Stringhalt
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Stringhalt is a sudden
flexion Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative ...
of one or both hind legs in the
horse The horse (''Equus ferus caballus'') is a domesticated, one-toed, hoofed mammal. It belongs to the taxonomic family Equidae and is one of two extant subspecies of ''Equus ferus''. The horse has evolved over the past 45 to 55 million y ...
, most easily seen while the horse is
walking Walking (also known as ambulation) is one of the main gaits of terrestrial locomotion among legged animals. Walking is typically slower than running and other gaits. Walking is defined by an 'inverted pendulum' gait in which the body vaults o ...
or
trotting The trot is a ten-beat diagonal horse gait where the diagonal pairs of legs move forward at the same time with a moment of suspension between each beat. It has a wide variation in possible speeds, but averages about . A very slow trot is someti ...
. It is most evident when the horse is backing up slowly, turning on the affected leg, or suddenly frightened. It can involve one or both hind legs of the horse. It is a
spasm A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ such as the bladder. A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a muscle c ...
odic contraction of the lateral extensor tendons of the hind legs. There are four forms of stringhalt: *Australian stringhalt: a flatweed ('' Hypochaeris radicata'') is the suspected cause *Pseudostringhalt: the apparent result of a painful condition in the affected leg *Unilateral stringhalt: cause unknown, but often relieved by section of the lateral extensor tendon *Bilateral stringhalt: in two out of two affected horses necropsied, abnormal
thalamus The thalamus (from Greek θάλαμος, "chamber") is a large mass of gray matter located in the dorsal part of the diencephalon (a division of the forebrain). Nerve fibers project out of the thalamus to the cerebral cortex in all directions, ...
Treatment varies.


Australian stringhalt

Australian stringhalt was described and differentiated from classical stringhalt in 1884. Australian stringhalt is differentiated from classical stringhalt by the severity, occurrence of outbreaks, distinct seasonal pattern and the ability of affected horses to recover spontaneously. This condition is characterised by the sudden exaggerated flexion of either one or both hocks. This form of stringhalt most commonly occurs in the summer and autumn while horses are out on pasture. Epidemics of Australian stringhalt are usually witnessed during
drought A drought is defined as drier than normal conditions.Douville, H., K. Raghavan, J. Renwick, R.P. Allan, P.A. Arias, M. Barlow, R. Cerezo-Mota, A. Cherchi, T.Y. Gan, J. Gergis, D.  Jiang, A.  Khan, W.  Pokam Mba, D.  Rosenfeld, J. Tierney, an ...
or abnormally dry conditions.


Affected areas in the horse

The long digital extensor muscle (usually in the hind limb) is the muscle that appears to be the most affected by this condition. The most severe muscle
lesion A lesion is any damage or abnormal change in the tissue of an organism, usually caused by disease or trauma. ''Lesion'' is derived from the Latin "injury". Lesions may occur in plants as well as animals. Types There is no designated classifi ...
s have been found within the long and lateral digital extensors and lateral deep digital flexor. The location of neuromuscular lesions in Australian stringhalt may be explained by the susceptibility of longer, larger myelinated nerve fibres to injury. Regenerating nerve fibres with disproportionately thin
myelin sheath Myelin is a lipid-rich material that surrounds nerve cell axons (the nervous system's "wires") to insulate them and increase the rate at which electrical impulses (called action potentials) are passed along the axon. The myelinated axon can be l ...
s are more common in the proximal parts of affected nerves in horses with Australian stringhalt. Distal axonopathy occurs most severely in the longest nerve in the horse. The cause for this distal axonopathy remains unknown.


Treatment

Horses affected with this condition rarely recover without surgical intervention, although there have been some instances where horses have recovered without treatment. The recovery time in affected horses can range from three months to three years. Horses may be affected so severely that
euthanasia Euthanasia (from el, εὐθανασία 'good death': εὖ, ''eu'' 'well, good' + θάνατος, ''thanatos'' 'death') is the practice of intentionally ending life to eliminate pain and suffering. Different countries have different eut ...
is necessary. It is unknown how long it takes for
clinical sign Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...
s to develop after the exposure to the cause of the condition. The majority of horses affected by stringhalt are dependent upon pasture for nutrition. Removal of the horse from its original paddock containing low-quality pasture, weeds and native grasses, along with dietary control, was the most common and successful treatment. Lateral digital extensor tenectomy has also been used as a treatment by veterinarians with a success rate of just over 50%.
Phenytoin Phenytoin (PHT), sold under the brand name Dilantin among others, is an anti-seizure medication. It is useful for the prevention of tonic-clonic seizures (also known as grand mal seizures) and focal seizures, but not absence seizures. The intr ...
has been used in the management of Australian stringhalt. Two weeks after treatment with phenytoin, significant improvement was observed in the gait abnormality of horses affected with Australian stringhalt at the trot and canter, but no significant improvement was observed at the walk or while turning.


Causes

The most common plant species that have been found and identified in pastures where affected horses were located include: flatweed ('' Hypochaeris radicata''), sheep's sorrel (''
Rumex acetosella ''Rumex acetosella'', commonly known as red sorrel, sheep's sorrel, field sorrel and sour weed, is a species of flowering plant in the buckwheat family Polygonaceae. Native to Eurasia and the British Isles, the plant and its subspecies are commo ...
'') and couch grass (''
Elymus repens ''Elymus repens'', commonly known as couch grass, is a very common perennial species of grass native to most of Europe, Asia, the Arctic biome, and northwest Africa. It has been brought into other mild northern climates for forage or erosion cont ...
''). The type of nerve damage sustained in horses with Australian stringhalt suggests a mould toxin (
mycotoxin A mycotoxin (from the Greek μύκης , "fungus" and τοξίνη , "toxin") is a toxic secondary metabolite produced by organisms of kingdom Fungi and is capable of causing disease and death in both humans and other animals. The term 'mycotoxin' ...
) or a fungal 'poison' found in the soils may be a cause for this condition. Mycotoxins can directly affect the long myelinated nerves in the hind limbs.


See also

*
Muscular system of the horse Types of muscle There are 3 types of muscle, all found within the equine: * Skeletal muscle: Contraction of these muscles leads to the muscle pulling a tendon, which in turn pulls a bone. Moving a bone results in either flexing or extending a joi ...
* Scotty cramp, a condition in dogs that may resemble stringhalt in horses


References

{{reflist, 32em Equine injury and lameness Articles containing video clips