Professional Documents
Culture Documents
o The primary diseases which can eventually cause laminitis are usually systemic
abnormalities.
o The disease process causes toxins to be released into the blood stream, producing
toxemia and, eventually, laminitis.
o Primary conditions or diseases associated with laminitis:
Retained Placenta
Gland Tumors
Laminitis
DEVELOPMENT OF LAMINITIS
o The primary disease process results in the release of toxins into the blood stream
causing toxemia.
o Toxemia produces spasm in the muscular walls of the blood vessels supplying the
hoof laminae and as a result the blood supply to the hoof laminae is restricted or
abolished and its cells begin to die.
o Cell death releases biochemical mediators (body chemicals) into the surrounding
tissues, causing inflammation, fluid swelling and pain (acute laminitis).
Laminitis
DEVELOPMENT OF LAMINITIS
o Signs include an increased heart rate, depressed appetite, sweating, trembling and
rapid, shallow breathing.
o The acutely laminitis horse stands and walks with its weight shifted onto its heels
and hind limbs with a typical stance or gait
Laminitis
DIAGNOSES / CLINICAL EXAMINATION
o The horse is reluctant to move, feeling footy (prefer soft ground) and may prefer
to lie down to keep weight off the feet.
o The sole, particularly at the toe, is painful to examination with hoof testers
o A palpable depression at the coronary band at the front of the hoof and a convex
and painful sole ('dropped sole') suggests rotation of the pedal bone and the risk of
sole penetration by the tip of the pedal bone
Laminitis
DIAGNOSIS / RADIOGRAPHY
o Used to determine whether the pedal bone has rotated or not, and to what degree
it has rotated.
o A wire taped to the front of the hoof helps to clarify the relationship between the
hoof wall and the pedal bone.
In normal hoof anatomy, the hoof wall is parallel to that of the pedal bone
Pedal bone rotation with < 5.5° between the hoof wall and pedal bone
favorable prognosis for athletic use, if the horse responds well to
treatment
Pedal bone rotation with > 11.5° between the hoof wall and pedal bone
poor prognosis
Laminitis
DIAGNOSIS / RADIOGRAPHY
o During the trimming and shoeing process the foot is gradually re-structured to
accommodate the effects of the pedal bone rotation
o Expert trimming progressively reduces the length of the toes and lowers the heels
to improve the angle between the pedal bone, hoof wall and sole and to allow new
shoes to seat further back under the weight of the foot at a better angle to the
pedal bone
o Heart bar shoes or other shoes designed to support the frog, transfer weight from
the damaged hoof walls and encourage blood circulation in the foot
Laminitis
TRIMMING & SHOEING
o Shoes which support the frog must be expertly and individually made and fitted or
their use may be counter-productive (can act as a fulcrum over which the pedal
bone will be encouraged to rotate further):
o Apex of the 'V' is positioned in front of the attachment of the deep digital flexor
tendon to the pedal bone (by approximately 2 cm)
o Bar should not extend beyond the limits of the frog or damage to blood vessels
may occur
Laminitis
CORRECTIVE SURGERY
o Deep digital flexor tenotomy:
The surgical section of the deep digital flexor
tendon has been suggested as a therapeutic
option, but results have been variable
o Keep horses (especially small ponies) in fit and healthy body condition, avoiding
obesity and sudden access to lush grass or a high grain diet
o attention without delay for lameness, diarrhea, retained placenta and generalised
illnesses
o Maintain correctly conformed and balanced feet by regular hoof trimming and
shoeing (especially to prevent the development of long toe conformation)
Laminitis
CAUTION
o Accurate placement, by the farrier, of each nail through the insensitive epidermal
laminae of the hoof is essential
o Nails must penetrate deeply enough to hold the shoe firmly, but without
penetrating the sensitive laminae of the hoof
o If the nail does penetrate the sensitive laminae, pain, infection and
lameness can
result
Nail 'bind'
is the term used when the nail has been driven too close to the sensitive
laminae.
