Foot penetrations and conditions of the hoof wall Flashcards
List the visible structures on the bottom of a horses hoof
- Hoof wall
- White line
- Sole
- Frog apex
- Bars
- Central sulcus
- Collateral sulcus
- Heel bulb
Hoof cracks usually run in which direction?
Proximo-distal
What are transverse hoof cracks associated with?
Coronary band injury
What are the consequences of hoof cracks
Instability -> shear forces -> further separation -> infection and pain
How should you assess hoof cracks before treatment?
- Characterise depth, direction,
- Determine sensitive/insensitive parts (do not nerve block)
- Incomplete often just need trimming/shoeing
How are hoof cracks treated?
- Farriery
- Debride/dremmel all necrotic tissue
- Filler to stabilise (plate; wire)
- Trim foot/unload crack/bar shoe/quarter clips - Identify underlying cause (and treat)
- Antibiotics (local/systemic) - Flush via catheter/tubing
What is white line disease?
Progressive, crumbling, poor quality hoof wall with separation at the white line
- Non-pigmented portion of the stratum medium and the laminar horn
Which factors can act as risk factors for white line disease?
Warm, wet weather
Biotin/methionine/zinc/selenium deficiency
Bacterial infection common
What are the clinical signs of white line disease?
+/- lameness
Separation of hoof wall esp at toes/quarters
Grey/black crumbly horn
How is white line disease treated?
- Remove abnormal horn
- Support remaining horn: Bar shoe+clips, Hoof acrylic
- Prevent progression: Environmental factors, Topical povidone/iodine, Feed supplementation
Wire lacerations/foot trapped (e.g. gate/fence)/overreach injuries most commonly cause injuries to which part of the hoof?
Coronary band and hoof wall
Why must you assess if there is damage to the coronary band?
Damage to the coronary band can affect how the hoof wall grows
List the clinical signs of damage to the coronary band and hoof wall
- Avulsion/disruption to the hoof wall +/- coronary band
- Lameness: Moderate/severe
- Haemorrhage++
Which other structures may be involved when there is damage to the coronary band and hoof wall?
Synovial structure = DIP/PIP/Navicular bursa/DFTS
Tendons/ligaments (DDFT/SDFT/extensor tendons/collateral ligaments)
How are injuries to the coronary band and hoof wall treated?
- Primary or secondary intention healing
- Preserve coronary band if you can
- Antibiotics
- NSAIDs
- Bandaging
- Cast
- Flush
- Shoes
Why is it important to flush synovial structures?
Treat sepsis early and aggressively
How should puncture wounds of the foot be assessed and managed?
- Common cause of lameness
- Most are managed conservatively with a good prognosis
- All foot penetrations have the potential to involve deeper structures resulting in life threatening complications
- Need to know what kind of object is involved
What is nail bind?
Nail close to sensitive structures
Mild lameness
Pain around nail
What is shoeing prick?
Nail into sensitive structures
Immediately painful/blood
May develop into subsolar abscess if left
How do subsolar abscesses occur?
Penetration of bacteria results in abscess formation and pressure on sensitive hoof lamina
What are the clinical signs of subsolar abscessation?
- Usually acute lameness: SEVERE!
- Increased digital pulse
- Increased hoof temperature
- Sensitive to hoof testers
How are subsolar abscesses treated?
- Key: DRAINAGE
- Remove shoe/nail (if present)
- Pare foot: follow tracts and remove all necrotic/underrun horn - Poultice or tub
- Bandage - Protect foot/apply poultice
- (NSAIDs/antibiotics)
- Check tetanus status
Which structures could be damaged when there are foot penetrations affecting synovial structures?
Navicular bone/bursa
DDFT
Distal sesamoidean impar ligament – joins the bottom of the navicular bone to the back of P3
DIP joint
DFTS
How are foot penetrations affecting synovial structures diagnosed?
- Moderate to severe lameness
- Presence of nail/foreign body in foot, particularly the middle third
- Puncture wound – can be difficult to find sometimes
- Distal limb swelling/DIP effusion/DFTS effusion
- Increased digital pulse to foot
- Sensitive to hoof-testers over tract
- Radiography
- Synoviocentesis
- MRI
