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vet med 4 > LOCO LA > Flashcards

LOCO LA Flashcards

1
Q

Supporting limb laminitis is due to ….

A

poor peripheral perfusion

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2
Q

Is supporting limb laminitis also due to mechanical overload?

A

NO

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3
Q

Is equine laminitis a disease?

A

No it is a syndrome

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4
Q

What is the most common cause of equine laminitis?

A

endocrinopathic- hyperinsulinemia

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5
Q

Does glucose toxicity and deprivation contribute to endocrinopathic laminitis?

A

No it does not.

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6
Q

What are the 3 causes of endocrinopathic laminitis?

A

1- PPID
2- GC
3- Equine Metabolic Syndrome

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7
Q

Can prednisolone or other corticosteroids initiate laminitis in a horse?

A

No, unless the horse is predisposed to hyperinsulinemia. Prednisolone can increase the chance of recurrence only.

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8
Q

What causes the Pars Intermedia in the horse to secrete more cortisol and CLIP hormones in laminitis?

A

loss of DA inhibition

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9
Q

What are the mechanisms that lead to loss of hemidesmosomes in the equine foot leading to inflammatory laminitis?

A

1- Inflammation (cytokine release, leucocyte adhesion, endothelial activation)

2- Hypoxia

Lead to structural damage

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10
Q

Medical treatment for PPID

A

Pergolide

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11
Q

Medical management of sepsis induced laminitis in horses

A
  • anti-endotoxins
  • digital cryotherapy
  • treat underlying cause
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12
Q

Prevention for EMS laminitis in horses

A
  • Reduce NSC consumption
  • exercise
  • weight loss
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13
Q

What do all horse laminitis cases have?

A

Bounding pulses

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14
Q

Is equine laminitis an emergency?

A

Yes

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15
Q

Prognosis of equine laminitis will depend on

A
  • previous history
  • severity of coronary band depression
  • degree of pedal bone rotation
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16
Q

Can OA be cured?

A

NO

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17
Q

Degenerative joint disease is a … process

A

inflammatory

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18
Q

In Degenerative joint disease which structures produce inflammatory cytokines leading to matrix breakdown?

A

All of them

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19
Q

In Degenerative joint disease (DJD), what increases and decreases (water, collagen, proteoglycans)

A
  • water increases
  • collagen decreases
  • proteoglycans decrease
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20
Q

is synovitis and joint distention painful?

A

Yes

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21
Q

Where are the pain receptors located in a joint?

A
  • The subchondral bone and the joint capsule
  • NO receptors on the articular cartilage
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22
Q

Does the articular cartilage have pain receptors?

A

No

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23
Q

What are the goals treatment in DJD?

A
  • stop inflammation
  • restore joint function
  • reduce pain
  • chondroprotection (disease modifying drugs)
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24
Q

What questions when hx taking would you ask when assessing a lame horse?

A
  • How many limbs? 1, 2, multiple?
  • other horses affected?
  • history of trauma
  • behavioural changes before?
  • onset?
  • duration?
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25
Q

what would you look for on a PE when assessing a lame horse?

A
  • which limb is lame?
  • is it lameness or laminitis?
  • score lameness on 0-10
  • where in limb? dx analgesia (intra-articular)
  • joint swelling? fibrous thickening? effusions? crepitus?
  • palpation and manipulation (ie. ROM)
  • muscle atrophy
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26
Q

what diagnostis tools do you have for assessing horse lameness?

A
  • local analgesia (peripheral nerve blocks vs intra-articular analgesia)
  • diagnostic imaging (X-rays, US, CT)
  • synovial fluid analysis (usually performed in infection is suspected)
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27
Q

What is the mainstay drug of choice for horses with OA?

A

NSAIDs

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28
Q

What features may you see on OA bone?

A
  • new bone
  • soft tissue swelling
  • dystrophic mineralisation
  • effusion
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29
Q

What NSAID can be used during pregnancy?

A

None

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30
Q

When can you not use an NSAID in a horse?

A
  • pregnancy
  • liver disease
  • if using corticosteroid
  • if using another NSAID
  • in a bleeding disorder
  • unaddressed dehydration
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31
Q

What farm animals have licensed NSAIDs?

A
  • Pigs
  • Cows
  • Horses
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32
Q

What conditions in the horse have licensed NSAIDs for them?

