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Equine foot and skeleton Flashcards

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1
Q

DDx for acute, severe unilateral lameness to foot

A

Subsolar abscess
Solar bruise
Pedal bone fracture

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2
Q

Aetiology of solar bruise

A

Blunt trauma to solar surface during locomotion causes haemorrhage into sensitive tissues –> get inflammation inside non-compliant keratinised hoof
So focal increase in pressure and extreme lameness

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3
Q

Risk factors for solar bruises

A

Uneven or highly concussive surfaces
Barefoot
hacking
Flat floor and low heel conformation e.g in racing TBs

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4
Q

What are corns

A

Focal bruising at seat of corm; affects shod horses

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5
Q

What is the most common cause of acute severe lameness

A

Subsolar abscess

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6
Q

Where do subsolar abscesses form

A

Between senstivie and non-sensitive tissue e.g at white line, seat of corn, frog

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7
Q

How to treat a subsolar abscess

A

Use paring knife to achieve drainage
Or if can’t do this, place foot poultice to soften sole to help achieve drainage later

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8
Q

How to initially manage acute unilateral lameness vs more mild or multi-limb lameness

A

Acute unilat: manage as subsolar abscess; bruises will just resolve quickly without pus draining

Mild/multi-limb: box rest and NSAIDs; if just burising will resolve quickly

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9
Q

What is the gold standard imaging method for looking at how FB in good sits within soft tissues

A

MRI

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10
Q

What is a ketaoma

A

Space occupying tumour that grows from the coronary band, down hoof wall and exits at white line

Painful as it causes abscesses

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11
Q

If we see recurrent abscesses at the same place in same foot, what should we be suspicious about

A

keratoma

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12
Q

How do pedal bone fractures present adn change

A

Presents intially like foot abscess; acute unilat lameness
But improvement is much slower than with abscess

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13
Q

How to diagnose navicular disease

A

= MRI diagnosis as are looking for inflammation

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14
Q

How to diagnose ossified collateral cartilages

A

Many sound horses have large ossification of side bones
So need MRI diagnosis to see inflammation here

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15
Q

How might soft tissue issues in the foot present (rather than classic acute severe lameness)

A

Bilateral insidious progressive lameness

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16
Q

What soft tissue ligament is often positive to distal limb flexion (NB: other aren’t)

A

Collateral ligaments

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17
Q

What bony changes might we see with collateral ligament disease

A

Ossified collateral cartilages
Enthesiopathy; bone remodelling at insertion site

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18
Q

How owuld we have to prepare the foot for transcuneal ultrasound

A

OVernight soaking

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19
Q

Whatis the most common soft tissue injury of the foot

A

DDFT pathology

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20
Q

Where do we tent to see DDFT pathology and why

A

Where it changes direction e.g at fetlock, around navicular bone
Because it is less elastic here due to need to resist compression

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21
Q

How can core lesions of tendons e.g DDFT progress

A

Can propagate proximally/distally over time
So we could do neurectomy to make horse comfortable but if it then propagated above this, would see sudden lameness again

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22
Q

How do sagittal splits of DDFT present, progress and where

A

Severe lameness but variable over time related to whether split pulled apart
Often at level of navicular
Propagate proximally/distally with time, especially after a neurectomy

Can lead to adhesion formation and burtisi because they involve the tendon surface

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23
Q

How does dorsal border fibrillation in DDFT present!

A

Cronic low grade degenerative lameness
Get fibrillation of fibres on the dorsal border where they are closely assocaited with the navicular bone
–> Often causes bursitis and adhesion formation

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24
Q

How can we treat DDFT and what structure do we made us of

A

Focus on navicular bursa to devilver treatment, accessed via tendon sheath

Intrabursal corticosteroids
Navicular bursoscopy for lesions that communication with bursa to break down adhesions and debride fibrillated tissues

