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Orthopedic Medicine > Equine Hoof > Flashcards

Equine Hoof Flashcards

1
Q

Is the forefoot or hindfoot generally larger

A

forefoot
-weight distribution
-shape of phalanx

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2
Q

Where is the hoof wall thickest

A

at the toe

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3
Q

What are the 3 hoof layers *

A

1) Stratum externum
2) Stratum medium
3) Stratum internum (contains interdigitation of laminae)
-Corial (sensative)
-Epidermal (insensitive)

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4
Q

What layer of the hoof has the interdigitation of laminae *

A

Stratum internum has corial (sensative) and epidermal (insensitive)

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5
Q

How fast do horse hoofs grow*

A

8-10mm per month (~12 months for the toe)

longer in cold or dry environment

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6
Q

What do transverse lines tell you

A

how long ago there was a insult with hoof forming

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7
Q

the weight-bearing structure in horses important for footing and needs good conformation to take weight off of the hoof wall

A

sole

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8
Q

a weight bearing strucuture in the horse that blends into the heel and is softer than the sole (50% water)
good indication of overall hoof health

A

frog

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9
Q

What structure in the horse’s hoof is a good indication of overall hoof health

A

frog

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10
Q

a shock absorbing structure in a horse’s hoof
between ungual (collateral) cartilages
made of connective tissue, adipose tissue, and cartilage

A

digital cushion

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11
Q

What cartilage is the ungual cartilage made of?

A

hyaline > fibrocartilage

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12
Q

ungual cartilages

A

hyaline > fibrocartilage
ossification
-side bones
-secondary centers of ossification
thinner in hind hoofs

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13
Q

What are the 5 normal forces in the equine hoof *

A

1) Tension directed toward wall laminae
2) Tension from DDFT
3) Downward compression from P2
4) Upward compression from the sole
5) Forces acting on extensior process; extensor branches of suspensory ligament; common digital extensor tendon

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14
Q

What is the difference between suspension system and support system of the equine foot

A

Suspension system: DDFT and lamina

Support system: sole, digital cushion, and wall

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15
Q

Describe the horse’s forces exhibited on foot impact *

A

1) Heel strikes first followed by bars, quarters, and toe
2) Concussion during impact is transferred from the distal phalanx to the stratum internum
3) Sole is slightly depressed as it counters the downward force
4) The frog acts with the sole to support the inner structures of the foot and to dissipate the force on the distal phalanx
5) Venous plexi are compressed forcing the blood into the digital veins
6) Venous plexu act as a hydraulic shock absorber

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16
Q

Concussion during toe impact is transferred from the _______ to the ______

A

distal phalanx to the stratum internum

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17
Q

the frog acts with the sole to

A

support the inner structures of the foot and to dissipate the force on the distal phalanx

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18
Q

what forces blood into the digital veins

A

compression of the venous plexi

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19
Q

venous plexi act as

A

hydralic shock absorbers

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20
Q

What are the goals of routine equine hoof care

A

preventative: balance, maintain healthy hoof structures

corrective: alterations to influence gait and conformation

therapeutic: protect/support an injured hoof

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21
Q

if you want to decreased pressure on the DDFT and laminae, you want the heel

A

high

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22
Q

If you want to take stress of the laminae, DDFT, and navicular bone do you want the toe to be long or short

A

short

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23
Q

T/F: the frog should not have contact with the ground

A

False- it needs to have contact with the ground

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24
Q

55% of the horse’s weight bearing needs to be behind the

A

extensor process

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25
Q

when should you shoe a horse

A

when the hoof wears faster than it grows

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26
Q

When should you trim vs shoe based on *

A

Based on:
-Genetics: hoof growth and horn quality
-Horse use/surface: traction and protection
-Owner preference

in general if the foot wears faster than it grows it needs a shoe

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27
Q

What time of year does the horse’s hoof grow slower in?

A

winter and dry

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28
Q

How often do you trim the horse’s hoofs *

A

every 6-8 weeks
more frequent to influence hoof conformation
Hoof growth is dependent on season, moisture, and diet
(take less of in the winter)

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29
Q

hoof care for farrier

A

goals for proper trimming/ shoeing - soundness of the hoof, can hoof hold nails
Correct angles (hoof pastern angles)
Correct toe length- long toe/low heel, club feet

if not take a radiograph

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29
Q

What does a broken forward horse mean

A

a horse that does not have >55% of weight bearing behind the lin drawn from the extensor process

angle of the hoof and pastern are not even

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30
Q

when should you start routine hoof care in foals

A

by 1 month of age unless there is an angular limb deformity (trim and balance)