Nail 'prick'
is used when the nail has been driven through the sensitive
laminae.
Nail Bind & Nail Prick
CAUSE
o Nail bind and nail prick are caused by the direct penetration of a nail through the
sensitive laminae of the hoof, or close enough to impinge upon the laminae.
o Horse becomes lame, often not immediately, but usually the next day or within the
first week after shoeing
o Increased digital pulse
o Pain on percussion of the hoof, or application of hoof testers, directly over the head
of the nail
Nail Bind & Nail Prick
TREATMENT
o The shoe should be removed, any pus drained, and the nail hole flushed with
antiseptic solution
o Politic ( antibiotic ointment + MgSo4 ) and hoof bandage should be applied
o Tetanus antitoxin injection given for prophylactic issue.
o In severe cases, infection may track under the sole, or even track up to and burst
out from the coronary band, in which case local resection of the necrotic sole
and/or hoof wall, and a course of antibiotic treatment may be necessary
AFTER-CARE
o Once the horse is sound, with no discharge from the nail hole, careful re-shoeing
may be recommended
Penetrating foot wounds
INTRODUCTION
o Site of Injury
To explain the correlation between the site of injury and the seriousness of the
injury, the hoof is divided into 3 regions: dorsal third, mid third and palmar
third
Deep penetration into the dorsal third of the hoof may involve the pedal
bone
Penetration into the mid third of the hoof is potentially the most serious
as it can involve the navicular bone, navicular bursa, deep digital flexor
tendon and the distal interphalangeal (DIP, coffin) joint
Penetration into the palmar third of the hoof is most likely to involve the
digital cushion
Penetrating foot wounds
CAUSE
o In all cases, lameness is the clinical sign which alerts an owner to a penetrating
injury.
o The most serious penetrating injuries are those which enter synovial structures
such as the navicular bursa or DIP joint
o Infection within these closed cavities is extremely difficult to treat, often leading to
a fatal outcome
Penetrating foot wouunds
TREATMENT
o Antiseptics and astringents (i.e. dilute povidone iodine) or antibiotic wound spray
should be applied to the wound daily
o Tetanus antitoxin injection given if necessary
o Horse should be kept in a clean, dry environment
Penetrating foot wouunds
CAUTION
o Almost invariably caused by shoes which fit improperly (fitted short and tight at the
heels) and traumatize the seat of corn
o Long heel conformation encourages the development of deep narrow frog sulci
which, under appropriate environmental conditions, become more prone to the
development of thrush.
Thrush
DIAGNOSIS: CLINICAL EXAMINATION
o A foul smelling, black discharge is found in the affected sulci of the frog
o Horse demonstrates pain when pressure is applied to the affected area
o Infection may result in a general swelling of the distal limb
Thrush
TREATMENT
o With early treatment and good stable and environmental management, the
prognosis for complete recovery is good (treatment will usually be required for 7 -
14 days)
o Prognosis for complete resolution is good unless the infection has been allowed to
become chronic and/or there is extensive involvement of the deeper tissues (even
then, diligent draining and plugging every two days for two weeks is usually
effective)
Canker
INTRODUCTION
o Removal of all abnormal, dead and infected tissue under general anesthesia
o Packing with sterile gauze socked in antiseptic solution,
o Foot bandage
o Antibiotic
o Tetanus toxoid
Canker
AFTERCARE
o Recognized as an important cause of lameness in the horse since the middle of the
nineteenth century.
o Despite considerable research it remains a poorly understood condition, which
may be attributable to the following:
Traditionally viewed as a single condition, it is now recognized to be a
complex, multi-factorial disease
In the past, diagnosis was often imprecise and not based upon thorough
veterinary examination
It involves other structures within the foot in addition to the navicular
bone
It is a dynamic and not a static disease (anatomical structures of the foot all
move in relation to one another as the horse exercises)
It is a progressive disease with clinical signs changing according to the stage
at
Navicular Syndrome
INTRODUCTION
o Navicular syndrome is most commonly diagnosed as a cause of chronic forelimb
lameness in middle aged (6 - 12 years old) performance horses but, with detailed
investigation, is probably a much less common condition.
o Hunters and show horses are more commonly affected.
o A thorough knowledge of the normal anatomy of the horse foot is essential in
understanding navicular syndrome.
