal phalanx, P3) bone by Jean-Marie Denoix. He termed the word "collateralmotion" to describe how the coffin bone moves slightly to the inside or outside, in a gliding motion, which most people do not usually consider when they consider the foot and what might cause lameness.

The collateral ligaments stabilize the coffin joint and allow the limited amount of gliding that a sound horse requires. Excess gliding may injure the ligaments, causing lameness. Conversely, excess gliding (such as "lunge til dead" training techniques) can injure the ligaments.

It certainly is hard to illustrate, however!

Denoix has a superb article in the January 2005 edition of Equine Veterinary Journal about how the weightbearing foot's coffin bone moves under the short pastern bone when a horse is turning. The article was dedicated to the memory of Jean-Louis Brochet, Denoix's sidekick and farrier who died tragically in Paris a few years ago of an unknown disease he contracted while working in Florida.
We are very grateful to have Drs Denoix and Dyson on our editorial board. Both of them will be speaking at the 3rd International Laminitis and Equine Diseases of the Foot Conference in Palm Beach, Florida November 4-6.

AAEP Convention Schedule Announced: Highlights Related to Lameness

The schedule for the 2004 American Association of Equine Practitioners Convention arrived at the office yesterday. The convention will be held December 4-8 in Denver, Colorado, and of course, Hoofcare & Lameness will be there with a double booth this time in the huge trade show.

Here are a few highlights from the schedule that may interest Hoofcare & Lameness readers.

Friday 12/3 Foot Surgery wet lab with Kent Carter, Bill Moyer, and Robin Dabareiner--the Texas A&M hoof surgery team--or Advanced Ultrasound with Jean-Marie Denoix, Norm Rantanen, Ron Genovese, and others.

Saturday 12/4 1-3 pm "Veterinarian-Farrier Relations Committee" is listed; I don't know if this is an open meeting or not. Stacey and I will be there setting up the booth that day (helpers welcome!).

Sunday 12/5 10 a.m. Larry Bramlage presents the "Kester News Hour". This is always fun--a rapid-fire review of veterinary developments over the past year, with some humor thrown in.

Sunday 12/5 NOON--Bill Moyer and our farrier friend Bob Pethick will host a lunchtime "table topic" on therapeutic shoeing. Should be great! Also at the same time: Cushings Disease and Hind Limb Lameness.

Monday 12/6--get up before dawn (or just stay up) for sunrise sessions on foot lameness, gaited horse lameness, racehorse lameness, laminitis, western performance horse lameness, and a lot more by presenters such as Bill Moyer, Tracy Turner, Scott Bennett, Scott Morrison, Steve O'Grady, Jay Merriam, Rick Mitchell, Reynolds Cowles, Kent Carter, Terry Swanson, Jerry Black and many more. You must reserve in advance!

Monday 12/6 1:30 I am looking forward to a group of presentations under the heading "The Unwanted Horse"..but unfortunately at the same time are "how-to" sessions with Tracy Turner, Steve O'Grady and Kevin Keegan on saddle fitting, canker, and head/pelvis movement evaluation in lameness diagnosis, respectively. I won't miss those three, but hope to see some of the welfare presentations, too!

Tuesday 12/7 The sports medicine session starts at 8 a.m. with one of our consulting editors, Sue Dyson, presenting "Collateral Desmitis of the Distal Interphalangeal Joint in 62 Horses". This is a great topic on what I think will be a new BUZZ in our industry. (Read Jean-Marie Denoix's article "Collateral Ligaments of the Distal Interphalangeal Joint: Anatomy, Roles, and Lesions" in Hoofcare #70 for more on this subject.)

Tuesday 12/7 At the same time Sue is presenting, there will also be an imaging panel in progress, with Jean-Marie Denoix, Rick Mitchell, Kent Carter, etc.

Tuesday 12/7 Lameness Program begins at 1:30 (unfortunately overlapping with the tearing down of the trade show! Helpers welcome!) with EIGHT interesting lectures including Sue Dyson again, this time of a VERY HOT TOPIC: "Is there an association between distal phalanx angles and deep digital flexor tendon lesions"? My guess is that she will be comparing lateral radiographs showing P-3 angle with MRIs of the same foot showing tendon lesions in the navicular area. This should be worthwhile. Robin Dabareiner (navicular bursa medication results), Scott McClure (shock waver therapy for navicular disease) and lots more in that special section of the convention.

Tuesday 12/7 Yes, at the same time, there are medical presentations on Cushings syndrome and thyriod dysfunction, plus Jim Belknap on using COX-2 inhibitors in developmental stages of laminitis.

Wednesday 12/8 A terrific program on sacroiliac lameness with Sue Dyson as moderator; speakers include Cornell's Kevin Haussler, Dan Marks, Jean-Marie Denoix.

Wednesday 12/8 NOON Table topics on shock wave therapy and a great one on treating sore backs with Dan Marks and Midge Leitch.

Wednesday 12/8 1:30 pm Hooray! The Hoof! Rood & Riddle's Scott Morrison (see article in our current issue on maggot debridement therapy) and our old friend (and the only farrier on the program) Bob Pethick from New Jersey will do an afternoon program on farriery, with live horses. In the surgery program that afternoon, Robin Dabareiner will speak on heel bulb lacerations and the UK's Andy Bathe will speak about medial patellar desmotomy cases.

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Those are just some of the highlights. Also, I don't know what the AAEP's policy is about non-veterinarians attending, so if you are not a veterinarian, you may want to register in advance to avoid late fees on top of non-member rates.

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Hotels:The Marriott City Center is the HQ hotel, but the Holiday Inn is much closer to the convention center and $50 less per night. Hoofcare rooms will be at the Holiday Inn.
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At the trade show: Visit the Hoofcare & Lameness booth and learn about the exciting new "in the field" (literally, sometimes) gait analysis system from the UK "Equinalysis", plus new lameness-related or farriery products from St Croix Forge, Harmany Equine, Eponaire, Grand Meadows, and The Smart Boot.

PLUS socialize at our booth during book signing events with Joyce Harman (The Horse's Pain-Free Back and Saddle Fitting Book), Hilary Clayton (The Dynamic Horse) and Doug Butler (Principles of Horseshoeing III), to name a few.