A
  • colic
  • musculoskeletal disease
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33
Q

65% of Antibiotic use on sheep farms is due to what disease?

A

lameness

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34
Q

Unlike cattle, most causes of sheep lameness are….?

A

contagious

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35
Q

This shows that sheep wall horn length varies with the time of year- isnt this great?

A

yes

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36
Q

What is the most common cause of lameness in sheep?

A

Scald

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37
Q

What is this?

A

Scald

inflammation of the interdigital skin

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38
Q

How do you treat scald?

A
  • oxytetracyclin
  • control footrot as footrot predisposes to scald (same bacteria)
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39
Q

What is this? What other disease does it look like?

A

Footrot

it resembles scald-

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40
Q

What distinguishes footrot from scald?

A

Like scald it has inflammation of the interdigital space, white grey scum and a smell.

But it has under-running of the hoof horn

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41
Q

Should you trim footrot in sheep?

A

NO!!!!!!!!

give oxytetracyclin, penicillin or macrolides in refrac cases

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42
Q

What is the causative agent of footrot in sheep?

A

D. nodosus

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43
Q

If footrot treatment is delayed that could lead to …

A

toe granuloma

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44
Q

How does D. Nodosus cause footrot and underunning of hoof horn?

A

digestive proteases

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45
Q

D. nodusus co-infects the sheep foot with which other bacteria?

A

Fusobacterium Necrophorum

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46
Q

Regular foot paring, regular foot bathing and regular buying in of new sheep has been associated to increased levels of…

A

lameness

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47
Q

What reduces sheep lameness incidence on a farm?

A
  • closed flock
  • isolating affected sheep
  • quarantining new stock
  • treating affected sheep in less than 3 days
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48
Q

What is the five point plan for the prevention of footrot?

A

1- DO NOT TRIM
2- CULL (heritability- reservoir for disease)
3- Quarantine
4- Vax
5- environmental factors ( unidirectional flow in footbaths, dry bedding, cleaning shears after use)

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49
Q

Why is footbathing bad for sheep?

A

Its bad if it is done poorly - can spread disease easily

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50
Q

What footbathing options do we have for sheep?

A

3% formalin

10% zinc sulphate

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51
Q

Should you footbathe a lame sheep?

A

NO!!!!

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52
Q

What’s bad about formalin footbaths?

A
  • carcinogenic
  • painful
  • inactivated by organic matter
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53
Q

What is this?

A

CODD

3rd most common cause of sheep lameness

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54
Q

What causes CODD?

A

Treponeme

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55
Q

How do you treat CODD

A

do not trim!

systemic Amoxicillin Ab

topical oxycyclin

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56
Q

What is this?

A

Shelly hoof

separation of sole horn with wall horn leads to pockets. These pockets can fill with mud and debris which may make the animal lame.

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57
Q

What is this?

A

CODD

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58
Q

How do you treat Shelly hoof?

A
  • Pare off the pocket
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59
Q

What predisposes to Shelly hoof?

A
  • genetics
  • nutrition
  • underfoot conditions
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60
Q

What is this?

A

Foot abscess

bacteria penetrate the white line- then pus bursts out of coronary band!!

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61
Q

How do you treat a foot abscess?

A

Pare off foot to RELEASE PUS!!

systemic antibiotics

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62
Q

What is this? What causes this?

A

Toe granuloma

red polyp made of granulation tissue.

caused by exposure of the corium

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63
Q

Do you need to treat this or can you just let it heal?

A

It will not heal on its own!!!

remove loose horn
cut neck of the polp
apply pressure bandage
change dressings weekly
plus systemic antibiotics

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64
Q

What is this?

A

Septic pedal arthritis

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65
Q

Where is the infection? How did this infection occur?

A

the distal interphalangeal joint

  • infection may have spread from foot or directly infection via a sharp object
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66
Q

How do you treat this?

A

arthrodesis or amputation

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67
Q

What is this?

A

strawberry foot

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68
Q

What causes this?

A

Co infection with ORF and D.Congolensis

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69
Q

What are the 3 causes joint ill in sheep?

A
  • S. Dysgalactia (neonatal bacteriemia)
  • E. Rhusiopathia (wet conditions)
    -tick bite pyemia
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70
Q

How can you prevent joint ill in sheep?

A

Navel dip
wear gloves at lambing
ensure housing is clean

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71
Q

Should we be trimming goats feet? why?

