The Horse Report There are many factors to consider in treating windgalls  From page 18 Some horses are prone, others resistant, to the development of the most common windgall because of their biomechanics of movement. Almost all of these horses are not lame and the blemish is purely cosmetic. There are some more problematic situations that can occur. Damage to either of the tendons in any form will dramatically increase the inflammation resulting in very high volumes of fluid production. The tendon injury may cause lameness, as may the turgidity of the high pressure of the massive secretion in the tight sheath which in itself will cause lameness. A very common development is stretching and tearing of the previously mentioned annular ligament that traverses horizontally across the back of the fetlock. These can be very painful. The synovial sheath and the annular ligament are part and parcel of the same structure and so a lot of fluid is produced, and often the ligament swells and increases in sized, sometimes "pinching" the tendons causing more trouble. An even worse situation is infection in the synovial sheath, usually the result of a puncture wound, and these are devastating, and difficult to deal with requiring urgent veterinary attention. So, what do we do? Hopefully I have already explained the great majority of windgalls are a result of the way the horse uses the leg. Windgalls are very
Where a horse lives and the use of the horse can be key factors in determining treatment of windgalls.
rare in horses that live in the paddock and are never ridden. Things have to change, and there are usually a multitude of factors in the ecosystem around the use and movement of the horse. When I look at a horse for a client with a windgall, the most important part of the assessment is a detailed exploration of all the factors relating to the use of the horse. By far the most useful and common adjustment we can make is in the way the horse is trimmed and shod and almost always there are things we can change and adjust. Each horse is different but most changes will involve improving the balance of the foot, shortening the breakover, and increasing the heel support. The surface the horse works on is also very
important. Very hard surfaces are going to exacerbate the effects of the small imbalances that may be present. Equally, deep sand surfaces can be wrong as the deeper the surface, the more work the tendons have to do to achieve liftoff and breakover. There are so many factors to consider, it is impossible to cover. Suffice to say, everything must be assessed and adjustments considered. Medical therapy can be very useful as it can markedly reduce inflammation. Phenylbutazone, and other anti-inflammatories will all help. In particular, injection of cortisone into the sheath can be dramatic. Cortisone stops the local inflammation and virtually ceases the secretion, absorption continues and the sheath goes down. It is critical to realise that if the factors that caused the windgall in the first place remain, the inflammation will continue as soon as the drugs wear off. Every owner invariably wants to "drain" the fluid. This on its own is a complete waste as the fluid will instantly be re-secreted and the swelling return. Surgery can be very useful in those cases where there is damage to the tendon or annular ligament. Careful ultrasound examination is very important to attempt to determine what damage may be present, and if there appears to be a lot of sonographic change in the tendons and sheath, surgery is very important in removing damaged tissue and allowing healing.
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