Lecture 16: Equine Foot Flashcards
What is the most important structure in regards to lameness
Foot
80% of forelimb lameness originates distal to the ___
Carpus
Horses should have their feet trim and/or shoe every __weeks
6 weeks
Heel pain originates from….
One or more of the bony and soft tissue structures in heel area
what wrong here
Tear in DDFT
Horse presents with heel pain, you do a palmar digital nerve block and suddenly they are lame on other front limb. What is likely cause
Navicular syndrome- switching lameness
What radiographic changes are associated with navicular syndrome
- Synovial invaginations- lollipops
- Rough flexor surface
- Elongated navicular bone
- Loss of corticomeduallary junction
What is wrong here
navicular syndrome- synovial invaginations- lollipops
What are some causes of navicular syndrome
- Low heel, long toe
- Wear and tear
Which normal vs abnormal and what is wrong
Left: broken back hoof pastern axis
Right: normal
What is a typical history for navicular syndrome
Bilateral lameness, chronic, tripping, shifting limb lameness
How do you diagnose navicular syndrome
- Lameness exam
- Hoof testers
- Normal digital pulses
- Exacerbated in tight circles
What part of foot is landing first with navicular syndrome
Toe first
What block do you perform to test for navicular syndrome
Palmar digital nerve block
What wrong here and what is it associated with
elongated navicular bone—> navicular syndrome
What is wrong here and what is it associated with
Loss of corticomedullary junction—> navicular syndrome
What wrong here and what is it associated with
Roughened flexor surface—> navicular syndrome
What do you see on ultrasound for navicular syndrome
- Effusive navicular bursa
- Enlarged lobe of DDFT
MRI allows good visualization of what
Soft tissue and bones, fluid in bones and soft tissue
What modality for navicular syndrome leads to a cure and decreases odds of doing a neurectomy
MRI- because we can identify problem more specifically
what wrong
Coffin joint effusion
What wrong
Navicular bursa effusion
What wrong
edema in navicular bone- likely due to bone bruise
What wrong
DDFT tendonitis
What wrong
DDFT tendonitis
What wrong
Impar ligament desmitis
What does the impar ligament connect
Navicular bone to P3
How do you treat navicular bone syndrome
- Trimming/shoeing (most important)
- Systemic-NSAIDS
- Intraarticular/intrabursal injections
- Surgery
What is required with all treatments for navicular syndrome
- Trimming/shoeing
Elevate heel, fix breakover back, sole support
What NSAIDS are used for navicular syndrome
Phenylbutazone, firocoxib
What is isoxsurpine used to tx and what does it do
Navicular syndrome, causes blood vessel dilation
What can you inject into joint and bursa for navicular syndrome
Corticosteroids (MPA) and hyaluronic acid
What surgery is performed for navicular syndrome
Palmar digital neurectomy
What is prognosis for navicular syndrome
- Good if caught early, minimal bone changes
- Poor of long standing or severe= navicular bone changes, cysts, roughened flexor surface, adhesions of DDFT to navicular bone
What are some causes of subsolar abscesses
- Wet/dry environment
- Sole bruise
- Laminitis
- Poor hoof care
What is typical history for subsolar abscess
- Acute onset- non-weightbearing or toe tapping
- Unilateral
- Severe lameness
- +/- lower limb swelling
What does lameness exam look like for subsolar abscess
- Increased digital pulses
- +/- edema
- Hoof tester positive
- Soft or drainage area
- Coronary band drainage
What wrong
subsolar abscess
What wrong
Subsolar abscess
What is treatment for subsolar abscess
- Pull shoe
- Open area and follow black spots
- Establish drainage
- Clean and cover
What are the owner instructions for subsolar abscess
- Soak foot daily for 20 minutes in warm epsom salt water for 7 days
- Apply poultice wrap
- Stall rest 10 days
- 10 minute daily hand walk
- Phenylbutazone
- Apply shoe with pad
What is prognosis for subsolar abscess
Great, unless osteomyelitis occurs
What is history for penetrating wounds to sole
- Acute onset
- Single foot
- Lameness none to severe
Should owner remove nail or take it out
Leave in, so can X-ray and see what structures are affected
What does lameness exam look like for penetrating wounds to sole
- Increased digital pulses
- Edema
Where is the worst spot to get a nail in sole
Near frog because near important structures like navicular bone and bursa and DDFT
What is tx for penetrating wounds to sole
- Debridement
- Establish drainage
- Treat structures involved
- Antibiotics
What is surgery for penetrating wounds to sole
Street nail procedure- cut hole as deep as nail, lavage, and antibiotics
What is prognosis for penetrating wounds to sole
Depends on structures involved, closer to the frog is worse
What are some causes of white line disease
- Unhealthy hoof care
- Poor environment
- Poor hoof structure
- Anaerobic bacteria
What is history for white line disease
Chronic onset, +/- lameness
How do you dx white line disease
- Visual inspection
- +/- hoof testers
- Lameness
- Increased Digital pulses
What is treatment for white line disease
- Debridement
- Hoof wall resection- expose anaerobic bacteria to O2
- Topical medications- formalin, methylene blue, copper sulfate
- Identify cause- shoeing/trimming, environment
What are some topical medications used for white line disease
- Formalin
- Methylene blue
- Copper sulfate
What syndrome is the most common cause of chronic bilateral forelimb lameness
Navicular syndrome
What two injuries to the foot are associated with bilateral lameness
- Navicular syndrome
- Laminitis
What foot injuries are associated with unilateral lameness (4)
- Subsolar abscess
- Penetrating wound to foot
- P3 fractures
- Keratoma
Are the following acute or chronic onset: laminitis, subsolar abscesses, penetrating wound to sole, p3 fractures
Acute
Are the following acute or chronic onset: navicular syndrome, teratoma, quittor
Chronic
