Lameness

Question 1

Grade 0 Lameness

Answer 1

Animal is sound

Question 2

Grade 1 Lameness

Answer 2

Inconsistent on circle

Question 3

Grade 2 Lameness

Answer 3

Inconsistent on straight line but consistent on a circle

Question 4

Grade 3 Lameness

Answer 4

Consistent on straight line

Question 5

Grade 4 Lameness

Answer 5

Lame at walk

Question 6

Grade 5 Lameness

Answer 6

Non-weight bearing

Question 7

What is the typical sign of front leg lameness?

Answer 7

Head goes up when the lame leg lands

Question 8

What is the typical sign of hindlimb lameness?

Answer 8

Hip hike - point of hip moves up and down more exaggeratedly when the lame leg lands

Question 9

What systematic process would you follow to diagnose lameness?

Answer 9

History, age, breed, use Examine from a distance Examine at trot in hand Identify lame leg/s Hoof testers Palpate each limb joint / soft tissue structure Flexion tests Nerve blocks Diagnostic Imaging Treatment plan

Question 10

What are the clinical signs of hoof lameness?

Answer 10

1. increased/asymmetric digital pulses 2. increased heat in hoof capsule 3. pain on palpation of the coronet 4. pain on hoof testers / percussion

Question 11

What are sites for local anesthetic of the distal limb?

Answer 11

Palmar digital nerve block (PDNB); Distal interphalangeal joint block (DIP); Abaxial sesamoid nerve block; Navicular bursa block

Question 12

What is blocked by a palmar digital nerve block? How would you test it has worked?

Answer 12

Caudal 1/3 of the foot (heels), navicular bone, P3, variable amount of sole and DIP joint. Test by pricking the heels.

Question 13

What is blocked by an abaxial sesamoid nerve block?

Answer 13

Mid pastern and below.

Question 14

What is blocked by a distal interphalangeal joint block?

Answer 14

The distal interphalangeal joint, the sole and navicular bone.

Question 15

What is a significant different between a DIP joint block and a palmar digital nerve block?

Answer 15

No loss of skin sensation from a DIP joint block.

Question 16

What does the term ‘dropped sole’ refer to?

Answer 16

Distal displacement of P3.

Question 17

How would you treat seedy toe?

Answer 17

Resection of diseases wall and laminae. Placement of a bar shoe with clips.

Question 18

What can cause corns on horse’s feet?

Answer 18

ill fitting shoes / prolonged shoeing interval

Question 19

How would you treat equine corns?

Answer 19

Resect bruised/thickened sole and place a wide webbed seated out shoe

Question 20

What is Brad’s favourite shoe type for horses?

Answer 20

Wide webbed deep seated out aluminium shoes

Question 21

What is the difference between a Type I and Type II hoof wall crack?

Answer 21

Type I wall cracks do not involve the coronet but Type II cracks do.

Question 22

What are your main differential diagnoses for 4-5/5 lameness?

Answer 22

Subsolar abscess Penetrating sole injury / foreign body Septic synovitis Fracture Cellulitis

Question 23

What is the most important thing to do for a subsolar abscess?

Answer 23

Provide an adequate drainage hole so it does not plug up prematurely.

Question 24

Describe a hospital plate?

Answer 24

A bar shoe with a plate secured to the solar surface to protect the sole / surgical site. Can unscrew plate to access sole.

Question 25

What condition is pictured and how would you treat it?

Answer 25

Canker - proliferative degeneration of the froh and digital cushion. Radical debridement under GA and packing with metronidazole paste.

Question 26

What condition is pictured and how would you treat it?

Answer 26

Sheared heels. Treat with bar shoe and 'float; the highest heel so it is non weight bearing.

Question 27

How would you treat a P3 fracture?

Answer 27

Bar shoe with side clips maintained for at least 3-6 months

Question 28

How would you treat navicular syndrome?

Answer 28

Intra-articular medication of the DIP joint / navicular bursa. Raised heel aluminium shoe. Palmar digital neurectomy.

Question 29

What can using a raised heel shoe for too long predispose to?

Answer 29

Crushed heels.

Question 30

What may indicate synovial involvement of a puncture wound to the hoof?

Answer 30

If the foreign body enters the frog; marked distal limb swelling; 5/5 lameness.

Question 31

How would you radiograph a puncture wound of the hoof?

Answer 31

With a sterile probe or contrast study (NOT BARIUM)

Question 32

Which synovial structures might be affected by a penetrating sole injury?

Answer 32

Navicular bursa; DIP joint; Digital tendon sheath

Question 33

What is a keratoma and how would you treat?

Answer 33

Benign tumor originating from keratinised laminae. Surgical resection.

Question 34

Describe laminitis:

Answer 34

Inflammatory disturbance to laminar attachments between P3 and hoof wall resulting in structural failure of P3-hoof wall interface and debilitating lameness.

Question 35

What are the principles of laminitis treatment?

Answer 35

Treat the underlying cause, provide analgesia and hoof support.

Question 36

What would you do for solar penetration of P3?

Answer 36

Eggbar shoe and hospital plate. Treat septic pedal osteitis. Antibiotics (local + systemic). Deep digital flexor tenotomy.

Question 37

What pathology is noticeable in this limb?

Answer 37

Fetlock joint effusion

Question 38

What local anesthetic techniques would you use to block out the fetlock?

Answer 38

Intra-articular fetlock Low 4 point (front) / Low 6 point (hind)

Question 39

What changes in the sesamoid vascular channels indicate sesamoiditis?

Answer 39

More than 2 vascular channels or a vascular channel \>2mm.

Question 40

Which is the only joint of the hock in which you will be able to appreciate effusion?

Answer 40

The tibiotarsal joint

Question 41

What is the most common location of OCD in the tarsus?

Answer 41

DIRT - distal intermedial ridge of the tibia

Question 42

Which splint bone has important weight bearing function?

Answer 42

The medial fore splint bone.

Question 43

Which structures have been damaged to cause this appearance?

Answer 43

Superficial digital flexor - dropped fetlock Deep digital flexor - raised toe