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CVSOH BVSc4 > Lame - Equine acute foot problems > Flashcards

Lame - Equine acute foot problems Flashcards

1
Q

What does bruising of the hoof look like?

A

Reddening of the hoof wall or sole

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2
Q

What are two types of cracks in hooves? What are they?

A

Grass cracks - up wall
Sand cracks - grow down from coronary band after injury

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3
Q

Where do swellings/depressions in the hoof occur?

A

At the coronary band

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4
Q

What causes depressions at the coronary band?

A

Laminitis - sinking of the extensor process of P3

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5
Q

What is thrush?

A

Destructive lesion of the hoof - fusebacterium

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6
Q

What can cause thickening of the white line in horses?

A

Laminitis

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7
Q

What is divergence in the equine hoof?

A

Growth lines on the hoof wall as they grow from the coronary band
Should be parallel
May be rasped off at the bottom by farrier

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8
Q

What can you palpate the coronary band for?

A

Depression - sinking of P3
Effusion of DIP joint
Hoof abcess tracking up - painful area

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9
Q

What is a grass crack?

A

Crack that is going up from the solar edge (like a blade of grass growing out the ground)

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10
Q

What is a sand crack?

A

Crack going down from the coronary band

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11
Q

What can you do to stop a grass crack moving up the wall of the hoof?

A

Avoid horseshoe clips put in that area
Rasp a horizontal line across it to interrupt the crack

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12
Q

What can you do to treat a sand crack coming down from the coronary band?

A

Reduce load on that area by shortening, shoeing

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13
Q

What are the 3 synovial structures in the equine hoof?

A

Navicular bursa
Distal interphalangeal joint (coffin)
Digital flexor tendon sheath

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14
Q

What are the key nerve blocks for the hoof?

A

Palmar/plantar digital
Abaxial sesamoid

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15
Q

What is the key joint block that you need to know how to do?

A

DIP joint

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16
Q

Where is the navicular bursa located?

A

Distal to the navicular bone

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17
Q

What other structures can cross react with a navicular bursa block?

A

Communicates with the DIP joint

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18
Q

What is a common cause of sepsis in the navicular bursa?

A

Solar puncture wound

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19
Q

Is the navicular bursa injection easy?

A

No, it is difficult - but can be done with experience, ultrasound or radiographic guided
Also can treat via DIP joint if both affected

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20
Q

What should you do to prepare equine hooves for radiograph?

A

Remove mud, shoes, and flaky sole
Pack frog with playdoh

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21
Q

Why do you pack frog with playdoh for radiographs?

A

Because it gives an artefact over the radiograph otherwise - flattens the surface to all one colour

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22
Q

Where do you apply markers on hooves for radiographs?

A

Dorsal hoof wall
Coronary band
Point of frog

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23
Q

What position do you use for P3 lateromedial radiograph?

A

Hoof weight bearing on block
Cassette against medial aspect of limb on the ground
Beam on mid coronary band

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24
Q

What do you use hoof wall markers for?

A

Evaluating rotation or sinking of the hoof on radiograph

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25
Q

What should all be parallel on lateromedial radiograph of the hoof?

A

Dorsal hoof wall
Dorsal P3
Heel
Pastern

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26
Q

Where should the centre of the ark of the distal interphalangeal joint be on radiograph?

A

Vertically over middle of hoof and point of frog

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27
Q

What does broken forward mean?

A

Dorsal hoof wall angle is pointing further forward than the angle of the pastern

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28
Q

What angle should the solar surface of P3 be from the the sole of the hoof?

A

5-10 degrees

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29
Q

What shape should the tip of P3 be?

A

A point, not a ski slope - this would suggest chronic P3 pathology

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30
Q

What is the positioning for dorsopalmar radiograph of a hoof?

A

Weight bearing on block - square to beam
Cassette on palmar aspect of limb
Beam parallel to the ground centred at coronary band

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31
Q

What features can you look at on dorsopalmar radiograph of a hoof?

A

Mediolateral imbalance - difference between P3 and sole
Hoof wall flare

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32
Q

What structures can often be mistaken for abnormal pathology?

A

Vascular channels - normal

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33
Q

What is the dorsoproximal palmaro-distal oblique view radiograph of a hoof used to look at?

A

Solar margin of P3
Dorsal navicular bone

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34
Q

What positioning do you use for the dorsoproximal palmaro-distal oblique view radiograph of a hoof?

