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Locomotor > Equine Foot (Bolt) > Flashcards

Equine Foot (Bolt) Flashcards

1
Q

How can examination of the hoof wall be caried out?

A
  • hoof testers
  • palpation
  • percussion
  • response to local analgesia
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2
Q

Which structures can be palpated around the hoof?

A
  • DOrsal DIP joint capsule
  • DIP joint collateral ligaments
  • Collateral cartilages
  • distal recess DFTS + DDFT
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3
Q

Can you relate specific structures to pain in the hoof?

A
  • no, not by direct visualisation palpaton or manipulation

- intrasynovial and perpheral nerve blocks not very specific

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4
Q

What should you look for when exmining the foot?

A
  • digital pulses
  • local heat
  • DIP joint effusion
  • pastern oedema
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5
Q

How can integrity of synovial structure be assessed?

A
  • contrast bursography/radiography

- MRI (soft tissue info too)

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6
Q

What is nail prick and nail bind?

A 
> nail prick 
- nail driven through sensitive laminae
> nail bind
- nail driven too close to sensitive laminae 
-> abscess
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7
Q

Tx septic pedal osteitis

A
  • curettage

- wound care

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8
Q

Aetiology of hoof cracks?

A
  • poor hoof quality
  • thin hoof full
  • abnormal hoof angles
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9
Q

Which direction are hoof cracks most commonly seen in?

A
  • parallel to horn tubules and lamellae

- can extend into sensitive laminae

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10
Q

Tx hoof cracks

A
  • shoe with bar shoe
  • sutures/clamps/plates over cracks
  • debridement and stabilisiation
    > as long as don’t reach the coronary band will be ok
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11
Q

Which aspects are foot imlanace looked at?

A
  • lat-med (pedal bones should be in line - eg. club foot)

- dorsopalmar (mroe difficult to correct)

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12
Q

How are hoof wall avulsions formed?

A
  • damage to coronary band -> permenantly disturbed growth
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13
Q

What is a keratoma? Common?

A

== “malignant tumour” -> columnar thickening of hoof horn extending towards inside of hoof
> aetiology: mechanical irritation/chronic infection (hoof abscess)
- ^ local pressure -> typical lysis distal phalanx with clear margins (not fuzzy like pedal osteitis)
- not common

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14
Q

Radiographic findings of keratoma?

A
  • local pressure -> lysis and resorption of pedal bone tip
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15
Q

Tx keratoma

A
  • remove (cut window, or go to sole but this will -> splay)
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16
Q

What 2 infectious causes of hoof pathology are most common?

A 
> thrush 
- looks like pus in the foot
- necrosis of the frog
- smelly
- usually limited to lateral and medial sulci of frog 
> Canker
- cream cheesey
- deep layers of frog
- mixed bacterial infectioin of the entire frog and heel -> disintegration of intertubular horn 
- warm humid enviroent
-
 oungent and tendency to bleed
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17
Q

Tx canker/thrush

A

resection and debridement

- not often painful, will heal

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18
Q

Pathogenesis of white lien dz?

A
  • deterioration of white line of hoof capsule -> loss of bond between oof wall and sole
  • poor quality horn colonised by bacteria and funghu
  • warm humid environment
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19
Q

Tx white line dz

A

> management
- dialy hoof care
- stall hygeine
debridement of necrotic and diseased horn
- disinfect are
- sensitive laminae (protective bandage)
- sulci hardening solutions (formalin or others)

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20
Q

What is a hoof abscess? Ddx?

A

> Ddx pedal bone fx

  • shod and unshod horses afefcted
  • infection of area of sensitive laminae after bacterial penetration (can be aftr shoeing)
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21
Q

What is “gravel”? Ddx?

A 
> gravel 
- chronic foot abscess 
- bursts out at coronary band
> Ddx: "Quittor" infection of lateral cartilages 
- above the coronary band
- palmar/plantar
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22
Q

Best rads for navicualr bone fx?

A
  • Dorsopalmar
  • Skyline navicular bursa
  • Echo other views
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23
Q

Tx navicular fx?

A
  • fix with single lag screw

> no rotational stability but can minimise DJD In coffin and damage to DDFT

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24
Q

Ddx navicular fx?

A

> Bipartite navicular bone

  • separate ossification centres
  • congenital
  • will be less lame than Fx!!
  • can result in chronic lameness and DIP joint OA
  • Rad other foot to r/o
  • rare condition
25
Q

What is navicular syndrome?

A

> most common forelimb lameness
palmar heel pain
no one cause, distinct pathophysiology or cure

26
Q

Which stuctures are involved in navicular syndorme?

A
  • navicular bone
  • navicular bursa
  • DDFT
  • DIP
  • collateral ligaments DIP joint
27
Q

How es a DDFT tear appear on MRI?

A

Intense signal cf. surrounding DDFT

28
Q

How may a DDFT tear present clinically?

A

3/10 lame

- blocked coffin and navicular bursa partial improvement

29
Q

Tx DDFT Tear?

A
  • navicular bursoscopy
30
Q

Clinical scenario for navicular syndrome?