Navicular Syndrome
CAUSES
o The causes of navicular syndrome are poorly understood, however current theories
include:
Abnormal foot conformation and foot imbalance predisposes the horse to
navicular syndrome
Repeated trauma to and wear and tear of the deep digital flexor
tendon, navicular bone and navicular bursa causes pain
Poor blood supply to the navicular bone, associated with thrombosis and
pressure from the deep digital flexor tendon on the damaged bone, causes
pain (this theory is less favored)
Navicular Syndrome
CAUSES
o History of intermittent forelimb lameness of variable degree, which may shift from
one leg to another or involve both legs simultaneously
o Lameness develops insidiously over a period of weeks or months
o Horse may have a tendency to point one foot forward and then the other while at
rest
o Horse has a short forelimb gait with a tendency to stumble (worsens on hard
ground)
Navicular Syndrome
DIAGNOSIS: CLINICAL EXAMINATIONS
o A local anaesthetic nerve block of the palmar digital nerves, the distal
interphalangeal (coffin) joint and/or the navicular bursa results in an improvement
or abolition of lameness.
Navicular Syndrome
DIAGNOSIS: RADIOGRAPHY
• TREATMENT
o Vasodilator drugs
Drugs (i.e. isoxuprine, papaverine) which cause blood vessels to dilate
May improve the blood supply to the navicular bone
o Thrombolytic drugs
Drugs (i.e. warfarin, streptokinase, alteplase, reteplase, and tenecteplase)
which dissolve blood clots
May help remove blood clots and improve blood circulation to the navicular
bone
Dosage must be carefully monitored through regular blood clotting tests to
prevent life-threatening internal haemorrhage
Warfarin must not be used in combination with other drugs,
especially phenylbutazone, where there is the risk of a potentially
fatal drug interaction
Navicular Syndrome
TREATMENT: DRUG THERAPY
o Desmotomy
Surgical section of the medial and lateral collateral (suspensory) ligaments of
the navicular bone under general anaesthesia
May relieve pressure on the damaged navicular bone and relieve the lameness
o Good foot shape and foot balance should be maintained through regular trimming
and shoeing by an experienced farrier
o A controlled exercise programme, whilst the horse is receiving non-steroidal anti-
inflammatory medication, is often helpful
o Feeding the horse supplements which include glucosamine and polysulphated
glycosaminoglycans may help cartilage repair
Navicular Syndrome
• PREVENTION
o Navicular syndrome is a complex problem which may end the working life of a
performance horse
o An accurate diagnosis as well as the elimination of other causes of heel pain is a
pre-requisite for successful management
o The most common factors predisposing a horse to navicular syndrome are an
abnormal foot shape and hoof imbalance caused by inadequate or improper hoof
trimming and shoeing, therefore use a properly qualified farrier regularly
o Corrective trimming and shoeing should be performed by a specifically-experienced
farrier
o If a horse shows signs of lameness a veterinarian should be contacted to accurately
diagnose the cause of the lameness
Side bones
INTRODUCTION
o Sidebone is a term that describes the ossification of the collateral cartilages of the
foot and results in the cartilages becoming no longer flexible
o Collateral cartilages are found on the inside and outside of the foot, and can be
palpated just above the level of the coronary band as flexible projections on either
side of the pastern
Sidebones
INTRODUCTION
o The cartilages are important in the shock absorbing mechanism of the foot .
