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equinee > Day 5 - Lameness 2 (Diseases) > Flashcards

Day 5 - Lameness 2 (Diseases) Flashcards

1
Q

Osteoarthritis - pathogenesis

A

Pathogen.: degradation and destruction of articular cartilage causing progressive loss of hyaline cartilage
- Subchondral sclerosis
- Decreased range of motion
- Subchondral cysts
- Osteophytes
- Synovitis, capsulitis (fibrosis)

Angular limb deformities

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2
Q

Osteoarthritis - CS

A
  • Joint effusion increased
  • Lameness
  • Joint range of motion decreased
  • Changes in the synovia
  • Cartilage damage (Osteoarthritis)
  • New bone formation (Osteophytes)
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3
Q

Osteoarthritis - Dx

A
  • Lameness Examination
  • Visualisation, Palpation
  • Examination during motion
  • Provocating tests (flexion is painful)
  • Perineural and intrasynovial anesthesia
  • Diagnostic imaging: X-rays, Ultrasound
  • Diagnostic arthroscopy
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4
Q

Osteoarthritis - joint cartilage

A
  • Chondrocytes: Matrix degeneration
  • PSGAG: loss? –> decr water binding capasity
  • Hyaluronic acid: Lubricant
  • Stratum fibrosum: Stability, motion
  • Stratum synoviae: HA, and Collagen production
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5
Q

OA: DITJ - TMTJ Bone spavin
dist. intertarsal joint (DITJ)
tarsomtatarsal joint (TMTJ)

A
  • adults
  • recurrance of compression and rotation
  • Conformational abnormalities
  • Metabolic causes protein and mineral imbalances endocrine disorders
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6
Q

OA: DITJ - TMTJ Bone spavin
CS

A
  • Acute onset of lameness
  • Shortened cranial phase of the strait
  • low arc of foot flight
  • In chronic cases: palpable bony swelling
  • Positive hock flexion test
  • Mild case: improves in training
  • Severe case: worsening during work
  • Outside of the hoof (shoe) is wearing off
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7
Q

OA: DITJ - TMTJ Bone spavin
Dx

A

Diagnostic anesthesia
- Intraarticular anaesthesia
- TibFib (N. tibialis and peroneus)

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8
Q

OA: DITJ - TMTJ Bone spavin
Tx

A
  • I.A. injection into the tarsometatarsal joint:
  • Na-hyaluronat + Glycocorticoids
  • Cunean tenectomy
  • Chemical / surgical arthrodesis
  • Osteosynthesis with LCP..
  • Kerf-cut cylinder
  • Orthopedic shoeing:
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9
Q

Synovial analysis - causes of synovial damage

A
  1. Congenital cartilage developmental disturbance
  2. Subchondral sclerosis
  3. Damage of healthy cartilage
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10
Q

Synovial analysis - Tx
Corticosteroids - Short acting, Long acting

A

Short acting
* Dexamethason,
* Flumethason,
* Hydrocortison,
* Triamcinolon acetat

Long acting
* Methylprednisolon acetat
* Triamcinolon hexacteonid
* Bethametason acetat

Methylprednisolon acetat, Triamcinolon acetate

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11
Q

Synovial analysis - Tx
NSAIDS

A

Fenilbutazone, Flunixin meglumin, Firocox, Carprofen

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12
Q

Synovial analysis - Tx
Na-hyaluronate

A

Na-hyaluronate
Hyaluronic acid

Decreases joint effusion

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13
Q

Synovial analysis - Tx
PSGAG’s

A

Glycosaminoglycans - Adequan
* Effect: anabolic on synovial fibroblasts and chrondrociytes (Hyaluronic acid and collagen
production)
* Inhibition of cytokines and PGE synthesis
* Increases Synovia viscosity
* Antiinflammatory effect

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14
Q

Synovial analysis - Tx
Tildren

A

Biphosphonate
Goal: inhibition of subchondral bone production
* Inhibition of osteoclast activity (bone resorption)
* Anti-inflammatory effect
* No direct effect on cartilage
* Side effects: nephrotoxicity especially if given too fast

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15
Q

Synovial analysis - Tx
Rest

A

Rest
* After treatment: few days generally accepted
* Reason:
Decrease clearance
Increase time of effect
* No EBM support to date

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16
Q

Synovial injury - surgical (4)

A
  • Arthrotomy
  • Synovectomy
  • Chondroplasty
  • Arthrodesis
17
Q

Synovial injury - surgical
Chondroplasty

A
  • Debridement (shaver)
  • Microfracture
  • Fixation
  • BMAC
  • Autograft
  • Allograft.
18
Q

