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Equine > Equine foot and skeleton > Flashcards

Equine foot and skeleton Flashcards

1
Q

DDx for acute, severe unilateral lameness to foot

A

Subsolar abscess
Solar bruise
Pedal bone fracture

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2
Q

Aetiology of solar bruise

A

Blunt trauma to solar surface during locomotion causes haemorrhage into sensitive tissues –> get inflammation inside non-compliant keratinised hoof
So focal increase in pressure and extreme lameness

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3
Q

Risk factors for solar bruises

A

Uneven or highly concussive surfaces
Barefoot
hacking
Flat floor and low heel conformation e.g in racing TBs

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4
Q

What are corns

A

Focal bruising at seat of corm; affects shod horses

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5
Q

What is the most common cause of acute severe lameness

A

Subsolar abscess

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6
Q

Where do subsolar abscesses form

A

Between senstivie and non-sensitive tissue e.g at white line, seat of corn, frog

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7
Q

How to treat a subsolar abscess

A

Use paring knife to achieve drainage
Or if can’t do this, place foot poultice to soften sole to help achieve drainage later

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8
Q

How to initially manage acute unilateral lameness vs more mild or multi-limb lameness

A

Acute unilat: manage as subsolar abscess; bruises will just resolve quickly without pus draining

Mild/multi-limb: box rest and NSAIDs; if just burising will resolve quickly

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9
Q

What is the gold standard imaging method for looking at how FB in good sits within soft tissues

A

MRI

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10
Q

What is a ketaoma

A

Space occupying tumour that grows from the coronary band, down hoof wall and exits at white line

Painful as it causes abscesses

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11
Q

If we see recurrent abscesses at the same place in same foot, what should we be suspicious about

A

keratoma

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12
Q

How do pedal bone fractures present adn change

A

Presents intially like foot abscess; acute unilat lameness
But improvement is much slower than with abscess

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13
Q

How to diagnose navicular disease

A

= MRI diagnosis as are looking for inflammation

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14
Q

How to diagnose ossified collateral cartilages

A

Many sound horses have large ossification of side bones
So need MRI diagnosis to see inflammation here

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15
Q

How might soft tissue issues in the foot present (rather than classic acute severe lameness)

A

Bilateral insidious progressive lameness

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16
Q

What soft tissue ligament is often positive to distal limb flexion (NB: other aren’t)

A

Collateral ligaments

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17
Q

What bony changes might we see with collateral ligament disease

A

Ossified collateral cartilages
Enthesiopathy; bone remodelling at insertion site

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18
Q

How owuld we have to prepare the foot for transcuneal ultrasound

A

OVernight soaking

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19
Q

Whatis the most common soft tissue injury of the foot

A

DDFT pathology

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20
Q

Where do we tent to see DDFT pathology and why

A

Where it changes direction e.g at fetlock, around navicular bone
Because it is less elastic here due to need to resist compression

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21
Q

How can core lesions of tendons e.g DDFT progress

A

Can propagate proximally/distally over time
So we could do neurectomy to make horse comfortable but if it then propagated above this, would see sudden lameness again

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22
Q

How do sagittal splits of DDFT present, progress and where

A

Severe lameness but variable over time related to whether split pulled apart
Often at level of navicular
Propagate proximally/distally with time, especially after a neurectomy

Can lead to adhesion formation and burtisi because they involve the tendon surface

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23
Q

How does dorsal border fibrillation in DDFT present!

