Equine Radiograph Case Study Angela Culp LVT Radiography 4/11/15

Mari Nordlandshest (pony) Mari, a 24 year old female Nordlandshest pony weighing 400 kg, was found by the owner on pasture on the evening 11/17/2013 and she was lame on the right hind leg (RH.) The attending veterinary surgeon the same evening recorded the pony to be 4/5 lame RH. There was no sign of trauma or swelling of the leg. Mari was put on NSAID’s and box rest. Medication prescription: Phenylbutazone (PZB or Bute) given at 4.4 mg/kg po every 12 hours for pain. Dosage: 1760 mg po q 12 hours. (Plumb, 2011)

Physical Exam On examination Mari was bright an alert, eating well but reluctant to move and was still 4/5 lame RH. The RH in the hip-stifle region caudal to the stifle was now showing swelling. On palpation there was no sign of pain below the stifle, higher up the leg there was sign of pain on deep palpation. On flexion of the stifle and hock there was no sign of pain. Mari was very reluctant manipulation of the hip joint. On the RH with auscultation you could hear crepitus with the stethoscope. RH stance was toe out with the whole leg rotated outwards, there was asymmetry of the hip.

Veterinarian Orders The veterinarian ordered individual images of each hip to get a clear image of the joints. Due to a previous case with the same type of lameness and crepitus over the hip joint the veterinarian is concerned that the right hip has become dislocated.

Radiographic Images Figure 1 MDNV, C. T. (2013). Lateral Right. BCF Technology. Figure 2 MDNV, C. T. (2013.). Lateral Left. BCF Technology.

Radiographic details Radiograph images of the hip joints were done separately with the generator under the Mari’s abdomen and the plate placed over the pelvis. The setting on the generator was 100kV with 40mAs.

Diagnosis and Treatment It was confirmed that the right hip had become dislocated. Relocation of the hip joint may be attempted under general anesthesia. (The Merck Company, )

Discharge Instructions The hip can dislocate when ligaments or joint membranes are ruptured due to trauma; however dislocation of the hip is uncommon in horses. When dislocation does occur, fracture of the hip bone or “locking” of the kneecap in an extended position often accompanies it. When the round ligament of the hip joint ruptures, the stifle and toe of the hind limb visibly rotate outward, while the hock rotates inward. The hip joint does not always completely dislocate, but when it does the gait is obviously affected. The thighbone rotates outward, and the horse resists bearing weight on that leg.. (The Merck Company, ) We set the hip and are going to continue with Phenylbutazone (PZB or Bute) given at 1760 mg po q 12 hours. (Plumb, 2011) We will recheck Mari in a week to make sure that everything is healing well, but the long-term outlook for recovery is usually poor.

References Figure 1 MDNV, C. T. (2013). Lateral Right. BCF Technology. Figure 2 MDNV, C. T. (2013.). Lateral Left. BCF Technology. Plumb, D. C. (2011). Plumb's Veterinary Drug Handbook. St. Paul: Pharmavet Inc. The Merck Company. ( ). The Merck Veterinary Manual. Retrieved from Tjerand Lunde, B. M. (2014). Retrieved from BCF Technology: ireland.bcftechnology.com/learning/equine/clinical-resources/equine-case-study---mari- nordlandshest