MSK 3 Flashcards
what is laminitis microscopically? macroscopically?
micro - basal keratinocytes lose attachment to basement membrane
macro - breakdown suspensory apparatus, sinking/rotation of pedal bone
what is the corium
sensitive part of hoof (dermis), provides nourishment to epidermis
layers of corium
coronary
laminar
solar
what direction does DDFT pull navicular bone
towards back on leg
causes of laminitis
carb overload
septicaemia
EMS
mechanical overload
2 theories of laminitis
Vascular
Inflammatory (proteolytic enzymes damage collagen)
normal lamellar enzymes
MMP
TIMPS
how are enzymes dysregulated in laminitis
-MMP increases –> damage collagen
-lack of TIMP inhibition
EMS pathophysiology of laminitis
high insulin
pro-inflammatory state
pathophysiology of carb laminitis
carbs –> into hindgut –> increase acid –> bowel wall damaged, gut substances flow into blood stream –> destroy lamellar BM
characteristic stance of laminitis horse
all 4 legs angled forward
what is a sinker
pedal bone falls within hoof capsule
signs of laminitis
digital pulse
convex frog
laminitic rings
radiographic signs of laminitis
gas at hoof wall
pedal bone no longer parallel
lose outline of p3
how to tell sinking on radiograph
place marker on edge of coronary band. start of pedal bone should be level with it
what will a venogram tell you
poor perfusion? ==> poor prognosis
purpse of ice for laminitis
vasoconstriction
decrease MMP activity
what pain relief options for acute lamitis
NSAIDs
Morphine
ACP (increase perfusion?, lie down)
Ketamine CRi
tx of acute laminitis
Reduce systemic dx, carb intake
Reduce stress on laminae (remove shoes, deep bed, heel support, small box)
Pain relief
how to move weight bearing to back part of foot
glue on shoes
Plaster of Paris
styrofoam pads
clog shoe
what to do for chronic laminitis
slow farriery:
hoof realigned to P3,
frog support
what sx tx exists for laminitis
DDFT tenotomy (extend)