A

Cronic low grade degenerative lameness
Get fibrillation of fibres on the dorsal border where they are closely assocaited with the navicular bone
–> Often causes bursitis and adhesion formation

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24
Q

How can we treat DDFT and what structure do we made us of

A

Focus on navicular bursa to devilver treatment, accessed via tendon sheath

Intrabursal corticosteroids
Navicular bursoscopy for lesions that communication with bursa to break down adhesions and debride fibrillated tissues

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25
Q

Why is it good to debride away fibrillated tissues via navicular bursoscopy

A

These tissues are drivers of snyovitis

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26
Q

Which lesions is it especially indicated to do navicular busoscopy

A

Sagittal splits and dorsal fibrillation since these communicate with bursa

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27
Q

What happens if the heel is lower than it should be (we want 5* uphill angle)

A

Get stressing and increasing loading of the palmar soft tissues

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28
Q

What issues does poor latero-medial foot ballance cause

A

Increased loading of collateral ligaments, navicular suspensory ligament

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29
Q

What issues do dorsopalmar/plantar impanance cause

A

Increased loading of palmar/plantar soft tissues = SDFT, DDFT, SL, DSIL

30
Q

How do bar shoes work

A

Heart bar provides heel and pedal bone support by transfering load from hoof wall to sole
+ restricts independent movement of heal bulbs

31
Q

How do graduated pads and shoes work

A

They are much thicker at the heel than toe and so artifically corrects poor foot balance and reduces strain on DDFT via shortening distance and offloading tendon

Raised heel also alters breakover to happen earluer (this means occurs when itssues at lower stress so better)

32
Q

Why do we not want to use graduated pads/shoes in longer term

A

Contributes to making poor foot conformation worse

33
Q

Farriery for laminitis

A

pedal bone support via heart bar or pads and packing
Wait until stabilised to shoe

34
Q

Farriery for navicular syndrome (palmar heel pain)

A

Use bar shoe to restrict independent heel movement

35
Q

Farriery for pedal bone fracture

A

Bar shoe and packing to help immobilise fracture and speed healing

36
Q

Farriery for horses prone to bruising

A

Pads and packing to reduce concussive forces

37
Q

How do we cause lateral flexion to check for pain

A

Dig nails into one side

38
Q

What is sternal lift (dynamic thoracolumbar exam)

A

Apply sustained pressure to sternum to encourage dorsiflexion of cranial thoracic spine
Should have a response which can be maintained

Those with back pain struggle

39
Q

How to dynamically test to sarcoiliac region

A

Apply firm pressure to skin either side of tail base
Expect horse to drop hindquarters towards floor and dorsiflex lumbosarcal joint; should hold this for 5-10 secs

= abnormal if there is no respnse, pain signs or unable to maintain

40
Q

What is different about lumbosacral anatomy in horses

A

All sacral vertebrae are fused in horse
SI joint is very small; mainly just soft tissue

41
Q

What is radiculopathy

A

Neuropathic pain due to compression of spinal nerve root in caudal cervical region
Can cause forelimb lameness

42
Q

Clinical signs with neck pathology

A

Neck pain; reduced range of motion in baited stretches
Forelimb lameness; due to cervical muscle dysfunction which are involved in limb protraction, radiculopathy of spinal nerve root feeding brachial plexus causing shooting pain down leg
Ataxia

Prognosis worse from neck pain < radiculopathy < spinal ataxia

43
Q

When might we see ataxia with neck pathology

A

With cervical stenotic myelopathy

44
Q

If we see poor quality canted but fine trot where might this suggest pathology is

A

In the thoracolumbar spine because there is spinal twist and roll at canter vs just some lateral flexion at trot

45
Q

How to manage neck pathology

A

Intra-articular medication with corticosteroids is mainstay to alleviate pain and infammation

46
Q

Clinical signs of thoracolumbar psine disease

A

Poor muscling
Pain on palpation
ABnormal dynamic responses (ventral flexion, lateral flextion, sternal lift)
Resenting ridden exercise
Poor quality canter

47
Q

What is kissing spines

A

Impingement of the dorsal spinal processes

48
Q

How to defintiively diagnose dorsal spinous process impingement

A

First latero-lateral radiography BUT can see this disease in horses without back pain so can’t just use this

