It is not unusual for horse owners to question me as to the costs and procedures associated with a lameness examination and the ensuing treatment. Many of our clients view the idea of lameness work up and diagnostics as a deep dark hole. Quite honestly I understand why they feel this way and hopefully I can address this issue in a manner that will make sense, both by explaining the dilemma and then offering some solutions.
At the crux of this problem are communications. In many cases neither the horse nor the owner can communicate exactly where the pain is coming from. So the first challenge is to isolate which area is causing the problem. This process will include any or all of the following; visual gait analysis on various surfaces and possibly both in a straight line and on a circle, to determine which limb or limbs are involved; palpation of joints and soft tissue structures; hoof tester evaluation; palpation and analysis of the spinal column; and flexion testing of individual joints, with ensuing re-evaluation of gaits. Our goal is that as a result of these procedures we can isolate a problem area or areas of pain. Should that not be the case, additional diagnostics may be necessary including diagnostic nerve or joint blocks, radiographs, soft tissue ultrasound and although rarely, possibly nuclear or CAT scans.
An additional problem is that many times, especially with chronic lameness issues, more than one area of the horse may be painful. As you can imagine once one limb or area of the body is painful, the horse will adjust his or her way of moving and this compensation can lead to additional areas of pain. Obviously, if there is more than one area of pain, the diagnostic procedures can become more involved and lengthy.
The cost of the lameness examination is a function of the veterinary time that the exam takes along with the cost of special procedures, which most often include nerve or joint blocks, radiographs and soft tissue ultrasonography. To help in keeping diagnostic costs in check the veterinarian must have excellent lameness diagnostic skills, as well as a solid clinical background and good intuitions. Combining lameness history, present condition and client goals is a piece of the art of good lameness diagnosis and the better the practitioner is at this art the less expensive diagnostics may be.
So, selecting a veterinarian with mastery of the art of diagnosis, and excellent communication skills is important in finding the source or sources of lameness and selecting the most appropriate and affordable therapy. Since there are multiple methods of diagnosis, it is important that you discuss expenses and any financial constraints with the veterinarian both at the onset of the exam and as the exam progresses to any additional diagnostics.
An initial lameness exam, by Equine Medical Service, which includes the gait analysis, hoof testing, flexion testing and spinal column analysis is $60 -$80. In many cases, with this base exam your horses lameness be analyzed and therapy discussed. If a complete diagnosis is not achievable through this examination, an outline of additional diagnostic recommendations and costs will be made, and you will be armed with the information needed, to make your decision on how to proceed.