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31
Q

What do reverse shoes “Bank Robber” shoes do

A

-Improve breakover
-Relieve pressure off of the toe
-Bring weight bearing backwards

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32
Q

inflammation of the lamina of the foot
systemic disease and clinical signs when the the lamellar tissue is already damaged
leads to failure of attachment between distal phalanx and hoof wall

A

laminitis

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33
Q

Laminitis leads to

A

leads to failure of attachment between distal phalanx and hoof wall

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34
Q

When are laminitis clinical signs noticed

A

when the lamellar tissue is already damaged

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35
Q

What is the clinical importance of equine laminitis

A

-painful condition
-terminate an athletic career
-life threatening
-economic losses to equine industry (diagnosis, tx, and loss of animal)

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36
Q

Why does the dorsal laminae have more issues than other parts of the laminae

A

mechanical forces

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37
Q

What are predisposing conditions to equine laminitis **

A

1) Endotoxemia
-GI tract (colic, grain overload, peritonitis, enterocolitis)
-Pleuritis/Pleuropneumonia
-Placentitis (retained placenta)/ metritis

2) Systemic metabolic dysfunction
- Cushing’s Disease (PPID), Metabolic syndrome

3) Non-weightbearing lameness
-Fracture/Septic synovial structure

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38
Q

What equine systemic metabolic dysfunctions can lead to laminitis *

A

Cushing’s Disease (PPID), Metabolic syndrome

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39
Q

What can cause endotoxemia and subsequent laminitis in horses *

A

-GI tract (colic, grain overload, peritonitis, enterocolitis)
-Pleuritis/Pleuropneumonia
-Placentitis (retained placenta)/ metritis

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40
Q

How might a non-weight bearing lameness lead to lamnitis in horses *

A

fracture of septic synovial structure

41
Q

Deprivation of _____ can lead to laminitis

A

glucose

42
Q

Why does glucose deprivation lead to laminitis *

A

Cells of the lamina preferentially consume glucose
-Lack of glucose
-Inflammatory response
-Release of MMPs
-Breakdown of basement membrane

43
Q

What might traumatic/mechanical cause laminitis

A

-Road founder- concussive forces
-Support limb laminitis
-Injuries

44
Q

In horses, is laminitis in the front or hind feet more common *

A

front feet > hind feet

45
Q

Signs of inflammation seen with equine laminitis *

A

-heat
-increased digital pulses
-positive to hoof testers (pain) especially at the toe

46
Q

What grading score is used for equine laminitis

A

Obel grading score

47
Q

What are the stages of laminitis *

A

1) Developmental Stage- no lameness or clinical signs (horses at risk)

2) Acute- lameness, clinical signs. active separation of dermis from epidermis

3) Chronic- displacement of distal phalanx: chronic lameness, abscesses, abnormal hoof growth

48
Q

What is seen in horses with development laminitis

A

no lameness or clinical signs (horses at risk)

49
Q

What is seen in horses with acute laminitis

A

lameness, clinical signs. active separation of dermis from epidermis

50
Q

What is seen in horses with chronic laminitis

A

displacement of distal phalanx: chronic lameness, abscesses, abnormal hoof growth

51
Q

What diagnostics can you use for equine laminitis

A

1) Lameness evaluation +/- in chronic cases: hoof tester and nerve blocks (abaxial sesamoid) - might not do nerve blocks on acute

2) Radiographs (P3)- lateral and DP: assess vertical or rotational displacement and serial radiographs to assess progression

3) Venogram to assess blood distribution to P3

52
Q

What radiograph views is important for assessing the progression of equine laminitis

A

lateral and DP of P3

53
Q

used to assess distribution of blood flow of P3 for prognostic laminitis determination

A

venogram

54
Q

What are the treatment goals of developmental laminitis *

A

-Prevention of clinical signs
-Treat systemic disease
-Remove inciting agent or prevent from reaching lamina (cryotherapy)
-Anti-endotoxin serum or plasma, anti-inflammatories, mineral oil/activated charcoal
-Sole support

55
Q

In developmental laminitis, how might you remove inciting agent or prevent from reaching lamina *

A

cryotherapy
-distal limb icing to constrict circulation and stop the cytokine storm and cytokine release
-submerged in an ice and water slurry for a minumum of 48 hours
can be kept in the ice bath for a full week
-up to the level of the fetlock

56
Q

What is the thought behind cryotherapy being used to treat laminitis *

A

-distal limb icing to constrict circulation and stop the cytokine storm and cytokine release
-submerged in an ice and water slurry for a minumum of 48 hours
can be kept in the ice bath for a full week
-up to the level of the fetlock