A

Yes

they have different management to sheep

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72
Q

Why do we tend to get laminitis in goats?

A

high concentrate diets

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73
Q

What bacterial agent has been associated to goat CODD like infections?

A

treponemes

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74
Q

Goat feet infections are caused by what two factors?

A

laminitis
Treponemes

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75
Q

Limb movement can be described is composed of 2 things

A

1- travel
2- action

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76
Q

Define travel (relating to limb movement)

A

travel is the flight of a hoof in relation to the other limbs.

It is a 2 peaked curve

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77
Q

What are the phases of stride in a horse?

A

landing- loading-stance-
breakdown- swing/ flights

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78
Q

Define action (relating to limb movement)

A

overall gait characteristics
varies between breeds

ie TB are designed for flat racing

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79
Q

When a lame horse is trotting, will the sound limb or lame limb make more noise?

A

“The sound limb makes more sound”

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80
Q

Which gait is best to analyse lameness?

A

the trot (2 beat)

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81
Q

Which gaits do not detect subtle lameness?

A

walk (4 beat)
canter (3 beat)

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82
Q

why do we want to identify the source of lameness in a limb when doing a PE?

A

To allow for targeted diagnostic imaging

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83
Q

In FL lameness, the head will drop on which limb?

A

the sound limb

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84
Q

Inertial sensors are placed in which 3 areas?

A

the poll
tuber sacrale
tuber coxae

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85
Q

If the horse is left FL lame, which FL will have increased movement on inertial sensors?

A

The Right FL will have increased movement > Left FL

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86
Q

Which side will have an increased pelvic hike?

A

the lame side

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87
Q

“Fetlock drop” can be seen on the lame side or the sound side?

A

The fetlock drop is more pronounced on the sound side except for when there is suspensory ligament/ tendon damage

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88
Q

Inertial sensors of the HL- will the sound or lame limb have increased excursion?

A

the lame side will have increased excursion

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89
Q

When an animal is drifting he is running in … tracks instead of 2

A

3

90
Q

does drifting indicate severity of lameness?

A

No

91
Q

Does conformation indicate severity of lameness?

A

No

92
Q

Is the deep digital flexor tendon healthy?

A

No - this is a normal DDFT-

No white material and the tendon is thinner

93
Q

During lameness, both the pelvic hike and the head nod drop on which limb?

A

sound limb

94
Q

The elevation of the Tuber Calcis is higher on which limb?

A

the sound limb

95
Q

During drifting the animal is running away from which limb?

A

running away from the lame limb (trying to leave it behind!)

96
Q

What are the 2 DFT of the horse

A

SDFT
DDFT

97
Q

Which DFT acts as an energy store and is more likely to be injured?

A

SDFT

98
Q

The DDFT inserts of the …

A

Distal phalanx

(remember d for d)

99
Q

The superficial flexor tendon inserts on the…

A

middle phalanx

100
Q

Most tendon injuries occur on the …. aspect of the equine foot

A

palmas aspect

101
Q

There are 2 types of tendon injury in horses

A
  • subcutaneous: involved with overStrain
  • percutaneous : involved in laceration and trauma
102
Q

Subcutaneous tendon injuries are caused by

A

overStrain

103
Q

What are the causes of subcutaneous tendon overstrain horse

A
  • sudden overextension
  • degeneration followed by overextension
104
Q

Overstrain of tendons in horses- temporary or persistent?

A

Can be both

105
Q

If a horse presents with lameness and increased overextension of the fetlock joint compared to the other limb- what may this mean?

A

Poor prognostic indication as it suggests tendons or ligaments are significantly damaged

106
Q

Which parts of the equine foots are most affected by tendon injuries?

A

palmar/ plantar aspect of the pastern and metacarpus/ metatarsus

107
Q

How can you assess the extend of the damage to a fetlock joint in a horse?

A

lift other limb up, to increase weight bearing on injured limb. Assess degree of overextension

108
Q

If the DDFT is ruptured what may be see?

A

elevation of the toe (it is the only tendon that inserts on distal phalanx)

109
Q

When palpating a lame horse’s legs, what are you looking for ?

A

Pain
oedema
suppleness of tendon

110
Q

What is the showing?

A

SDFT injury- notice the bowing on the palmar aspect of the metacarpus

111
Q

Which areas are difficult to palpate on a horses’ limb?

