I was called out to Sue’s farm to check out her big Quarter Horse gelding, Carlos, for lameness. When I arrived, Sue said that she hoped this wasn’t a wasted trip. She wasn’t positive that Carlos was lame, but knew he was not himself and had not been performing well. She offered to bring Carlos to me from his stall at the far end of the barn. I welcomed that chance so that I could watch him as he walked up the long aisle. Watching horses at a walk is important in lameness exams and often provides clues as to where and what the problem is.
I sat down on a bale of hay as Sue went to get a lead shank and Carlos. The old yellow tom barn cat jumped up and started rubbing against me. As I was patting and looking at him, something startled me. Sue’s barn aisle floor is concrete, the barn itself is cavernous, and Carlos was shod. The sound bouncing off the walls was striking. “Clip, clop, clip, thunk. Clip clop, clip, thunk“, all the way up to where I was sitting. I laughed and said, “Sue, did you hear that?” “Hear what?”
“The sound of Carlos walking!”
“No, I didn’t. Guess I wasn’t paying any attention.”
“OK, turn him around and let’s walk him back to his stall. Listen for his foot fall.”
“Clip, clop, clip, thunk”. “Yes! I do hear it, he sounds way different when his right fore hits the ground, doesn’t he?”
Carlos was light on the right fore, but not obviously lame. If he had been walking on rubber mats instead of the concrete, you wouldn’t have noticed a thing. The footfalls were a place to start, and we began watching how he landed on each foot. He was consistently landing toe first with the right fore. After checking the pulse strength above that foot and using hoof testers, I diagnosed a soreness in the heel. The problem turned out to be a chronic abscess which was easily taken care of.
The early hint as to what was bothering Carlos was that lack of symmetry as he walked. “Clip, clop, clip, thunk. ” Left hind, left fore, right hind, and then the different sound of the right fore. We tend to think of symmetry as something we can see. Examples are a big knee, a swollen hind leg, a pelvis high on one side, or perhaps a half closed eye. When we see something different like that, our eyes automatically go to the other side to compare. Symmetry is when they are the same, and that’s usually good. Asymmetry is when they aren’t, and that lack of “sameness” catches our eye. It is helpful in examining our animals to use all of our senses. Not just what we see, but also what we hear, palpate (touch) and even smell. Outside of a few memorable occasions when I had my mouth open at the wrong time and got a squirt of one horse fluid or another, I think that taste is the only one sense I have never consciously used when examining horses.
When you see a big leg, it is helpful to see if even a light touch causes a painful reaction which may mean an infection. Gently squeezing different areas may tell us if we have soreness in a bone, tendon, or ligament. The symmetry part here is to check the same areas on the opposite leg. Some horses don’t even want their good leg squeezed.
If I am examining a horse with respiratory problems, I like to smell the air coming out of the nostril on one side and then the other. I cover one nostril with the palm of my hand and put my nose close to the other. When the horse exhales, I inhale. Then I do the same for the other side. Sinus infections that involve a bad tooth are super stinky and much more pronounced on that side.
Symmetry is also important when checking a painful eye. You can easily see that that eye is partially closed. Take the horse to a dark stall and look a little deeper. Use a flashlight to compare the size of the pupil in the painful eye with the horse’s other side. Serious conditions of the eye will cause a constriction (gets smaller) of the pupil on that side. Eyes with that lack of symmetry should be seen by your vet right away.
Checking symmetry is a handy tool because on the same horse you have the other leg, the other eye, or whatever on the other side to compare the problem area to. I am thinking of a horse I see every year for his annual physical and vaccinations. As I listen to his heart, I always notice his eighth rib. It bows out away from the rib cage a solid inch. The first time I saw it I thought that this must affect him in some way. It turns out that the eighth rib on the other side of his body also sticks out. There is no pain when the rib is manipulated on either side. As his owner says, “it goes with him”. So, it’s an oddity that is part of who he is and has never been a problem. He is symmetrical and sound.
The take home is to recognize that ideally horses are symmetrical both in their body structure, and in the way that they move, feel, sound, and even smell. Compare what you think is new and unusual to the other side using all the senses that you can. By being observant and always checking symmetry you will be able to catch problems more readily.