Week 7- Approach to Conditions of the Equine Hoof

Question 1

What three things normally cause equine hoof conditions?

Answer 1

• Neglect/ Poor trimming
• Environment
• Trauma

Question 2

What is a grass crack?

Answer 2

Crack from the ground up, normally due to poor conformation

Question 3

What is a sand crack?

Answer 3

Crack that extends from the coronary band distally, due to lesions at the coronary band

Question 4

How would you treat a hoof crack?

Answer 4

• Identify and treat the underlying cause
• Biotin 15-20mg a day
• Moisturising products
• Hoof hardeners

Stabilise the crack
* Clean and debride
* Farrier clips/ wire
* Fill with synthetic resin
* Good shoeing

Question 5

What is thrush?

Answer 5

Exudative bacterial dermatitis in the sulci frog
caused by poor hygeine and poor footcare
Fusobacterium necrophorum

Question 6

How would you diagnose thrush?

Answer 6

By appearance and smell

Question 7

How would you treat thrush?

Answer 7

Debridement of necrotic frog
* Improved hygiene
* Topical treatments – povidine/iodine, formalin, H2O2
* Antimicrobials if deep/sensitive structures
affected

Question 8

What is a sub-solar abscess?

Answer 8

Most common cause of lameness in horses
* ascending bacterial infection into the chorium

Question 9

How would you diagnose a sub-solar abscess?

Answer 9

• Acute and severe unilateral lameness
• Increased digital pulsation to the affected hoof
• Heat in the hoof
• Distal limb swelling
• Repeatable and marked pain response on application of hoof testers

Question 10

How would you treat a sub-solar abscess?

Answer 10

Aim to encourage drainage
Remove the shoe
Explore any discoloured tracts or defects in the white line

Question 11

What pain relief is recommended for a sub solar abscess?

Answer 11

24-48 hours of NSAID therapy
Phenylbutazone

Question 12

What would you do for a chronic abscess?

Answer 12

Might rupture at the coronary band or heel bulb
Still aim to encourage draining distally
May require repeat flushing

Question 13

What would you do for a purulent abscess?

Answer 13

• Deeper structure most likely involved
• Will require further diagnostics
• Likely to need extensive surgery

Question 14

What should you do if the nail/ Wire has already been removed by the owner?

Answer 14

• Try to identify the tract
• Clean, Lavage and dress the lesion
• Beware delay in onset lameness
• Further investigations ASAP if any suspicion of complications

Question 15

What are the potential sequelae for solar penetrations?

Answer 15

• Damage to the pedal bone
• Damage to soft tissue structures
• Synovial infection

Question 16

How would you treat a simple uncomplicated penetration?

Answer 16

• As per solar abscess, pare and poultice
• Antibiotics only if clear of infection
• Judicious use on analgesia

Question 17

How would you treat a synovial penetration?

Answer 17

• Broad-Spectrum antimicrobial therapy
• Procaine penicllin
• Gentamicin

Surgical intervention = arthroscopic lavage

Question 18

What are the three clinical categories of laminitis?

Answer 18

• Endocrinopathic
• Inflammatory
• Traumatic

Question 19

What are the clinical signs of laminitis?

Answer 19

• acute onset lameness
• Shifting weight
• Reluctance to walk
• Short, Choppy gait,
• bounding digital pulse
• heat through the dorsal hoof wall

Question 20

What are the poor prognostic indicators of laminitis?

Answer 20

• Severe rotation of P3
• Sinking of P3 into teh hoof capsule
• Prolapse of P3 through the sole
• Mediolateral rotation
• Chronicity

Question 21

What are the main principles of laminitis treatment?

Answer 21

• Strict rest during the acute phase
• Support the foot (soft/ deep bed)

Question 22

What is cryotherapy?

Answer 22

• Icing the feet prior to or at the onset of laminitis
• reduced enzymatic degredation
• aim to maintain surface hoof wall temperature

Question 23

How would you supress inflammation in laminitis?

Answer 23

Non-steroidal anti-inflammatory therapy
o Phenylbutazone 4.4mg/kg IV/PO for 24-48 hrs
2.2mg/kg PO BID after 48 hrs
Additional pain relief (multimodal):
o Paracetamol – Not licensed
o Gabapentin – Not licensed
o Opioid analgesia in severe cases

Question 24

How would you restrict the diet to prevent laminitis?

Answer 24

• Low quality/ Soaked hay
• Stop any concentrate feeding
• Balancer should also be given

Question 25

How does remedial farriery work?

Answer 25

Once displaced (rotated or sunken), the pedal bone cannot be replaced
Essential to engage with a good farrier (remedial farrier) who can
* Rebalance the hoof to encourage weight bearing
* Provide longer term frog/sole support
* Reduce breakover
* Work with the hoof over 6-8 months and encourage new hoof growth to align
with the position of the pedal bone

Question 26

How might you treat a simple uncomplicated penetration?

Answer 26

• as per solar abscess- pare and poultice
• antibiotics ONLY if clear evidence of infection
• judicious use of analgesia

Question 27

How might you treat a penetration with synovial penetration?

Answer 27

Broad Spectrum antimicrobial therapy
* Procaine penicillin
* Gentamicin

Surgical Intervention = Arthroscopic lavage of the synovial cavity

Question 28

How would you treat Pituitary Pars Intermedia Dysfunction?

Answer 28

• Endogenous ACTH concentration
• TRH- stimulation test
• Treat = peroglide

Question 29

How might you treat Insulin dysregulation?

Answer 29

• Resting hyperinsulinaemia
• In feed glucose test
• Treat = diet and exercise (once recovered)
• +/- Metformin

Question 30

What is the function of Ertuglifozin?

Answer 30

sodium-glucose cotransporter 2 inhibitor