LOCO LA Flashcards
(220 cards)
1
Q
Supporting limb laminitis is due to ….
A
poor peripheral perfusion
2
Q
Is supporting limb laminitis also due to mechanical overload?
A
NO
3
Q
Is equine laminitis a disease?
A
No it is a syndrome
4
Q
What is the most common cause of equine laminitis?
A
endocrinopathic- hyperinsulinemia
5
Q
Does glucose toxicity and deprivation contribute to endocrinopathic laminitis?
A
No it does not.
6
Q
What are the 3 causes of endocrinopathic laminitis?
A
1- PPID
2- GC
3- Equine Metabolic Syndrome
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.
8
Q
What causes the Pars Intermedia in the horse to secrete more cortisol and CLIP hormones in laminitis?
A
loss of DA inhibition
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
10
Q
Medical treatment for PPID
A
Pergolide
11
Q
Medical management of sepsis induced laminitis in horses
A
- anti-endotoxins
- digital cryotherapy
- treat underlying cause
12
Q
Prevention for EMS laminitis in horses
A
- Reduce NSC consumption
- exercise
- weight loss
13
Q
What do all horse laminitis cases have?
A
Bounding pulses
14
Q
Is equine laminitis an emergency?
A
Yes
15
Q
Prognosis of equine laminitis will depend on
A
- previous history
- severity of coronary band depression
- degree of pedal bone rotation
16
Q
Can OA be cured?
A
NO
17
Q
Degenerative joint disease is a … process
A
inflammatory
18
Q
In Degenerative joint disease which structures produce inflammatory cytokines leading to matrix breakdown?
A
All of them
19
Q
In Degenerative joint disease (DJD), what increases and decreases (water, collagen, proteoglycans)
A
- water increases
- collagen decreases
- proteoglycans decrease
20
Q
is synovitis and joint distention painful?
A
Yes
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
22
Q
Does the articular cartilage have pain receptors?
A
No
23
Q
What are the goals treatment in DJD?
A
- stop inflammation
- restore joint function
- reduce pain
- chondroprotection (disease modifying drugs)
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?
25
what would you look for on a PE when assessing a lame horse?
- 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
26
what diagnostis tools do you have for assessing horse lameness?
- local analgesia (peripheral nerve blocks vs intra-articular analgesia)
- diagnostic imaging (X-rays, US, CT)
- synovial fluid analysis (usually performed in infection is suspected)
27
What is the mainstay drug of choice for horses with OA?
NSAIDs
28
What features may you see on OA bone?
- new bone
- soft tissue swelling
- dystrophic mineralisation
- effusion
29
What NSAID can be used during pregnancy?
None
30
When can you not use an NSAID in a horse?
- pregnancy
- liver disease
- if using corticosteroid
- if using another NSAID
- in a bleeding disorder
- unaddressed dehydration
31
What farm animals have licensed NSAIDs?
- Pigs
- Cows
- Horses
32
What conditions in the horse have licensed NSAIDs for them?
- colic
- musculoskeletal disease
33
65% of Antibiotic use on sheep farms is due to what disease?
lameness
34
Unlike cattle, most causes of sheep lameness are....?
contagious
35
This shows that sheep wall horn length varies with the time of year- isnt this great?
yes
36
What is the most common cause of lameness in sheep?
Scald
37
What is this?
Scald
inflammation of the interdigital skin
38
How do you treat scald?
- oxytetracyclin
- control footrot as footrot predisposes to scald (same bacteria)
39
What is this? What other disease does it look like?
Footrot
it resembles scald-
40
What distinguishes footrot from scald?
Like scald it has inflammation of the interdigital space, white grey scum and a smell.
But it has under-running of the hoof horn
41
Should you trim footrot in sheep?
NO!!!!!!!!
give oxytetracyclin, penicillin or macrolides in refrac cases
42
What is the causative agent of footrot in sheep?
D. nodosus
43
If footrot treatment is delayed that could lead to ...
toe granuloma
44
How does D. Nodosus cause footrot and underunning of hoof horn?
digestive proteases
45
D. nodusus co-infects the sheep foot with which other bacteria?
Fusobacterium Necrophorum
46
Regular foot paring, regular foot bathing and regular buying in of new sheep has been associated to increased levels of...
lameness
47
What reduces sheep lameness incidence on a farm?
