Description

Capped elbow and capped hock are inflammatory swellings of the subcutaneous bursa overlying the point of the elbow or the point of the hock. The word capped refers to the swollen, distended appearance that these areas take on following trauma.

Although lameness is rare in cases of capped elbow and capped hock, a firm fibrous capsule often forms in a short time, especially if there is a recurrence of an old injury and this may lead to lameness. The point of the hock and the top of the elbow are similar in that they have a synovial bursa, a sac lined by synovial or joint-like tissue under the skin and these bursas are the site of the inflammatory swellings.

The purpose of the synovial bursa is to reduce the pressure on the tendon as it moves across the bones and it helps to keep the tendon from being traumatized by the repeated flexing and extending of the hock or elbow joint.

While a simple swelling will eventually go down, repetitive injury or a puncture wound to the bursa will frequently result in serious infection that can present difficulties in the recovery process.

Symptoms

• Observable contusions
• Swelling over and around the bursa
• A hot area that is tender to the touch
• Occasional lameness

Causes

Capped elbow, capped hock, shoe boil, and olecranon bursitis are usually caused when the heel of the foot hits the point of the elbow or hock while the horse is lying down. Occasionally, the foot strikes the elbow in gaited horses while the horse is in motion.

Trauma from lying on hard floors, riding the tailgate of the trailer, and prolonged recumbency may also lead to injuries when the horse's shoed hoof or other hard object comes in contact with the elbow or the hock of the horse.

Prevention

When transporting horses in an enclosed trailer, be sure to use padded leg wraps. Review the horse's shoeing to ensure that it is proper and also apply a large doughnut-looking roll to the pastern to prevent trauma to the region of the elbow.

When a horse lies down, the horse's foot and shoe often come into contact with the elbow as the horse curls its leg up under itself. Repeated injuries resulting in a swollen irritated area are also known as a shoe boil because of the swelling and inflammation.

If the injuries occur because the horse kicks the stall walls or other hard materials, causing capped hock, behavioral modification offers the best hope of permanently resolving the problem.

Treatment

The first course of action in providing treatment for a capped hock or elbow is to eliminate the known causes of the trauma by reviewing the state of the horse's shoeing and providing padded leg wraps and pads to the pastern to diminish the chances of injuries.

Trailers and stalls may need to be modified to limit the chances of contact with surfaces that can cause trauma to the horse's elbow or hock.

Cold hydrotherapy is often recommended to reduce swelling and relieve any pain. Treatment with steroid injections directly into the affected bursa can also reduce the swelling of the sac, but this should be done by a veterinarian to reduce chances of infection.