Lecture 6.pptx equine lamness unit6 l 6 l

equine lameness unit 6

1. Lecture 6 Dr Jasmeet Singh Khosa

2. Quittor Side bone Navicular disease Pyramidal disease Tendinitis Keratoma

3. Quittor Quittor is a chronic, septic condition of one of the collateral cartilages of the distal phalanx characterized by necrosis of the cartilage and one or more sinus tracts extending from the diseased cartilage through the skin in the coronary band region

4. Signalment Lateral cartilage of forelimb commonly affected

5. Etiology

6. Clinical signs

7. Diagnosis Radiographs: Can rule out bone involvement Ossified collateral cartilage- osteomylitis Depth and dimension of draining tract using fistulography

8. Treatment

9. Side bone is ossification of the cartilages of the third phalanx (coffin bone) Most common in forefeet of heavy horses working on hard surfaces Side bone

10. Causes Frequent in hunters and jumpers but rare in racing Thoroughbreds Repeated concussion to the quarters of the feet May be inherited Improper shoeing Direct trauma Base narrow conformation Side bone Base narrow

11. Sidebone may be suspected after palpation and observation, but radiographic examination is essential for confirmation Remember that ossification of the cartilages often develops without signs of lameness When lameness is present shoe to promote expansion of the quarters protect the foot from concussion Applying a counterirritant (tincture of iodine) to the coronary region will promote hoof growth and is thought to promote expansion of the wall. Side bone

12. NAVICULAR DISEASE

13. Inflammation and degeneration of the navicular bone and surrounding tissue

14. CA U S ES   Genetic and poor conformation Improper nutrition Continual impact of the toe on hard surfaces

15. CLINICAL SIGNS   Intermittent lameness - Progressive Worn out toe Front feet- more common Treatment : Proper trimming and shoeing Medication to increase circulation and decrease pain Surgery Adequate exercise avoiding athletic stress

16. Dorsoproximal-palmarodistal oblique radiographic images of two navicular bones showing a large discrete mineralized fragment on the distal medial sloping border of the bone (arrows) (A) and a distal border fragment (white arrows) located distal to the lateral angle of the navicular bone (B); there is a large radiolucent zone in the adjacent navicular bone (black arrow).

17. PYRAMIDAL DISEASE

18. Osteoperiosteitis , soft tissue swelling and consequent exostosis of the pyramidal process of the ospedis (3rd phalanx). Buttress foot – Deformed foot condition due to oedema at the coronary band region more common -hind feet Pyramidal disease or buttress foot

19. Strain of the common or long digital extensor tendon at the insertion level. Direct trauma Fracture of the extensor process Defective conformation of the hoof - upright or forward broken hoof –pastern axis ETIOLOGY:

20. CLINICAL SIGNS: Varying degrees of lameness Shortened stride bearing of the weight on heal Swelling on the dorsal coronary band Pain at the distal interphalangeal joint V-shaped foot DIAGNOSIS: Clinical signs, Radiography, Abaxial sesamoid/Palmar digital nerve block

21. Pressure bandage with cast application Stall rest Hoof trimming and corrective shoeing Neurectomy PROGNOSIS FOR SOUNDNESS Guarded in early stages Poor in advanced stages TREATMENT:

22. BOWED TENDON

23. Inflammation of a tendon Acute or chronic, with varying degrees of tendon fibril disruption. Most common in horses used at fast work, particularly racehorses. Flexor tendons of forelimb-more common than hindlimb . Racehorses- the superficial flexor is involved most frequently. Primary lesion -rupture of tendon fibers with associated hemorrhage and edema. Tendinitis / Bowed Tendon

24. Etiology : Tendinitis usually appears after fast exercise Associated with overextension and poor conditioning, fatigue, and poor racetrack conditions Also, persistent training when inflammatory problems in the tendon already exist. Improper shoeing may also predispose to tendinitis. Poor conformation and poor training also have been implicated.

25. Treatment: Best treated in the early, acute stage. Stall-rested, and the swelling and inflammation treated aggressively with cold packs and systemic anti-inflammatory agents. Some degree of support or immobilization should be used, depending on the amount of damage to the tendon. Recently, the use of bone marrow injection of the core lesion (to introduce stem cells and growth factors) has been done with encouraging results. The horse should be rehabilitated using a regimen of increasing exercise. Other treatments for chronic tendinitis have included superficial point firing (of questionable benefit), tendon splitting, and carbon fiber implantation. Tendinitis (Bowed Tendon)

26. Excessive keratin is produced between the hoof wall and distal phallanx “ oma ” implies neoplastic but keratoma is no neoplastic Hyperplasia Keratoma

27. Lameness of unknown origin Abnormal contour of hoof capsule Deviation of the coronary band and hoof wall Common site- toe and quarter Chronic abscessation in foot Affects any age , any breed Can be multifocal Signalment

28. Unknown Proposed: trauma to hoof and its associated structures Chronic irritation Sole abscessation Etiology

29. Pain upon palpation over the lesion Nerve blocks –depends on location Radiograph- discrete, semi circular radiolocent abnormality with non sclerotic smooth rim DX: pedal ostietis - irregular sclerotic margins Diagnosis

30. Complete surgical removal under GA or standing Partial or Complete hoof wall resection Creat 2 vertical incision on either side of the keartoma 3 rd cut at the base of the mass 4 th cut proximal to the mass but under the coronary band Depth down to the sensitive laminae Motorozed burr/ cast cutter Treatment

31. KERATOMA - TREATMENT  Complete surgical removal is required  Incomplete removal = re-growth  Surgery performed standing or under general anesthesia  Partial or complete hoof wall resection  Create two parallel vertical incisions on either side of keratoma  3 rd cut made distally at base of the mass  4 th cut made proximal to mass (but under coronary band)  Depth – down to the sensitive laminae  Cut using motorized burr (dremel), cast cutters , osteotome

32. Partial vs complete

33. Thanks