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MSK2 > Equine MSK diseases 2 > Flashcards

Equine MSK diseases 2 Flashcards

Farriery, back

1
Q

What are the aims of improving equine foot balance?

A
  • Promote even weight bearing
  • Level foot fall
  • Facilitate ease of movement
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2
Q

What are the 3 dimensions of equine foot balance?

A
  • Mediolateral (long axis)
  • Hoof pastern axis
  • Foot shape
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3
Q

How can the long axis of the equine foot be assessed with regards to foot balance?

A
  • Look for even amount of forelimb and foot either side of mid line
  • Can place T square over limb to assess more accurately
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4
Q

What is the approximate ratio that the equine toe wall and heel should be at?

A

Toe wall: heel wall at 3:1

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5
Q

What are the main aims of shoeing a horse?

A
  • Achieve balanced foot with a normal axis
  • Or as protection from abrasive forces
  • Or to provide additional grip
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6
Q

Outline the code of conduct for the working relationship between vet and farrier

A
  • Attend cases at the same time where possible
  • Dialogue between vet and farrier is essential
  • Share knowledge
  • No messages passed via the owner
  • Discuss cases together and decide on approach together with owner
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7
Q

What are the different categories of equine shoe available?

A
  • Remedial
  • Therapeutic
  • Surgical
  • Special
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8
Q

Outline the function and properties of a straight bar shoe

A
  • 360degree support
  • Load/offload parts of the foot
  • Heel support
  • Increased ground surface
  • Equal weight distribution
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9
Q

In what conditions would a straight bar shoe be appropriate?

A
  • Sheared heels
  • Hoof cracks
  • Conditions of balance that cannot be corrected by trimming
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10
Q

Outline the functions and properties of an egg bar shoe

A
  • 360degree support
  • Load/offload
  • SDFT support
  • Fetlock joint support
  • Moves centre of gravity of foot rearwards
  • Can extend behind the heels of the foot
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11
Q

What is the key feature that needs to be ensured with the application of an egg bar shoe?

A

The end of the shoe must bisect the centre of the fetlock

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12
Q

In what conditions is an egg bar shoe indicated?

A
  • Strained SDFT
  • Navicular syndrome
  • Caudal foot pain
  • Can be used in the same way as a straight bar shoe
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13
Q

Outline the functions and properties of a heart bar shoe

A
  • 360degree support
  • Load/offload
  • Frog support
  • Allows front of foot to take some weight
  • Can be aluminium, steel, plastic, leather, pads etc.
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14
Q

In what conditions is the use of a heart bar shoe indicated?

A
  • Hoof cracks
  • Frog pressure
  • Frog support
  • Laminitis
  • Heel avulsions
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15
Q

What is the key feature that needs to be ensured with the application of a heart bar shoe?

A

The tip of the bar should be level with the widest part of the shoe

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16
Q

What is the function of a lateral extension shoe?

A

Provide lateral support to the limb

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17
Q

When is use of a lateral extension shoe indicated?

A
  • Poor conformation
  • Angular Limb Deformity
  • Foals: bow-legged, carpal deviation, mediolateral deviation of limb
  • To provide comfort in older horses
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18
Q

Outline the function of a graduated shoe

A
  • Heel elevation

- Alters angle of the dorsal wall, HPA, DIP joint

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19
Q

In what conditions is use of a graduated shoe indicated?

A
  • Poor conformation e.g. broken forward HPA
  • DDFT strain/injury
  • Alleviate stress in coffin joint
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20
Q

How does placement of a graduated shoe aid with DDFT strain/injury?

A

Slackens area, reduces strain on DDFT

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21
Q

What is the main risk associated with a graduated shoe?

A

Hoof capsule may run away with itself and become too long

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22
Q

What may cause a sole infection in horses?

A

Penetrating foreign bodies e.g. stones, nails, thorns

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23
Q

What clinical signs would be expected with a solar infection in the horse?