A

proximal SL
pastern

112
Q

What diagnostic modality is useful for evaluating tendon/ligament injuries in horses?

A

US

113
Q

When assessing a lame limb on palpation and ultrasound, should you also assess the other limb?

A

YES, BOTH LIMBS

as can be degenerative even if one limb is more severely affected than the other

114
Q

When do you assess a tendon injury via US on horses?

A

Best wait 7 days post-injury

115
Q

Superficial digital flexor tendinopathy- what part of the limb swells? what does it look like on US?

A

Palmar metacarpal swelling

on US you see classic core lesion

116
Q

The lameness present with SDF tendinopathy is

A

variable

can have initial lameness that then resolves

117
Q

Suspensory ligament desmitis is divided into

A
  • proximal
  • body
  • 2 branches
118
Q

Proximal suspensory desmitis is caused by

A

conformational abnormalities

straight hock
overextended fetlock

119
Q

Lameness with proximal suspensory ligament desmitis is

A

variable- can just be associated with poor performance

120
Q

Proximal suspensory desmitis usually affect the HL or the FL?

A

the HL

121
Q

What diagnostics may you use for assessing Proximal suspensory desmitis ?

A

radiography (as this is attached to bone)
US
scintigraphy

122
Q

What desmitis is seen here?

A

suspensory ligament body and branch desmitis

123
Q

SL body and branch desmitis looks alot like SDF tendinopathy- what is different about the swelling?

A

Closer to the cannon bone

124
Q

What can you commonly see on US with SL body and branch desmitis?

A

Periligament fibrosis

(this is a ligament - cuffing is seen)

125
Q

Swelling of the proximal metacarpal region (just below the carpus) can be associated with which desmitis?

A

Desmitis of the accessory DDFT accessory ligament

126
Q

What is this showing?

A

enlargement and disruption of the accessory ligament of the DDFT (just below the carpus)

127
Q

DDFT tendinopathy is always within

A

synovial cavities

  • tendon sheath or
  • navicular bursa
128
Q

There are 2 types of damage in DDFT tendinopathy

A
  • midsubstance tears (on the inside)
  • marginal tears
129
Q

Why are marginal tears DDFT tendinopathy problematic?

A

interact with synovial fluid- which stops them from healing!

130
Q

What is a common consequent of DDFT tendinopathy?

A

tenosynovitis

131
Q

Tenosynovitis is inflammation of the

A

Digital sheath

132
Q

tenosynovitis can be causes by

A
  • idiopathic
  • septic penetrating injury
  • non-septic inflammation
133
Q

Define annular ligament syndome

A
  • thickening of the digital tendon sheath
  • causes secondary Notch of the palmar annular ligament
134
Q

What is the function of the palmar annular ligaments?

A

attached to the sesamoid bones of the fetlock
keep the flexor tendons in place

135
Q

Can you sometimes see abnormal gliding of the flexor tendons with Annular ligament syndrome?

A

Yes sometimes

136
Q

Intra-thecal tendon tears in the FL usually affects the

A

DDFT

137
Q

Intra-thecal tendon tears in the HL usually affects the

A

manica flexoria (loop of the DDFT that wraps around the SDDF above the fetlock)

138
Q

Dx of intra-thecal tears requires ..

A

contrast tenography

139
Q

What are the phases of tendon healing?

A
140
Q

Treatment for tendonitis should be based on what 2 factors?

A
  • phase of tendon healing
  • tendon pathology
141
Q

How do we treat tears in the DDFT?

A

debride tenoscopically

142
Q

How do we treat manica flexoria tears?

A

remove them ! very good prognosis

143
Q

Name some developmental deformities of equine limbs

A
  • carpal flexural deformity
  • distal interphalangeal joint deformity (type 1 and 2)
  • MCP joint deformity
  • tendon laxity
144
Q

Carpal flexural deformity is always

A

congenital

145
Q

How do you treat carpal flexural deformity?

A
  • exercise
  • physio
  • tube cast
146
Q

What are the 2 types of distal interphalangeal joint flexural deformities?

A

type 1: dorsal hood less than vertical
type 2: dorsal hoof past vertical

147
Q

What is this showing?

A

tendon laxity

148
Q

IS tendon laxity acquired or congenital?

A

can be both (can be acquired following casting)

149
Q

How do we treat tendon laxity?

A

heel extension shoe
heel trimming
controlled exercise

150
Q

MCP joint flexural deformity can be acquired or congenital?