57
Q

What are the treatment goals in acute laminitis *

A

1) Pain management (Phenylbutazone, DMSO, opioids, ice)
2) Increase perfusion (Pentoifylline, isoxsuprine) and heel elevation (to decrease the pull of DDFT)
3) Treat Wind-up (Gabapentin, acupuncture/chiropractic)
4) Prevent overload of hoof wall with sole support

YOU MUST SUPPORT THE FEET- minimizes laminae disruption- elevate heels and give support to frog

58
Q

In acute laminitis cases, what can you do for pain management *

A

(Phenylbutazone, DMSO, opioids, ice)

59
Q

In acute laminitis cases, what can you do to increase perfusion

A

1) Pentoifylline
2) isoxsuprine
3) heel elevation (to decrease the pull of DDFT)

60
Q

In acute laminitis cases, what can you do to treat Wind-up

A

-Gabapentin
-Acupuncture/chiropractic

61
Q

In acute laminitis cases, what can you do to prevent overflow of hoof wall

A

Sole support- decrease the strain on the lamina
-use sand substrate
-foam shoes

62
Q

What can you do to decrease the pull of the DDFT *

A

Heel elevation

63
Q

What are the treatment goals with chronic laminitis? *

A

1) Decrease tension on DDFT
2) Realign hoof-pastern axis
-normal mechanical forces on foot
-trimming
3) Treat systemic disease (Cushing’s, Insulin resistance, etc)

64
Q

What surgery can be done for laminitis

A

Deep digital flexor tenotomy (cutting the DDFT)
-De-rotation and increase perfusion to the foot

65
Q

What might hoof wall resection/ grooving do for laminitis

A

the hoof wall acts as a tourniquet for foot
removing hoof wall allows for perfusion of lamina
good for removing abscesses

66
Q

How should you manage laminitis after treatment?

A

1) Dietary- decrease grain and legume content, methionine to provide better hoof growth
2) Exercise- depends on type of and response to therapy

67
Q

In horses with laminitis what should you change in their diet

A

decrease grain and legume content, methionine to provide better hoof growth

68
Q

What is the prognosis of equine laminitis

A

Depends on clinical signs - mild, moderate, and severe
response to treatment

guarded: some can do well and return to full function

69
Q

What kind of horses does navicular disease typically occur

A

middle aged horses
quarter horses
small hooves and big bodies

70
Q

Is navicular disease typically in the forelimb or hindlimb

A

forelimb lameness - often bilateral

71
Q

Is navicular disease typically unilateral or bilateral

A

bilateral, typically forelimb lameness

72
Q

What block do you do for chronic laminitis vs navicular disease

A

chronic laminitis- basilar or axial sesamoid block

navicular - palmar/ plantar digital block

73
Q

What lameness is seen with navicular disease *

A

history of intermittent, shifting leg lameness and a short shuffling gait

74
Q

What is navicular disease typically misdiagnosed as

A

shoulder lameness

75
Q

How do you distinguish navicular disease *

A

history of intermittent, shifting leg lameness and a short shuffling gait
commonly forelimbs, although one of limbs may be more severely affected
when standing the horse will often “point” the most severely affected limb
if both limbs are equally affected, the horse will either alternately point the limbs or will stand with both front limbs held forward in the classical camped in front stance
-when moving the horse will often land on the toe, or flatly on the foot to avoid excess concussion
-horse will stumble at walk or trot

76
Q

In horses with navicular disease, what will you see with a hoof tester examination

A

pain at the center of the frog and across the heels but its not always diagnostic

77
Q

How might lameness from navicular bone disease be exacerbated *

A

turning the horse in a circle (inside leg most sore)

78
Q

With navicular bone disease, does the foot change shape over time?

A

yes- change shape as the heels contract and the foot narrows across the quarters

79
Q

How do you diagnose navicular bone disease*

A

depends almost completely upon clinical examination
typical histroy, gait, and hoof tester response
lameness often exacerbated when a 3/4” board is placed under the toe as it places more pressure on the DDFT and navicular area

80
Q

How might you diagnostically make navicular bone lameness worse?

