Large Animal Sx - Conditions of the Equine Foot (Specifics) 3

drraythe's version from 2015-11-24 20:06

Subsolar Abscess/ puncture wounds/ sidebones

Question Answer
what is a Subsolar Abscess?Localized pocket of infection under the hoof sole/wall
how common are subsolar abscesses?Most common cause of acute lameness (said in class: can just go lame overnight. owners might even think they fx something)
how does an abscess usually move?usually follows the pathway of least resistance
Etiology of primary causes of subsolar abscesses?Penetrating wound, Seedy toe, Subsolar bruise, "Hot" nail, Idiopathic – wet ground,
what is "hot nail"?when you cut too close to sensitive structures (farrier)
what is seedy toe?when white line is a little open for whatever reason and lets bact get in there
etiology of secondary causes of subsolar abscesses?can be secondary to Laminitis, keratoma, or pedal osteitis
Subsolar Abscess usually presents as what kinda lameness? (on the scale)4/5 lameness.. "fracture lame". Distal limb might swell, and horse does not always respond to blocks
what are some ways you can dx a subsolar abscess?Elevated digital pulse, Heat in the hoof wall, Focal response to hoof tester, finding the draining tract, +/- radiographs
what might you want to look for on radiographs if youre looking for a subsolar abscess?DONT look for water-- same radio opacity as the hoof. Instead look for AIR/GAS since a lot of bact make gas
how do you treat a subsolar abscess?**Drainage!!! (but Don't be overzealous- however, DO remove necrotic debris). Can also provide NSAIDs. He said Abx usually not necessary if you get to drain it well. make sure foot stays in a clean environment. Use a poultice (a soft, moist mass of material, typically of plant material or flour, applied to the body to relieve soreness and inflammation and kept in place with a cloth), followed by a dry bandage
If you are going to treat a horse with a subsolar abscess, what should you always do for the horse that you might not think of?**TETANUS PROPHY
prognosis for subsolar abscesses?Excellent for simple! (complicated is if the abscess was festering and couldnt drain through the hoof so it came up and out the coronary band)
how long to see improvement after draining a subsolar abscess?Marked decrease in lameness after drainage
how urgent is a puncture wound?True Surgical Emergency-- career and life threatening.
where are the worst places for a puncture wound to be?frog and coronary band
when do you want to take your rads if there is a puncture wound?take them BEFORE you remove the foreign body. you need to know what structures might be involved.
what soft tissue structures are you concerned about when there is a puncture wound?Deep digital flexor tendon and tendon sheath, Coffin joint (and bone), Navicular bursa (and bone)
Clinical Signs of puncture wounds?Lameness varies from mild to severe, Chronic are often severely lame. You might see effusion in the Coffin joint or the tendon sheath
which views do you want to use for radiography of the puncture wound?(*DONT FORGET- RADS BEFORE REMOVAL!) Lateromedial and 0° DP. Can consider contrast studies
how would you treat a puncture wound on the farm?+/- remove foreign body (radiographs first!!), clean foot, debride wound, bandage, refer
what pharmaceutical treatments can you use for a puncture wound?ANTIMCROBIALS! can choose from systemic, regional limb perfusion, of a synovial infusion system. Also can use NSAIDs for pain and inflammation. MAKE SURE to UPDATE TETANUS PROPHYLAXIS
how can you surgically treat a puncture wound?General Anesthesia, Arthroscopy/Tenoscopy/Bursoscopy (for assessment and lavage), Streetnail Procedure
what is the Streetnail Procedure? window is cut around the puncture wound, all devitalized tissue is removed and drainage is established.
why might you not be able to do a Bursoscopy?any oscopy-- need a cavity to see. so without bursa you cant do burscocopy
how do you finish up your treatment (regardless of if surgically or in the field)?cover hoof with Cast/ Bandage/Treatment Plate
prognosis of Puncture Wounds in the synovial structures?Guarded for life. Guarded/poor for athleticism. Prognosis should be reserved until response to treatment is observed. Hindlimb>forelimb (Early intervention is ideal).
which has better prognosis if it's damaged from puncture wound- hind or front limb?Hindlimb > Forelimb
treatment of choice for puncture wound which damages synovial structures?Arthroscopic debridement (Streetnail procedure has fallen out of favor)
what is sidebones?mineralization of the collateral cartilages
who usually gets sidebones? how much does it debilitate them?Common in older horses- Not usually a source of pain
so you are looking at a radiograph and you notice the horse has sidebones. you also notice a dark radiolucent line going through the sidebone. What should you know about this?Probably not fracture- most likely separate centers of ossification.

pastern region

Question Answer
what are the 4 standard radiographic views you use in the pastern region?Dorsopalmar, Lateral, DMPLO, DLPMO
3 major Anatomic areas in the pastern region?Proximal interphanlangeal joint, Collateral ligaments, Distal sesamoidean ligaments
Osteoarthritis of pastern joint aka?ringbone
what is ringbone?Osteoarthritis of pastern joint
what's going on here? this is ringbone (OA of the pastern)
what is "High ringbone"?Osseous proliferation along P2 and P1 at level of joint secondary to OA of PIPJ
Subchondral cysts in distal aspect of proximal phalanx usually happen where?in the Rearlimbs most often. CAN be bilateral.
how do you treat OA in the PIP joint?Systemic NSAIDS, Corrective shoes, Change level of exercise, Surgical Ankylosis
what are all the joints you can surgically ankylose?PIP (pastern), distal intertarsal (aka centrotarsal), tarsometatarsal
what would you call this procedure? Pastern arthrodesis
what is "Low Ringbone"?Osseous proliferation along P2 and P3 at level of joint secondary to OA of DIPJ
how do you Treat OA of DIPJ?medically treat- Arthrodesis not common and would not result in performance sound horse
Middle phalanx fractures--> 3 varieties of fx here?Palmar/plantar eminence, Sagittal, Comminuted