Horses Feet Flashcards
Causes of toxic laminitis
Compromised bowel - colitis, enteritis, strangulation
Severe infection - retained foetal membranes, sepsis
How does support limb laminitis occur
Increased pressure within the foot creates hypoxia within the other leg which causes inflammation and MMP production
How do steroids induce laminitis
Causes hyperinsulinaemia and MMP production as with endocrine production
What age are at lower risk of laminitis
Foals and weanlings
Why can donkeys be severely affected
They don’t tend to show pain until it’s very bad
What is the incidence of laminitis
1 in 10
When does laminitis have a higher incidence
April-June
And a bit more in autumn
Why do horses with laminitis lean backwards
A lot of the pain is down the dorsal aspect of the hoof wall so to relieve pressure
What is the most common laminitis presentation
Bilateral forelimb lameness
Where is the most common pain point on hoof testers
Just in front of the point of frog
What does depression on the coronary band show
Sinking of the bones
How can hindlimb laminitis present
High stepping gait
What radiographs are needed for laminitis
Latero-medial
Dorso-palmar
What are the classifications of rotation in laminitis
<5° mild
5-10° moderate
> 10° severe
What causes the rotation of the pedal bone
Consistent pull of the DDFT with breakdown of the laminae
How do you measure pedal rotation
Hoof wall and dorsal aspect of pedal bone should be parallel so measured from hoof wall
What is the DP view used to assess in laminitis
If one side is more effected than the other
Factors affecting laminitis prognosis
Lameness severity
Sinking
Degree of rotation
Patient weight
Ability to control endocrine disease
What procedure can salvage a horse with laminitis
DDFT tenotomy
What is common in the history of keratomas
Recurrent hoof absesses in the same location
Clinical signs of keratomas
Raised digital pulse
Hoof wall distortion
White kind deviation with cork like growth
Localized pain on hoof testers
Diagnosis of keratomas
Radiography at Dorso60°proximal palmar distal oblique aka upright pedal
What do you need to be sure to remove with keratomas
To take out the germinal cells at the top of the hoof wall
Treatment for keratomas
Hydrogel to fill the wound to encourage granulation
Replaced by iodine once granulation is filling in
How does septic pedal osteitis occur
Following solar penetration into the distal phalanx
Signs of septic pedal osteitis
Nail penetration into sole r
Raised digital pulse on one foot
Discharge and pain with hoof testers
Initial radiographs can look normal
Treatment for septic pedal osteitis
Poultice,
Antibiotics
Nsaids
Remove sequestrum/dying bones - requires surgery and hospital plate
Prognosis for septic pedal osteitis
Excellent if all infection is removed and site maintained correctly
Common signalment for coffin OA
Middle age/older horses
Faster or jumping work
Number of years of work
Repetitive concussion
Hoof balance
Nutrition when growing
Previous injury
Under what conditions are horses likely to be more lame with OA
Hard ground
What is the best imaging for coffin OA
Lateral Radiograph
What does MRI allow you to see in coffin OA
Effusion
Cartilage degeneration
Tendon issues
What intraarticular corticosteroids can you use in the coffin
Triamcinalone and methylprednisolone
What are some bruises
Blunt trauma to solar surface causing haemorrhage to sensitive tissues of the foot
Inflamed tissues increase tissue fluid
Increased fluid increased pressure in the hoof
How can you diagnose some bruises
Hoof tester sensitivity
Increased digital pulse
Increased hoof temperature
When is a solar bruise a corn
When it’s in the seat of corn
Risk factors for solar bruising
Surface - uneven/highly concussive
Shoeing/farriery - barefoot more prone, long shoeing intervals
Activity - hacking prone
Activity lever - repetitive concussive force
Conformation - flat feet, low heels
Considerations for solar bruising
Shoes
Pads
Packing material
Heel sparing trimming
Avoid working on bad surfaces
Predisposing factors to osteoarthritis
Repetitive impacts
Landing
Poor/hard work surface
Hoof imbalance
Clinical exam points for coffin joint OA
Effusion palpable 1cm proximal to coronary band on midline
Hoof balance and shoeing important
Long toe low heal and broken back HPA can predispose
What areas can you block for coffin arthritis
DP
Distal interphalangeal
What is the use of MRI/CT
Will show degree of joint effusion and cartilage degeneration
Shows additional pathology
Treatments for coffin OA
Oral NSAIDS - PBZ, suxibuzone
Intra-articular corticosteroids - triamcinalone, methylprednisolone
Alternative intra-articular medications
Hyaluronic acid - lubricant
Polyacrylamide gel - arthromid - lubricating and cushioning filler
IRAP, PRP, Articell, BMAC
Slow acting disease modifying osteoarthritis agents
Cartrophen
Other OA treatments
Corrective farriery
- shorten toe
- support heels
- cushion
Surgery
- arthroscopy
- neurectomy
What is a keratoma
Hyperplastic keratin mass within the hoof
What is common in the history and exam of keratomas
Recurrent hoof abscesses in same location
Raised pulse in single foot
Deviation of the white line with cork like growth
Localized pain on hoof testers
What radiograph do you use for a keratoma
Dorso60°proximal - palmar/plantar distal oblique view
How do you treat a keratoma
Surgical excision
Pack hole with hydrogel moving to iodine soaked swabs when granulation bed is forming
Septic pedal osteitis
Follows solar penetration - usually nail into the pedal bone can cause osteomyelitis. Can form sequestrum
Management of septic pedal osteitis
Poultice, antibiotics, nsaids, TAT (targeted alpha therapy)
Initial management of laminitis
Pain relief
Vasodilator - acp
Support feet - frog support
Deep shavings bed
Diet - soaked hay, weight loss with vitamin/mineral balancer
How does laminitis occur
MMP allows the growth of the hoof wall, over production of MMP causes breakdown and separation of the sensitive and insensitive laminae
How does EMS cause laminitis
Insulin dysregulation = hyperglycemia= hyperinsulinaemia = excess MMP
How does PPID cause laminitis
Increased ACTH = hyperinsulinaemia = increased MMP
