Capped Hock in Horses
Capped Hock or Calcaneal Bursitis in Horses is caused by the bursitis of the subcutaneous calcaneal bursa at the point of hock. Swelling at the point of the hock (calcaneus) is usually attributable to damage to the subcutaneous calcaneal bursa (capped hock) or problems within the intertendinous calcaneal bursa located beneath the superficial digital flexor tendon (SDFT).
The intertendinous calcaneal bursa may be further divided into the gastrocnemius calcaneal bursa and the intertendinous calcaneal bursa, but in most horses these 2 bursae communicate and should be considered as a single synovial structure.
Etiology
- Direct trauma
- Horse hitting the hard object such as stall wall
- Penetrating wound – swelling and lameness
Clinical signs
- Soft fluctuating swelling at the hock
- Subcutaneous edema around hock in acute cases
- Thickening and fibrosis of surrounding tissue in chronic cases
- Lameness may or may not be present, if present usually minimal for few days
Diagnosis
- Clinical signs
- Flexion test
- Intrasynovial anaesthesia
- Plain and contrast radiography
- Ultrasonography
- Synovial fluid analysis and culture
- Scintigraphy
- MRI
Treatment
- Small swelling require no treatment with careful observation towards progression of the condition
- Topical anti-inflammatory – DMSO, Surpass combined with bandaging
- Aseptic drainage and followed by injection of corticosteroids and HA
- Horses with septic calcaneal bursitis should be treated with a combination of synovial lavage (endoscopy), local and parenteral antibiotics including IV regional perfusion, and NSAIDs
Prognosis
Horses with septic calcaneal bursitis tend to have a fair to guarded prognosis for athletic use because of the high motion required in this area during limb flexion.