The Equine Foot Flashcards
What is the weak point in the hoof?
White line - can form abscesses
What are the different layers in the hoof wall?
(White zone with white line then —>)
Medial: Stratum lamellum
Stratum internum
Stratum medium hoof wall
How is the pedal bone positioned in the hoof?
Suspended by the sensitive laminae
What can you palpate when there are issues in foot?
Digital pulses
Local heat
DIP joint effusion
Pastern oedema
Why do farriers have to be careful when placing shoes on horses?
a) two types of problems:
Nails do not go through the sensitive laminae - only the hoof wall - outside the white line
a) Nail prick - nail driven into sensitive laminae
or
Nail bind - nail driven too close to sensitive laminae
What can be carried out to check the navicular bursa?
Navicular bursa gram - close to NB (palmar aspect)
see if contrast spills over
What is the treatment for septic pedal osteitis?
a) Curettage (spooning out the infected tissue)
b) Wound care
Good prognosis with local tx + placing a plate
What does pedal osteitis mean?
o-Inflammation for the bone
Caused by repetitive concussion leading to chronic inflamm of laminae - bone resorption - increased vascular pattern
What are common problems to the hoof capsule?
- Hoof cracks
- Foot imbalance
- Hoof wall avulsions
- Keratoma
- Thrush
- Canker
- White line disease
What is the aetiology of hoof cracks?
Poor horn quality
Thin hoof wall
Abnormal hoof angles
What tx methods are there for hoof cracks?
- Cover with artificial horn
- Umbilical tape laced around small protruding screws in hoof wall
- Clamps
- Metal plate glued on or screwed in
What are hoof wall avulsions?
Avulsion - forcibly pulled away
-Damage to coronary band - permanently disturbed growth
What is a keratoma?
Rare, benign tumour of keratin
Columnar thickening of hoof horn extending towards inside of hoof
What is the aetiology of keratoma?
Mechanical irritation
Hoof abscess
Increased local pressure - typical lysis distal phalanx
What is possible tx for keratoma?
Resect a part of the hoof wall (window) to remove tumour?
What is thrush of the hoof wall?
Infection leading to necrotic processes in frog area
(restricted to medial/lateral sulci)
Smells and blackish
What is canker of the hoof wall?
Mixed bacterial infection in deep tissues of frog and heel
Cheesy white pus, pungent odour, tendency to bleed
(disintegration of intertubular horn)
Resect and clean out area, remodel by removing the infected material
What is white line disease?
Deterioration of white line of hoof capsule leads to loss of bond between hoof wall and sole
Poor quality horn - colonised by diff bac + fungi
What is the treatment for hoof capsule?
Management: meticulous hoof care daily, stall hygiene
Debridement of all necrotic + diseased horn
Disinfect area
Bandage sensitive lamina
Sulci - hardening solutions (formalin)
What common problems are there with the solar soft tissues?
- Abscesses - bursting out of coronary band - need to drain
Gravel - Quittor - infection in collateral cartilage
What are some aetiology for abscesses?
Wrong placement of nail
FB - stones
Any sole bruise (blood medium culture for bac to enter horn tubules)
What are bipartite navicular bones?
Congenital anomaly - different centres of ossification - causing degen joint disease - lameness over time
Can look like fractures on rads but they cause acute lameness
Chronic lameness and DIP joint OA later
What is navicular syndrome also called?
Palmar heel pain
seen in 6-12yo horses
toe first gait
Usually bilaterally
How would you diagnose navicular syndrome?
History: bilateral lameness, toe elevation (increasing lameness), hoof tests usually -ve
+ve response to palmer digital nerve block
- navicular bursa analgesia
- DIP joint analgesia
Plank test - hoof on raised plank - hyperextend limb
RADS
Advanced imaging - MRI*, CT, Nuclear scintigraphy, U/s
What are the different blocks in a horse’s foot?
Navicular bursa
Coffin joint
DFTS
How do you block the distal interphalangeal joint?
Dorsal midline approach (dorsal pouch of DIP joint)
Approach lateral/medial to extensor tendon
Palmar/plantar approach (palmar pouch)
How do you block the navicular bursa?
a) Midline- navicular horizontal approach
b) Midline - navicular position 30° oblique approach
c) Lateral palmar/plantar approach
What common approaches can help in cases of navicular syndrome?
Correct identification of affected structures
Navicular bursocopy (indications from analgesia/advanced imaging)
Corrective farriery
Corrective exercise
pain relief
What common problems can be found in the distal phalanx?
1) Osseous cyst-like lesions
2) Fractures
3) DIP osteoarthritis
4) Pedal osteitis
What are Osseous cyst-like lesions?
Midline
P3 - near collateral ligament - verify sig by blocks
(also in navicular bone, middle phalanx)
What is the treatment for Osseous cyst-like lesions?
Variable
Arthroscopy - look inside joint
Drilling (Forage)
Medication DIP joint
What clinical signs can fractures cause?
Acute onset of severe lameness (seen at exercise - kicking out)
What are the classifications?
Numerical and Descriptive
What types of fractures can you get in the distal phalanx?
Type I - Wing non-articular Type II - Wing, articular Type III - Sagittal Type IV - Extensor process Type V - Comminuted Type VI - Solar margin (chip fracture)
How can you diagnose Type I and type II fractures?
Rads - see lucent line - better oblique projections
CT/MRI
HARD TO SEE
What is involved with a extensor process fracture?
involves DIP joint
Displacement of common digital extensor tendon
matched fracture bed/fragment
What is the treatment option for Type I and II fracture?
WING FRACTURE
Bar shoe
Foot cast, hoof cast
Lag screw?
Box rest - 6months
Complications - OA DIP joint (type II), fibrous union
What is the treatment option for Type III Fracture?
MID-SAGITTAL FRACTURE
Lag screw
Bar shoe
Box rest
Complications - OA DIP joint
What is the treatment option for Type IV fracture?
for small and large
Extensor process (small) Removal - Arthroscopy, arthrotomy (open up joint)
Box rest
Extensor process (large) Removal - Arthrotomy, lag screw
Box rest
Complications: OA DIP joint
What is the treatment for Type V fracture?
COMMINUTED
Transfixation cast - pins (distal cannon bone) and suspend limb with box rest
Euthanasia
complications: OA DIP joint, laminitis
What is the treatment for Type VI fracture?
SOLAR MARGIN
Bar shoe?
Box rest
What is the treatment for DIP joint Osteoarthritis?
Intraarticular medication - sodium hyaluronate, corticosteriods, polysulphated glycosaminoglycans
Prolonged NSAIDs
Corrective farriery
