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Equine Med > Foot issues > Flashcards

Foot issues Flashcards

1
Q

History of chronic heel pain can include…

A
  • intermittent uni-bilat lameness
  • worse after shoeing or walking on hard ground
  • decr performance
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2
Q

Predisposing causes to foot pain

A
  • poor shoeing
  • hard ground
  • abd stress forces (e.g turns, jumps, etc.)
  • poor conformation
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3
Q

How does poor conformation cause navicular pain?

A
  • incr stress center on navicular bone

- long toe = longer time to lift off ground = longer time stress on navicular bone

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4
Q

Dx options for foot lameness

A
  • hoof tester
  • wedge test
  • flexion
  • nerve/joint block
  • Xray
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5
Q

What to block in foot lameness test

A 
Joints more helpful than nerve as more specific:
- DIP joint
- navicular bursa
Nerve blocks:
- palmar digital (above P2)
- Abaxial sesamoid n. block
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6
Q

What does palmar digital n. block block?

A
  • DIP joint
  • navicular apparatus
  • all of sole
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7
Q

Procedure for navicular bursa block

A
  • 3mL of block

- 5min wait (if longer diffuse to other structures)

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8
Q

Procedure for DIP joint block

A
  • 5-6mL of block

- 10min wait

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9
Q

What views on Xray do you want? What are you looking for in those views?

A
  • Lateral: enthesiophytes from collateral sesamoidean lig.
  • Dorsoprox-palmarodistal: synovial formina on navicular bone
  • palmaroprox-palmarodistal: flexor cortex erosions, corticomedullary definition (of nav bone)
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10
Q

What to do if:

  • pain + xray abn
  • pain + xray normal
  • no pain + xray abn
A
  • dx and tx
  • need more info/dx
  • depends if is significant
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11
Q

Advance dx for navicular structures?

A
  • nav bursogram
  • nuclear scintigraphy
  • US
  • MRI** (needed to ddx specific)
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12
Q

Tx for palmar heel pain

A
  • rest: 3-4wk, 6-12m if ligament
  • corrective shoeing
  • systemic anti-inflammatories: phenylbutazone, hyaluronic acid, polysulf glycoaminoglycans
  • local anti-inflammatories: hyaluonic acid, corticosteroids
  • Bisphophonate
  • extra-corp shockwave
  • sx: neurectomy
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13
Q

Goal of corrective shoeing?

A
  • front and back of hoof parallel to foot angle
  • sole parallel to ground
  • shorten toe to ease breakover
  • trim so angle of front vs back edge of hoof <5d
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14
Q

Complications of neurectomy

A
  • DDFT rupture, n. regrowth, neuroma/neuritis
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15
Q

Navicular bone fx tx and prognosis

A
  • conservative: rest, bar shoe
  • sx
  • guarded
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16
Q

DIP osteoarthritis

  • dx
  • prognosis
  • tx aim
A
  • blocks
  • irreversible
  • palliative
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17
Q

Laminitis causes

A
  • toxin (black walnut, red oak, avocado, white clover, selenium, rattle snake venom, Hg)
  • iatrogenic
  • infectious (endo/exotoxins)
  • colic (endotoxins)
  • carb overload
  • metabolic/ hormone induced
  • obesitiy
  • MSK
  • idiopathic
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18
Q

Laminitis pathophysiology (3 theories)

A

1) ischemia - reperfusion
2) enzymatic: metallomatrix proteins degrade lamella –> decr nutrience exchange
3) mechanical overload

19
Q

Phases of laminits

A

1) dev: before clinical signs
- acute vasodilation, incr MMP
- ice and NSAID important here
2) acute (up to 72h): laminar degen, _3 not moved
3) chronic compensation: P3 moved but not anymore, no active laminar degen
4) chronic uncompensated P3 move, laminar degen

20
Q

Exam steps for laminitis

A
  • PE
  • gait
  • foot exam: digital pulses, sole, coronary band, hoof wall
21
Q

characteristic gait for laminitis

A

put all 4 feet under, relunctant to move

22
Q

What measurements to take on Xray

A
  • coffin bone to dorsal wall width
  • thickness of hoof wall
  • hoof wall to top of P3 (coronary band to DDE distance?)
23
Q

What is a venogram? use?

A
  • xray with contrast in blood
  • looking for avascular areas of foot in laminitis
  • incl coronary plexus, circumflex vessels, terminal arch
24
Q

Seqelae of laminitis

A
  • rotation of P3 in hoof
  • sinking of P3 in hoof
  • loss of P3 bone
25
Q

Laminitis Tx

A
  • mech support feet: rest, bedding, therapeutic trim
  • ICE
  • NSAID, analgesia
  • tx cause
  • shoeing
26
Q

What shoeing changes in tx of laminitis? aim of tx options?

A
  • load sole, frog bar: transfer load axially

- elevate heels: decr tensile force on anterior laminae (ie counters pull from DDFT?)

27
Q

Tx goals and options for chronic compensating laminitis?

A
  • ease breakover: trim hoof back
  • preserve sole depth
  • move base to support heel region: shoeing
28
Q

Tx for uncompensated laminitis

A
  • if coronary band seperated: grooving
  • if shering: dorsal hoof wall resection
  • DDFT tenotomy (decr pull on coffin bone)
29
Q

Street nail injury:

  • exam incl
  • dx
  • prelim tx
  • prognosis
A
  • asses direction of nail using metal probe
  • xray +/- contrast synoviocentesis
  • remove, clean, banadge, abx, tetanus booster
  • guarded, incr with prompt tx
30
Q

What is the lamellae and what does it do?

A
  • is BM between P3 and hoof wall

- attachs P3 to hoof and allows for nutrients exchange

31
Q

Signs of poor hoof quality

A
  • brittle, spongy or soft
32
Q

Causes of poor hoof quality

A
  • poor nutrition
  • disease
  • bad environment (e.g. wet pasture)
  • trauma
  • poor farriery
33
Q

tx for poor hoof quality

A
  • good farriery
  • good nutrition
  • biotin/methionine supp
34
Q

Sole bruising

  • pre-disposition
  • tx
A
    • flat, thin, and/or soft soles –> if step on something hard, bleed under hoof
  • drain out bleeding?
35
Q

Sheared heels

  • what
  • why is it an issue
  • tx
A
  • heel bulbs move independently
  • mediolat imbalance
  • bar-shoe for stability
36
Q

Subsolar abscess

  • signs
  • cause
  • xray
A
  • very lame, digital pulses, painful on hoof testing
  • something invaded into under hoof –> 2nd bac infection
  • tracks and focal incr lucency
37
Q

Hood wall crack tx options

A
  • metal plate, wire laces, bar-shoe, acrylic material to cover
38
Q

Hoof wall laceration tx

A
  • suture back coronary band if affected

- foot cast

39
Q

Keratoma

  • what
  • tx
A
  • abn growthin hoof –> abn pressure and resorption of bone

- dig growth out

40
Q

Thrush

  • cause
  • tx
A
  • ground too wet –> enyzmes lyse keratin

- debride superficial layer off

41
Q

Canker

  • what
  • cause
  • tx
A
  • “chronic hypertrophy and apparent suppuration of the horn-producing tissues” (Merck)
  • unknown
  • debride until healthy tissue, abx
42
Q

White line disease

A

???

43
Q

P3 fracture tx and prognosis

A
  • wires/clips

- worse if fx goes to joint

44
Q

Other feet dz’s

A
  • pedal osteitis
  • ## lateral cartilage

Equine Med (8 decks)

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