Week 7- Approach to Conditions of the Equine Hoof Flashcards
What three things normally cause equine hoof conditions?
- Neglect/ Poor trimming
- Environment
- Trauma
What is a grass crack?
Crack from the ground up, normally due to poor conformation
What is a sand crack?
Crack that extends from the coronary band distally, due to lesions at the coronary band
How would you treat a hoof crack?
- 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
What is thrush?
Exudative bacterial dermatitis in the sulci frog
caused by poor hygeine and poor footcare
Fusobacterium necrophorum
How would you diagnose thrush?
By appearance and smell
How would you treat thrush?
Debridement of necrotic frog
* Improved hygiene
* Topical treatments – povidine/iodine, formalin, H2O2
* Antimicrobials if deep/sensitive structures
affected
What is a sub-solar abscess?
Most common cause of lameness in horses
* ascending bacterial infection into the chorium
How would you diagnose a sub-solar abscess?
- 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
How would you treat a sub-solar abscess?
Aim to encourage drainage
Remove the shoe
Explore any discoloured tracts or defects in the white line
What pain relief is recommended for a sub solar abscess?
24-48 hours of NSAID therapy
Phenylbutazone
What would you do for a chronic abscess?
Might rupture at the coronary band or heel bulb
Still aim to encourage draining distally
May require repeat flushing
What would you do for a purulent abscess?
- Deeper structure most likely involved
- Will require further diagnostics
- Likely to need extensive surgery
What should you do if the nail/ Wire has already been removed by the owner?
- Try to identify the tract
- Clean, Lavage and dress the lesion
- Beware delay in onset lameness
- Further investigations ASAP if any suspicion of complications
What are the potential sequelae for solar penetrations?
- Damage to the pedal bone
- Damage to soft tissue structures
- Synovial infection
How would you treat a simple uncomplicated penetration?
- As per solar abscess, pare and poultice
- Antibiotics only if clear of infection
- Judicious use on analgesia
How would you treat a synovial penetration?
- Broad-Spectrum antimicrobial therapy
- Procaine penicllin
- Gentamicin
Surgical intervention = arthroscopic lavage
What are the three clinical categories of laminitis?
- Endocrinopathic
- Inflammatory
- Traumatic
What are the clinical signs of laminitis?
- acute onset lameness
- Shifting weight
- Reluctance to walk
- Short, Choppy gait,
- bounding digital pulse
- heat through the dorsal hoof wall
What are the poor prognostic indicators of laminitis?
- Severe rotation of P3
- Sinking of P3 into teh hoof capsule
- Prolapse of P3 through the sole
- Mediolateral rotation
- Chronicity
What are the main principles of laminitis treatment?
- Strict rest during the acute phase
- Support the foot (soft/ deep bed)
What is cryotherapy?
- Icing the feet prior to or at the onset of laminitis
- reduced enzymatic degredation
- aim to maintain surface hoof wall temperature
How would you supress inflammation in laminitis?
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
How would you restrict the diet to prevent laminitis?
- Low quality/ Soaked hay
- Stop any concentrate feeding
- Balancer should also be given
How does remedial farriery work?
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
How might you treat a simple uncomplicated penetration?
- as per solar abscess- pare and poultice
- antibiotics ONLY if clear evidence of infection
- judicious use of analgesia
How might you treat a penetration with synovial penetration?
Broad Spectrum antimicrobial therapy
* Procaine penicillin
* Gentamicin
Surgical Intervention = Arthroscopic lavage of the synovial cavity
How would you treat Pituitary Pars Intermedia Dysfunction?
- Endogenous ACTH concentration
- TRH- stimulation test
- Treat = peroglide
How might you treat Insulin dysregulation?
- Resting hyperinsulinaemia
- In feed glucose test
- Treat = diet and exercise (once recovered)
- +/- Metformin
What is the function of Ertuglifozin?
sodium-glucose cotransporter 2 inhibitor