A
  • Lameness
  • Heat/pain in the foot
  • Increased digital pulse
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24
Q

Outline your approach to diagnosing a suspected solar infection in the horse

A
  • Foreign body may be visible

- If not, use hoof testers, even pressure all the way around moving from bulb to bulb

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25
Q

Outline the treatment for a solar infection in the horse

A
  • Release pressure
  • Drainage
  • Poultice
  • Antibiotics
  • Hospital plate on top of straight bar shoe, remove daily and flush
  • Foot pads if soles are weak
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26
Q

Outline the signs of white line infection in the horse

A
  • Cracks/fissures of the hoof wall
  • Separation of the hoof wall
  • Crumbling horn
  • Hollow wall
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27
Q

Outline the treatment of white line infection in the horse

A
  • Debride area
  • Remove loose wall
  • Keep area clean using topical solutions, avoid turnout onto wet/muddy fields
  • Glue can be used to fill gaps left by debridement, then rasped down to produce smooth wall
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28
Q

What is equine foot thrush?

A

Aerobic infection of the clefts of the frog

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29
Q

Describe the signs of foot thrush in the horse

A
  • Foul odour
  • Black discharge
  • Exposed tissue
  • Atrophy
  • Lameness
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30
Q

What may cause foot thrush in the horse?

A
  • Poor conditions

- Lack of foot trimming

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31
Q

Outline the treatment of equine foot thrush

A
  • Remove the underlying cause
  • Debride area
  • Trim foot
  • Keep area clean/dry
  • Peroxide, antibacterial sprays
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32
Q

What is meant by solar bruising in the horse?

A

Rupture of capillary beds

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33
Q

What may cause solar bruising in the horse?

A
  • Unshod feet
  • Foot wearing out
  • Stones
  • Uneven ground
  • Can be caused by shoe, if flattened sole drops through and contacts the ground i.e. becomes convex
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34
Q

Describe the signs of solar bruising in the horse

A
  • Reddening of the sole
  • Pain on hoof testers
  • Lameness
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35
Q

Outline the treatment of solar bruising in the horse

A
  • Apply seated shoe
  • Pads (synthetic or leather)
  • Sole packs
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36
Q

What may lead to hoof wall lesions in the horse?

A
  • Uneven weight bearing
  • Imbalance
  • Direct trauma
  • Poor quality horn
  • Environmental factors
  • Poor farriery
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37
Q

Outline the treatment of hoof wall lesions in horses

A
  • Address foot balance
  • Immobilise foot
  • Support foot
  • Use of bar shoes
  • Foot trimming
  • Filler to provide rigidity and stability to foot as well as preventing further cracking
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38
Q

What shoe would be most appropriate to use in a case of laminitis?

A

Heart bar shoe

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39
Q

What is meant by nail bind in horses?

A

Where the nail from a shoe is in contact with, but not penetrating, the sensitive structures of the foot leading to lameness

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40
Q

How many thoracic, lumbar and sacral vertebrae does a horse have?

A
  • 18 thoracic
  • 6 lumbar
  • 5 sacral
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41
Q

What is the function of the longissimus dorsi muscle? Origin and insertion?

A
  • Back movement and stabilisation

- From 6th and 7th cervical vertebrae to the ilium

42
Q

What is the function of the gluteal muscles?

A

Extend hip, retract limb and support outward rotation

43
Q

Outline the key signs of back pain in the horse

A
  • Loss of performance
  • Loss of suppleness/impulsion
  • Stiffness/reluctance to bend/flex
  • Cold backed to saddle/rider
  • Changes in temperament
  • Bucking/rearing
  • Pain on palpation
  • Difficult shoeing/urinating
44
Q

Outline the assessment at rest where back pain is suspected in the horse

A
  • Pain on palpation of back
  • Muscle wastage/spasm, localised swelling
  • Reduced movement (lateral bending, dorsal and ventral flexion, circling)
  • Tail tone
  • Saddle fitting
45
Q

Outline the assessment at exercise where back pain is suspected in the horse

A
  • Walk and trot in straight line
  • Flexion tests to rule out bilateral HL lameness
  • Lunging, circling, serpentine
  • Backing
  • Canter work on lunge
  • Ridden exercise
  • Look for signs of lameness
46
Q

What diagnostic tools are used for diagnosis of back pain in horses?