A

both

151
Q

How do we treat Type 1 distal interphalangeal flexural deformity?

A
  • exercise and physio
  • toe extension shoe
  • surgery of the ALDDFT
152
Q

How do we treat Type 2 distal interphalangeal flexural deformity?

A
  • desmotomy of the ALDDFT
  • (tenotomy DDFT)
153
Q

How do we treat the acute phase of tendon injury?

A
  • ice
  • compression
  • rest
  • corticosteroids to stop inflammation
  • NSAIDs for pain
  • percutaneous tendon splitting
154
Q

How do we treat the sub acute phase of tendon injury? (1 week- 6 months)

A
  • optimise organisation of scar tissue
  • rehab programm
  • monitor with US (cross section should not be >10%)
  • biologicals
155
Q

How do we treat the chronic phase of tendon injury? (3-18months)

A
  • promote remodelling
  • prevent re-injury
  • controlled exercise
  • desmotomy of the Acc ligament of thr SDFT
156
Q

What is this? (cow foot)

A

Sole ulcer

157
Q

What is this?

A

interdigital hyperplasia, Tyloma, Corns

158
Q

What is this?

A

interdigital hyperplasia, Tyloma, Corns

159
Q

What is this?

A
160
Q

What is this?

A

digital dermatitis

161
Q

What is this? Causal agent? (cattle)

A

Toe necrosis
caused by Treponemes

162
Q

What is this? (cattle)

A

Interdigital phlegmon

also known as foot rot, interdigital necrobacillus

163
Q

What is this?

A

Digital dermatitis,

infection of the digital or interdigital skin

Strawberry heel, Mortellaro disease

164
Q

White line disease define

A

separation of the white line with or without purulent exudation

165
Q

What is this? (cattle)

A

bruising of the sole

166
Q

What is slurry heel in cattle?

A

Softening and erosion of the heel.

167
Q

Foul in cattle affects what part of the foot?

A

the interdigital space

168
Q

Foul in cattle is also called..

A

interdigital phlegmon

169
Q

Digital dermatitis is an infection that usually affects which part of the foot?

A

between the bulbs-

can have exudation and or hyperkeratosis

170
Q

What is this?

A

a heel ulcer

171
Q

Cattle lameness affects commonly what part of the body- leg or foot? HL or FL?

A

feet

HL - the lateral claws

172
Q

If you have FL lameness in cow, which claw will be more commonly affected?

A

the medial claw

173
Q

When starting the 5 step Dutch technique- which claw do you start with?

A

the non weight bearing claw

174
Q

Uncomplicated sole ulcers are commonly found on which foot and claw (Cow)?

A

HL
lateral (the weigh bearing claw)

175
Q

What is the tx for sole ulcers in cattle?

A

Remove collar by trimming back sole to chorium -

very thin sole

Block on healthy claw

anti-inflammatories

soft bedding

176
Q

Sole ulcers have a tendency to

A

recur!

177
Q

What is the pathogenesis of sole ulcers after calving

A

1- relaxation of the suspensory apparatus —> flexor tendon becomes loose—> P3 can rotate

2- loss of BCS —> loss of foot pad fat

3- overgrown claws–> increases weight bearing on heels

178
Q

Do laminitis and SARA directly cause sole ulcers?

A

NO!!!!!!!!!!!

they can indirectly impact it by:

laminitis—> might weaken suspensory apparatus

SARA—> decreased BCS

179
Q

White line disease is a continuum of disease processes - which are?

A

bruising—> separation—> abcessation–> WALL ULCER

180
Q

What is this? What causes this? (cattle)

A

Stages of digital dermatitis

Treponemes

181
Q

What footbaths are used for cattle?

A
  • formalin
  • copper sulphate

DO NOT USE ANTIBIOTIC FOOTBATHS

182
Q

What causes this? (Cattle)

A

Foul in the foot

Fusobacterium Necrophorus

(F for F)

183
Q

How do you treat M1 and M2 digital dermatitis?

A

clean, dry, topical antibiotics

( LEAVE UNCOVERED)

184
Q

How do you treat M4 digital dermatitis?

A

clean, LA, debride and debulk, bandage and antibacterial agent

185
Q

How can you prevent digi derm on a cattle farm?

A
  • footbaths (formalin or copper)
  • slurry management
186
Q

Claw amputation- which method are you aiming for?