Angle of regular hoof

A
  • 45-50 ° front hoof
  • 50-55 ° hind hoof
19
Q

Trush

A

Degenerative infective condition of the frog
- Wet, unhygienic
- Predisposing factor: long contracted heels, deep sulci
- Fusobacterium necrophorum
* Clinical signs: Black necrotic exudate, odor
(cellulitis, phlegmon)
* Treatment: Cleaning, Debridement
- Dry clean bedding
- Cooper sulphate; phenol : iodine 7%; 10% formalin

20
Q

Canker

A

Chronic hypertrophic moist pododermatitis of the epidermal tissue starting mainly at the frog region
(Moist pasture, unhygenic conditions
Fusobacterium necrophorum, Bacteroides

No lameness

Topical AB
- Superficial or radical debridement??
- AB therapy (procain penicillin, tetracyclin

21
Q

OCD - pathogen

A
  • Disturbance of cellular differentiantion in the growing cartilage
  • Damage to vessels in cartilage canals: Improper vascular supply of the young cartilage
  • Loading: mechanical insult, fragmentation on weak points

Result: resorption

22
Q

OCD - growth rate

A

Large foals
Hyperinsulinaemia -> rapid removal of T3, T4 from the circulation
* T3 T4 responsible for chondrocyte differentiation + invasion of blood vessels

23
Q

OCD - predeliction sites (5)

A
  • Neck facet joints
  • Shoulder
  • Fetlock
  • Hock
  • Femoropatellar-joint
24
Q

OCD/OC - shortenings

Clinical forms (5)

A

OCD/OC – Clinic
* Osteochondrosis (OC)
* Osteochondritis dissecans (OCD)
* Subchondral Bone Cysts

Clinical forms
* Flattening of the joint surface
* Cartilage flaps
* Cartilage with subchondral bone changes
* OCD fragments free in joint

25
Q

OCD/OC - Diagnosis

A
  • 2-4 months, joint effusion, lameness, normal synnovial fluid. Improve with ana
26
Q

OCD/OC - Tx surgical and conservative

A

Arthroscopy

conservative have bad prognosis

27
Q

Subchondral Bone Cysts
Predil sites and Dx

A
  • Medial Femoral Condyle
  • Distal MCIII/MTIII
  • Medial proximal Radius epiphysis
  • Distal phalanx
  • Scapula cavum glenoidale
  • Intraarticular block is not always positive
  • X-rays
  • Scintigraphy
28
Q

Subchondral Bone Cysts - CS

A

Lameness after work
Sometimes acutely lame
- Medial Femur Condylus
- Distal MCIII
Joint effusion not always

29
Q

Subchondral Bone Cysts - Treatment

A
  • Steroid inj. into the cyst
  • Extra-articular approach and Parathormon
  • Enucleation of the cyst inside lining
  • Position screw through the cyst
  • Bone Morphogenic Protein-2 into the debrided cyst
  • Autologous Osteochondral Transplantation
30
Q

With regard to strength (transport)
Compression, shear, tension

A
  • Bone is strongest in compression
  • Weakest in shear
  • Intermediate in tension
31
Q
A

A- translation
B- angulation
C- Shortening

32
Q
A
33
Q

Laminitis - pathophysiology

A
  • Hyperinsulinaemia- lamellar lamellar attachment apparatus defomation
  • Injury of basement membrane- lysis
34
Q

Laminitis theories (13)

A
  • Enzymatic theory
  • Ischemia/reperfusion injury
  • Decreases digital blood flow, lamellar perfusion
  • Gram negative – endotoxin
  • Hyperinsulinemia, insulin resistance
  • Lamellar separation
  • Equine Metabolic Syndrome
  • Cresty neck
  • Increased adipose tissue
  • Cushing disease
  • Pituitary enlargement
  • Corticosteroids
  • Supporting limb laminitis
35
Q

Laminitis - Dx

A
  • Most often both front feet are affected
  • Lameness is worse on hard ground
  • Digital pulse amplitude occurs
  • Radiographic examination
36
Q

Laminitis - Tx

A
  • Cryotherapy – all four limbs
  • Aggressive treatment of primary disease
  • Fluids and electrolyte therapy
  • Antibiotics and NSAIDs
  • Uterine lavage – retained placenta
  • Cushing’s disease

Generally to lift heal to get less tension of DDFT

37
Q

Septic arthritis - general

A

Foals
*Haematogen – joint/bone
*Gram-negative
*Bacteremia, septicemia

38
Q

Septic arthritis - Types of infections (3)

A

S-type: Synovial fluid and synovial membran
E-type: Articular epiphyseal complex
P-type: Majority. Long bones physis and joints. Enerobacteriacae( E. Coli, Salm.) Streptococcus, Rhodococcus

39
Q

OA - Tx

A

Conservative:
- Rest
- PSGAGs, Hyaluronic acid
- NSAIDs, Corticosteroids
- Stem cells

Surgical:
- Synovectomy and arthroscopy

equinee (24 decks)

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