A

Weight bearing with foot stood on tunnel that you slide the cassette into
Beam 2cm above coronary band at 60 degree angle from cassette

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35
Q

What do you change when you want to focus on P3 or navicular bone?

A

Increase exposure
Reduce collimation
Decrease angle by 5 degrees

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36
Q

What is the crena?

A

Midline P3 margin - variable appearance

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37
Q

What is the dorsolateral-palmaromedial oblique radiograph of a hoof?

A

Same as the dorsoproximal palmaro-distal oblique view radiograph of a hoof but moved 45 degrees lateral to medial

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38
Q

What is the dorsolateral-palmaromedial oblique radiograph of a hoof useful for?

A

Assessing pedal wings, DIP joint and symmetry

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39
Q

What is the palmaroproximal-palmarodistal oblique radiograph of the hoof?

A

Navicular skyline:
Limb extended caudally while weight bearing on cassette in tunnel
Beam into divot at back of pastern avoiding the fetlock

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40
Q

What structures does the palmaroproximal-palmarodistal oblique radiograph of the hoof show?

A

Navicular bone
P3 - particularly wings

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41
Q

What does transcutaneous view ultrasound show? What can you see?

A

MRI used more now
Collateral ligament of DIP
DIP joint effusion
DDFT can be seen between heel bulbs

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42
Q

How do you do a solar view ultrasound through the frog of a hoof?

A

Difficult, not really done much now
Lots of preparation, soak hoof for hours

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43
Q

What can you see on solar view ultrasound through frog of hoof?

A

DDFT
Navicular bone/bursa
P3

44
Q

What is gold standard imaging of the horses hoof? Why?

A

MRI - due to superior contrast details

45
Q

What types of MRI are there?

A

Low field MRI - distal limb (25 in country)
High field MRI - head and neck, limbs (2 in country)

46
Q

What is a pricked hoof/nail bind?

A

a nail placed in or axial to the white line during farriery

47
Q

What does a pricked hoof present as?

A

Acute severe lameness a few days after the farrier has been

48
Q

How do you diagnose a hoof prick?

A

Hoof testers and paring

49
Q

How do you treat a pricked hoof?

A

Remove nail/shoe
Poultice - dressing
Week of rest

50
Q

When do you get hoof bruising?

A

Unshod hooves walking on rough ground

51
Q

How do you treat bruising in hooves?

A

Rest
Unshoe and poultice dressing
Reshoe after pairing

52
Q

What are corns? What are they caused by?

A

Specific type of bruising at heel caused by a collapsed bar or too long shoeing interval

53
Q

How do you diagnose corns?

A

Pain on hoof testers, usually specifically at the heel

54
Q

What causes a hoof subsolar abscess?

A

Penetrating injury to solar surface
Bacteria tracking up the white line

55
Q

What are the clinical signs of a hoof abcess?

A

Acute non weight bearing lameness
Increased digital pulses
Pain on hoof testers

56
Q

How do you diagnose a hoof abcess?

A

Pus released during paring

57
Q

How do you treat a hoof abcess?

A

Poultice - hoof dressing/bandage
Tubbing
Rest

58
Q

What is tubbing?

A

Hoof in a bucket of salt water for 20 mins

59
Q

Where do most hoof abcesses drain?

A

At the white line

60
Q

What are some other hoof abcess draining sites than at the white line?

A

Coronary band
Frog
At the penetration site

61
Q

What animals get very deep foot abcesses?

A

Donkeys
Small horses

62
Q

What should you do in deep puncture wound cases?

A

Leave the foreign body in situ
Use wooden blocks for weight bearing

63
Q

What structures must you assess in deep puncture wounds?

A

DIP joint
Navicular bursa
Digital flexor tendon sheaths

64
Q

What should you do if the puncture wound affected any of the synovial structures of the hoof?

A

Arthroscopic lavage
Or euthanasia
Or poultice and rest
Analgesia

65
Q

What is pedal osteitis?

A

Septic focus in P3 often following a puncture or pus in the foot

66
Q

What are the clinical signs presentation of pedal osteitis?

A

Acute severe lameness which persists
Increased digital pulses
Pain on hoof testers

67
Q

How is pedal osteitis diagnosed?

A

Imaging

68
Q

How is pedal osteitis treated?

A

Curettage back to healthy bone - remove disease bone
Manage open wound - hospital plate, bandaging

69
Q

How long will pedal osteitis surgical treatment take to heal?