- closed flock
- isolating affected sheep
- quarantining new stock
- treating affected sheep in less than 3 days
48
What is the five point plan for the prevention of footrot?
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)
49
Why is footbathing bad for sheep?
Its bad if it is done poorly - can spread disease easily
50
What footbathing options do we have for sheep?
3% formalin
10% zinc sulphate
51
Should you footbathe a lame sheep?
NO!!!!
52
What's bad about formalin footbaths?
- carcinogenic
- painful
- inactivated by organic matter
53
What is this?
CODD
3rd most common cause of sheep lameness
54
What causes CODD?
Treponeme
55
How do you treat CODD
do not trim!
systemic Amoxicillin Ab
topical oxycyclin
56
What is this?
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.
57
What is this?
CODD
58
How do you treat Shelly hoof?
- Pare off the pocket
59
What predisposes to Shelly hoof?
- genetics
- nutrition
- underfoot conditions
60
What is this?
Foot abscess
bacteria penetrate the white line- then pus bursts out of coronary band!!
61
How do you treat a foot abscess?
Pare off foot to RELEASE PUS!!
systemic antibiotics
62
What is this? What causes this?
Toe granuloma
red polyp made of granulation tissue.
caused by exposure of the corium
63
Do you need to treat this or can you just let it heal?
It will not heal on its own!!!
remove loose horn
cut neck of the polp
apply pressure bandage
change dressings weekly
plus systemic antibiotics
64
What is this?
Septic pedal arthritis
65
Where is the infection? How did this infection occur?
the distal interphalangeal joint
- infection may have spread from foot or directly infection via a sharp object
66
How do you treat this?
arthrodesis or amputation
67
What is this?
strawberry foot
68
What causes this?
Co infection with ORF and D.Congolensis
69
What are the 3 causes joint ill in sheep?
- S. Dysgalactia (neonatal bacteriemia)
- E. Rhusiopathia (wet conditions)
-tick bite pyemia
70
How can you prevent joint ill in sheep?
Navel dip
wear gloves at lambing
ensure housing is clean
71
Should we be trimming goats feet? why?
Yes
they have different management to sheep
72
Why do we tend to get laminitis in goats?
high concentrate diets
73
What bacterial agent has been associated to goat CODD like infections?
treponemes
74
Goat feet infections are caused by what two factors?
laminitis
Treponemes
75
Limb movement can be described is composed of 2 things
1- travel
2- action
76
Define travel (relating to limb movement)
travel is the flight of a hoof in relation to the other limbs.
It is a 2 peaked curve
77
What are the phases of stride in a horse?
landing- loading-stance-
breakdown- swing/ flights
78
Define action (relating to limb movement)
overall gait characteristics
varies between breeds
ie TB are designed for flat racing
79
When a lame horse is trotting, will the sound limb or lame limb make more noise?
"The sound limb makes more sound"
80
Which gait is best to analyse lameness?
the trot (2 beat)
81
Which gaits do not detect subtle lameness?
walk (4 beat)
canter (3 beat)
82
why do we want to identify the source of lameness in a limb when doing a PE?
To allow for targeted diagnostic imaging
83
In FL lameness, the head will drop on which limb?
the sound limb
84
Inertial sensors are placed in which 3 areas?
the poll
tuber sacrale
tuber coxae
85
If the horse is left FL lame, which FL will have increased movement on inertial sensors?
The Right FL will have increased movement > Left FL
86
Which side will have an increased pelvic hike?
the lame side
87
"Fetlock drop" can be seen on the lame side or the sound side?
The fetlock drop is more pronounced on the sound side except for when there is suspensory ligament/ tendon damage
88
Inertial sensors of the HL- will the sound or lame limb have increased excursion?
the lame side will have increased excursion
89
When an animal is drifting he is running in ... tracks instead of 2
3
90
does drifting indicate severity of lameness?
No
91
Does conformation indicate severity of lameness?
No
92
Is the deep digital flexor tendon healthy?
No - this is a normal DDFT-
No white material and the tendon is thinner
93
During lameness, both the pelvic hike and the head nod drop on which limb?
sound limb
94
The elevation of the Tuber Calcis is higher on which limb?
the sound limb
95
During drifting the animal is running away from which limb?
running away from the lame limb (trying to leave it behind!)
