This radiograph shows a complete dislocation of the fetlock joint. While there are no fractures, there is severe tearing of the soft tissue.

We’ve all been engrossed with the episode of Barbaro and his fate. (The 2006 Kentucky Derby winner broke down during the second leg of the Triple Crown at the Preakness Stakes.) Historically, when a horse has fractured a leg he was euthanized. We’ve now been made aware that there are options to save these horses. I would like to briefly discuss things to consider if you’re faced with a decision of what to do should your horse suffer a major breakdown.

There are some very basic differences to consider when dealing with leg fractures in the horse versus people. We can’t tell a horse he will need three months of bed rest with no weight-bearing on the leg. We can’t teach him to use crutches, either. The horse’s lower leg has limited blood supply, and often what it has is damaged with the injury. Should there be an open wound, such as with a compound fracture, infection is very difficult to prevent or treat because of the environment of horses’ lower legs.

In dealing with leg fractures in the horse, specialists say if there is a break in the skin with the injury, the prognosis for success is so poor, because of infection, that euthanasia is advised. Another very serious threat is catastrophic failure of the opposite leg because of constant weight-bearing. When a horse is non-weight-bearing on the affected leg, the blood supply to the opposite foot is compromised. Over time this can result in severe laminitis.

In this radiograph, alignment has been re-established and the leg has been cast for stability. The result will be extensive scarring and probable loss of joint mobility.

I treated a broodmare once that had a small puncture wound into the tendon sheath on a hind leg. The wound was so small it wasn’t noticed until the mare was severely lame from infection of the tendon sheath. Because the mare was non-weight-bearing for a couple of weeks, the coffin bone of the opposing leg rotated through the sole and we had to put her down, despite treatment.

Another factor that impacts outcome in the horse with severe leg injuries is life-threatening impaction colic secondary to stress, dehydration and/or medications. The temperament or attitude of some horses can cause serious problems with treatment and outcome.

What I’ve discussed here may seem negative, but, in my opinion, that’s reality. In the heat of the moment, sometimes we make decisions based on emotion. Every case has different components, so listen to your veterinarian or the specialist you’re referred to before making a decision.