See a swelling on your horse’s leg and your first reaction might be to panic - will it take ages to mend, cost me a fortune and potentially affect his future? But don’t panic. With good management, most leg problems can be prevented and early intervention from your vet will more often than not lead to successful treatment.
What are they?
A windgall is swelling of the digital tendon sheath – a sterile fluid-filled sleeve covering the flexor tendons over the back of the fetlock joint. Often these swellings appear with no associated lameness. However, in some cases they can be a sign of a more serious problem and associated with a moderate to severe lameness. Windgalls without lameness are common and usually only a concern for cosmetic reasons – they’re likely to be the result of wear and tear.
Injury to the digital flexor tendon within the sheath will cause a more problematic windgall, and lameness, and this is known as inflammatory tenosynovitis. A wound that pierces the tendon sheath can cause infection, which will also cause swelling. Septic tenosynovitis is associated with severe lameness and requires urgent veterinary attention.
Persistent swelling ofthe tendon sheath can also cause Annular Ligament Syndrome. The annularligament is situated between the tendon sheath and the skin over the back of the fetlock joint – it holds the flexor tendons in place. This ligament can hold back some swelling, which results in bulging of the sheath above and below this region, and gradual thickening of the ligament.
Diagnosis and treatment
Heat and pain at the site of the windgall can indicate more serious problems. The area should be checked for wounds, as even the smallest puncture can result in sheath infection.
Clip the hair from just above the fetlock to the heel bulb if necessary. An ultrasound examination is recommended for significant windgalls. The fibre pattern of the flexor tendons can then be assessed together with any thickening of the annular lgament. If it looks to be infected, a sample of the fluid within the tendon sheath can be taken for investigation. If lameness is mild and there’s no evidence ofinfection or tendon or ligament damage, rest, cold therapy and systemic anti- inflammatory drugs may be all that’s required.
If lameness is more severe or persistent, anti-inflammatory medication can be administered directly into the sheath. If there is tendon damage, your horse will need a longer rest period with repeated ultrasound scans to monitor progress. Treatment of annular ligament thickening is initially directed at reducing sheath swelling, but may need operating on. If infection is present, surgery is needed. The tendon sheath is flushed with high volumes of sterile saline.
Most horses will developsome degree of tendon sheath swelling, usually in the hindlegs. Care should be taken to minimise the risk of tendon injury through avoidance of bad ground and sensibly managed exercise regimes. Leg boots can be used to protect the tendon sheath area during exercise or turnout.