o The front feet are more commonly affected than the hind feet
o The condition is more frequently seen in the heavy breeds of horses (especially
draft horses) than the lighter breeds and ponies
Sidebones
CAUSE
o Ossification, which begins at the junction between the collateral cartilage and the
pedal bone, is believed to be part of the horse's normal ageing process.
o Mild sidebone formation, unassociated with lameness, is sometimes
seen in radiographs taken from older horses and young heavy horses.
o Clinical
Examination
Lameness rarely seen and, if present, is usually associated with
complications
is due to advanced ossification
The coronary band may bulge over the affected cartilage
o Radiography
Ossification of the cartilages is confirmed by radiographic examination of the
foot (normal cartilage cannot be seen, whereas bony cartilages can),
comparing one with another, to aid interpretation
Sidebones
• TREATMENT
o Prognosis is poor for cases where sidebone is causing lameness, especially those
with extensive cartilage ossification and hoof deformity
Quittor
INTRODUCTION
o Quittor is an old term for a septic condition which involves the necrosis of the
collateral cartilages of the pedal bone following an infection in the foot.
o Quittor more commonly affects the front feet rather than the hind feet and was
more frequently seen in the heavy breeds of horses rather than in the lighter
breeds or ponies
o uncommon
Quittor
CAUSE
o The collateral cartilages of the pedal bone have a poor blood supply and so they
respond poorly when infected and consequently infections can become chronic and
damaging.
o Quittor can be caused by the following:
A condition known as 'treads':
Draft horses which pulled loads in teams would tread on the feet of the
horse in front
if they stood on another horse, resulted in damage to the skin over the
coronary band and introduced infection into the cartilages
Occasionally occurs following external trauma or interference injuries to the
pastern and coronary band.
May occur, very rarely, extending from a sub-solar abscess (see Pus in the
Foot).
Quittor
DIAGNOSIS
o Once the collateral cartilage of the pedal bone is damaged and infection
established, bacteria converge on the area of dead tissue to live and multiply. The
infection results in an intermittently discharging wound on the inside or outside of
the hoof over the collateral cartilages.
o Clinical Examination
Wound area is frequently warm, swollen, painful and multiple sinuses (holes)
may appear above the coronary band (over the infected cartilage)
Purulent discharge erupts out of the sinuses
Horse may exhibit mild to very severe lameness (lameness usually subsides
after the infection discharges or 'breaks out')
Long term cases of quittor may result in deformity of the hoof wall
Quittor
DIAGNOSIS
o Radiography
Radiographic examination of the foot may reveal necrosis and/or gas shadows
which confirm the presence of infection or ossification of the cartilages (see
Sidebones), depending on the stage of the condition
May be confused with an abscess (see Pus in the Foot)
Quittor
TREATMENT
• CAUTION
o Wall Cracks
Cracks which appear in the wall of the
hoof, such as toe cracks, quarter cracks or
heel cracks
o Solar Cracks
Cracks which appear in the sole of the
hoof, such as sole cracks or bar cracks
Sole cracks are often superficial and
usually radiate out from the apex of the
frog, however they can also be deep and
occasionally infected
Bar cracks are often deep
Hoof Wall
DEPTHS OF HOOF CRACKS
Cracks
o Superficial
Penetrate only the outer insensitive horn of the
foot
If neglected they can become deep cracks
o Deep Cracks
Penetrate the sensitive laminae of the foot
Often bleed during exercise and may become
infected
Hoof
CAUSE:
Wall Cracks
GRASS CRACKS
o In general, hoof wall cracks, including grass cracks, are the caused by:
Poor hoof quality: hooves of a brittle or 'shelly' consistency which are easily
split
Environmental conditions: hooves are weakened in either extreme wet or dry
conditions
Incorrect nailing: hooves can be split by the use of over-large nails and nailing
too superficially ('fine') into the hoof wall
Hoof
CAUSE:
Wall Cracks
SAND CRACKS
o Caused by uneven stress to the hoof capsule, arising from a foot-limb imbalance.
o Sand cracks can occur following a traumatic injury or after excessive and repeated
concussive stress
o Additional causative factors include poor hoof quality, environmental
conditions, type of exercise surface and speed at exercise
o Although coronary band treads were often considered to be a cause of sand cracks
in working horses of the past, direct trauma to the coronary band is unlikely to
cause sand cracks in modern athletic horses.