A
  • 6-12 yo horses
  • taller, lighter breeds (some evidence hereditary trait)
  • usually bilateral
  • insidious onset
  • occassionaly “toe first” gait
31
Q

Hx and PE associated with navicular syndrome?

A
  • bilateral lamess
  • toe elevation ^ lameness
  • hoof testers usually negatvie
    • response to PDNB
  • navicular and DIP
32
Q

Further diagnostics for navicular syndrome?

A
  • Radiography
  • MRI [gold standard]
  • CT
  • Not really scintigraphy
  • Ultrasoound (very user dependent)
33
Q

Structures taken ou by palmar digital?

A
  • DFTS
  • Coffin joint
  • Navicular bursa and bone
  • Collateral ligaments
  • hoof wall
  • pedal bone
  • T ligament
  • Impar ligament
34
Q

DIP joint blocking process

A
  • go dorsal midline (through extensor tendon)

- can go palmar/plantar but risk of navicular bursa

35
Q

Outline navicular bursa block

A
  • midline - navicular position horizontal approach
  • midline- navicualr position 30* oblique approach
  • lateral palmar/plantar approach
36
Q

Function and physiology of the hoof capsule?

A 
> elastic and flexible under load
- "hoof mechanism" 
> protective function 
- stones and blunt trauma
> no possibility for swelling/draining 
*weak point = WHITE LINE*
37
Q

If navicular region is implicated in foot pain with diagnostic analgesia what further Dxx can be used?

A

Navicular bursoscopy

38
Q

Current approach to tx of navicular syndrome?

A

Corrective farriery (roll toel use bar eg. Egg/heart bar) controlled exercise and pain relief

39
Q

Where are osseus cyst like lesions commonly found?

A

Distal phalanx
- P3 near collateral ligament
Also in navicular bone and middle phalanx

40
Q

Are osseus cyst like lesions always significant if found on imaging?

A

No! Verify with diagnostic analgesia

41
Q

Tx available for distal phalanx DJP

A
  • arthroscopy
  • drilling (forage)
  • medicating DIP
42
Q

Why does the entire cyst need to be removed ?

A

Cyst lining secretes inflam mediators (PG2, IL1) disrupts inter stridulate cartilage

43
Q

Typical presentation of distal phalanx (peda bone) fractures

A
  • acute onset severe lamenss

- associated with excercise or kicking out

44
Q

How can pedal bone fx be classified?

A
  • numericl or descriptive
    1: wing, non-articular
    2: wing, articular
    3: saggital
    4: extensor process
    5: comminuted
    6: solar margin
    7: foal
45
Q

Are type 1 and 2 pedal bone fx seen easily on rads?

A

No not routine rads

  • take appropriate obliques
  • CT/MRI if necessary
46
Q

How can fx be sen on mRI?

A

surrounded by decreased signal

47
Q

WHen can type 3 fx be most eaily seen on imaging?

A

> 7d (bone resorption seen)

- before this hoof capsule will keep most fx. held together and not visable

48
Q

What other structure is involved in a IV extenory process fx? Cause? Other things to r/o?

A

DIP joint

  • displacement by common digital extensory tendon (Long in HL)
  • matched fx bed and fragment can be seen
  • NB: exensor yprcoess can be variable in shape, 2* ossification centres may appear similar to chip fx (dependant on clinical signs- verify need for sx)
49
Q

Tx of wing fx? Poss complications?

A
  • bar shoe
  • foot cast/hoof cast
  • lag screw?
    > 6 months box rest
    Complications
  • OA DIP (type 2)
  • fibrous union
50
Q

Tx midsagittal fx? Poss complications?

A
  • Lag screw + 3-6mo box rest
  • Bar shoe + 6-12mo box rest
    > complications
  • OA DIP
51
Q

Tx small extensor process fx? Large? Poss complications?

A 
Small 
- removal via arthroscopy or arthrotomy 
\+ 3-4mo box rest
> no complicatinos 
Large 
- removal arthrotomy 
-lag screw
\+ 4-6mo box rest 
> OA DIP joint
52
Q

Tx cominuted fx? Poss complications?

A
  • transfixation cast
  • euthanasia
    + 4-6mo box rest
    > OA DIP or laminitis
53
Q

Tx solar margin fx? Poss complications?

A
  • bar shoe?
    > 6 months box rest
  • no complications
54
Q

How do bar shoes work?

A

Eliminate “hoof mechanism” doesnt let capsule flex

55
Q

Are foo cast advocated?

A

Not really necessary

56
Q

Where are osteophytes commonly seen in DIP joint OA?

A
  • @ po int of reflexion of joint capsule
57
Q

Tx DIP joint OA?

A 
> intra-articular medication 
- sodium hyaluronate 
- corticosteroids
- polysulphated GAGs (PSGAG) 
- Il-1 R antagonist protein (irap) 
> prolonged NSAIDs
> corrective farriery (=navicular syndrome, ^ heel to facilitate breakover)
58
Q

What is pedal osteitis? What is its aetiology similar to?

A

= keratoma aetiology

  • repetitive concussion -> chronic inflammation of the laminae -> bone resorption
  • on rads lysis/resorption of bone not associated with hoof wall deformity and with FUZZY edges = pedal osteitis
  • cf. keratoma with well defined clear margins

Locomotor (29 decks)

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