owner refusing flexion test ??

[siennamum]

Presumably they don't often insure? I know you don't always have to have a vets cert, but it would be a handicap if horse is over a certain value.

 

[Pale Rider]

It's pretty wicked to treat a horse poorly if it's cheap and well if it's expensive. Expensive horses get treated pretty poorly by their cost concious owners. In fact worrying about flexion tests is bizarre really when some of the worlds most expensive pampered horses are chronically lame.
If you took the shoes off Totilas he'd be as lame as a cat, If they are lame without shoes they're lame with them, just hide it with shoes.
I'm not impressed by insurance company rules, nor vets and their vettings. I know of many people who wasted money on a vetting and bought a horse that was ill or injured. Vets always say that the horse was ok on the day. Bit of a get out clause, lol.
End of the day flexion tests are inconclusive and risky.

 

[Booboos]

It's pretty wicked to treat a horse poorly if it's cheap and well if it's expensive. Expensive horses get treated pretty poorly by their cost concious owners. In fact worrying about flexion tests is bizarre really when some of the worlds most expensive pampered horses are chronically lame.
If you took the shoes off Totilas he'd be as lame as a cat, If they are lame without shoes they're lame with them, just hide it with shoes.
I'm not impressed by insurance company rules, nor vets and their vettings. I know of many people who wasted money on a vetting and bought a horse that was ill or injured. Vets always say that the horse was ok on the day. Bit of a get out clause, lol.
End of the day flexion tests are inconclusive and risky.

It would be a far more interesting discussion if you took a bit of time to substantiate your claims rather than merely repeting them.

What evidence leads you to believe that flexion tests are inconclusive and risky?

Cats are lame? I am completely confused!

 

[SusieT]

Curious how you think holding a leg bent will hurt a horse.....No matter how 'tight' the flexion is, it's not possible to overflex a joint and only a horse with an underlying problem will show a bad reaction

 

[cptrayes]

Finding someone who can do a consistent flexion test would be an achievement. Unreliable at best, potentially damaging at worse. Originally developed as a dope test. Just because someone is buying a horse doesn't give them a right to dictate what tests they want done, against the sellers wishes, as a buyer if you're not happy, go else where. No-one is forced to buy a horse, or sell it if they are not happy with the seller, buyer or vet.

Damaging HOW. PR????

The jumping horse puts immense pressure into its joints on take off and landing. How on earth can a human lame a sound horse horse by flexing when the direction of bend of the leg prevents over flexing the joints being tested.

 

[Pale Rider]

The Ramey Study David Ramey did one a comprehensive studies of flexion tests. He examined 50 horses, or 100 front legs. All horses were judged to be clinically sound on hard ground prior to the test. Both front legs of each horse were flexed twice; once with normal pressure, and once with "extra firmness." The horses were also x-rayed for abnormality in the joints. Findings are below: Of 50 horses, 20 of them, or 40%, showed some positive response (positive=lameness) to the regular flexion. Forty-nine of the 50 horses showed a degree of lameness in response to a "firm" flexion. Thirty-nine of the firmly flexed horses were lame on a scale of 4 out of 5 or greater. Flexion results were compared with each horse's x-rays. Abnormal x-rays didn't correlate with a finding of lameness on flexion. Twenty-four of the 50 horses had radiographic abnormalities, but only eight of these showed any lameness on flexion. Working and older horses were more likely to show a degree of lameness on flexion. (reprisal: Hey dude, ever hear of warming up?)Busschers and van Hoogmoed Studies A study by Busschers of 100 horses sound showed similar findings to Ramey. Their study included both front and hind legs of horses actively working/competing... Like Ramey, they found that the amount of pressure applied and the length of the flexion affected the outcome of the test. Sound horses tended to be slightly positive (showing lameness) in the hind limb. Mares were more likely to show a degree of lameness on flexion than geldings. Repeating a flexion in 10 minute or 30 minute intervals increased the likelihood of a horse showing some lameness on flexion. Repeating a flexion 48 hours later did not increase the likelihood of a positive flexion (flexion showing lameness). The horses were retested in 6-months. On the retest, the number flexions showing a degree of lameness decreased significantly and the horse's range of motion increased significantly. Sixty percent of 100 sound riding horses in this study showed some degree of lameness on flexion.