Hoof
CAUSE:
Wall Cracks
HORIZONTAL CRACKS
o Caused from an injury to the coronary band which results in the temporary
cessation of healthy horn growth
Hoof
CAUSE:
Wall Cracks
SOLAR CRACKS
o Sole Cracks
Most commonly seen in horses with chronic
laminitis Caused by the direct pressure from a
rotating pedal bone
and in young horses with upright or 'clubby'
feet
In a young horse solar cracks are temporary, but
in the laminitic foot they can be persistent
o Bar Cracks
Can be caused by some cases of low
grade, chronic laminitis and in horses with a long
toe/low heel syndrome
Hoof
DIAGNOSIS
Wall Cracks
o Hoof wall cracks are visibly obvious, but their
significance is determined by the extent of coronary
band involvement and whether or not infection is
present
o In lame horses, a crack through the coronary band may
be painful to palpate and the edges of the crack may
move apart when the horse bears weight (signifies
instability, pinching and inflammation of the sensitive
laminae)
o In lame horses, a crack through the ground surface of
the hoof may be associated with a localized area of pain
on palpation (signifies infection and abscess formation)
o In chronic cases of hoof wall cracks, radiographic
examination may reveal secondary changes to the pedal
bone.
Hoof
TREATMENT
Wall Cracks
o Crack is trimmed out to debride the cavity and hoof wall, exposing the area to air
o If a solar abscess is present, it should be located, trimmed and treated
o Infected crack is flushed with a topical antibiotic
o Proper shoe (i.e. full-bar shoe) is applied to stabilize the foot (nails should not
intrude into crack)
o If required, toe or quarter clips are fitted on either side of the crack (clips should
not intrude into crack)
Hoof
TREATMENT
Wall Cracks
o If crack is recent and uncomplicated it is wired or laced together (using horizontal
holes drilled through the hoof wall)
o If crack is long-standing and complicated it is filled with an acrylic hoof repair
material to hold the edges of the crack
o Bar and sole cracks should not be covered by any repair material
o Hoof hardener can be applied
Hoof
AFTER-CARE
Wall Cracks
o Stable rest is required until the hoof wall crack is stabilized and healing
o The hoof should be trimmed and the stabilization components (i.e. wires or
laces, patch, shoe, clips) reapplied as the hoof grows and the crack changes
position
o Note: The hoof wall grows approximately 0.6 cm every month
Hoof
PREVENTION
Wall Cracks
o Maintain regular hoof trimming and shoeing at all times but especially during times
of dry weather
o Feed supplements containing biotin and methionine to aid good quality hoof
growth, especially for horses with naturally brittle feet
Bruised Sole
INTRODUCTION
o Horse may become suddenly lame and then appear to recover but will often be
lame the next day
o Pain is located when pressure is applied with hoof testers
o Sole paring at the area of pain reveals a visible bruise
Bruised Sole
TREATMENT
o The poultice should be removed after 24 hours but the protective bandage can be
left on for a further 48 hours
o The foot is trimmed and shod when it is no longer painful
o The horse may remain lame until it is reshod
Bruised Sole
PREVENTION
o Pick and thoroughly clean out the horse's feet before exercise
o Avoid exercise on stony ground
o Maintain regular hoof trimming and shoeing
o Consider the use of pads to protect the sole if the horse is prone to bruising
Bruised Sole
CAUTION
o A foot abscess can cause a similar type of sudden lameness with focal pain
o Abscesses must be found, drained and poulticed without delay