96
What are the 2 DFT of the horse
SDFT
DDFT
97
Which DFT acts as an energy store and is more likely to be injured?
SDFT
98
The DDFT inserts of the ...
Distal phalanx
(remember d for d)
99
The superficial flexor tendon inserts on the...
middle phalanx
100
Most tendon injuries occur on the .... aspect of the equine foot
palmas aspect
101
There are 2 types of tendon injury in horses
- subcutaneous: involved with overStrain
- percutaneous : involved in laceration and trauma
102
Subcutaneous tendon injuries are caused by
overStrain
103
What are the causes of subcutaneous tendon overstrain horse
- sudden overextension
- degeneration followed by overextension
104
Overstrain of tendons in horses- temporary or persistent?
Can be both
105
If a horse presents with lameness and increased overextension of the fetlock joint compared to the other limb- what may this mean?
Poor prognostic indication as it suggests tendons or ligaments are significantly damaged
106
Which parts of the equine foots are most affected by tendon injuries?
palmar/ plantar aspect of the pastern and metacarpus/ metatarsus
107
How can you assess the extend of the damage to a fetlock joint in a horse?
lift other limb up, to increase weight bearing on injured limb. Assess degree of overextension
108
If the DDFT is ruptured what may be see?
elevation of the toe (it is the only tendon that inserts on distal phalanx)
109
When palpating a lame horse's legs, what are you looking for ?
Pain
oedema
suppleness of tendon
110
What is the showing?
SDFT injury- notice the bowing on the palmar aspect of the metacarpus
111
Which areas are difficult to palpate on a horses' limb?
proximal SL
pastern
112
What diagnostic modality is useful for evaluating tendon/ligament injuries in horses?
US
113
When assessing a lame limb on palpation and ultrasound, should you also assess the other limb?
YES, BOTH LIMBS
as can be degenerative even if one limb is more severely affected than the other
114
When do you assess a tendon injury via US on horses?
Best wait 7 days post-injury
115
Superficial digital flexor tendinopathy- what part of the limb swells? what does it look like on US?
Palmar metacarpal swelling
on US you see classic core lesion
116
The lameness present with SDF tendinopathy is
variable
can have initial lameness that then resolves
117
Suspensory ligament desmitis is divided into
- proximal
- body
- 2 branches
118
Proximal suspensory desmitis is caused by
conformational abnormalities
straight hock
overextended fetlock
119
Lameness with proximal suspensory ligament desmitis is
variable- can just be associated with poor performance
120
Proximal suspensory desmitis usually affect the HL or the FL?
the HL
121
What diagnostics may you use for assessing Proximal suspensory desmitis ?
radiography (as this is attached to bone)
US
scintigraphy
122
What desmitis is seen here?
suspensory ligament body and branch desmitis
123
SL body and branch desmitis looks alot like SDF tendinopathy- what is different about the swelling?
Closer to the cannon bone
124
What can you commonly see on US with SL body and branch desmitis?
Periligament fibrosis
(this is a ligament - cuffing is seen)
125
Swelling of the proximal metacarpal region (just below the carpus) can be associated with which desmitis?
Desmitis of the accessory DDFT accessory ligament
126
What is this showing?
enlargement and disruption of the accessory ligament of the DDFT (just below the carpus)
127
DDFT tendinopathy is always within
synovial cavities
- tendon sheath or
- navicular bursa
128
There are 2 types of damage in DDFT tendinopathy
- midsubstance tears (on the inside)
- marginal tears
129
Why are marginal tears DDFT tendinopathy problematic?
interact with synovial fluid- which stops them from healing!
130
What is a common consequent of DDFT tendinopathy?
tenosynovitis
131
Tenosynovitis is inflammation of the
Digital sheath
132
tenosynovitis can be causes by
- idiopathic
- septic penetrating injury
- non-septic inflammation
133
Define annular ligament syndome
- thickening of the digital tendon sheath
- causes secondary Notch of the palmar annular ligament
134
What is the function of the palmar annular ligaments?
attached to the sesamoid bones of the fetlock
keep the flexor tendons in place
135
Can you sometimes see abnormal gliding of the flexor tendons with Annular ligament syndrome?