A

Method 3- through P1

187
Q

Impinging spinous processes usually affects which Vertebrae

A

T14-T15

188
Q

If a horse has impinging spinous processes does it mean it will have back pain?

A

NO

80% of racehorses have this without any evidence of back pain

189
Q

You do scintigraphy of a horses spinal process and see this? Is it clinically relevant?

A

Impinging spinous processes can be seen-

No if no clinical signs

190
Q

How do you distinguish between a horse with clinically significant impinging spinous processes and those that are not?

A

Local anaesthetic around spinous processes

then you evaluate if there are reporoducible clinical signs when ridden

191
Q

What radiographic view do you use to evaluate the spinous processes of a horse?

A

Lateral lateral

overlapping views

192
Q

The most common site for OA in the articular processes of a horse

A

T16-T17 followed by T15-T16

193
Q

What radiographic view is needed for assessing OA in the articular processes of a horse?

A

20 degree lateral oblique

194
Q

Apart from a 20 degree lateral X ray, is there any other diagnostic modality that can be used to assess the articular process joint?

A

Yes US

Normally looks like the corner of a box

in disease has a curved corner

195
Q

Which epaxial muscles provide stability locomotion in the horse’s back

A
  • multifidus
  • longissimus dorsi
196
Q

Retraction of the FL and protraction of the HL in the horses flexes the..

A

spine

197
Q

To flex the spine- do you lower or raise the head of the horse?

A

lower the head

198
Q

How do you treat impinging spinous processes?

A
  • intralesional medication:
    (corticosteroids)
  • phenylbutazone
    -extracorporeal shockwave therapy (3 tx 2 weeks apart)
  • 48 hours box rest
  • non ridden exercise program
199
Q

If you increase the depth of water when a horse is doing water treadmill exercises what happens to the back kinematics

A

T18 and L3 flexion increases

HL flexion increases

extends cranial thoracic spine

200
Q

What treatment options do we have for impinging spinous processes?

A
201
Q

What is the main complication of subtotal ostectomy?

A
202
Q

What is this surgical procedure ? (horse)

A

cranial Wedge

203
Q

What is this surgical procedure? (horse)

A

subtotal ostectomy

204
Q

What is this operation (horse)?

A

Interspinous ligament desmotomy

205
Q

What is this?

A

transfixation casting

distal limb fracture that is unstable under axial loading.

Axial loading gets transferred onto cast

206
Q

What is this?

A

external fixator

207
Q

What is the purpose of cast in horses

A
  • treatment of fractures (less common than in SA)
  • treatment of joint luxation
    protection of wounds and tendon laceration
  • stress protection after internal fixation
208
Q

What drugs can you give to an emergence orthopaedic case? (Horse)

A
  • Detomidine, Xylazine

-or Detomidine with and opioid

  • NEVER GIVE PHENOTIAZINE —> HYPOTENSION with oocur if in presence of catelochamines

NEVER GIVE OPIOIDS ALONE!!

209
Q

Which splints keep the horses fetlock in a flexed position?

A

Monkey splint and the Kimzey splint

210
Q

Condylar fractures of the horses fetlock should be immobilised in a felxed or neutral position?

A

neutral position

211
Q

A horse with a FL fracture should travel facing forwards or backwards?

A

backwards

weight is thrown on two sound limbs when vehicle stops

212
Q

A horse with a HL fracture should travel facing forwards or backwards?

A

forwards

213
Q

How do you immobilise a fetlock distraction injury?

A

flexed position

214
Q

For division2 of the Horses FL (distal metacarpus to distal radius- where should the splints be positioned?

A

Laterally and caudally

215
Q

What is this and why do we do it?

A

Robert Jones Bandage with and extended splint

its is to prevent the digital extensors and flexors from abducting

216
Q

What brace would keep the horse’s fetlock in extension?

A

The Farley brace

217
Q

What is the main limiting biomechanical factor in division 1 of the HL?

A

the reciprocal apparatus

218
Q

What are the immobilisation techniques for division 1 of the HL?

A

Same as FL

219
Q

What immobilisation technique can you use for proximal metatarsus to the stifle of a horse?

A

MODIFIED Schroeder Thomas Splint

220
Q

Can you stabilise fractures between femur to the pelvis (horse)?

A

No- poor prognosis

vet med 4 (11 decks)

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