Equine MSK Emergencies Flashcards
(23 cards)
What are the (4) top differential diagnoses for severe lameness?
Fracture
Infection in a confined space (hoof abscess, septic synovial structure, cellulitis)
Laminitis
Severe soft tissue injury
What are the clinical signs of septic arthritis?
Moderate to severe peri-articular swelling/edema
Grade 4-5/5 lameness
Pain, heat, fever (foals)
How can septic arthritis be diagnosed? (5)
Arthrocentesis (cytology with degenerative neutrophils and intracellular bacteria)
Culture and sensitivity
Radiographs (lysis/erosion)
Ultrasound (particulates in fluid)
POC analyzers of synovial fluid (SAA, lactate)
What are the characteristics of septic synovial fluid? Color, turbidity, viscosity, total protein, nucleated cell count, WBC differential
What are the treatment options for septic arthritis?
Lavage
Antimicrobials (regional, systemic)
NSAIDs
Limb support (bandaging, splinting, casting)
How should casts be monitored?
Twice daily (at least)
Heat
Drainage (Strike Though)
Lameness
Fly accumulation
Unwilling to stand on it
How often should casts be changed?
Adults: 3-4 weeks
Foals: 1-2 weeks
Splints: usually with bandage changes or every 1-2 weeks
What are the most common sites for cast sores?
Proximal dorsal MC3/MT3
Palmar/plantar fetlock
Heel bulbs
What are the 4 goals of fracture immobilization?
Prevent further soft tissue damage
Minimize further bone damage/fracture displacement
Stabilize limb to improve comfort and reduce anxiety
Determine best coaptation strategy (based on region)
Fracture Immobilization: Forelimb Region I
Dorsal splint with leg non-weight bearing
Aligns dorsal cortices of cannon bone/phalanges
Fracture Immobilization: Forelimb Region II
Lateral and caudal splint
Prevents medial to lateral and dorsal to palmar instability
Fracture Immobilization: Forelimb Region III
Caudal splint (ground to elbow)
Lateral splint (above shoulder)
Prevents limb abduction and further injury to the medial aspect
Fracture Immobilization: Forelimb Region IV
No coaptation necessary
Surrounding muscles provide support
Exception: full limb bandage and caudal splint for olecranon fractures - prevents limb abduction and further injury to the medial aspect
Fracture Immobilization: Hindlimb Region I
Plantar splint with leg non-weight bearing
Aligns plantar cortices of cannon bone/phalanges
Fracture Immobilization: Hindlimb Region II
Plantar splint (to calcaneus)
Lateral splint (to stifle)
Prevents medial to lateral and dorsal to plantar instability
Fracture Immobilization: Hindlimb Region III
Extended lateral splint (to hip)
Prevents limb abduction and further injury to the medial aspect
Fracture Immobilization: Hindlimb Region IV
No coaptation necessary
Surrounding muscles provide support
What are indicators of better prognosis with fracture repair?
Young age (foals)
Small patient
Closed fracture
Simple/minimally displaced fracture
Early intervention
Non-articular
Good mental attitide
What are indicators of worse prognosis with fracture repair?
Older horse (relative to foals)
Large patient
Open fracture
Comminuted fracture
Severe soft tissue disruption
Articular
Poor mental attitude
Compare the appearance of (A) SDFT laceration, (B) SDFT and DDFT laceration, and (C) SDFT, DDFT, and suspensory ligament lacerations
What structure is lacerated?
SDFT
What structure is lacerated?
DDFT
What structure is lacerated?
SDFT, DDFT, suspensory ligament
