Dressage Today - - Content - By Court­ney Var­ney, DVM

Should You Be Con­cerned About Wind­puffs?

When you ob­serve the fet­lock re­gion of your horse, you may find a puffi­ness or fluid-filled area on the back side (pal­mar/plan­tar re­gion) of his fet­lock. This fluid-filled area may be what is re­ferred to as a wind­puff.

Wind­puffs, or wind galls, are a re­sult of fluid dis­ten­tion of the dig­i­tal flexor ten­don sheath (DFTS) and do not in­volve the fet­lock joint it­self. They typ­i­cally have a bi­lat­eral pres­ence in the hind limbs, although they may be present in all four limbs. The fluid dis­ten­tion of the DFTS caused by wind­puffs is usu­ally in­ci­den­tal and is not as­so­ci­ated with dis­com­fort or lame­ness.

The de­vel­op­ment of wind­puffs is a re­sult of ac­cu­mu­la­tion of fluid in the DFTS. The DFTS serves a pro­tec­tive func­tion, al­low­ing fric­tion­less move­ment as the ten­dons tra­verse the bony promi­nences of the fet­lock joint. Over time, the repet­i­tive glid­ing of the ten­dons over these bony sur­faces can cause the nat­u­rally oc­cur­ring fluid in the DFTS to in­crease. This can re­sult in a puffy ap­pear­ance to the DFTS—hence the term “wind­puff.” Some own­ers wish to lessen the blem­ish for cos­metic pur­poses, but most treat­ments will only de­crease the ef­fu­sion for a few days, and it will most likely re­turn to its en­larged state within a week or two.

Wind­puffs can be ob­served in per­for­mance horses of all ages, but they are most com­mon in older horses. Any horse in a con­sis­tent train­ing pro­gram is a pos­si­ble can­di­date to de­velop wind­puffs, and most older horses who have had a long ca­reer in com­pet­i­tive sport have them. If a horse has bi­lat­er­ally sym­met­ric wind­puffs with no as­so­ci­ated lame­ness, heat, pain or his­tory of in­jury to the DFTS, their pres­ence is most likely with­out con­se­quence. With that said, it is im­por­tant to have any new swelling or ef­fu­sion that is asym­met­ric ex­am­ined by a vet­eri­nar­ian to de­ter­mine if fur­ther di­ag­nos­tics are nec­es­sary.

There is usu­ally noth­ing you can do to pre­vent the for­ma­tion of wind­puffs. Even ban­dag­ing and sweats will only tem­po­rar­ily de­crease the ef­fu­sion, which will usu­ally re­turn a few hours af­ter ban­dage re­moval. Once wind­puffs have de­vel­oped, there is rarely any­thing that can be done to cor­rect them.

Con­versely, tenosyn­ovi­tis is a con­di­tion that causes in­creased fluid ac­cu­mu­la­tion in the DFTS that mim­ics the ap­pear­ance of a wind­puff. It causes vary­ing de­grees of lame­ness as well as a pos­i­tive flex­ion test. Ul­tra­sound of the DFTS is nec­es­sary to eval­u­ate all soft-tissue struc­tures lo­cated within the DFTS and is a nec­es­sary di­ag­nos­tic when tenosyn­ovi­tis is sus­pected. MRI can also be use­ful to de­ter­mine the ex­tent of soft-tissue in­jury within the DFTS and is some­times needed for ac­cu­rate di­ag­no­sis. Treat­ment for tenosyn­ovi­tis varies de­pend­ing on the du­ra­tion of in­flam­ma­tion and if any soft tissue struc­tures are in­volved.

If your horse has de­vel­oped fluid ac­cu­mu­la­tion in the area of the DFTS, it is im­por­tant to ask cer­tain ques­tions to help de­ter­mine the pos­si­ble long-term con­se­quences. How long has the fluid dis­ten­tion been present? Is there a cor- re­spond­ing fluid ac­cu­mu­la­tion that is sym­met­ric on the op­po­site limb? Is the horse lame or is there any his­tory of lame­ness? Is the horse pos­i­tive to a flex­ion test of the dis­tal limb? Has the DFTS had an ul­tra­sound exam per­formed, and if so, what were the find­ings? All of these ques­tions when dis­cussed with your vet­eri­nar­ian may help de­ter­mine if there is an ac­tive in­jury to the DFTS or if the fluid is a re­sult of a wind­puff. These ques­tions are also use­ful when look­ing at horses to pur­chase who have fluid ac­cu­mu­la­tion in the DFTS.

If the horse is de­ter­mined to have wind­puffs, it is most likely that they will not bother him in the long term. But in some cases, acute for­ma­tion of wind­puffs may war­rant treat­ment to de­crease the chance of lame­ness in the fu­ture.

There­fore, it is al­ways im­por­tant to con­sult your vet­eri­nar­ian to de­ter­mine which course of ac­tion will be ap­pro­pri­ate for your horse.

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