EVENTING is generally considered the most all-round test of a horse’s athletic ability. Eventing competitions consist of three disciplines; dressage, show jumping and cross-country. The need for the event horse to perform sufficiently well in all three disciplines rather than excelling in one, creates a characteristic array of injuries seen in these equines athletes.

Foot Soreness

Foot pain is a common problem in the event horse. Bruising of the sole is commonly diagnosed as the source of foot pain following the cross country phase, especially in Thoroughbred or Thoroughbred cross horses with flat and/or thin-soled feet. Shoe loss often occurs in eventers, more so than in other sports horses. Shoe loss can often lead to the hoof wall breaking up, and further problems at the time of subsequent shoeing.

Foot imbalance often contributes to foot pain. Regular, high-quality farriery is vitally important in maintaining the soundness of an event horse.

Osteoarthritis

The lower limb joints of horses, in particular the coffin and fetlock joints, are commonly affected by osteoarthritis (OA) in the forelimbs of the event horse.

Puffiness or swelling of a joint, and an increase in the horse’s lameness following flexion of that joint, are factors that indicate that the joint may have OA. This is then definitively diagnosed by observing any changes within the joint on x-rays, and/or observing an improvement in the horse’s lameness following the injection of local anaesthetic into the joint (intra-articular block).

In terms of treating early OA, there is usually a good response to injection of anti-inflammatory medication directly into the joint (intra-articular medication).

The two most common drugs to be used for intra-articular medication are anti-inflammatory steroids (corticosteroids), and hyaluranon. Hyaluranon is a substance which naturally occurs in joints and acts to lubricate the joint and it is normally a highly concentrated form of this substance which is used in intra-articular medication.

Osteoarthritis of the hock joint is also a common cause of lameness in the event horse, which again can usually be managed with intra-articular medication.

In some cases, arthroscopic evaluation or ‘key-hole surgery’ of the joint may be beneficial. This allows lesions within the joint to be directly viewed and potentially debrided or ‘cleaned-up’, often resulting in an improvement in lameness.

Superficial digital flexor tendonitis

Although less common than joint conditions superficial digital flexor (SDFT) tendonitis is probably one of the biggest causes of time out from competition.

Affected horses with this condition usually require lengthy periods of rehabilitation. The condition usually arises from an accumulation of microscopic damage due to the repeated stress placed on the tendon during normal training and competing. Occasionally, a single traumatic event, such as a fall or stumble, may also result in tendon injury.

This damage results in the usually seen signs of heat and filling in the tendon(s), and can occur quickly after training or a competition, or more gradually over a few days for milder injuries to the SDFT.

Tendonitis is best diagnosed with an ultrasound scan and the optimum timing for scanning is about 7-10 days after the initial injury, when a lot of the swelling will have subsided. The scan allows the vet to diagnose the extent of the tendon damage and therefore gauge how long or possible a full recovery from the injury is likely to be.

The initial treatment for SDFT tendonitis is based around limiting inflammation and preventing any further tendon damage. This usually involves box rest with oral anti-inflammatories, cold hosing or ice application to the affected limb, as well as stable bandages being applied to the limb.

Following the early intervention, controlled exercise is then instigated to encourage more appropriate and organised healing of the tendon tissue. This usually consists of increasing periods of in hand walking over a period of weeks or months depending on the severity of the injury.

There are also a number of other treatments which may speed up the healing process and improve the quality of tendon healing.

Tendon splitting is an older form of treatment, in which the tendon has a split placed in it with a scalpel blade. This is especially useful in core lesions of tendons as this relieves the pressure within the tendon, allowing healing to progress.

Injecting stem cells into injured tendons has become fashionable lately, but the jury still appears to be out with regard to how effective it is, with some research specialists claiming it works wonders whilst others are still dubious.

External trauma

Event horses are prone to traumatic lacerations during competition, with the most common injury being overreach injuries to the heel bulbs, as well as abrasions and lacerations to the stifle and carpus (knee), usually as a result of direct trauma from jumping solid cross country fences.

As with any wound which occurs during the competition season, there is usually pressure and the wound healed to get the horse back into training and out competing as soon as possible.

Therefore, aggressive early management of lower limb wounds with a Robert Jones bandage or a cast, over a period of weeks, depending on the severity and location of the wound and the decision of the vet.

Box rest prevents excessive movement from delayed healing or worse, encouraging the growth of proud flesh. Thorn penetrations from brush or hedge fences may complicate things further if they manage to penetrate a joint, leading to infected arthritis, which will need to be managed with surgical flushing of the joint.

Occasionally, direct trauma to the surface of a bone can lead to the horse being severely lame as the result of bruising to the bone. This lameness often resolves quickly following a few days of rest and anti-inflammatory therapy.