Dr. Chris White - Equine Sports Medicine

11/01/2024

Happy to have contributed to this very well-written article on managing long term navicular disease in the Horse Magazine

Navicular syndrome, once feared as a career-ending diagnosis, can now be managed more effectively, despite ongoing challenges.

10/24/2024

Was honoured to be apart of the first ever Atlantic Canada Equine Symposium a few weeks ago! Participants from across the Maritimes met for a day of equine education.

07/16/2024

This ultrasound image is from a 25 year old Quarter Horse mare. She was chronically lame with navicular disease, and underwent a neurectomy surgery bilaterally to relieve her of heel pain. Several weeks thereafter she escaped from the pasture to run around the property, and showed excessive swelling in her left forelimb the following day.

This ultrasound image shows the same site on both the left forelimb (left side) and the right forelimb (right side). You can see there is a lack of fiber alignment and grey scale on the left in the middle of the tendinous structures compared to the right. This shows a rupture of the Deep Digital Flexor Tendon, or DDFT. Compare the normal on the right to the abnormal findings on the left.

This is relatively rare occurrence and happened through no fault to the owner. There is a increased risk of tendon ruptures following neurectomies, but in most cases the pros of surgery outweigh the cons. Lots of horses get neurectomies and don't rupture any tendinous structures. This was an incredibly unfortunate situation for both the horse and owner, who did her due diligence in getting veterinary care for her horse.

Options for this case include rigorous rehab, corrective shoeing with a high degree wedge, and potential biologic injections. In this case, due to the extent of injuries and age of horse, euthanasia is recommended.

05/15/2024

This is a 12yo Warmblood mare that presented after she escaped from her paddock overnight. She came back with wounds over her knees, but the owner noticed this swelling over her right hock. She is also 8mo in foal. She was very tender to palpation of the swelling.

This is a very common presentation for curb, a colloquial term for injury of the soft tissues in this area. Most commonly, either the superficial digital flexor tendon or long plantar ligament are affected.

An ultrasound showed a lesion in the long plantar ligament of the right hindlimb. The images show the original ultrasound and circled lesion for comparison, both in transverse and longitudinal view.

The mare is currently being treated with small paddock rest and laser therapy. They tend to do well with this condition, though some lameness may be residual.

04/05/2024

This 10yo QH Mare presented with a right forelimb lameness of several months duration. There was effusion (swelling) of her right coffin joint on exam. A nerve block was performed to block out her right heel, and she became lame on her left forelimb.

These are the same radiograph, taken as a part of a series on the horse. The first image was the initial radiograph, where you can see the entirety of the coffin bone and the hoof capsule. The second and third images are when I manipulated the brightness and contrast of the image to focus on the navicular bone, where a large cyst is visible over the flexor surface of the navicular bone.

The old saying rings true: missing diagnoses isn't so much from failure of knowing, but failure to look.

03/27/2024

Great message from my friends out in Calgary!

We know emergencies can be extremely stressful situations as a horse owner, and we want you to feel as prepared as possible when faced with an emergency. Join Dr. Amanda Gacioch and Dr. Bailey Smith on Thursday April 18 @ 4pm at the High River Ag Society to cover the basics of equine emergency care and first aid. This event is complimentary, but registration is still required. Follow the link below to register!

Have specific questions or scenarios you'd like covered? Send us an email at [email protected] and we'll do our best to tailor the event to your needs! We hope to see you there!

https://www.eventbrite.ca/e/equine-emergency-care-first-aid-tickets-871272679037

03/24/2024

WARNING: Anatomic Specimen

Anatomy dissections aren't just for vet students; they are incredibly helpful in learning about the horse's biomechanics and visualizing pathologies.

This was an incidental finding during a leg dissection. The photo shows the proximal (top) part of long pastern bone, which makes up the distal (bottom) of the fetlock joint. The blue circle shows defects in the bones hyaline cartilage, the protective cartilage that lines the bones in the joint capsule. These defects are called subchondral cysts, and are a relatively common cause of lameness in the horse.

These are diagnosed best by xray, but can also require more advanced imaging such as CT or MRI.

03/12/2024

Staying busy through the winter teaching! Shamelessly piggy backing this post

02/15/2024

Hock osteoarthritis with joint fusion

Joint fusion is not an uncommon event in horses with osteoarthritis. It occurs to primarily low motion joint, most commonly in the distal hock. Fusion of a joint is an advanced stage of osteoarthritis, in which the cartilage completely wears and allows the bones to bridge across the joint space.

Joint fusion is a painful process, and can result in marked lameness of the horse. Once the fusion process has started, there is no way (to my knowledge) to reverse it. The unfortunate reality is there is no way to determine how long it will take a joint to fuse. Some fuse over months, some years.

The goal is to keep the horse comfortable through the process. That can be achieved by oral medications such as firocoxib, and joint injections, either into the joint or around the joint (if there isn't enough space to set the needle). There is also a surgical approach where the remaining cartilage is removed under anesthesia and the joint is allowed to fuse naturally over the usual 6 to 12 months.

The below radiograph is of a 14yo Quarter Horse who presented with pretty marked lameness. It was referred to me after she did not improve with time with rest. This horse was severely lame that she did not really show a localized area of pain. After several nerve blocks up the limb, it was discovered the area was localized to the hock. Radiographs showed the distal intertarsal joint (red arrow) is markedly narrow and clearly in the process of fusing. The horse was started on firocoxib and joint injections will occur in early spring. Last report was she was doing well and is hopeful that her riding career is not over!

01/19/2024

DON'T PULL THE NAIL

This is a case I assisted a colleague, Dr. Katherine Lahey of Cornwallis Veterinarians, with on emergency last week. This horse came in from the pasture non-weight bearing. The owner did everything right, she taped blocks under the hoof on either side of the nail, and called her veterinarian.

The first two radiographs below were taken (excuse the obliquity, in this situation we're never as concerned about getting the perfect image) to show where the nail was in the hoof.

But why not just pull the nail? The third radiography I marked up to show the important structures we're careful not to miss (I'm not an artist!). The yellow line indicates the deep digital flexor tendon (DDFT) traversing down the limb and attaching itself at the bottom of the coffin bone. The blue indicates the synovial structures in the hoof capsule: the coffin joint and the navicular bursa. If the nail penetrated either synovial structure, the treatment and outcome would look very different. In that case, I would suggest referring the horse to a specialty facility for intensive care, as a synovial infection in the horse is life threatening. However, we don't know this until we xray with the nail still in the hoof.

In this case, it was determined that the nail missed all important structures. I expect a hoof abscess to happen secondary to the pe*******on, so the horse began a daily routine of soaking and poultice. A course of antibiotics and ensuring the horse was up to date on tetanus, and she is doing fantastic 1 week later.

01/02/2024

I try to emphasize the importance of a full series of any joint when I x-ray! Orthogonal views are incredibly important when imaging a horse, as one view may reveal a pathology not seen in the others!

This is a middle aged Quarter Horse I saw for hind end lameness. He was positive of hind limb flexion. This was the series of his right hock. The joint space of his tarsometatarsal and distal intertarsal joint were both narrowed, but the arrow on his DMPLO is pointing towards wearing of the joint. This is definitive for osteoarthritis.

His right and left hock joints were injected (tarsometatarsal and distal intertarsal) and he has been doing great ever since!

01/02/2024

I wanted to start this page primarily to post interesting cases and educate horse owners! I hope you enjoy!

Here Copper is waiting for me to get a diagnostic image...