A

Several months
Need to wait for granulation tissue to form and hoof to grow in to hole

70
Q

What is a common cause of P3 fractures?

A

Trauma
Kicking brick walls - especially hind limbs

71
Q

What is a type 1 P3 fracture?

A

Involve the palmar/plantar process
Dont enter DIP joint
Wing fracture

72
Q

What is a type 2 P3 fracture?

A

Oblique or parasagittal fracture
Articular but not on the midline
Wing fracture

73
Q

What is a type 3 P3 fracture?

A

Midline articular fracture
Bisect pedal bone into 2 equal halves

74
Q

What is a type 4 P3 fracture?

A

Involve the extensor process of the pedal bone (top bit)

75
Q

What is a type 5 P3 fracture?

A

P3 split into multiple fragments

76
Q

What is a type 6 P3 fracture?

A

Solar margin fracture - chip out the bottom

77
Q

What is a type 7 P3 fracture?

A

Exclusive to foals
Fracture of solar margin

78
Q

What are the two treatment options for P3 fractures?

A

Depends on configuration
Surgical lag screw across fracture
Or conservative management - bar shoe and rest

79
Q

What radiographic view is best for navicular bone fracture?

A

Palmaroproximal-palmarodistal oblique view

80
Q

What does a parasaggital fracture mean?

A

Close to midline but not on it

81
Q

What is the configuration of navicular bone fractures?

A

Usually parasagittal and slightly oblique

82
Q

What is a fracture associated with ossification in the hoof?

A

Fracture of ossified ungual cartilages - ossification usually asymptomatic but are predisposed to trauma

83
Q

How do fractured ossified ungual cartilages present?

A

Acute severe lameness
Increased digital pulses
Pain on palpation of heel bulbs

84
Q

How are fractured ossified ungual cartilages treated?

A

Bar shoes and rest

85
Q

What are the 4 phases/types of laminitis?

A

Developmental stage
Acute
Sub-acute
Chronic

86
Q

What is the developmental stage of laminitis?

A

Causal event up until the clinical signs - need to act before clinical signs start if you can

87
Q

What is acute laminitis?

A

From onset of signs to 72 hours

88
Q

What is subacute laminitis?

A

Repair over 2-3 months

89
Q

What is chronic laminitis?

A

Structural failure developing over an indefinite period

90
Q

What is the main primary cause of laminitis?

A

Endocrinopathies - PPID, EMS, corticosteroids given to uncontrolled endocrinopathy horses

91
Q

What causes of laminitis are there other than endocrinopaties?

A

Excess carb intake
Toxaemia
Contralateral limb lameness

92
Q

What is the pathogenesis of laminitis?

A

Dermal epidermal separation of lamellae
Basement membrane lysis

93
Q

What is the recurrence rate of laminitis?

A

30% recurrence rate

94
Q

What breeds/types of horses are predisposed to laminitis?

A

Ponies
Heavy horses
Obese
Crest neck

95
Q

What are the clinical signs of acute laminitis?

A

Weight on heels stance
Reluctant to move
Increased digital pulses
Pain on hoof testers
flatter solar surface
Coronary band depression
Solar bruising

96
Q

What are the clinical signs of chronic laminitis?

A

Divergent growth rings
Change in hoof shape - boxy

97
Q

What hoof changes can you see on radiograph in laminitis cases?

A

Rotation
Sinking
Gas
Remodelling/lysis

98
Q

What degree rotation is non consistent with survival in laminitis?

A

More than 20 degrees

99
Q

What can you use to alter laminar perfusion in the developmental phase of laminitis? Why?

A

Cold - ice feet
Vasoconstriction - prevent endotoxins reaching foot

100
Q

What can you do to alter laminar perfusion in the acute phase? Why?

A

ACP
Vasodilation - increase perfusion, more oxygen

101
Q

How can you prevent inflammation in laminitis treatment?

A

NSAIDs - also some analgesia

102
Q

What mechanical support can you give laminitis cases?

A

Rest on deep bed
Styrofoam pads for frog support
Remove length of toe
Elevate heel

103
Q

How do you trim hooves in subacute or chronic phases of laminitis?

A

Shorten toe
Remove heel height
Heart bar shoes

104
Q

What is the prognosis for laminitis cases?

A

Very difficutl to predict - can go either way

105
Q

How do you treat navicular bone fractures?

A

Surgical - lag screw (tricky)
Conservative - bar shoe and rest

CVSOH BVSc4 (86 decks)

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