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CVSOH BVSc4 > Lame - Equine acute foot problems > Flashcards

Lame - Equine acute foot problems Flashcards

(105 cards)

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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
What should all be parallel on lateromedial radiograph of the hoof?
Dorsal hoof wall Dorsal P3 Heel Pastern
26
Where should the centre of the ark of the distal interphalangeal joint be on radiograph?
Vertically over middle of hoof and point of frog
27
What does broken forward mean?
Dorsal hoof wall angle is pointing further forward than the angle of the pastern
28
What angle should the solar surface of P3 be from the the sole of the hoof?
5-10 degrees
29
What shape should the tip of P3 be?
A point, not a ski slope - this would suggest chronic P3 pathology
30
What is the positioning for dorsopalmar radiograph of a hoof?
Weight bearing on block - square to beam Cassette on palmar aspect of limb Beam parallel to the ground centred at coronary band
31
What features can you look at on dorsopalmar radiograph of a hoof?
Mediolateral imbalance - difference between P3 and sole Hoof wall flare
32
What structures can often be mistaken for abnormal pathology?
Vascular channels - normal
33
What is the dorsoproximal palmaro-distal oblique view radiograph of a hoof used to look at?
Solar margin of P3 Dorsal navicular bone
34
What positioning do you use for the dorsoproximal palmaro-distal oblique view radiograph of a hoof?
Weight bearing with foot stood on tunnel that you slide the cassette into Beam 2cm above coronary band at 60 degree angle from cassette
35
What do you change when you want to focus on P3 or navicular bone?
Increase exposure Reduce collimation Decrease angle by 5 degrees
36
What is the crena?
Midline P3 margin - variable appearance
37
What is the dorsolateral-palmaromedial oblique radiograph of a hoof?
Same as the dorsoproximal palmaro-distal oblique view radiograph of a hoof but moved 45 degrees lateral to medial
38
What is the dorsolateral-palmaromedial oblique radiograph of a hoof useful for?
Assessing pedal wings, DIP joint and symmetry
39
What is the palmaroproximal-palmarodistal oblique radiograph of the hoof?
Navicular skyline: Limb extended caudally while weight bearing on cassette in tunnel Beam into divot at back of pastern avoiding the fetlock
40
What structures does the palmaroproximal-palmarodistal oblique radiograph of the hoof show?
Navicular bone P3 - particularly wings
41
What does transcutaneous view ultrasound show? What can you see?
MRI used more now Collateral ligament of DIP DIP joint effusion DDFT can be seen between heel bulbs
42
How do you do a solar view ultrasound through the frog of a hoof?
Difficult, not really done much now Lots of preparation, soak hoof for hours
43
What can you see on solar view ultrasound through frog of hoof?
DDFT Navicular bone/bursa P3
44
What is gold standard imaging of the horses hoof? Why?
MRI - due to superior contrast details
45
What types of MRI are there?
Low field MRI - distal limb (25 in country) High field MRI - head and neck, limbs (2 in country)
46
What is a pricked hoof/nail bind?
a nail placed in or axial to the white line during farriery
47
What does a pricked hoof present as?
Acute severe lameness a few days after the farrier has been
48
How do you diagnose a hoof prick?
Hoof testers and paring
49
How do you treat a pricked hoof?
Remove nail/shoe Poultice - dressing Week of rest
50
When do you get hoof bruising?
Unshod hooves walking on rough ground
51
How do you treat bruising in hooves?
Rest Unshoe and poultice dressing Reshoe after pairing
52
What are corns? What are they caused by?
Specific type of bruising at heel caused by a collapsed bar or too long shoeing interval
53
How do you diagnose corns?
Pain on hoof testers, usually specifically at the heel
54
What causes a hoof subsolar abscess?
Penetrating injury to solar surface Bacteria tracking up the white line
55
What are the clinical signs of a hoof abcess?
Acute non weight bearing lameness Increased digital pulses Pain on hoof testers
56
How do you diagnose a hoof abcess?
Pus released during paring
57
How do you treat a hoof abcess?
Poultice - hoof dressing/bandage Tubbing Rest
58
What is tubbing?
Hoof in a bucket of salt water for 20 mins
59
Where do most hoof abcesses drain?
At the white line
60
What are some other hoof abcess draining sites than at the white line?
Coronary band Frog At the penetration site
61
What animals get very deep foot abcesses?
Donkeys Small horses
62
What should you do in deep puncture wound cases?
Leave the foreign body in situ Use wooden blocks for weight bearing
63
