Diseases of the foot Flashcards

1
Q

What structures does the broken back hoof pastern axis stress and strain the most?

A

Navicular apparatus, DDF, dorsal hoof wall, heel region (prone to bruising, abscessing)

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2
Q

How should you compensate for a broken back conformation?

A

-Trim more toe than heel to improve axis, apply shoe to reduce toe lever and increase base of support
-wedge up the heel, ease breakover through modifying toe, provide larger shoe

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3
Q

What structures are under more strain with a broken forward hoof pastern axis?

A

Suspensory ligament, dorsal hoof wall, SDFT, distal sesamoidean ligaments

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4
Q

Describe a trimming/shoeing plan for the broken forward conformation associated with pathogenesis of suspensory ligament?

A

Wide toe, more narrow in heels (increases tension on DDF, decreases strain on SDF)
-or use fish tail bar shoe or egg bar (lever on heel to engage DDF to help support the fetlock)- works well in hindlimbs

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5
Q

Describe a treatment plan for a broken forward conformation due to club foot (congenital)?

A

Don’t lower heel! Will increase strain on DDF which already has too much strain
-physiologically strain DDF to encourage it to relax
-inferior check ligament desmotomy, or DDF desmotomy in severe cases
-requires vet/farrier team

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6
Q

What structures are under increased strain when there is a club foot?

A

Dorsal lamellae (can lead to mechanical laminitis), entire toe, entire P1 (also P2 and P3)

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7
Q

Describe a shoeing/trimming plan for a club foot deformity.

A

Ease breakover in toe region, lower heel (slightly), load frog and sole
-best addressed when young

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8
Q

Define wry foot

A

A distorted hoof capsule- deviating either medial or lateral

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9
Q

How should wry foot abnormalities be addressed?

A

Bar or extension on side that is more straight up (fill the triangle)

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10
Q

T/F: hoof is designed to expand in the heel region when limb is loading

A

True

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11
Q

What are some causes of wry foot?

A

base narrow horse
- will grow more straight on medial side, flare laterally on outside
-predisposes to quarter cracking and sheared heels

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12
Q

What does wry foot predispose to?

A

Quarter cracks due to increased stresses and strains on side more upright, as well as on collateral ligaments

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13
Q

Describe “sheared heels”

A

One of the heel bulbs is displaced proximally to the other
-predisposes to abscessation, quarter cracks

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14
Q

what is a good trimming/shoeing plan for wry foot?

A

Decrease load in more vertical heel (wider shoe, extension)
-make that side non-weight bearing-can put pad onto that side

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15
Q

What are some things you can do in terms of shoeing with thin soles or thin hoof wall?

A

Not much room for error with nails
-use glue on shoes!! -eliminate nails

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16
Q

What are some disadvantages of glue on shoes?

A

-Expensive, can trap dirt and bacteria in causing white line/abscess, need to have the skill set
-soft rides, rest
-wooden clog-cast on
-can create artificial hoof wall (very time and labor intensive)

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17
Q

What are the advantages/disadvantages of glue on shoes?

A

Expensive, less time consuming, more frequent replacements

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18
Q

T/F: you can glue on any shoe made to be screwed on

A

True

19
Q

Should you be able to see the growth rings of a horses hoof?

A

Yes

20
Q

What can disruptions to the rings on a horses foot be due to?

A

Disrupting diet, changes in environment
-should be parallel to coronet
-if wider at heel than toe- indication of laminitis or structural limb deformity
-wider growth rings on side growing faster

21
Q

What causes solar bruising?

A

Thinning of sole, increased stress/strain in the area
-can be painful or non painful
-predisposes to abscesses

21
Q

What are some of the treatment options for solar bruising?

A

Frog pad, heart bar, fit shoe wide with air in between it and the frog, pour in pad (soft)

22
Q

What is thrush?

A

Bacterial infection of the epidermal portion of the frog

23
Q

What are some disadvantages of using koppertox for treatment of thrush?

A

-Stains the horse, stains you
-caustic to the tissue, can lead to scarification and entrapment of bacteria underneath the upper layer

24
Q

What are the recommended treatments for thrush?

A

Most importantly: change the environment (clean and dry)
-debride to healthy margins
-Can follow with topicals: Dry powders, betadine
-shoe/pad to act as 6-8 week bandage

25
Q

Describe canker.

A

Infection affecting the germinal layers of the frog
- vascular growth pattern
-often a complication of thrush

26
Q

What is the treatment for canker?

A

-surgical debridement after block with a tourniquet
-then treat topically (10% benzyl peroxide dissolved in acetone and crushed metronidazole powder)
-place in clean/dry environment
-place in hospital plate

27
Q

Define a keratoma

A

Benign tumor of keratin producing cells of hoof wall

28
Q

What is the classic presentation of a keratoma?

A

Chronic and Recurrent subsolar abscesses in one portion of the horses foot
-can also present as changes in the white line
-quarter cracks

29
Q

What radiographic view is diagnostic for a keratoma?

A

65 degree DP
-will see disruption to distal phalynx with sclerotic rim around it

30
Q

Describe the pathogenesis of why bone is degraded in keratoma cases

A

Pressure necrosis and resorption from the tumor growing between the hoof and the bone

31
Q

What is the most aggressive treatment for keratomas?

A

Surgical resection-involves removal of entire hoof wall over area of tumor. Usually requires GA
-be sure to have support on opposing limb
-can also do window style resections- lower risks of cracking, earlier return to work, lower risk of excessive granulation tissue

32
Q

What should you do to protect the foot after hoof wall resection for keratoma?

A

External fixation, sole support

33
Q

Describe the conservative method for treatment of keratoma

A

Shoes and pads, keep area clean

34
Q

How do you treat toe cracks?

A

Reduce toe lever, recruit sole and frog into load bearing
-debride the crack-reduce to healthy margins, rebuild and reinforce (fiberglass, vectran, polyester, equilox)

35
Q

What are the properties of molding materials to support the hoof wall?

A

Stronger than hoof wall in tension and bend, not compression

36
Q

How can you relieve compression forces on cracks?

A

Metal bars- aluminum, brass, steel over coronet

37
Q

How do you deal with quarter cracks?

A

Treat underlying problem (angular limb deformation)
-rest
-if continuing work need to stabilize through debridement and patching

38
Q

What structure does white line disease affect?

A

The non-pigmented stratum medium (aka NOT THE WHITE LINE)
-caused by opportunistic microbes that are keratinolytic leading to separation and crack formation
-wont become as lame as laminitis cases

39
Q

How is white line disease treated?

A

Trimming and shoeing
-as long as you are foot is growing faster than microbes can grow
-need to expose microbes deep to all dirt and debris- must debride to healthy margins (bugs die when exposed to UV light and air)
-follow up with tinctures of iodine
-bandage/shoeing, think about opposite foot

40
Q

What radiographic changes do you see with pedal osteitis?

A

Rim fractures of solar margin
-treat with shoes, pads, rest, NSAIDs

41
Q

What should you do about hoof wall avulsions?

A

Debride, keep clean and dry
-otherwise can result in abnormal growth patterns

42
Q

Is sidebone an actual disease condition?

A

No- as long as they don’t fracture
-due to ossification of collateral cartilages of distal phalanx

43
Q

What is quittor?

A

Infection of the collateral cartilages, often secondary to puncture wound
-often waxes and wains