There are many terms used to describe the actual sheath or pouch containing synovial fluid and surrounding the flexor tendons at the level of the fetlock. When this sheath is actually swollen, most horsemen tend to call it a windpuff or windgall. The purpose of this sheath is to decrease the friction between the bones of the ankle and the flexor tendons. The fluid inside the sheath allows the tendons to move freely over the fetlock joint.
It is not unusual to find horses in which the sheaths are filled with fluid. This swelling may occur in any leg, front, or hind. The vast majority of horses seem to be completely unaffected by the swelling. The problem is more a pain to the horseman's eye than it is to the horse.
There are some animals, however, in which pain will be present. Usually, these animals will demonstrate pain by simply putting manual pressure on the sheath. If the pain is great enough, then the animal may even head nod or get on a line/rein.
When a windpuff is present and painful, then drainage of the area is indicated. This is accomplished by inserting a small needle into the sheath and allowing the excess fluid to drain off. Once the needle is in, and the sheath is draining, there are two things possible. Firstly the windpuff may contain fluid only. This fluid is exactly the same as joint fluid (i.e. it is called synovial fluid). Removing this excess liquid may be sufficient therapy for this problem, Many horses will return to soundness on this technique alone. For other horses, it may be necessary to inject the area with cortisone or cortisone and a dulling agent (P-Block). This will immediately decrease the inflammation and make the animal sound again. The only problem is that the technique is temporary and therefore the sheath will likely have to be reinjected 30-90 days later. It should be noted, however, that repetitive treatments of this type will not harm the animal.
The second thing possible when entering the sheath is finding that blood is the only thing present. In these horses, the sheath has actually ruptured with the result that there is continual bleeding into the area. Drainage and injection will prove to be useless. The best thing to do is to simply rest the horse until bleeding has stopped. Drugs that aid in blood clotting can be injected into the area and results have been somewhat successful.
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