 

[Pale Rider]

In my non-veterinary opinion the only thing a flexion test tells you is that it may hurt a horse to have a joint forced into an unnatural position. Maybe that means the joint is not in good shape, maybe it doesn't. It tells you diddly squat about the likelihood of future soundness, and next to nothing about soft-tissue problems. On any given day, a horse might or might not flex "positive", depending on whether or not it was just lying down in a funny position, had another horse bang it in the knee, or just because. How does a negative flexion by vet "A" measure up to a positive flexion by vet "B"? Maybe vet "B" is bigger and stronger. Maybe horse "A" is sound and horse "B" isn't. WAY too many confounding variables for me.

 

[SusieT]

So regardless- you think its worthless but what damage do you think it does?

 

[cptrayes]

The Ramey Study David Ramey did one a comprehensive studies of flexion tests. He examined 50 horses, or 100 front legs. All horses were judged to be clinically sound on hard ground prior to the test. Both front legs of each horse were flexed twice; once with normal pressure, and once with "extra firmness." The horses were also x-rayed for abnormality in the joints. Findings are below: Of 50 horses, 20 of them, or 40%, showed some positive response (positive=lameness) to the regular flexion. Forty-nine of the 50 horses showed a degree of lameness in response to a "firm" flexion. Thirty-nine of the firmly flexed horses were lame on a scale of 4 out of 5 or greater. Flexion results were compared with each horse's x-rays. Abnormal x-rays didn't correlate with a finding of lameness on flexion. Twenty-four of the 50 horses had radiographic abnormalities, but only eight of these showed any lameness on flexion. Working and older horses were more likely to show a degree of lameness on flexion. (reprisal: Hey dude, ever hear of warming up?)Busschers and van Hoogmoed Studies A study by Busschers of 100 horses sound showed similar findings to Ramey. Their study included both front and hind legs of horses actively working/competing... Like Ramey, they found that the amount of pressure applied and the length of the flexion affected the outcome of the test. Sound horses tended to be slightly positive (showing lameness) in the hind limb. Mares were more likely to show a degree of lameness on flexion than geldings. Repeating a flexion in 10 minute or 30 minute intervals increased the likelihood of a horse showing some lameness on flexion. Repeating a flexion 48 hours later did not increase the likelihood of a positive flexion (flexion showing lameness). The horses were retested in 6-months. On the retest, the number flexions showing a degree of lameness decreased significantly and the horse's range of motion increased significantly. Sixty percent of 100 sound riding horses in this study showed some degree of lameness on flexion.

None of this is of any use unless the studies say how many of these horses would have failed a prepurchase vetting. A very high proportion of horses will take some lame steps but that is normal and does not make them vetting failures.

Xrays have never correlated well with lameness, so that's a red herring.

I've sold many horses subject to vet. Only one has ever failed a flexion, and in his case it exposed a shoulder injury which required rest. None of the others ever developed any lameness issues that I am aware of. I've also bought two after vetting. One passed flexions and was fine, joint wise. The other failed a front flexion but the vet told me it was just a bruise, so I bought the horse. Six months later it was a navicular write-off. My sound Eventer suddenly started refusing fences. We flexion tested his hocks and exposed early spavins.

That's a 100% a record for my personal experience of flexion tests, so I can't agree with your opinion about them.

 

[Booboos]

The Ramey Study David Ramey did one a comprehensive studies of flexion tests. He examined 50 horses, or 100 front legs. All horses were judged to be clinically sound on hard ground prior to the test. Both front legs of each horse were flexed twice; once with normal pressure, and once with "extra firmness." The horses were also x-rayed for abnormality in the joints. Findings are below: Of 50 horses, 20 of them, or 40%, showed some positive response (positive=lameness) to the regular flexion. Forty-nine of the 50 horses showed a degree of lameness in response to a "firm" flexion. Thirty-nine of the firmly flexed horses were lame on a scale of 4 out of 5 or greater. Flexion results were compared with each horse's x-rays. Abnormal x-rays didn't correlate with a finding of lameness on flexion. Twenty-four of the 50 horses had radiographic abnormalities, but only eight of these showed any lameness on flexion. Working and older horses were more likely to show a degree of lameness on flexion. (reprisal: Hey dude, ever hear of warming up?)Busschers and van Hoogmoed Studies A study by Busschers of 100 horses sound showed similar findings to Ramey. Their study included both front and hind legs of horses actively working/competing... Like Ramey, they found that the amount of pressure applied and the length of the flexion affected the outcome of the test. Sound horses tended to be slightly positive (showing lameness) in the hind limb. Mares were more likely to show a degree of lameness on flexion than geldings. Repeating a flexion in 10 minute or 30 minute intervals increased the likelihood of a horse showing some lameness on flexion. Repeating a flexion 48 hours later did not increase the likelihood of a positive flexion (flexion showing lameness). The horses were retested in 6-months. On the retest, the number flexions showing a degree of lameness decreased significantly and the horse's range of motion increased significantly. Sixty percent of 100 sound riding horses in this study showed some degree of lameness on flexion.

