Managing foot infections (Dryden)

Question 1

Common access point of microbes

Answer 1

White line

-porous and subject to tearing when wall become long, flared, or cracked

Question 2

Penetrating injuries to central area of hoof are

Answer 2

medical emergencies

Question 3

Prognosis for return to soundness decreases significantly if injury untreated for

Answer 3

over 12 hours

Question 4

Remove a foreign body before rads if

Answer 4

horse may do more damage to itself by leaving it in

Question 5

Helpful tool to explore wound and determine affected structures

Answer 5

Sterile malleable probe

Question 6

Threshold for Dryden to consider a wound septic

Answer 6

> 30,000 cells/micro liter

Total protein ~ 5 mg/dL

Question 7

Street Nail procedure

Answer 7

• Draining infected navicular bursa via frog
• Poor prognosis to return to athletic career
• Salvage procedure

Question 8

To pare out abscess avoid

Answer 8

paring sole. Start at white line

Question 9

Most abscesses are in

Answer 9

submural and subsolar region, can be drained at white line

Question 10

Overnight poultice recipe

Answer 10

1. Bran, 2-3 handfulls
2. DMSO, 20 mls
3. Epsom salt, 1/2 handful
4. Povidine solution, 20 mLs
5. Warm water to oatmeal consistency

Question 11

Goals for management foot infections

Answer 11

1. Debride necrotic tissue
2. Maintain drainage
3. Antibiotic therapy
4. Protection
5. Support surrounding healthy tissue
6. Support contralateral foot

Question 12

Debridement techniques

Answer 12

1. Surgery
2. Lavage
3. Medical maggots

Question 13

Can remove some solar/toe of coffin bone

Answer 13

up to 20%

Question 14

Intravenous regional limb perfusion

Answer 14

• use 1/3 systemic dose
• 30 mL volume for average sized horse (60 for draft)
• use water soluble abx in isotonic solutn

Question 15

Intravascular pressure results in

Answer 15

dilation of venous capillaries and relaxation of endothelial cells and pericytes

Question 16

Arterial endothelial cells

Answer 16

more sensitive than those of veins

Question 17

Beta Lactams

Answer 17

Time dependent with concentrations greater than MIC

Question 18

Aminoglycosides

Answer 18

Concentration dependent and prolonged post admin effects

Question 19

Common abx IV reg limb perf

Answer 19

1. Amikacin
2. Gentamicin
3. Naxcel
4. K-pen
5. Imipenim

Question 20

Optimal perfusion duration

Answer 20

30 min to 1 hr

Question 21

Larval tx

Answer 21

1. Green blow fly maggots
2. Debrides necrotic tissue
3. Creates basic environment that is antibacterial
4. Evidence of enhanced wound healing

Question 22

Quittor

Answer 22

Infection and necrosis of collateral cartilage

Question 23

Thrush

Answer 23

• Caused by gram negative anaerobic bacteria
• Can invade sensitive tissue and cause lameness
• Hoof conformation?

Question 24

Thrush tx options

Answer 24

1. Debride necrotic tissue
2. Open infected areas to oxygen
3. Topical antiseptic
4. Clean Trax (Oxychlorosene)
5. New Day/Tomorrow Mastitis treatment (cephalosporins)

Question 25

Canker

Answer 25

Proliferative pododermatitis unknown etiology - intracellular G- bact - bovine papilloma virus - autoimmune

Question 26

To tx canker it's necessary to

Answer 26

debride all dystrophic tissue surgically

Question 27

Additional canker txs

Answer 27

1. CO2 laser 2. Cryotherapy with liquid nitrogen 3. Chemo with cisplatin 4. Canker paste - Metronidazole+oxytetracycline+copper sulfate 5. Immunosuppressive doses prednisolone

Question 28

White line disease

Answer 28

- Caused by anaerobic fungi and bacteria, attack insensitive lamina - Insidious, ush no lameness until laminitis - Debride infected area to healthy foot

Question 29

Other tx white line dz

Answer 29

1. Expose to O2 2. Clean Trax (oxychlorsene) 3. Antifungal topical 4. Ozone treatments 5. Supportive and protective shoeing