A
  • Regional infiltration of local anaesthesia
  • Biochemistry
  • radiography
  • Scintigraphy
  • Ultrasonography, themography
47
Q

What condition causing back pain is regional infiltration of anaesthesia a useful diagnostic tool for?

A

Impingement of dorsal spinous processes (aka kissing spine)

48
Q

What conditions causing back pain is biochemistry a useful diagnostic tool for?

A

Myopathies (look at CK and AST)

49
Q

What conditions causing back pain are radiography and scintigraphy useful diagnostic tools for?

A

Bony lesions, fractures, kissing spine

50
Q

Give examples of soft tissue conditions that may lead to back pain in the horse

A
  • Muscle strains e.g. longissimus dorsi
  • Ligament injuries e.g. supraspinous ligament
  • Post exercise myopathy
51
Q

Give examples of joint conditions that may cause back pain in the horse

A
  • Sacroiliac joint disease

- Osteoarthritis

52
Q

Give examples of bone conditions that may cause back pain in the horse

A
  • Impingement of dorsal spinous processes (kissing spine)
  • Fractures (usually associated with trauma, stress fractures in vertebrae of racehorses)
  • Congenital or acquired vertebral deformities
  • Osteomyelitis (rare)
53
Q

Outline the prognosis for acute soft tissue injuries causing back pain in the horse

A

Generally respond well to local or systemic anti-inflammatories, rest and adjusting exercise regime

54
Q

Outline the prognosis for joint conditions causing back pain in the horse

A

Poor prognosis for return to previous performance levels

55
Q

Outline the prognosis for impingement of dorsal spinous processes

A

Can be treated by local or systemic anti-inflammatories, may not return to performance, surgical treatment is an option in some cases (refractory to conservative treatment, lesions located dorsally)

56
Q

What structures make up the pelvis of the horse?

A

Os coxae (made up of ilium, ischium, pubis), sacrum and first 2/3 fused coccygeal vertebrae

57
Q

What are the 5 articulations of the lumbosacral junction in the horse?

A
  • Paired lumbosacral facet joint
  • Paired inter-transverse joints
  • Lumbosacral joint between 6th lumbar vertebra and first sacral vertebra, between which lies lumbosacral disc
58
Q

What may a lack of symmetry in tubera coxae of the horse indicate?

A

Stress/traumatic fracture in one of these structures

59
Q

What does a disparity in level of tubera sacrale indicate?

A

Displaced ilial wing - may also find crepitus of underlying bone

60
Q

What may asymmetry of the gluteals indicate?

A
  • If mild, low grade HL lameness

- If severe, may indicate pelvic injury e.g. complete pelvic fracture, acetabular or iliac shaft fracture

61
Q

How can iliopsoas strain in the horse be diagnosed?

A

Palpation per rectum resulting in apparent pain response

62
Q

How can subluxation and partial disc herniation of the lumbosacral joint in the horse be diagnosed?

A

Palpation per rectum to apply digital pressure to LS joint, resulting in pain response

63
Q

How can osteoarthritic changes to the lumbosacral joint in the horse be diagnosed?

A
  • No pain response on palpation

- Diagnose by ultrasonography

64
Q

What may callus formation and/or soft tissue swelling felt in the pelvis during per rectum palpation indicate?

A

Complete fracture of acetabulum, iliac shaft, sacrum or pubis

65
Q

What is the main indication for use of ultrasonography in a horse with pelvic pain?

A

To rule out pelvic fracture

66
Q

What structures can be imaged using a linear transducer at the pelvis, transcutaneously?

A
  • Dorsal sacral ligaments
  • Tuber sacrale
  • tuber coxae
  • Tuber ischii
67
Q

Outline the ultrasonographic examination of the dorsal sacral ligaments in the horse

A
  • Linear probe, 8-13MHz
  • evaluate transverse and longitudinal planes, assess shape, size, symmetry
  • Echogenicity, typically homogenous
  • Fibre pattern usually good
  • Caudal extension of thoracolumbar fascia aka thin DSL can sit variably dorsal or medial to short DSLs
68
Q

In which structures of the equine pelvis can fractures be detected in with variable sensitivity?

