Managing foot infections (Dryden) Flashcards
Common access point of microbes
White line
-porous and subject to tearing when wall become long, flared, or cracked
Penetrating injuries to central area of hoof are
medical emergencies
Prognosis for return to soundness decreases significantly if injury untreated for
over 12 hours
Remove a foreign body before rads if
horse may do more damage to itself by leaving it in
Helpful tool to explore wound and determine affected structures
Sterile malleable probe
Threshold for Dryden to consider a wound septic
> 30,000 cells/micro liter
Total protein ~ 5 mg/dL
Street Nail procedure
- Draining infected navicular bursa via frog
- Poor prognosis to return to athletic career
- Salvage procedure
To pare out abscess avoid
paring sole. Start at white line
Most abscesses are in
submural and subsolar region, can be drained at white line
Overnight poultice recipe
- Bran, 2-3 handfulls
- DMSO, 20 mls
- Epsom salt, 1/2 handful
- Povidine solution, 20 mLs
- Warm water to oatmeal consistency
Goals for management foot infections
- Debride necrotic tissue
- Maintain drainage
- Antibiotic therapy
- Protection
- Support surrounding healthy tissue
- Support contralateral foot
Debridement techniques
- Surgery
- Lavage
- Medical maggots
Can remove some solar/toe of coffin bone
up to 20%
Intravenous regional limb perfusion
- use 1/3 systemic dose
- 30 mL volume for average sized horse (60 for draft)
- use water soluble abx in isotonic solutn
Intravascular pressure results in
dilation of venous capillaries and relaxation of endothelial cells and pericytes
Arterial endothelial cells
more sensitive than those of veins
Beta Lactams
Time dependent with concentrations greater than MIC
Aminoglycosides
Concentration dependent and prolonged post admin effects
Common abx IV reg limb perf
- Amikacin
- Gentamicin
- Naxcel
- K-pen
- Imipenim
Optimal perfusion duration
30 min to 1 hr
Larval tx
- Green blow fly maggots
- Debrides necrotic tissue
- Creates basic environment that is antibacterial
- Evidence of enhanced wound healing
Quittor
Infection and necrosis of collateral cartilage
Thrush
- Caused by gram negative anaerobic bacteria
- Can invade sensitive tissue and cause lameness
- Hoof conformation?
Thrush tx options
- Debride necrotic tissue
- Open infected areas to oxygen
- Topical antiseptic
- Clean Trax (Oxychlorosene)
- New Day/Tomorrow Mastitis treatment (cephalosporins)
Canker
Proliferative pododermatitis unknown etiology
- intracellular G- bact
- bovine papilloma virus
- autoimmune
To tx canker it’s necessary to
debride all dystrophic tissue surgically
Additional canker txs
- CO2 laser
- Cryotherapy with liquid nitrogen
- Chemo with cisplatin
- Canker paste
- Metronidazole+oxytetracycline+copper sulfate - Immunosuppressive doses prednisolone
White line disease
- Caused by anaerobic fungi and bacteria, attack insensitive lamina
- Insidious, ush no lameness until laminitis
- Debride infected area to healthy foot
Other tx white line dz
- Expose to O2
- Clean Trax (oxychlorsene)
- Antifungal topical
- Ozone treatments
- Supportive and protective shoeing