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To evaluate the analgesic and tissue effects of liposomal bupivacaine administered SC as an abaxial sesamoid nerve block in horses with experimentally induced lameness.


6 healthy mature light-breed horses.


In a randomized crossover study, a circumferential hoof clamp was applied to a forelimb to induce reversible lameness. An abaxial sesamoid nerve block of the lame forelimb was performed by SC perineural injection of 10 mg of liposomal bupivacaine or bupivacaine HCl/site. Quantitative gait data were objectively obtained with a body-mounted inertial sensor system before (baseline) and at 30-minute intervals after treatment. Time to return to 85% of baseline lameness was determined. After a minimum 4-day washout period, procedures were repeated with the alternate limb and treatment. Lastly, the palmar digital nerves and perineural tissues were collected and examined histologically.


SC perineural injection of liposomal bupivacaine ameliorated forelimb lameness in 5 of 6 horses. The median duration of analgesia was not significantly different between liposomal bupivacaine (4.5 hours) and bupivacaine HCl (3.0 hours). Histologically, mild inflammation was noted in 3 of 10 sites injected with liposomal bupivacaine and in none of the sites injected with bupivacaine HCl.


SC perineural injection of 10 mg of liposomal bupivacaine/site ameliorated experimentally induced forelimb lameness in some horses. At milligram-equivalent doses, liposomal bupivacaine had a similar duration of analgesia to that of bupivacaine HCl. Further investigation is required before recommending clinical use of liposomal bupivacaine for nerve blocks in horses.

Full access
in American Journal of Veterinary Research
in Journal of the American Veterinary Medical Association


Objective—To characterize the normal ultrasonographic appearance of the podotrochlear apparatus in horses by use of standardized measurements and identify soft tissue changes associated with navicular syndrome.

Design—Prospective study.

Animals—7 clinically normal horses and 28 horses with navicular syndrome.

Procedure—The feasibility of identifying and measuring the soft tissue structures of the podotrochlear apparatus ultrasonographically via the transcuneal approach was assessed in 2 additional horses without navicular syndrome; both horses were euthanatized, and the structures identified ultrasonographically were confirmed at necropsy. Ultrasonographs were obtained in the study horses. Objective and subjective data were obtained to characterize ultrasonographic changes associated with navicular syndrome.

Results—Abnormalities of the flexor surface of the distal sesamoid (navicular) bone, the impar ligament, the distal digital annular ligament, deep digital flexor tendon (DDFT), and the podotrochlear (navicular) bursa were assessed via the transcuneal ultrasonographic approach. No significant differences were found between the measurements of the podotrochlear apparatus in normal horses and those with navicular syndrome; however, important subjective differences were detected ultrasonographically in horses with navicular syndrome. In horses with navicular syndrome, ultrasonographic findings were indicative of navicular bursitis, dystrophic mineralization of the DDFT and impar ligament, tendonitis and insertional tenopathy of the DDFT, desmitis of the impar ligament, and cortical changes in the flexor surface of the navicular bone.

Conclusions and Clinical Relevance—Findings of ultrasonographic evaluation of the hoof appear to be useful in determining the cause of caudal heel pain and characterizing the components of navicular syndrome in horses. (J Am Vet Med Assoc 2004;225:1881–1888)

Full access
in Journal of the American Veterinary Medical Association