A
  • Iliac wing
  • Iliac shaft
  • Acetabulum
  • Ischium
69
Q

Discuss the usefulness of ultrasonography in the detection of fractures of the iliac wing and shaft, acetabulum and ischium in the horse

A
  • Usefulness depends on degree of callus formation and/or displacement of fracture edges
  • Negative scan on TBs with clinical presentation of pelvic fracture should not reduce index of suspicion
  • Subtle/early lesions easily missed
70
Q

When should scintigraphy be carried out in horses in cases of suspected pelvic injury?

A

10-14 days after onset of signs to ensure significant amount of bone remodelling

71
Q

Outline the typical appearance of lameness resulting from pelvic stress fractures in horses

A
  • Similar to any other HL stress injury
  • Plaiting, short strided HL gait
  • Hx of variable lameness, may be sudden onset non-weight-bearing to low grade lameness when ridden that improves with rest
72
Q

What are the 2 main differentials for a horse showing HL lameness, with gluteal and lumbar muscle spasms, and how can these conditions be differentiated?

A
  • Bilateral iliac wing lesions
  • Exertional rhabdomyolysis
  • Rule out rhabdomyolysis on biochemistry
73
Q

Outline the clinical signs of iliac shaft fractures in the horse

A
  • Muscle wastage over affected area, occurs rapidly
  • Severe lameness
  • Variable asymmetry of tuber coxae
  • Rocking of pelvis may demonstrate crepitus
74
Q

Outline the clinical signs of acetabular fracture in the horse

A
  • Muscle wastage over affected area, occurs rapidly
  • Dramatic reduction in caudal phase of stride
  • Hip region more prominent on clinical exam due to loss of muscle mass
  • Soft tissue swelling
75
Q

What would the following indicate in the horse?

Focal muscle loss to one/both sides of dorsal spine of sacrum, loss of bladder control, loss of anal sphincter reflex

A
  • Sacral fracture

- Possibly EHV-1 (loss of bladder control)

76
Q

What does the following finding on clinical examination indicate in the horse?
Palpation of fractured bone fragment in the sublumbar fossa, lameness

A
  • Fracture of the tuber coxae

- Fragment displaced cranioventrally, may cause soft tissue trauma

77
Q

What are the differentials for the following signs in a hose presented following a traumatic incident, and how can they be differentiated?
Obvious swelling of caudal thigh, loss of definition of ischial tuberosity, pain when firm digital pressure applied to area

A
  • Fracture of ischial tuberosity

- Tears of semitendinosus/semimembranosis (differentiate by ultrasonography)

78
Q

What will be detected on rectal palpation in the horse in a case of fractures through the acetabular physis?

A

Large soft tissue masses at 4 and 8 o’clock positions within the pelvis

79
Q

What pelvic structures should be evaluated on per rectum ultrasonography in the horse?

A
  • Sacroiliac joints
  • Ventral sacroiliac ligaments
  • Lumbosacral joints and disc
  • Intertransverse joints
  • Nerve roots and fossae
  • Axial aspect of the coxofemoral joint
  • Pubic symphysis
80
Q

In a horse where pelvic fracture is suspected, but not identified on initial ultrasonography, how should the case be managed?

A
  • Scintigraphy
  • If scintigraphy not available, tie up in stable 10-14 days, repeat ultrasound
  • If still nothing found, manage as a fracture until proven otherwise
81
Q

Outline the clinical signs of sacroiliac and lumbosacral dysfunction in the horse

A
  • Low grade lameness
  • Poor performance
  • Poor propulsion over fences
  • Occasional reluctance to elevate HLs
  • Shortened cranial swing phase, toe drag
82
Q

Compare the clinical signs of acute sacroiliac ligament rupture, chronic SI ligament injury and lumbosacral joint injury

A
  • Acute ligament: palpable discomfort surrounding tuber sacrale
  • Chronic ligament: bucking after jumping or in groundwork
  • Joint injury/luxation: ataxia
83
Q

Outline the diagnosis of sacroiliac joint dysfunction

A
  • Local anaesthesia using cranial, cranial midline and caudal approaches to the SIJ to localise pain to this region
  • Ultrasonography and scintigraphy: modelling of joint margins (LS, SI, and ITJ), dystrophic mineralisation, hypoechoic/hyperechoic regions within disc tissue, protrusion of disc
84
Q

In the equine pelvis, what is the ITJ?

