Poor Performance

Investigating respiratory noise and poor performance:

From elite equine Olympic athletes to childrens’ ponies, poor performance presents a significant problem in many of our patients. Subtle changes can be very challenging to detect, sometimes requiring special diagnostic tests, equipment and expertise.

Poor performance investigations should be tailored to the individual case presented, but may include: overground upper respiratory tract endoscopy to investigate wind problems, exercising ECG to check for heart problems (cardiac arrhythmias), blood tests, gastroscopy to detect gastric ulceration, lameness investigation, investigation of lower airway disease such as inflammation, infection, heaves and allergies using video-endoscopy, tracheal washes and broncho-alveolar lavage (lung washes).

If your horse makes a noise when he/she is exercising, overground endoscopy is likely to be the most useful diagnostic test. A small endoscope is placed up the nose, fastened in position on a bridle and the horse is then ridden or exercised as normal. The exercise test must replicate the conditions under which the horse normally makes the noise, so being ridden in the school is suitable for most horses but racehorses and eventers should be exercised at speed on the gallops. A huge variety of laryngeal and pharyngeal abnormalities can be diagnosed, many of which are completely undetectable when scoping horses at rest. In 40% – 50% of cases, more than one abnormality is diagnosed. From here we can decide which (if any) wind surgeries are appropriate, or if other tests such as lung washes, should be performed. For horses with poor performance and no respiratory noise, an exercising ECG can be performed at the same time as the exercising endoscopy. It should be borne in mind that around 30% of horses with palate problems are ‘silent’, so the absence of noise does not rule out a palatal problem.

Our poor performance assessments are competitively priced, and discounts are available for groups of horses. Please contact the hospital on 01903 883050 for further information.

Bandaging

The ability to bandage your horse effectively when they injure themselves or have undergone a veterinary procedure, is advantageous to both horse, owner and bank account. This article aims to give you the basic theory and principles behind applying safe secure bandages.

Every bandage, no matter how simple or complex, is composed of three basic layers: a primary layer which is a sterile material/pad that is applied directly to the wound or surgical site. This keeps the site clean, allows you to apply topical treatments such as Manuka honey and absorbs any discharge produced; a secondary layer which holds the primary pad in place and provides padding to the horse's leg. This padding acts as cushioning and is compressed by the outer layers to provide support to the leg; finally a tertiary layer which is composed of elastic bandage materials that bind the bandage together and compress the padding. This is also the outer layer of the bandage that holds everything together and hopefully is slightly waterproof.

The aims of a bandage are varied depending on what you are trying to achieve but all bandages should follow the contour of your horse’s leg and provide firm, even, pressure with no lumps, bumps or creases. Bandages have the ability to reduce swellings, encourage healthy wound healing by keeping wounds clean, removing discharge and immobilising the wound. Bandages will also provide some protection from further knocks and trauma from the environment. However, if bandages are not applied correctly, they can cause their own problems.

Bandage sores are a frustrating risk when bandaging your horse and usually occur when a bandage is either too loose and rubs the leg, or is too tight in one particular place which cuts off the blood supply to the skin causing it to die. If you have a wound, fracture or tendon injury that requires an immobilising bandage to be in place for several days or even weeks then bandage sores are to be expected but good bandaging principles will minimise these. Bandaging a horse for a long period of time will deprive the skin of oxygen and this makes bandage sores more likely. Frustratingly, once you have a bandage sore you will need to keep it bandaged until the sore is ready to be exposed to the environment.

Bandage bows are a consequence of uneven pressure throughout the bandage. If you are bandaging the lower half of your horse’s leg it is imperative that your bandage goes from the bottom of the knee/hock all the way down to the heel bulbs. This is because the flexor tendons at the front and back of the leg run from within the knee/hock all the way down to the pedal bone so to avoid any steps or changes in pressure along these tendons we need to bandage the length of the tendons also. A bandage bow can still be generated within a bandage that is the correct length if there is uneven pressure within the bandage. A common mistake is to pull the bandage tighter over the area where the injury is to “give it that little bit more help,” however, this uneven pressure can also cause a bow. Remember we want firm, even, pressure with no lumps, bumps or creases. A bow is bruising of the tissues around a tendon, however, the majority of bows are superficial and will resolve with the application of a good bandage. Generally, a bandage bow doesn't lead to damage of the underlying tendons but if you are concerned an ultrasound scan of the area is advised to check the tendons are unaffected.

A helpful indication that your horse isn't happy with a bandage, and could be getting a sore or bow, is if the horse starts to itch or rub the bandage. Some horses will do this regardless because they insist on refusing help and just don't understand we are actually trying to help! But generally if a horse is bothering at a bandage then it should be changed as it may be too tight or rubbing.
Generally, bandages can be left on for 3 to 4 days, however, this is very dependent on the type and location of the bandage. It must also be said if a bandage looks untidy and has slipped or creased after only 2 days but was expected to last 5, it is better to change the bandage now than wait.

When applying a bandage the leg should be fully weight bearing. When a horse unloads a leg the angle of the joints within the leg change, especially the fetlock. If you apply a bandage to a leg not fully loaded then when your horse does load the leg the angles of the leg within the bandage will also change, generating areas of increased focal pressure and areas of very little pressure. This is then not an even pressure and may lead to problems.

When you are next placing a bandage remember the padding layers are just padding and there is no need to pull them tight. When you do apply the pressure layers you are only trying to conform and crush the padding with firm pressure, not tight pressure. If you need lots of pressure on a bandage then keep adding secondary and tertiary layers of increasing pressure - don't go super tight on the first layers. To stop bleeding don't apply a really tight small bandage, just keep adding layers of firm pressure and the bleeding will stop. It doesn't matter if you go clockwise or anticlockwise round the leg but whatever direction you start in, keep going that way. If you have any concerns regarding a bandage or you need to apply one in an emergency call your vet and we can help talk you through it over the phone.