Low 4 Point Minimize

(Palmar nerve and Palmar metacarpal Nerve block)

Prepare skin as discussed previously

  1. Ensure adequate restraint of horse to do this procedure with the foot on the ground.
  2. Palpate DDFT and the SL. Avoid digital sheath by measuring a hand's breadth above fetlock joint.
  3. Insert needle parallel to the ground and perpendicular to the skin between the DDFT and the SL. (22gx1" needle
  4. Insert needle to the hub, check for blood and deposit 2-3mL mepivicaine. This will anesthetize the medial branch. Withdraw the needle until it is subcutaneous on the lateral side and deposit 2-3mL.
  5. Palpate the bell (button) of MC 4. Insert needle distal to bell of splint bone, pointing slightly upwards. (25gx5/8" needle) Check for blood and inject 2-3mL mepivicaine. Support hub of needle with one hand and inject with the other. Repeat on medial aspect of limb.

Structures Anaesthetized

  • All structure of previous block (all of structures distal to the location of nerve block)
  • Navicular structures
  • Soft tissue structures of pastern and foot
  • Sole, Laminae
  • Three phalanges
  • Coffin and Pastern and Fetlock joint
  • Distal Digital tendon Sheath
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