A couple of things:
1. When you copy directly off a website, it is courteous (not to mention avoids plagiarism!) to clearly indicate this (I have no idea who you are, this may well be your website, but since you post anonymously there is no way of knowing this for people who read the thread). The site your info comes from is http://www.behindthebitblog.com/2008/02/flexion-tests-what-do-they-mean.html This is not a published paper, just someone's blog and when doing research it's worth reading studies directly and making one's own mind up.

2. Have you actually read the studies the other guy is quoting? If yes could you please explain to me the relevance of the of the van Hoogmoed et all (2003) to your argument? I have read the study and to the best of my understanding it compares pre-purchase clinical and radiographical evidence with similar post purchase evidence. This study is primarily about the difficulty of detecting navicular and tarsus problems than with the effect of flexion tests.

3. Busschers and van Weeren (2001) has not been cited since it was done which is slightly worrysome don't you think? I can only find one citation in Jonsson et al (2013) and their results are critical and B&vanW.

4. Ramsey (1997) study design is criticised even by those skeptical about the role of flexion tests, e.g. see this very useful summary of cricial literature on flexion tests: Singer E., "Provocative tests for lameness evaluation" http://www.beva.org.uk/_uploads/documents/p93-116-fri-hall-1a.pdf

5. What about contrary evidence (more recent studies at that), like?
Jonsson L, et al, "Prevalence of clinical findings at examinations of young Swedish warmblood riding horsess" Acta Vet Scand. 2013 (55)1:34
Starke S.D., et al, "Proximal hindlimb flexion in the horse: effect on movement symmetry and implications for defining soundness", Equine Veterinary Journal, 44 (6): 657-663

6. And finally the theoretical point at the crux of this: how do we establish cause and effect in this area? How do we design a study that differentiates between horses that were subtly and undetectably lame until the flexion test showed the lameness and horses that were sound but were made lame by the flexion test?

 

[cptrayes]

Thanks for taking the time to do that Booboos, some very useful additional research stuff there.

 

[cptrayes]

tells you .... next to nothing about soft-tissue problems..

Flexion tests on front feet are actually very effective at revealing damage to the soft tissue injuries inside the foot which used to be diagnosed as navicular disease. I've seen two horses which were completely sound on a straight line almost fall flat on their faces after flexions.

My horse with the shoulder injury was also a soft tissue problem, and PSD will also flex unsound (possibly not 100% I'm not sure)

A friend of mine had a sound horse fail the vet on one them, which when xrayed had detached a ligament from the bone and would have almost certainly been lamed by arthritis at some point in the future. Without the failed flexions, the xrays would not have been done and she'd have bought herself a heap of trouble.

 

[siennamum]

It tells you diddly squat about the likelihood of future soundness, and next to nothing about soft-tissue problems. On any given day, a horse might or might not flex "positive", depending on whether or not it was just lying down in a funny position, had another horse bang it in the knee, or just because. How does a negative flexion by vet "A" measure up to a positive flexion by vet "B"? Maybe vet "B" is bigger and stronger. Maybe horse "A" is sound and horse "B" isn't. WAY too many confounding variables for me.

A flexion test can tell a good vet where the issue is likely to be, which is pretty useful IMO.

The same vet doing a flexion test over time on the same horse can spot changes, which is also pretty useful.

I really think you need to meet a good vet PR.

Neither of the horses I m spending huge amounts of money on (& getting flexion tests on) are worth anything, so your analogy about value vs treatment is meaningless. I don't insure them, though I will insure my only valuable horse (and he will have numerous flexion tests in his life)

 

[Pale Rider]

Ok booboo, I'd have thought the cut and paste job was obvious, even to a one eye'd donkey, but there you go.

