Scarlett: diagnosing subtle lameness in a western performance horse

Diagnostic nerve blocks

Based on the flexion test response, Beau performed a sequence of nerve blocks targeting  Scarlett’s left front limb:  

Fetlock joint block – no improvement.

Palmar digital block – no improvement and a new push-off asymmetry 

Abaxial block – no change 

Low four-point block – no significant change

“At that point, we went to imaging, given the likelihood of bilateral proximal suspensory issues,” Beau explains.

Imaging 

Ultrasound revealed signs of chronic scar tissue and mixed echogenicity in both left and right front proximal suspensory ligaments. The findings were consistent with a chronic active proximal suspensory desmitis, indicating a wear-and-tear issue rather than an acute injury. “If I hadn’t seen anything on the imaging, I would have gone back to blocking the right front limb”, he adds.

Treatment and follow-up 

The treatment plan included a series of three shock wave therapies as well as suspensory support shoes and continued light exercise at a walk. 
As Scarlett and her owners live some distance away from his clinic, they are using the Sleip app so that Beau can monitor progress remotely. Tiffany records Scarlett weekly on the circle, with the analysis data and video automatically uploaded to Beau’s phone. 

“They live over three hours away, so this setup means I can monitor weekly without them having to travel,” he says. “If there’s no improvement soon, we’ll bring her back in. I’m also considering regenerative therapy if needed.”

The value of baseline data

Beau Whitaker notes the potential for baseline data from repeated use of the app on other horses to aid in interpretation.
“I have some clients who record their horses for me at home every other week, so we have a baseline that allows us to pick up on changes. We correlate the Sleip app with how the horse feels in the saddle, and then we can decide if we need to bring the horse in to have a look at it.  

In many cases the asymmetry parameters do not fully go away, but we can see that the horse functions and that the pain component seems to go away. 

“We see this frequently, and it is a good take-home I think. Horses can have slight asymmetries and function well; most have some degree of natural asymmetry. We need to be attuned to the pain component and have a holistic approach to both diagnostics and rehabilitation”, concludes Beau.

Beau Whitaker emphasises the value of longitudinal measurements beyond a single case:
“I have clients who record their horses at home every other week. That gives us a baseline to detect changes early. We correlate what Sleip shows with what the rider feels in the saddle, and then decide whether to bring the horse in.”

Not every asymmetry needs to be eliminated, he adds.

“In many cases, the asymmetry doesn't fully disappear, but the horse functions, and the pain component goes away. That’s the key. Most horses have some degree of natural asymmetry. It’s about tuning into discomfort and using a holistic approach to both diagnosis and rehabilitation.”