Yes sometimes
136
Intra-thecal tendon tears in the FL usually affects the
DDFT
137
Intra-thecal tendon tears in the HL usually affects the
manica flexoria (loop of the DDFT that wraps around the SDDF above the fetlock)
138
Dx of intra-thecal tears requires ..
contrast tenography
139
What are the phases of tendon healing?
140
Treatment for tendonitis should be based on what 2 factors?
- phase of tendon healing
- tendon pathology
141
How do we treat tears in the DDFT?
debride tenoscopically
142
How do we treat manica flexoria tears?
remove them ! very good prognosis
143
Name some developmental deformities of equine limbs
- carpal flexural deformity
- distal interphalangeal joint deformity (type 1 and 2)
- MCP joint deformity
- tendon laxity
144
Carpal flexural deformity is always
congenital
145
How do you treat carpal flexural deformity?
- exercise
- physio
- tube cast
146
What are the 2 types of distal interphalangeal joint flexural deformities?
type 1: dorsal hood less than vertical
type 2: dorsal hoof past vertical
147
What is this showing?
tendon laxity
148
IS tendon laxity acquired or congenital?
can be both (can be acquired following casting)
149
How do we treat tendon laxity?
heel extension shoe
heel trimming
controlled exercise
150
MCP joint flexural deformity can be acquired or congenital?
both
151
How do we treat Type 1 distal interphalangeal flexural deformity?
- exercise and physio
- toe extension shoe
- surgery of the ALDDFT
152
How do we treat Type 2 distal interphalangeal flexural deformity?
- desmotomy of the ALDDFT
- (tenotomy DDFT)
153
How do we treat the acute phase of tendon injury?
- ice
- compression
- rest
- corticosteroids to stop inflammation
- NSAIDs for pain
- percutaneous tendon splitting
154
How do we treat the sub acute phase of tendon injury? (1 week- 6 months)
- optimise organisation of scar tissue
- rehab programm
- monitor with US (cross section should not be >10%)
- biologicals
155
How do we treat the chronic phase of tendon injury? (3-18months)
- promote remodelling
- prevent re-injury
- controlled exercise
- desmotomy of the Acc ligament of thr SDFT
156
What is this? (cow foot)
Sole ulcer
157
What is this?
interdigital hyperplasia, Tyloma, Corns
158
What is this?
interdigital hyperplasia, Tyloma, Corns
159
What is this?
160
What is this?
digital dermatitis
161
What is this? Causal agent? (cattle)
Toe necrosis
caused by Treponemes
162
What is this? (cattle)
Interdigital phlegmon
also known as foot rot, interdigital necrobacillus
163
What is this?
Digital dermatitis,
infection of the digital or interdigital skin
Strawberry heel, Mortellaro disease
164
White line disease define
separation of the white line with or without purulent exudation
165
What is this? (cattle)
bruising of the sole
166
What is slurry heel in cattle?
Softening and erosion of the heel.
167
Foul in cattle affects what part of the foot?
the interdigital space
168
Foul in cattle is also called..
interdigital phlegmon
169
Digital dermatitis is an infection that usually affects which part of the foot?
between the bulbs-
can have exudation and or hyperkeratosis
170
What is this?
a heel ulcer
171
Cattle lameness affects commonly what part of the body- leg or foot? HL or FL?
feet
HL - the lateral claws
172
If you have FL lameness in cow, which claw will be more commonly affected?
the medial claw
173
When starting the 5 step Dutch technique- which claw do you start with?
the non weight bearing claw
174
Uncomplicated sole ulcers are commonly found on which foot and claw (Cow)?
HL
lateral (the weigh bearing claw)
175
What is the tx for sole ulcers in cattle?
Remove collar by trimming back sole to chorium -
very thin sole
Block on healthy claw
anti-inflammatories
soft bedding
176
Sole ulcers have a tendency to
recur!
177
What is the pathogenesis of sole ulcers after calving
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
Do laminitis and SARA directly cause sole ulcers?
NO!!!!!!!!!!!
they can indirectly impact it by:
laminitis---> might weaken suspensory apparatus
SARA---> decreased BCS
179
White line disease is a continuum of disease processes - which are?
bruising---> separation---> abcessation--> WALL ULCER
180
What is this? What causes this? (cattle)
Stages of digital dermatitis
Treponemes
181
What footbaths are used for cattle?