A

lameness often exacerbated when a 3/4” board is placed under the toe as it places more pressure on the DDFT and navicular area

81
Q

local anesthesia for navicular bone dusease

A

1) PD nerve block- most diagnostic test, horses may become lame on other leg
2) DIP joint anesthesia (10-15 minutes)
3) Navicular Bursa Anesthesia (Dorsal to DDFT) for 5-10 min

82
Q

What is the most diagnostic test for navicular bone disease

A

PD nerve block- most diagnostic test, horses may become lame on other leg

83
Q

Why might the horse have failure to become completely sound after PD block

A

fibrous adhesions between navicular and DDFT
Possible arthritis of the coffin joint
accessory nerve supply sole bruising
concurrent traumatic arthritis of the fetlock
improper or incomplete anesthesia

84
Q

T/F: diagnosis of navicular bone disease is made with radiology

A

FALSE- radiographic evidence of navicular disease may only be present in 40% of navicular cases and also in normal horses

make sure to remove shoes and clean foot well
pack sole

85
Q

What are the radiographic abnormalities seen with navicular bone disease

A

-Enlarged vascular foramina
-Cysts
-thinning/roughening of flexor cortex or loss of corticomedullary junction
-impar ligament: evulsion fx sometimes

86
Q

What is the best method for diagnosing navicular bone disease

A

MRI

87
Q

What do you look for in ultrasound for navicular bone disease

A

hard to get visualization
-Collalteral ligaments DIJ
-DDFT
-Suspensory/collateral ligament of navicular bone
-Impar ligament
-Requires preparation

88
Q

T/F: with navicular bone disease you need bony changes to make a diagnosis

A

false- use to think if the bone was okay everything was fine
underdiagnosed soft tissue injury
MRI especially has helped
treatments still very similar

89
Q

How do you treat navicular bone disease *

A

1) Stall rest
2) NSAIDs
3) Trimming- correct the hoof pastern axis and balancing the foot
Increase the angle of the foot by raising the heel or shortening the toe to remove excess pressure from navicular bone

90
Q

What should you consider when shoeing a horse? *

A

-Balance foot: dorsal-palmar and medial-lateral balance is really important
-Squaring or rolling the toe for easier and faster breakover
-Provide caudal, lateral, and medial support
-Shoe (wedge pad or shoe with wide web)

at least some type of corrective trimming and/or shoeing be performed before other therapy is begun
many horses will respond to balancing od diet

91
Q

What should you do for medical management of navicular bone disease *

A

1) NSAIDs
2) Isoxsuprine hydrochloride
3) Injections (DIP and/or Navicular bursa) with Triamcinolone +/- sodium hyaluronate or IRAP
4) Bisphosphonates- but beware renal disease, colic . better if lame less than 6 months, problems with future bone healing

92
Q

What are the issues with bisphosphonates for navicular bone disease *

A

1) renal disease, colic (No NSAIDs)
2) Fractures- problems with future bone healing

. better if lame less than 6 months,

93
Q

What is used for injections of the DIPJ and/or navicular bursa to help treat navicular bone disease *

A

Triamcinolone +/- sodium hyaluronate or IRAP
-beware of abnormal mineralization with this, might want to use more natural

94
Q

What can you do surgically to treat navicular bone disease

A

Navicular Bursoscopy
-Adhesions
-DDFT lesions
-Flexor cortex lesions

Palmar Digital Neurectomy
-Side effects of palmar digital neurectomy
-Loss of proprioception

95
Q

What causes subsolar abscesses in horses *

A

rain
poor husbandry

very common

96
Q

What are the clinical signs of subsolar abscesses in horses *

A

1) Mild to severe lameness “Fracture lameness” (insidious to acute)
2) Usually single limb
3) Digital pulses: bounding (R/o laminitis)
4) Hoof tester instability- can be blunted w hard soles
5) Drainage at coronary band

97
Q

How do you treat subsolar abscesses? *

A

1) create ventral drainage
-hoof testers to guide
-black area on sole
-can rupture at coronary band if dont create ventral drainage
-nerve blocks help to pare out but might allow going too deep

2) Soak- hyperosmotic MgSO4/Salt

3) Bandage foot- keep debris out and allow tract to close, Boot/IV bag

4) Treatment plate for large abscesses

5) Tetanus toxoid

6) Exercise- some is good

98
Q

What do you use to soak subsolar abscesses

A

hyperosmotic MgSO4/Salt

do not use betadine

99
Q

What is the prognosis of subsolar abscesses in horses

A

acute lameness should improve once establish drainage
residual lameness if coronary band rupture

good to excellent prognoses

if recurrent abscesses- look for inciting causes with radiographs and MRI

100
Q

How do you treat navicular syndrome vs subsolar abscess

A

1) Navicular syndrome: shoeing and medical managemetn

2) Subsolar abscess: create ventral drainage

101
Q

Are subsolar abscesses in horses typically unilateral or bilateral

A

unilateral

Orthopedic Medicine (8 decks)

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