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Flashcards in Equine foot 1 Deck (56):
1

Properties - hoof capsule under laod

- elastic and flexible (this is known as the hoof mechanism)
- protective (stones, trauma)

2

What does the hoof allow? 2

- internal swelling
- drainage

3

What is the weak point of the hoof?

white line

4

What is the hoof mechanism important for?

foot perfusion

5

What are the parts of the white line? 5

- sole
- white zone
- stratum lamellum
- stratum internum
- stratum medium hoof wall

6

How can you examine the hoof?

- hoof testers/ palpation
- percussion
- response to local analgesia
- Imaging (radiographs, advanced)

7

What is the most common site of lameness?

hoof/foot

8

What parts of the hoof can you palpate?

- dorsal DIP joint capsule
- DIP joint collatral ligaements
- collateral cartilages
- (distal recess DFTS and DDFT)

9

What can you look for when palpating the hoof?

- local heat
- digital pulses
- DIP joint effusion
- pastern oedema

10

Name 2 farriery related problems of the hood

- Nail prick (nail driven through sensitive laminae)
- Nail bind (nail driven too close to sensitive laminae)

11

How well does the hoof wall heal?

well if the coronary band is not damaged

12

T - septic pedal osteitis

- curettage
- wound care

13

What are hoof cracks?

- disruption of hood wall parallel to horn tubules and lamellae
- can extend into sensitive laminae (lame)
- multifactorial aetiology (poor horn quality, thin hoof wall, abnormal hoof angles)

14

What 2 aspects of foot balance should be assessed?

hoof from side and lateromedial foot balance

15

What are hoof wall avulsions?

- damage to coronary band --> permanently disturbed growth

16

What is a keratoma of the hoof capsule?

- columnar thickening of hoof horn extending towards inside of hoof
- mostly dorsal wall
- aetiology (mechanical irritation, hoof abscess)
- increased local pressure (typical lysis distal to phalanx)

17

What is a characteristic sign of hoof capsule keratima?

- clear lucency in solar aspect of pedal bone d/t local pressure keratoma --> bone resorption in this area

18

Name 2 infectious problems of hoof capsule

- thrush
- canker

19

Describe hoof capsule thrush

- infection leading to necrotic processes in frog area
- usually limited to lateral and medial sulci of frog (solar area)
- v smelly

20

Describe canker of hoof capsule

- mixed bacterial infection in depper tissue layers of entire frog and heels leads ot disintegration of intertubular honr
- warm, humid
- cheesy white pus
- pungent odour
- tendency to bleed

21

Tx - hoof capsule thrush and canker

- same for both
- area resected to expose lamellar area underneath

22

What is white line disease of horse hoof capsule?

- deterioration of white line of hoof capsule --> loss of bond b/w hoof wall and sole
- poor quality horn gets colonised by different bacteria and fungi
- warm, humid

23

Tx - hoof capsule disease

- management/ prevention (meticulous daily hoof care, stall hygiene)
- debride all necrotic and diseases horn
- disinfect area
- protective bandages for sensitive laminae
- sulci --> hardening solutions (formalin, alternatives)

24

CS - hoof abscesses

- various
- shod and unshod horses
- infection on area of sensitive lamina after bacterial penetration

25

What is the commonest cause of TL lameness?

hoof abscess

26

Name 2 types of solar soft tissue

- chronic foot abscess
- quittor

27

What is a chronic foot abscess?

- burst out of coronary band
- aka 'gravel' amongst owners

28

What is quittor?

- infection of collateral cartilage
- seen on palmar/plantar aspect, above coronary band (Vs. chronic foot abscess which bursts out at the coronary band)

29

Tx- navicular fractures

- single screw

30

What are bipartite navicular bones?

- congentital anomaly
- important ddx to fx (usually lamer)
- can result in chronic lameness and DIP joint OA (athletic horses)
- usually both TL affected
- relatively rare
- classic xray appearance

31

How are navicular disease and syndrome different?