A

Inter transverse joint - the joint formed between the last transverse process of the lumbar vertebrae (L6) and the sacrum

85
Q

List the indications for radiography of the equine foot

A
  • Lameness/pathology localised to foot/pastern
  • Penetrating injuries
  • Chronic infection/discharge
  • Evaluation and monitoring or lamintis
  • Assessment of foot balance
  • Monitoring of treatments/corrections
  • Pre-purchase/insurance examinations
86
Q

List the radiographic views for a standard equine foot series

A
  • Lateromedial
  • Dorsopalmar
  • 2x dorsoproximal, palmarodistal 60degree oblique views (pedal, navicular, or upright pedal)
  • Palmaroproximal palmarodistal 45 degree oblique view
87
Q

Describe the positioning for a lateromedial radiograph of a horse’s foot

A
  • Fully weight bearing, standing square
  • Centre on coronet band midway dorsopalmar
  • Align beam parallel to heel bulbs
  • Adjust film focal distance, collimate
  • Marker placed dorsally on plate
88
Q

Describe the positioning for a dorsopalmar radiograph of a horse’s foot

A
  • Weightbearing
  • Centre on coronet band, midway medial-lateral
  • Adjust film focal distance, collimation, ensure beam horizontal
89
Q

Describe the positioning for an upright peda/D60Pr-PaDi oblique projection of a horse’s foot

A
  • D60Pr-PaDi oblique requires less people, may get image distortion
  • Centre on coronet band
  • Pack sulci
  • Oblique: place toe at edge of plate, weight bearing, angle beam 60degrees to hoof wall
  • Upright pedal: upright block, place toe on block, sole perpendicular to floor, plate behind, use horizontal beam perpendicular to plate
90
Q

Describe the method for obtaining upright navicular/D60PrPaDi oblique projections of the equine foot

A
  • Pack sulci
  • Upright: use block, tip foot forward slightly so dorsal hoof wall ~85degrees from horizontal
  • Tunnel/oblique: same as for P3 view, but centre 1-2cm above coronary band
  • Tight collimation needed
91
Q

Describe the method for obtaining a flexor navicular (Pa45PrPaDi) projection of the equine foot

A
  • Foot on tunnel, place caudal on block
  • Foot must be placed behind the foot not being radiogaphed
  • Not always taken at 45degrees - take at steepest angle possible without hitting back of fetlock
  • Centre between the bulbs
  • Collimate, FF distance, angle sorted before taking radiograph to ensure minimal time spent under horse
92
Q

What aspects are highlighted in the equine limb in a DLPMO view?

A
  • Dorsomedial

- Palmarolateral

93
Q

What aspects are highlighted in the equine limb in a DMPLO view?

A
  • Dorsolateral

- Palmaromedial

94
Q

Which horses are predisposed to axial skeletal disoders?

A

Adult athletes esp/ show jumpers and eventers

95
Q

Which horses are predisposed to axial soft tissue injuries?

A
  • Heavy framed

- Long backed TBs

96
Q

Which breeds of horse are predisposed to vertebral injuries e.g. overriding spinous processes?

A
  • Standardbreds, quarterhorses, other short backed breeds
  • Warmbloods
  • Racing TBs
97
Q

Which breed of horse is prediposed to congenital spinal disorders?

A

Arabs

98
Q

Give examples of congenital spinal disorders found in horses

A
  • Sacralisation of the last lumbar vertebra
  • Hemivertebrae (wedge shaped vertebral bodies causing spinal deformities
  • Block vertebrae (fusion of several vertebral bodies)
99
Q

What is roach back in horses and when does it commonly occur?

A
  • Acquired kyphosis

- Younger Tbs in association with flexural limb deformities

100
Q

Which horses are predisposed to marked lordosis/sway back?

A

Aged animals, frequently brood mares

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