- formalin
- copper sulphate
DO NOT USE ANTIBIOTIC FOOTBATHS
182
What causes this? (Cattle)
Foul in the foot
Fusobacterium Necrophorus
(F for F)
183
How do you treat M1 and M2 digital dermatitis?
clean, dry, topical antibiotics
( LEAVE UNCOVERED)
184
How do you treat M4 digital dermatitis?
clean, LA, debride and debulk, bandage and antibacterial agent
185
How can you prevent digi derm on a cattle farm?
- footbaths (formalin or copper)
- slurry management
186
Claw amputation- which method are you aiming for?
Method 3- through P1
187
Impinging spinous processes usually affects which Vertebrae
T14-T15
188
If a horse has impinging spinous processes does it mean it will have back pain?
NO
80% of racehorses have this without any evidence of back pain
189
You do scintigraphy of a horses spinal process and see this? Is it clinically relevant?
Impinging spinous processes can be seen-
No if no clinical signs
190
How do you distinguish between a horse with clinically significant impinging spinous processes and those that are not?
Local anaesthetic around spinous processes
then you evaluate if there are reporoducible clinical signs when ridden
191
What radiographic view do you use to evaluate the spinous processes of a horse?
Lateral lateral
overlapping views
192
The most common site for OA in the articular processes of a horse
T16-T17 followed by T15-T16
193
What radiographic view is needed for assessing OA in the articular processes of a horse?
20 degree lateral oblique
194
Apart from a 20 degree lateral X ray, is there any other diagnostic modality that can be used to assess the articular process joint?
Yes US
Normally looks like the corner of a box
in disease has a curved corner
195
Which epaxial muscles provide stability locomotion in the horse's back
- multifidus
- longissimus dorsi
196
Retraction of the FL and protraction of the HL in the horses flexes the..
spine
197
To flex the spine- do you lower or raise the head of the horse?
lower the head
198
How do you treat impinging spinous processes?
- intralesional medication:
(corticosteroids)
- phenylbutazone
-extracorporeal shockwave therapy (3 tx 2 weeks apart)
- 48 hours box rest
- non ridden exercise program
199
If you increase the depth of water when a horse is doing water treadmill exercises what happens to the back kinematics
T18 and L3 flexion increases
HL flexion increases
extends cranial thoracic spine
200
What treatment options do we have for impinging spinous processes?
201
What is the main complication of subtotal ostectomy?
202
What is this surgical procedure ? (horse)
cranial Wedge
203
What is this surgical procedure? (horse)
subtotal ostectomy
204
What is this operation (horse)?
Interspinous ligament desmotomy
205
What is this?
transfixation casting
distal limb fracture that is unstable under axial loading.
Axial loading gets transferred onto cast
206
What is this?
external fixator
207
What is the purpose of cast in horses
- treatment of fractures (less common than in SA)
- treatment of joint luxation
protection of wounds and tendon laceration
- stress protection after internal fixation
208
What drugs can you give to an emergence orthopaedic case? (Horse)
- Detomidine, Xylazine
-or Detomidine with and opioid
- NEVER GIVE PHENOTIAZINE ---> HYPOTENSION with oocur if in presence of catelochamines
NEVER GIVE OPIOIDS ALONE!!
209
Which splints keep the horses fetlock in a flexed position?
Monkey splint and the Kimzey splint
210
Condylar fractures of the horses fetlock should be immobilised in a felxed or neutral position?
neutral position
211
A horse with a FL fracture should travel facing forwards or backwards?
backwards
weight is thrown on two sound limbs when vehicle stops
212
A horse with a HL fracture should travel facing forwards or backwards?
forwards
213
How do you immobilise a fetlock distraction injury?
flexed position
214
For division2 of the Horses FL (distal metacarpus to distal radius- where should the splints be positioned?
Laterally and caudally
215
What is this and why do we do it?
Robert Jones Bandage with and extended splint
its is to prevent the digital extensors and flexors from abducting
216
What brace would keep the horse's fetlock in extension?
The Farley brace
217
What is the main limiting biomechanical factor in division 1 of the HL?
the reciprocal apparatus
218
What are the immobilisation techniques for division 1 of the HL?
Same as FL
219
What immobilisation technique can you use for proximal metatarsus to the stifle of a horse?
MODIFIED Schroeder Thomas Splint
220
Can you stabilise fractures between femur to the pelvis (horse)?
No- poor prognosis
