Diseases of the Foot 1 (not done)

What is white line disease?

Deterioration of the white line of the hoof capsule resulting in the loss of the bond between the hoof wall and sole

What are the problems with white line disease?

Allows for bacteria and fungus to colonize compromised areas. More common in warm environments and infrequent farrier care

As hoof wall separates from sole there is increased tensional forces causing inflammation in sensitive lamina and lameness

If necrotic pressure extends proximally entire hoof wall undermines

How do you treat white line disease?

Proper hygiene and adequate hoof care

Soaking in povidone iodine or clean trax (bleach)

What are hoof wall cracks?

Longitudinal disruption of hoof wall parallel to horn tubules and lamellae

Can be entire length of hoof wall, superficial, or deep

What are hoof crevices?

Similar to hoof wall cracks but horizontal not longitudinal

What causes hoof wall cracks?

Poor horn quality or horn walls that are too thin

What can predispose to hoof wall cracks?

Abnormal hook angles producing tension gradients

What type of hoof wall cracks are usually superficial and do not cause lameness?

Distal

What causes proximal hoof wall cracks?

Near coronary band causing poor horn quality in that area

How do you treat hoof wall cracks?

Depends on location, degree of lameness, and use of horse

Start with debridement of crack then place an acrylic patch

Stabilization with a metal apparatus is common too

Bar shoes are also used

What is the prognosis of hoof wall cracks?

Guarded to good but the crack often recurs especially if inciting factor is not resolved

What is a keratoma?

Columnar thickening of the hoof horn that extends towards the inside of the hoof

Usually on dorsal, dorsolatera/medial aspect of horse

What causes keratoma?

Localized inflammations or trauma at transition between new horn and coronary band causing scar tissue that grows distally

What is the pathogenesis of a keratoma?

Puts pressure on sensitive lamina and P3 causing chronic infections or hoof abscesses

How do you diagnose a keratoma?

DR

CT

MRI

When do you decide to surgically treat a keratoma?

Depends on degree of lameness and if NSAIDs can calm inflammation before surgery

How do you treat a keratoma?

Complete surgical excision under GA or standing

What do you need post op for a keratoma surgery?

Pain management is very important with a good farrier

Shoes with clips for stability

What do you need to tell the owner before a keratoma surgery?

Will put the horse out for a very long time for healing

What is the prognosis of a keratoma?

Pretty good with surgical treatment, 50/50 for medica

What causes septic pedal osteitis?

Foot abscesses that do not drain and invade bone

Administration of NSAIDs due to lameness from an abscess

How do you diagnose septic pedal osteitis?

Rads with lysis of P3

How do you treat septic pedal osteitis?

Open sole or lateral aspect over affected area for drainage and curettage of affected bone

RLP

Systemic antibiotics

Ball bandages

What is pedal osteitis?

Non septic process caused by chronic inflammation of P3 from repeated concussion and working on a hard surface

How do you diagnose pedal osteitis?

Regional blocks and rads

How do you treat pedal osteitis?

Shoe changes (rim pads or full pads)

Softer surface

Rest

What are steet nails?

Puncture wound to foot

How do you diagnose puncture wounds to the foot?

Can be hard because owner will just report lameness thinkin its an abscess

Need rads with object in place

What can a nail in the foot puncture?

Distal phalanx

Distal sesamoid bone

DIP joint

DDFT

Navicular bursa

What is a major risk of a puncture wound to the foot?

Grossly contaminated and introduce bacteria, soil, rust, or manure

How do you manage puncture wounds to the foot?

Depends on direction and radiographic evidence

If superficial then open area and allow drainage while soaking in Epson salt and iodine

If soft tissue or bone involvement, referral

Ask about tetanus status and vaccinate if needed