- disease = 1 cause
- syndrome = variety of CS, aka ' palmar heel pain'

32

Dx - navicular syndrome

- ID multiple structures involved in heel pain syndrome:
- navicular bone
- navicular bursa
- DDFT
- DIPJ
- collateral ligaments of DIPJ

33

What is navicular bursoscopy?

- sx to address DDFT tear
- method: enter DDFT sheath, separate ligament that attaches to navicular bursa (T-ligament)
- 60-70% success rate

34

Signalment - navicular syndrome

- 1/3 chronic TL lameness
- 6-12 yo horses (i.e. middle aged)
- taller, lighter breeds (some evidence of hereditary)

35

Presentation - navicular syndrome

- usually bilateral
- insidious onset
- occasionally 'toe first' gait
- toe elevation may increase lameness (on ramp)
- hoof testers (usually negative)
- positive response to PDNB
- radiography (advanced changes to detect)
- advanced imaging

36

How sensitive are radiographs for diagnosis a lameness?

not very - 70% yield no diagnosis

37

Outline use of ultrasound for diagnosing foot problem

- limited use for feet
- user dependent

38

Outlien use of nuclear scintigraphy for diagnosing foot problem

- high sensitivity
- low specificity

39

Outline use of CT for diagnosing foot problem

- little information on soft tissue

40

Outline use of MRI for diagnosing a foot problem

- diagnosis in 90% cases
- limited area examined

41

Define DFTS

digital flexor tendon sheath

42

What does the PDNB do?

- non-specific block
- if positive, do further smaller blocks to localise lesion (e.g. navicular bursa)
- blocks DFTS, navicular bursa, coffin joint/ DIPJ

43

Where should you aim when blocking the DIPJ?

- 1cm below coronary band
- 50% b/w dorsal and palmar aspects of hoof

44

Where might you get indications for navicular bursoscopy? 2

- diagnostic analgesia
- advanced imaging

45

What are osseous cyst-like lesions?

- midline
- P3 near collateral ligmaent
- verigy significance (blocks)
- also in navicular bone, P2

46

Tx - osseous-like cysts

VARIABLE:
- arthroscopy
- drilling (forage)
- medication of DIPJ
- etc.

47

CS - P3 fractures

- acute onset severe lameness
- d/t exercise, kicking
- 6 point classification (numerical and descritive)

48

Outline the classification of P3 fractures

1.) wing, non-articular
2.) wing, articular
3.) sagittal
4.) extensor process
5.) comminuted
6.) solar margin

49

Dx - type 1 and 2 P3 wing fractures

- may be hard to see on routine radiographs
- take appropriate oblique projections
- CT/ MRI if necessary

50

Describe type 3 P3 fractures-

narrow well-defined lines of acute fracture

51

Describe type 4 P3 fracture

- involves DIPJ
- displacement by CDET
- matched fracture bed and fragment
- remember extensor process has variable shape, determine if secondary ossification centre versus chip fracture (based on CS, verify need for sx)

52

Tx - fracture of P3

varies according to which type (1-6) of fracture

53

Differentiate a hoof cast and a foot cast

- hoof cast only covers hoof
- foot cast covers hoof and rest of foot

54

CS - DIPJ osteoarthritis

- CS can be v subtle
- look for osteophyte on dorsal aspect and palmar aspect of navicular bone
- remember 4-5 variations of extensor process

55

Tx - DIPJ osteoarthritis

- intra-articular medication (sodium hyaluronate, corticosteroids, polysulphated GAGs = PSGAGs, IL-1 receptor antagonist protein = irap)
- prolonged use of NSAIDs
- corrective farriery

56

What is pedal osteitis?

Repetitive concussion leads to chronic inflammation of laminae --> bone resorption (appears as fuzzy edge on radiograph versus sharply define pressure resoprtion seen with hoof capsule keratoma)