What structures must you assess in deep puncture wounds?
DIP joint Navicular bursa Digital flexor tendon sheaths
64
What should you do if the puncture wound affected any of the synovial structures of the hoof?
Arthroscopic lavage Or euthanasia Or poultice and rest Analgesia
65
What is pedal osteitis?
Septic focus in P3 often following a puncture or pus in the foot
66
What are the clinical signs presentation of pedal osteitis?
Acute severe lameness which persists Increased digital pulses Pain on hoof testers
67
How is pedal osteitis diagnosed?
Imaging
68
How is pedal osteitis treated?
Curettage back to healthy bone - remove disease bone Manage open wound - hospital plate, bandaging
69
How long will pedal osteitis surgical treatment take to heal?
Several months Need to wait for granulation tissue to form and hoof to grow in to hole
70
What is a common cause of P3 fractures?
Trauma Kicking brick walls - especially hind limbs
71
What is a type 1 P3 fracture?
Involve the palmar/plantar process Dont enter DIP joint Wing fracture
72
What is a type 2 P3 fracture?
Oblique or parasagittal fracture Articular but not on the midline Wing fracture
73
What is a type 3 P3 fracture?
Midline articular fracture Bisect pedal bone into 2 equal halves
74
What is a type 4 P3 fracture?
Involve the extensor process of the pedal bone (top bit)
75
What is a type 5 P3 fracture?
P3 split into multiple fragments
76
What is a type 6 P3 fracture?
Solar margin fracture - chip out the bottom
77
What is a type 7 P3 fracture?
Exclusive to foals Fracture of solar margin
78
What are the two treatment options for P3 fractures?
Depends on configuration Surgical lag screw across fracture Or conservative management - bar shoe and rest
79
What radiographic view is best for navicular bone fracture?
Palmaroproximal-palmarodistal oblique view
80
What does a parasaggital fracture mean?
Close to midline but not on it
81
What is the configuration of navicular bone fractures?
Usually parasagittal and slightly oblique
82
What is a fracture associated with ossification in the hoof?
Fracture of ossified ungual cartilages - ossification usually asymptomatic but are predisposed to trauma
83
How do fractured ossified ungual cartilages present?
Acute severe lameness Increased digital pulses Pain on palpation of heel bulbs
84
How are fractured ossified ungual cartilages treated?
Bar shoes and rest
85
What are the 4 phases/types of laminitis?
Developmental stage Acute Sub-acute Chronic
86
What is the developmental stage of laminitis?
Causal event up until the clinical signs - need to act before clinical signs start if you can
87
What is acute laminitis?
From onset of signs to 72 hours
88
What is subacute laminitis?
Repair over 2-3 months
89
What is chronic laminitis?
Structural failure developing over an indefinite period
90
What is the main primary cause of laminitis?
Endocrinopathies - PPID, EMS, corticosteroids given to uncontrolled endocrinopathy horses
91
What causes of laminitis are there other than endocrinopaties?
Excess carb intake Toxaemia Contralateral limb lameness
92
What is the pathogenesis of laminitis?
Dermal epidermal separation of lamellae Basement membrane lysis
93
What is the recurrence rate of laminitis?
30% recurrence rate
94
What breeds/types of horses are predisposed to laminitis?
Ponies Heavy horses Obese Crest neck
95
What are the clinical signs of acute laminitis?
Weight on heels stance Reluctant to move Increased digital pulses Pain on hoof testers flatter solar surface Coronary band depression Solar bruising
96
What are the clinical signs of chronic laminitis?
Divergent growth rings Change in hoof shape - boxy
97
What hoof changes can you see on radiograph in laminitis cases?
Rotation Sinking Gas Remodelling/lysis
98
What degree rotation is non consistent with survival in laminitis?
More than 20 degrees
99
What can you use to alter laminar perfusion in the developmental phase of laminitis? Why?
Cold - ice feet Vasoconstriction - prevent endotoxins reaching foot
100
What can you do to alter laminar perfusion in the acute phase? Why?
ACP Vasodilation - increase perfusion, more oxygen
101
How can you prevent inflammation in laminitis treatment?
NSAIDs - also some analgesia
102
What mechanical support can you give laminitis cases?
Rest on deep bed Styrofoam pads for frog support Remove length of toe Elevate heel
103
How do you trim hooves in subacute or chronic phases of laminitis?
Shorten toe Remove heel height Heart bar shoes
104
What is the prognosis for laminitis cases?
Very difficutl to predict - can go either way
105
How do you treat navicular bone fractures?
Surgical - lag screw (tricky) Conservative - bar shoe and rest

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