  • Gamma scintigraphy used to identify areas of remodelling
49
Q

How does gamma scintigraphy work (diagonsing kissing spine)

A

INject bisphosphonate with radio-isotope on it which will localise to osteoclasts so highlgihts areas of remodelling

50
Q

Management of dorsal spinous process impingement

A

Surgical cranial wedge ostectomy = very invasive procedure to remove chunks of cranial portion of dorsal spinous processes
- Very long, painful recovery but good outcomes

Interpsinous ligament desmotomy to gut interspinous lig and allow back to spread out; short rehab period but doesn’t change underlying anatomy so not really done much; maybe in young racehorses

51
Q

Typical presentation of lumbosacral and sacroiliac disease

A

Buckling under saddle
Becoming disunited at canter
Poor hind limb engagement
May have overt lameness

52
Q

What is a potential risk of blocking the SI joint

A

THat there is inadvertent blockage of the cranial gluteal nerve which will make horses recumbent for hours
–> Walk straight to stable in case they lie down

53
Q

Why can we say we are actually medicating SI region rather than joint

A

Joint very small only 3ml fluid
Vs we inject 15ml on each side

54
Q

Rehab programs for animals with axial pain

A

Strengthen core using sternal lifts, dorsiflexion, tail pulls
Water treadmill
Shart non-ridden in school + can use devices to encourage dorsiflexion

HIll work
Pole exercises

55
Q

Why does fracture line become more radiographically visible after a couple of days

A

Due to phagocytosis along fracture lines and fragmen end resoprtion

56
Q

What must we achieve to get primary repair of a fracture

A

Perfect natomical reduction
Rigid fixation
Sufficient blood supply

Get haversian remodlling to restore previous structural integrity quickly

57
Q

Why do we want some stress on bone during secondary fracture repair

A

Otherwise rigid immobility can suppress callous formation

58
Q

Why do we want a horse to be weight bearing on the lame leg using multi-modal analgesia ASAP

A

To prevent overloading of the sound leg and severe contralateral lamintiis developing
(happens esp on forelimbs)

59
Q

What can we do to reduce risk of contralateral laminitis if expected to be non-weight bearing a whole

A

Soft boots

60
Q

What fractures are commonly due to repetitive strain injury

A

Prox phalanx
Lateral condylar fracture
carpal fracture

61
Q

What joints might we suspect to have microfractures on their way to failure

A

Joints that repeatedly need to be medicated

62
Q

Predilection site for stress fracture in racehorses

A

Distal tibia; lameness that improves with work
Pelvis, vertebrae; more like poor performance

63
Q

How can a pelvic fracture lead to a fatal bleed

A

Via displacement and cutting abdominal vessels

64
Q

What is the safety factor of many structures in equine distal limb

A

Just 1.2
So easy to go abvoe this with single supraphysiological event

65
Q

Why might a distal phalanx fracture still look radiographically broken but horse is sound

A

Because it had headed by fibrous malunion

66
Q

What does quick infill of fibrous tissue in distal phalanx fracture mean for surgical prospects

A

Not such good surgical candidates

67
Q

When do proximal sesamoid bone fractures commonly occur

A

During fast work
So see with racehorses commonly

68
Q

What are common sites from fracture due to external trauma e.g kick

A

Dorsomedial radius as nothing between skin and bone to take force
Dorsomedial tibia

69
Q

If a horse has had direct trauma and shows a wound but no fracture visible on X ray what do we do

A

Put in cross ties anyway; fracture may just not be visitble

70
Q

Why do we put a splint on the carpus for an olecranon fractures

A

This allows it to be used as a crutch for enough movement to walk onto lorry for transport

71
Q

How to do an ethmogram for ortho pain behaviour and how many signs must a horse have to be suggestive of orthopaedic pain focsu

A

Ride and walk/trot for 10-15 mins
If have >8/24 of the behaviours, suggestive of ortho pain

72
Q
A

Equine (18 decks)

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