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25
Why is it good to debride away fibrillated tissues via navicular bursoscopy
These tissues are drivers of snyovitis
26
Which lesions is it especially indicated to do navicular busoscopy
Sagittal splits and dorsal fibrillation since these communicate with bursa
27
What happens if the heel is lower than it should be (we want 5* uphill angle)
Get stressing and increasing loading of the palmar soft tissues
28
What issues does poor latero-medial foot ballance cause
Increased loading of collateral ligaments, navicular suspensory ligament
29
What issues do dorsopalmar/plantar impanance cause
Increased loading of palmar/plantar soft tissues = SDFT, DDFT, SL, DSIL
30
How do bar shoes work
Heart bar provides heel and pedal bone support by transfering load from hoof wall to sole + restricts independent movement of heal bulbs
31
How do graduated pads and shoes work
They are much thicker at the heel than toe and so artifically corrects poor foot balance and reduces strain on DDFT via shortening distance and offloading tendon Raised heel also alters breakover to happen earluer (this means occurs when itssues at lower stress so better)
32
Why do we not want to use graduated pads/shoes in longer term
Contributes to making poor foot conformation worse
33
Farriery for laminitis
pedal bone support via heart bar or pads and packing Wait until stabilised to shoe
34
Farriery for navicular syndrome (palmar heel pain)
Use bar shoe to restrict independent heel movement
35
Farriery for pedal bone fracture
Bar shoe and packing to help immobilise fracture and speed healing
36
Farriery for horses prone to bruising
Pads and packing to reduce concussive forces
37
How do we cause lateral flexion to check for pain
Dig nails into one side
38
What is sternal lift (dynamic thoracolumbar exam)
Apply sustained pressure to sternum to encourage dorsiflexion of cranial thoracic spine Should have a response which can be maintained Those with back pain struggle
39
How to dynamically test to sarcoiliac region
Apply firm pressure to skin either side of tail base Expect horse to drop hindquarters towards floor and dorsiflex lumbosarcal joint; should hold this for 5-10 secs = abnormal if there is no respnse, pain signs or unable to maintain
40
What is different about lumbosacral anatomy in horses
All sacral vertebrae are fused in horse SI joint is very small; mainly just soft tissue
41
What is radiculopathy
Neuropathic pain due to compression of spinal nerve root in caudal cervical region Can cause forelimb lameness
42
Clinical signs with neck pathology
Neck pain; reduced range of motion in baited stretches Forelimb lameness; due to cervical muscle dysfunction which are involved in limb protraction, radiculopathy of spinal nerve root feeding brachial plexus causing shooting pain down leg Ataxia Prognosis worse from neck pain < radiculopathy < spinal ataxia
43
When might we see ataxia with neck pathology
With cervical stenotic myelopathy
44
If we see poor quality canted but fine trot where might this suggest pathology is
In the thoracolumbar spine because there is spinal twist and roll at canter vs just some lateral flexion at trot
45
How to manage neck pathology
Intra-articular medication with corticosteroids is mainstay to alleviate pain and infammation
46
Clinical signs of thoracolumbar psine disease
Poor muscling Pain on palpation ABnormal dynamic responses (ventral flexion, lateral flextion, sternal lift) Resenting ridden exercise Poor quality canter
47
What is kissing spines
Impingement of the dorsal spinal processes
48
How to defintiively diagnose dorsal spinous process impingement
First latero-lateral radiography BUT can see this disease in horses without back pain so can't just use this * Gamma scintigraphy used to identify areas of remodelling
49
How does gamma scintigraphy work (diagonsing kissing spine)
INject bisphosphonate with radio-isotope on it which will localise to osteoclasts so highlgihts areas of remodelling
50
Management of dorsal spinous process impingement
Surgical cranial wedge ostectomy = very invasive procedure to remove chunks of cranial portion of dorsal spinous processes - Very long, painful recovery but good outcomes Interpsinous ligament desmotomy to gut interspinous lig and allow back to spread out; short rehab period but doesn't change underlying anatomy so not really done much; maybe in young racehorses
51
Typical presentation of lumbosacral and sacroiliac disease
Buckling under saddle Becoming disunited at canter Poor hind limb engagement May have overt lameness
52
What is a potential risk of blocking the SI joint
THat there is inadvertent blockage of the cranial gluteal nerve which will make horses recumbent for hours --> Walk straight to stable in case they lie down
53
Why can we say we are actually medicating SI region rather than joint
Joint very small only 3ml fluid Vs we inject 15ml on each side
54
Rehab programs for animals with axial pain
Strengthen core using sternal lifts, dorsiflexion, tail pulls Water treadmill Shart non-ridden in school + can use devices to encourage dorsiflexion HIll work Pole exercises
55
Why does fracture line become more radiographically visible after a couple of days
Due to phagocytosis along fracture lines and fragmen end resoprtion
56
What must we achieve to get primary repair of a fracture
Perfect natomical reduction Rigid fixation Sufficient blood supply Get haversian remodlling to restore previous structural integrity quickly
57
Why do we want some stress on bone during secondary fracture repair
Otherwise rigid immobility can suppress callous formation
58
Why do we want a horse to be weight bearing on the lame leg using multi-modal analgesia ASAP
To prevent overloading of the sound leg and severe contralateral lamintiis developing (happens esp on forelimbs)
59
What can we do to reduce risk of contralateral laminitis if expected to be non-weight bearing a whole
Soft boots
60
What fractures are commonly due to repetitive strain injury
Prox phalanx Lateral condylar fracture carpal fracture
61
What joints might we suspect to have microfractures on their way to failure
Joints that repeatedly need to be medicated
62
Predilection site for stress fracture in racehorses
Distal tibia; lameness that improves with work Pelvis, vertebrae; more like poor performance
63
How can a pelvic fracture lead to a fatal bleed
Via displacement and cutting abdominal vessels
64
What is the safety factor of many structures in equine distal limb
Just 1.2 So easy to go abvoe this with single supraphysiological event
65
Why might a distal phalanx fracture still look radiographically broken but horse is sound
Because it had headed by fibrous malunion
66
What does quick infill of fibrous tissue in distal phalanx fracture mean for surgical prospects
Not such good surgical candidates
67
When do proximal sesamoid bone fractures commonly occur
During fast work So see with racehorses commonly
68
What are common sites from fracture due to external trauma e.g kick
Dorsomedial radius as nothing between skin and bone to take force Dorsomedial tibia
69
If a horse has had direct trauma and shows a wound but no fracture visible on X ray what do we do
Put in cross ties anyway; fracture may just not be visitble
70
Why do we put a splint on the carpus for an olecranon fractures
This allows it to be used as a crutch for enough movement to walk onto lorry for transport
71
How to do an ethmogram for ortho pain behaviour and how many signs must a horse have to be suggestive of orthopaedic pain focsu
Ride and walk/trot for 10-15 mins If have >8/24 of the behaviours, suggestive of ortho pain
72

Equine (26 decks)

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