So you tell me how you differentiate between lameness before a flexion test or caused by a flexion test.

I know people who claim otherwise sound horses were lamed by the test.

Until this is resolved why would anyone risk this. It's alright for potential purchasers to cause a sound horse to be lamed, they just walk away.

 

[Goldenstar]

Ok booboo, I'd have thought the cut and paste job was obvious, even to a one eye'd donkey, but there you go.

So you tell me how you differentiate between lameness before a flexion test or caused by a flexion
I know people who claim otherwise sound horses were lamed by the test.

Until this is resolved why would anyone risk this. It's alright for potential purchasers to cause a sound horse to be lamed, they just walk away.

I would say you know people with lame horses who did not realise they where lame until a flexion test was done.
There is no risk and people allow it to be done because no horse can be vetted without it being done .

 

[Booboos]

Ok booboo, I'd have thought the cut and paste job was obvious, even to a one eye'd donkey, but there you go.

So you tell me how you differentiate between lameness before a flexion test or caused by a flexion test.

I know people who claim otherwise sound horses were lamed by the test.

Until this is resolved why would anyone risk this. It's alright for potential purchasers to cause a sound horse to be lamed, they just walk away.

That's the most bizarre excuse for plagiarism I have ever heard in my life, and I have sat on endless academic plagiarism committees! If you cut and paste someone else's words, just reference them. Easier than relying on one eyed donkeys (what happened to the lame cat by the way?).

Well that was my point. There is an even more significant point that related to the subjectivity of seeing a lameness. One of the studies I referrenced above mentions a 75% agreement amongst the vets watching the videos on whether the horses were indeed lame or not...which leaves a 25% disagreement!

Given how difficult it is for professionals to see lameness and how difficult it is to establish cause and effect in this area, anecdotal evidence about our respective acquaintances is fairly useless. I also know people who claim that their horses were cured by homeopathy or the animal communicator but it still doesn't make it so.

That is not the only risk...you also have the risk that flexion tests actually work in bringing out a lameness and by not doing one you are buying a horse that only appears lame. Seeing as the evidence for your risk is very, very limited I know which risk I take. I take it as a buyer you buy without flexion tests?

 

[cptrayes]

I would say you know people with lame horses who did not realise they where lame until a flexion test was done.

I agree.

PR, can you point me to one substantiated case where a flexion test permanently or even medium term lamed a sound horse?

 

[Pale Rider]

Well booboo, you sitting on an academic committee doesn't suprise me in the least. Lol.

Looks like I'll continue to be against flexion tests. I expect someone will come up with some research for not doing them in the future. They nearly always do.

 

[MagicMelon]

I dont really see why the owner would refuse the flexion test unless the horse has clearly failed it before and she knows that it will again. I dont like flexion tests as I have had a horse a few years ago fail a pre-sale flexion test even though I got my own vet out 2 hours after who passed him... that lost me a sale but then he sold to the next person and has never been lame, so I dont agree with them either. But I wouldnt stop someone having one on one of my horses if they wanted it, I'd just hope that IF the horse failed then as long as it was only a very low degree then it wouldn't put them off because they should be taken with a pinch of salt!

OP, be careful - you took her out on the road, that's fine BUT remember the owner was leading her so this does NOT mean the horse is good on her own / in traffic etc. Most horses behave pretty well when led but take them off the lead and it may be a very different story so make sure if you want to hack this horse that you do hack it out properly (and not on a lead). The fact the horse has no shoes on makes no difference, it shouldn't be lame without. With regard to the x-rays, I personally would never fork out for x-rays on request of a buyer either, its really up to you to make yourself happy as it is buyer beware. Its not really up to her to prove the horse is sound Im afraid. If there's ANY doubt then simply walk away! But then again, as someone who is trying to rehome one of my horses as a gentle hack due to his lameness (which I make very clear to people) - even if the horse was slightly lame, it may be absolutely fine for years hacking. It really depends what the issue is though of course, if there is one. Too many people who are actually just gentle hackers only seem to demand 100% sound horses when there are loads of not 100% sound horses (but not in pain ones, like mine) that could do the job perfectly well!

