Severe Lameness

Common causes on severe to non-weight bearing lameness:

  • Foot abscesses
  • Foot penetrations
  • Joint infections
  • Fractures
  • Tying up
  • Laminitis

Foot abscess

By far the most common cause of sudden onset of severe lameness. Common signs:

  • Toe pointing
  • Reluctant but able to bear weight
  • Heat in foot and throbbing digital pulse
  • Lower limb swelling may occur due to lack of normal weight bearing

Foot penetrations

What to do:

  • Do not remove penetrating object
  • Pad around object to prevent further damage while waiting for the vet
  • Penetrations towards the central foot are potentially life threatening, penetrations around the periphery of the sole or heel are less serious

Joint infections:

  • A wound near to a joint is usually present but this can be as small as a thorn puncture, well hidden beneath winter coat
  • Lameness increases over 12 hours. At 6-24 hours the horse will be unable to put any weight on the limb, the horse will also be distressed, sweating and have an elevated heart rate and respiratory rate.
  • Yellow tinged fluid oozing from wound in vulnerable location
  • Increased heat and/or swelling of joint/sheath/bursa

What to do

This is an emergency, please call the practice immediately. The treatment involves the joint being flushed under general anaesthesia; if treated within 24 hours the prognosis is usually very good.


  • Some fractures can be fixed (chip fractures, hairline fractures, fractures of small bones, fractures of long bones in foals)
  • If the bone comes through the skin or if it is a long bone in an adult horse, the fracture is not repairable.

What to do:

  • Keep the horse calm and still (food and quiet equine company can be useful)
  • If the horse is panicking try to leave it in a safe place where nobody will be hurt by it.
  • Horses can walk short distances on three legs if required.

Tying up


  • Sudden onset reluctance to move during exercise or right after.
  • Range from slight stiffness to complete inability to move, sweating, pawing the ground, distress
  • Muscles over the back very hard

What to do:

  • Do not move the horse, except on to a trailer/to a nearby loose box.
  • Offer water at head height.
  • Keep warm, rug up well.
  • Massage muscles gently.
  • The horse must be seen by the vet if the tying up episode is moderate to severe for pain relief and sometimes fluids. All cases need to be seen at 24-48 hours after tying up to blood sample for assessment of the severity of muscle damage. 


  • Sudden onset reluctance to move
  • Range from slight stiffness on hard ground (especially at turns) to typical laminitic stance (with all weight over the hind legs and inability to lift either of legs up)
  • Increased digital pulse (easily palpated on the side of the fetlocks)

What to do:

  • Move the horse slowly into the stable and lay down shavings - at least 30 cm depth, from door to the walls
  • Call the practice, the horse will need pain relief and further frog support
  • When the acute phase is over the horse will also need blood test (to diagnose the underlying condition leading to laminitis); and he will also need feet x-rays done so your farrier can correct the damage already done.