The Equine Foot Flashcards
What is the normal function of the hoof and capsule?
Elastic and flexible under load
Protective
No possibility for internal swelling or drainage
What is the weak point of the hoof capsule?
The white line
What techniques can be used for diagnosis of disease in the hoof capsule?
Hoof testers, palpation, percussion, response to local analgesia, radiography, MRI
What structures can be palpated inside the hoof capsule?
Dorsal DIP joint capsule, DIP joint collateral ligaments, collateral cartilages and distal recess to DFTS and DDFT
Why is it difficult to relate pain to specific structures?
Can’t really use direct visualisation, palpation or manipulation
Intra-synovial and peripheral nerve blocks aren’t very specific
What farriery related disease can damage the laminae
Nail prick or nail blind
What are hoof cracks?
Disruption to the hoof wall parallel to horn tubules and laminae
Can extend into the sensitive laminae causing pain and lameness
What is the aetiology of hoof cracks?
Poor horn quality
Thin hoof wall
Abnormal hoof angles
How do you treat hoof cracks?
Plating or gluing to support hoof and prevent widening and extension to coronary band
What can hoof capsule punctures lead to?
Septic pedal osteitis
What foot imbalances can cause disease to the hoof capsule and laminae?
Broken back axis, broken forward foot, club foot
What causes hoof wall avulsions?
Damage to the coronary band results in permanently disturbed growth
What is a keratoma?
Columnar thickening of hoof horn extending towards inside of the hoof mostly in the dorsal wall
What is the aetiology of a keratoma?
Mechanical irritation or hoof abscess
What internal trauma can a keratoma cause?
Increased local pressure so typically lysis of distal phalanx
What is the treatment for a keratoma?
Local resection trying not to extend to solar margin
What is thrush?
Infection leading to necrotic processes in frog area usually limited to lateral medial sulci
What is canker?
Mixed bacterial infection in deeper tissue layers of entire frog and heel
What does canker lead to?
Disintegration of intertubular horn
When does canker occur?
Warm humid environment
What does canker look like?
Cheesy white pus with a pungent odour with a tendency to bleed
How do you treat canker?
Resecting affected area
What does white line disease lead to?
Loss of band between hoof wall and sole
What happens in white line disease?
Poor quality horn gets colonised by different bacteria and fungi
What is the treatment for white line disease?
Meticulous daily hoof care, stall hygiene, debridement of necrotic and disease horn, disinfect area, protect laminae with bandage, use hardening solutions on sulci
What do hoof abscesses result from?
Infection of sensitive laminae after bacterial penetration
Where do chronic abscesses burst out and what treatment is required?
Coronary band
Lavage
What is quitter? What treatment is often needed?
Infection of collateral cartilage and often requires removal of part of cartilage
What are bipartite navicular bones? What are their clinical significance?
Congenital anomally
Important DDx to fractures and can result in chronic lameness and DIP joint osteoarthritis
What is navicular syndrome?
Palmar heel pain with no one cause, distant pathophysiology or cure
What are advanced imaging methods used to visualise for navicular syndrome?
Navicular bone, navicular bursa, DDFT, DIP joint, collateral ligaments of DIP joint
What is the classic history behind navicular syndrome?
6-12 year old, taller lighter breeds, usually bilateral, insidious onset, occasionally toe first gait
What is the diagnostic approach to navicular syndrome?
History, toe elevation may increase lameness, hoof testers usually negative, positive response to palmar distal nerve block, radiography, MRI, CT, nuclear scintigraphy, ultrasonography
What is the current approach to treatment of navicular syndrome?
Identification of affected structures, navicular bursoscopy, corrective farriery, controlled exercise, pain relief
Where are osseous cyst like lesions seen?
Distal phalanx in midline near collateral ligament
Navicular bone
Middle phalanx
What are the significance of osseous cyst like lesions?
Vary
Diagnose with diagnostic analgesia
What is the treatment for osseous cyst like lesions?
Arthroscopy, drilling and medicating DIP joint
How do distal phalanx fractures present?
Acute onset severe lameness due to exercise or kicking
What are the different classifications of distal phalanx fractures?
Type 1 = wing, non-articular Type 2 = wing articular Type 3 = sagittal Type 4 = extensor process Type 5 = comminuted Type 6 = solar margin
What radiographs need to be taken to see wing fractures?
Oblique projections
What treatments are appropriate for wing fractures? What are possible complications?
Bar shoe, foot cast, hoof cast, lag screw and box rest for 6 months
OA of DIP joint and fibrous union possible
What treatments can be used for midsagittal fractures? What are possible complications?
Lag screw (3-6 months) or bar shoes (6-12 months) OA of DIP joint with bar shoe
What treatment is used for small extensor process fractures?
Removal by arthroscopy or arthotomy with 3-4 month box rest
What treatment is used for large extensor process fractures? Complications?
Removal by arthrotomy or lag screws with 4-6 months box rest
OA of DIP joint
What is the treatment for comminuted fractures? Complications?
Transfixtion cast with 4-6 months box rest
Possible OA of DIP joint or laminitis
What is the treatment for solar margin fractures?
Bar shoe with up to 6 months box rest
What is the treatment for DIP joint osteoarthritis?
Intra-articular medication/prolonged use of NSAIDs/corrective farriery \+/- sodium hyaluronate Corticosteroids Polysulphated glycosaminoglycans IL-1 receptor antagonist protein