 

[Booboos]

Well booboo, you sitting on an academic committee doesn't suprise me in the least. Lol.

Looks like I'll continue to be against flexion tests. I expect someone will come up with some research for not doing them in the future. They nearly always do.

I am an academic philosopher, I post openly, this is me: http://homepages.nildram.co.uk/~pocket/
The page is a bit out of date I need to get it sorted but my profiles on academia.edu and philpapers.org give access to my work.

 

[cptrayes]

I agree.

PR, can you point me to one substantiated case where a flexion test permanently or even medium term lamed a sound horse?

No, I didn't think you could.

 

[amage]

PR just out of interest when you buy a horse do you tell them not to bother flexing it at the vetting??

 

[Pale Rider]

Well, this business of being anti flexion tests started for me about 20 yrs ago. I had a nice stallion at stud. A number of people brought mares, now brood mares because they reckoned that flexion tests lamed these mares. Different vets involved all round the country. These were expensive mares and totaled three in number over a couple of yrs. These horses were sound and working until they were being sold and vetted. In the blink of an eye, lame and devalued. Obviously folk bred from them because the lines were good. Now, I can't prove any of this, but you hear the same tale a few times and you'd be daft to let the same thing happen to you.

I've bought a lot of horses over the years and never had any vetted. I trust my own judgment, never had cause to regret it.

 

[SusieT]

oh excellent, so you encouraged the breeding of sub standard specimens.

 

[cptrayes]

oh excellent, so you encouraged the breeding of sub standard specimens.

Yup, fantastic, let's breed from mares that are so fragile that a flexion test that the vast majority of horses would have no problem with permanently lamed them.

Triffic idea!

 

[Pale Rider]

Well, you prove a flexion test didn't lame them and I'll agree, but of course you can't.

 

[cptrayes]

Well, you prove a flexion test didn't lame them and I'll agree, but of course you can't.

It did lame them.

The question is why they were so frail that a test which the vast majority of horses pass with no issues, otherwise they would not be used for diagnosis and vettings, lamed them permanently.

 

[Magnetic Sparrow]

I've read this thread with interest, thanks for something worthwhile to read on a day when the weather is too nasty to do much with my horse.

Question: If an owner is unwilling to allow you to do a flexion test, would it be possible to ask them to make available the horse's veterinary records instead? That would at least show whether the horse had known issues.

 

[hnmisty]

Question: If an owner is unwilling to allow you to do a flexion test, would it be possible to ask them to make available the horse's veterinary records instead? That would at least show whether the horse had known issues.

My dad is a vet, so when I was looking at Barry the lady selling him said I could get my dad to phone up the practice he was registered with to check his record. I thought either there was nothing on it, or it was a good double bluff.

His passport had no record of him being given bute (he wasn't signed out of the food chain) but I have since found out from the actual owner that he had been given bute before. They obviously had their own supply they didn't need a vet for. So the vets would have said they'd only had to visit him for routine things...but that clearly wouldn't have meant all too much.

The vet now thinks he has arthritis... Had him 5* vetted in April when he was 8.

 

[Booboos]

Well, this business of being anti flexion tests started for me about 20 yrs ago. I had a nice stallion at stud. A number of people brought mares, now brood mares because they reckoned that flexion tests lamed these mares. Different vets involved all round the country. These were expensive mares and totaled three in number over a couple of yrs. These horses were sound and working until they were being sold and vetted. In the blink of an eye, lame and devalued. Obviously folk bred from them because the lines were good. Now, I can't prove any of this, but you hear the same tale a few times and you'd be daft to let the same thing happen to you.

There is a reasoning test called Occam's razor which says that faced with a number of competing explanations, the one with the fewest assumptions is more likely to be correct. So here we have two competing explanations:

either vets are in a global conspiracy to turn horses they vet lame and hide this fact thus gaining...ermmmh not too sure what they have to gain here, perhaps we should ask the anti-vaccination crowd?

or owners work horses that have subtle problems that do not become detectable until the horses are put under the strain of vetting, e.g. trotting on concrete on small circles, flexion tests, etc.

Pick your choice.

By the way when you have had owners with horses found to have heart problems at the vetting did you conclude that vets somehow give horses cardiac disease as part of the vetting or did you think that this was a pre-existing and undetected by the owner condition?