Foot penetrations + conditions of the hoof wall

Question 1

What can cause hoof cracks?

Answer 1

• Poor foot balance / care
• Poor horn quality
• Environment
• Trauma

Question 2

How are hoof cracks treated?

Answer 2

• Characterise sensitive / insensitive parts
• Debride / dremmel necrotic tissue
• Filler to stabilise
• Trim foot / unload crack / bar shoe / quarter clips
• Identify underlying cause (+treat)
• Antibiotics

Question 3

What is white line disease? What are risk factors? CS?

Answer 3

• Progressive, crumbling, poor quality hoof wall with separation at the white line
• Risk factors = warm, wet weather
  -biotin / methionine / zinc / selenium deficiency
  -bacterial infection
• CS = +/- lameness
  -separation of hoof wall
  -grey/black crumbly horn

Question 4

How is white line disease treated?

Answer 4

• Removal of abnormal horn
• Support remaining horn - bar shoe + clips / hoof acrylic
• Prevent progression - environmental factors, feed supp, topical povidone iodine

Question 5

What causes injuries to the coronary band + hoof wall? What are CS?

Answer 5

• Causes = wire lacerations / foot trapped (gate/fence)
  -overreach injuries
• CS = avulsion / disruption to the hoof wall +/- coronary b
  -Lameness
  -Haemorrhage ++ (digital cushion = highly vascularised)
  -Involvement of other important structures (DIP/PIP/NB/DFTS, Tendons/ligaments)

Question 6

What is treatment of injuries to the coronary band + hoof wall?

Answer 6

• Primary / second intention healing??
  -preserve coronary band + check tissue viability
• Antibiotics
• NSAIDs
• Bandaging - protect / debride tissue
• Cast - foot / distal limb cast best way to stabilise
• Flushing synovial structures
• Shoeing

Question 7

How are most puncture wounds of the foot managed?

Answer 7

• Conservative management = analgesia, antibiotics + anti-inflammatory

Question 8

What is a nail bind?

Answer 8

• Nail going close to sensitive structures
• Mild lameness
• Pain around nail

Question 9

What are shoeing prick?

Answer 9

• Nail into sensitive structures
• Immediately painful / blood
• May develop into subsolar abscess if left

Question 10

What is subsolar abscessation? (pus in the foot)

Answer 10

• Common - penetration of bacteria results in abscess formation and pressure on sensitive laminae
• Acute lameness - SEVERE
• Increased digital pulse, hoot temp + sensitive to hoof testers
• Tx = Drainage = remove shoe / nail, pare foot (trim with knife) - remove necrotic + underrun horn
  -poultice daily
  -bandage - protect foot + NSAID + antibiotics
  -check tetanus status

Question 11

How are foot penetrations involving synovial structures diagnosed?

Answer 11

• Moderate / severe lameness
• Presence of nail / foreign body
• Puncture wound
• Distal limb swelling / DIP effusion / DFTS effusion
• Increased digital pulse to foot
• Sensitive to hoof testers
• Radiography +/- contrast
• Synoviocentesis
• MRI

Question 12

What is treatment of foot penetrations involving synovial structures?

Answer 12

• Debridement of infected tissue
• Flushing of affected synovial structures
• Resection of damaged tissue
• Systemic Abs + NSAIDs
• Bandaging then hospital plate + raised heel

Question 13

What are causes of chronic hoof abscessation?

Answer 13

• Immunocompromise - cushings
• Keratoma
• Sequel to laminitis
• Bone sequestrum / collateral cartilage infection
• Infective (pedal) osteitis

Question 14

What is a keratoma? Dx? How is it treated?

Answer 14

• Benign tumour of hoof / solar horn
• Intermittent lameness / discharge
• Dx = radiography - smooth radiolucent defect in P3
• Tx = surgical resection under GA

Question 15

What is Quittor? What is seen? Tx?

Answer 15

• Infection of the collateral cartilages
• Swelling / chronic discharge from coronary band
• Tx = surgical debridement of infected tissues

Question 16

What is Canker? What is it linked with? What does it lead to?

Answer 16

• Chronic condition associated with hypertrophy of the germinal layer of the epithelium of the frog
  -often linked with fusobacterium / bacteriodes spp
• Infection leads to dyskeratosis of the keratin producing cells
• Results in abnormal hyperkeratotic horn with keratolysis and fronds of unconnected intertubular horn

Question 17

How is canker treated?

Answer 17

• Early mild cases = improve environment, debride, apply metronidazole bandages, Astringents
• Advanced / severe cases = aggressive surgical debridement + bandaging / shoeing