Exam III: Equine MSK emergencies, conditions of the forelimb and conditions of the hindlimb Flashcards
Nelson
emergency
How do you diagnose septic arthritis in the equine and what are the synovial fluid characteristics?
arthrocentesis (cytology)
culture and sensitivity
radiographs (lysis)
ultrasound (particles)
point of care analyzers (serum amyloid a and lactate acid)
infection has >90% neutrophils, low viscosity, orange/opaque, greater than 4 g/dl protein, and >30k NCC
emergency
What are some considerations for cast care?
Cast Care
u Monitoring – twice daily (at least)
u Heat
u Drainage (strike through)
u Lameness
u Fly accumulation
u Unwilling to stand on it
u pick up contralateral (uncasted) limb
u Changing casts
u Adults: 3-4 weeks
u Foals: 1-2 weeks
u Splints – usually with bandage changes or every 1-2 weeks
Common sites for cast sores
- Proximal dorsal MC3/MT3
- Palmar/plantar fetlock
- Heel bulbs
emergency
how do you immoblize fracture in the four regions of the equine forelimb and hindlimb
forelimb
I: hoof to distal MC3 (P1,P2, P3 and distal MC3 fractures), bandage and apply DORSAL splint, aligns DORSAL cortices of cannon bone/phalanges
II: distal MC3 to distal radius (Mc3, carpal, distal radius fractures), thick bandage and apply LATERAL and CAUDAL splint. prevents medial to lateral and dorsal to palmar instability.
III: distal radius to elbow (radius fractures), thick bandage and CAUDAL ground to elbow and LATERAL above shoulder. prevent limb abduction and further injury to the medial aspect
IV: elbow to scapula. no coaptation EXCEPT olecranon fractures (dropped elbow) apply full limb bandage and CAUDAL splint up to elbow. prevents limb abduction and further injury to medial aspect.
hindlimb
I: hoof to distal MT3 (P1, P2, distal MT3), bandage and PLANTAR splint, aligns PLANTAR cortices of cannon bone/phalanges.
II: distal metatarsus to distal tarsus (MT3, tarsal fractures/luxations), thick bandage and PLANTAR splint to calcaneus and LATERAL splint to stifle. prevents medial to lateral and dorsal to plantar instability.
III: tibia to mid tarsus (tibia fractures), thick bandage and LATERAL splint to hip (challenging with and and reciprocal apparatus), prevents limb abduction and further injury t the medial aspect
IV: stifle to hip. no coaptation. attahcments enable stability.
A horse present swith a dropped fetlock with the toe off the gorund which soft tissue structures have been lacerated? Which is still intact?
droppd fetlock: SDF
raised toe: DDF
fetlock to ground: SDF, DDF, and suspensory ligament
what can OA of DIP and PIP be referred to as? How can they be managed?
ringbone
challenging, intra-articular injections, NSAIDs, extracorporeal shockwave, arthodesis (good for PIP and better prognosis in hindlimbs, salvage in DIP)
In splint bone fractures, when do you wnat to preserve the splint bone?
What is the treatment?
what ligaments do you want to check?
mid body to proximal fractures. distal most common and can be removed if necesary up to 2/3. check suspensary ligament here.
conservative treatment. rest bandage and NSAIDS, surgery if causing lameness.
What re the differentials for a dropped elbow?
(disrupted TRICEPS apparatus) radial nerve paralysis, triceps myopathy, humerus fracture
stabilize for transport by locking the carpus in extension
How does prevelance in location of injury differ from forelimb to hindlimb? Where is OCD most common?
most injuries (70%) of hinlimb lameness is localized to the hock or above where as in the forelimb, most injuries occur below the fetlock.
OCD most common in tarsus and stifle
What would a dropped fetlock in the hindlimb signal?
suspensory branch desmitits (degenerative DSLD), a bilatera condition.
difficult to treat if degenerative, traumatic better prognosis, entire suspensory involved.
What are the most common locations for OCD in the tarsus?
distal intermediate ridge of the tibia (DIRT)
lateral trochelar ridge of the talus
medial malleolus
treatment
athroscopic debridement and good prognosis
