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What is a Diplomate?
The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery.

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Lameness in Horses

The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.

Your ACVS board-certified veterinary surgeon completed a three-year residency program, met specific training and caseload requirements, performed research and had research published. This process was supervised by ACVS Diplomates, ensuring consistency in training and adherence to high standards. After completing the residency program, the individual passed a rigorous examination. Only then did your veterinary surgeon earn the title of ACVS Diplomate.


Lameness refers to an abnormality of a horse's gait or stance. It can be caused by pain, a mechanical problem, or a neurological condition. Lameness, most commonly results from pain in the musculoskeletal system (muscles, tendons, ligaments, bones, or joints) leading to abnormal movement at the walk, trot, or canter.

Signs and Symptoms: 

Lameness can range from being very mild (i.e. may not be easy to see but can be felt while riding the horse) to severe (the horse won’t bear any weight on the leg). With more subtle lameness issues you may notice a decrease in your horse’s performance or a change in their behavior or attitude even though you can’t see or feel an obvious lameness. Sometimes horses will “stand off” of a lame leg or point that leg more often than usual. Horses with chronic problems may develop compensatory gait abnormalities to deal with the primary problem. This may complicate the lameness evaluation and possibly its treatment. Therefore, it is important to have a lameness evaluated as soon as it is recognized.


If your horse is lame, it should be evaluated by your primary care veterinarian as soon as possible. In some cases the examination may be simple; in others it may be more extensive, requiring nerve or joint blocks & diagnostic imaging to make a diagnosis. Your veterinarian may choose to do some or all of the following if your horse is lame:

  • Take a thorough history; certain lameness issues are more common in different breeds or disciplines of activity
  • Physical Exam:
    • Palpation of the entire horse to check for any areas of heat, pain, or swelling
    • Hoof testers - to see if there is a painful response to pressure on the feet (Figure 1)
  • Lameness Exam: The horse is evaluated at various gaits to determine if lameness can be seen by your veterinarian. This may be done with an assistant trotting the horse in hand, on a lunge line, or occasionally while the horse is being ridden.
  • Flexion Tests: May be helpful if the lameness is subtle or there are no obvious signs of a problem (Figure 2); they involve bending or "flexing" a joint for up to 1-2 minutes. The horse is then immediately trotted off & evaluated for an increase in lameness. If a particular flexion test increases the lameness, your veterinarian may want to do further testing on that body part to determine if it is the cause of the lameness.
  • Nerve or Joint Blocks (“Diagnostic Analgesia”): A local anesthetic is injected either around nerves or directly inside of a joint to desensitize specific structures on the horse’s limb (Figure 3). The horse is then evaluated again to watch for lameness. If the lameness improves after an area is desensitized, then the lameness is assumed to be coming from that location.
  • Diagnostic Imaging: Once a specific part of the limb is isolated as the cause of the lameness, some type of imaging test is usually recommended. Depending on the body part involved your veterinarian may recommend radiographs, ultrasound, nuclear scintigraphy (aka “bone scan”, Figure 5), CT or MRI (Figure 4).
  • Quantitative Assessment: The use of specially placed motion detectors on the limbs and trunk of the horse can aide in the detection of subtle gate asymmetries and responses to the aforementioned diagnostic tests. 

Treatment varies widely depending on the cause of the lameness. However, treatment for common lameness issues often includes joint injections and administration of medications aimed at decreasing inflammation. For some lameness conditions specific, shoeing recommendations may be made and a period of rest and rehabilitation may be needed. Some causes of lameness can be treated surgically. If so, your veterinarian may choose to consult an ACVS board-certified veterinary surgeon on possible surgical or adjunctive therapy for your horse’s problem.

Aftercare and Outcome: 

Varies widely with cause of the lameness and the treatment given.

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Also known as: 
Lameness in Horses

This Animal Health Topic was written by and reviewed by Diplomates of the American College of Veterinary Surgeons.  Any opinions stated in this article are not necessarily the official position of the American College of Veterinary Surgeons.

The American College of Veterinary Surgeons recommends contacting an ACVS board-certified veterinary surgeon or your general veterinarian for more information about this topic.

To find an ACVS Diplomate, visit www.acvs.org/find-a-surgeon.