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String Halt and its Management in a Mare

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Intas Polivet (2012) Vol. 13 (II): 255-256 Short Communication

String Halt and its Management in a Mare

K. Kachwaha1, T.K. Gahlot, M.C. Parashar and S.M. Qureshi
Department of Veterinary Surgery and Radiology
College of Veterinary and Animal Science
Rajasthan University of Veterinary and Animal Sciences
Bikaner- 334001 (Rajasthan)

Abstract
A six year old mare was presented with involuntary and exaggerated upward flexion of right hind limb during walk,
graze or exercise.The animal was operated after confirming as string halt condition. Two linear incisions were
given over lateral digital extensor muscle and tendon joint and distal end of lateral digital extensor tendon before
it joins the tendon of long extensor. First distal portion of tendon was transected then proximal portion with muscle
belly. Mare showed an almost immediate improvement with complete recovery within 2 weeks.
Keywords: Mare; myotenotomy; string halt

Introduction was prepared by shaving, scrubbing and painting

String halt is a myoclonic affliction of one or both
hind limbs seen as spasmodic overflexion of the
joints. Severe forms of the string halt have been
attributed to lathyrism (sweet pea poisoning) in
USA and possibly to flat weed (Hypochoeris
radicata) intoxication in Australia (Domange et al.,
2010; Araujo et al., 2008). Horses of any breed
may be affected, it is rare in foals.
Many of these cases apparently recover
spontaneously. In chronic cases, myotenectomy
of lateral digital extensor tendon and some portion
of the muscle, has given best results (Stashak,
2002). Present report deals with a successful
surgical management of string halt in a mare.
History
A grey mare aged six years was presented with
involuntary and exaggerated upward flexion of
right hind limb during walk, graze or exercise. The
limb flexions were acute and touched the belly in
every step (Fig. 1). Animal was kept off-feed and
water for 24 hours prior to surgery. Mare was taken
into lateral recumbency under general
anaesthesia and site was prepared for aseptic
surgery.
Surgical Treatment
A general anaesthesia was administered using
Atropine, Xylazine and Ketamine combination
(Hall et al., 2001) to the hobbled horse and was
taken to lateral recumbency after induction. Site
1. Corresponding Author
E-mail:kapilsingh814@gmail.com
of betadine.
Fig. 1: String halt characterized by flexion of hind leg
and pastern touching the belly.
Two linear incisions approximately 2 cm long were
given over lateral digital extensor muscle and
tendon joint and distal end of lateral digital
extensor tendon before it joins the tendon of long
extensor (Fig. 2). Pulling on the muscular portion
revealed movement in the distal portion just before
it was attached to the long extensor confirmed
tendon’s anatomical location. First distal portion
of tendon was transected then proximal portion
with 7 to 10 cm of muscle belly. The incised tendon
was removed from proximal incision site. After
removal of the tendon, the fascia surrounding the
muscle and subcutaneous tissue were sutured
with Vicryl no. 1 and skin wounds were closed by
simple interrupted sutures using silk no. 1. Animal
was administered 5 litre of 5% Dextrose normal
saline preoperatively followed by 10 litres of 5%
Dextrose normal saline and Ringer’s lactate in

255
 Kachwaha et al.
next 12 hours. Tetanus toxoid 5 ml was
administered deep intramuscularly.
Fig. 2: Exteriorization of proximal and distal end of
lateral digital extensor tendon through two incisions
on lateral aspect of hock joint.
Post-Operative management
Mare was administered Ceftriaxone 3 gm bid
intramuscularly for next 5 days and Meloxicam
50 mg intramuscular was given for 3 days. Wound
was kept protected from flies and dirt by wrapping
a secure cloth bandage around the site. Skin
sutures were removed after 10 days. Mare
showed an almost immediate improvement (Fig.
3) and clinical signs of string halt disappeared.
Complete recovery took place within 2 weeks.
Fig. 3: Recovered animal
Discussion
String halt may affect horses of any breed and
may be seen in one or both hind legs. The exact
etiology in present study could not be ascertained.
However, Slocombe et al. (1992) found that clinical
signs of String halt were due to lesions limited to
peripheral nerves and muscles.
Domange (2010) studied bilateral string halt in
seventy horses with history grazing on pastures
infested with Hypochoeris radicata. With hind
limbs hyperflexion and a abnormal gait because
of distal axonopathy with skeletal muscle
denervation and atrophy. Fifty percent of them
recovered spontaneously in eight months and
only the more affected horses were unable to
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recover even if they looked healthy on dry and
hot days. Clinical troubles revealed also
depression or aggressive behaviour and treatment
with phenytoin resulted in a rapid noticeable
improvement of string halt in some horses.
Wijnberg et al. (2009) said that therapeutic options
for string halt in horses are limited, whereas
medical experiences with botulinum toxin type A
(Botox) have been positive.
Horses with string halt were treated with exercise,
including daily hand-walking with pasture turnout,
followed by lunging or surgically, using lateral
digital extensor myotenectomy. Of the horses
treated with exercise, 1 had resolution of string
halt, 2 improved but had residual string halt and 1
had no change. Two of the horses having lateral
digital extensor myotenectomy had resolution of
string halt (Crabill et al., 1994). In present case
also similar treatment was undertaken without
recurrence.
References
Araújo, J.A., Curcio, B., Alda, J., Medeiros, R.M. and
Riet-Correa, F. (2008). String halt in Brazilian horses
caused by Hypochaeris radicata. Toxicon 52:190-93.
Cahill, J.I., Goulden, B.E., Pearce, H.G. (1985). A review
and some observations on string halt. New Zealand
Vet. J. 33:101-04.
Crabill, M.R., Honnas, C.M., Taylor, D.S., Schumacher,
J., Watkins, J.P. and Snyder, J.R. (1994). String halt
secondary to trauma to the dorsoproximal region of the
metatarsus in horses: 10 cases (1986-1991). J. Am.
Vet. Med. Assoc. 205:867-69.
Domange, C., Casteignau, A., Collignon, G., Pumarola,
M. and Priymenko, N. (2010). Longitudinal study of
Australian string halt cases in France. J. Anim. Physio.
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Hall, L.W., Clarke, K.W. and Trim, C.M. (2001). Vet.
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Wijnberg, I.D., Schrama, S.E., Elgersma, A.E., Maree,
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Slocombe, R.F., Huntington, P.J., Friend, S.C., Jeffcott, L.B.,
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Stashak, T.S. (2002). Lameness. In: Adam’s Lameness
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