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13 Cards in this Set
- Front
- Back
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What are the basic components of a lameness examination? |
1. History 2. Observation and examination of horse at rest 3. Observation and examination of horse moving 4. Palpation and manipulation of limbs If lameness not yet localised 5. Diagnostic nerve and joint blocks > start distally and progress proximally > highest nerve blocks just above carpus and hock
6. Diagnostic imaging |
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What are the common conformational abnormalities identified on examination of the horse at rest. |
With the horse standing, weightbearing evenly on all 4 limbs: > low heel-long toe > fetlock/carpus/tarsus valgus or varus > mediolateral foot imbalance > asymmetry between feet > hyperflexion or - extension of distal limbs also asssess for muscle wastage and obvious swellings e.g. over joints/tendon sheaths |
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What is the best gait for determining which limb is lame? Why? |
Trot, |
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A) What is the classic sign of unilateral forelimb lamness? B) What is the classic sign of unilateral hindlimb lameness? |
At TROT A) Head nod - down on the sound, up on lame B) Hip hike - increased excursion/up-down movement of the gluteal region on lame side |
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What are other features of lameness? |
> shortened stride of affected limb > increased dropping/extension of fetlock on sound(er) limb HINDLIMB LAMENESS > medial swinging of affected limb as it is carried forward > toe-dragging (reluctance to flex hocks) |
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Which are the two most important nerve blocks covered asy Day 1 Competencies? Should these be used if lameness very subtle of intermittent? |
> palmar digital nerve block > abaxial sesamoid nerve block No. Diagnostic blocks are harder to interpret in these situations so best not to embark on that process if you cannot see a clear lameness. |
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Forelimb Lameness A) Where is most lameness localised to? B) What tool should be utilised |
A) Foot; hoof abscesses, corns, solar bruising B) Hoof testers |
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Point evaluated in Clinical Examination of Horse's Foot Balance |
i) Toe length (coronary band to toe) ii) Hoof angle (between dorsal hoof wall and sole + HPA, FL: 50 - 54, HL: 53 - 57) iii) Mediolateral hoof balance iv) Wall contour and ground surfaces v) Sole thickness and frog (Normal sole; concave, margin of 3-5mm around its circumference at weight bearing, slightly flexible to digital pressure) (vi) Symmetry of hooves (vii) Contact of hooves or limbs |
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Define Palmar Foot Pain/Navicular Syndrome |
i) Pain associated with pathology of the navicular bone and/or surrounding soft tissue structures (bursa, collateral sesmoidean and impar ligaments, DDFT) ii) Improves or blocks out to a palmar digital nerve block (PDNB) |
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A) What is the classical presentation B) How can it be definitively diagnosed |
A) 6 - 12 years, present with lameness in one forelimb --> gets PDNB --> suddenly lame on other forelimb. B) Radiography - Lateral, - Dorsoproximal-Palmarodistal and - PalmaroproximalPalmarodistal navicular medullary clerosis, distal border synovial fossae, enthesiophyte |
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What are the palliative treatment options available? |
> Corrective farriery e.g. egg bar or graduated shoes, shortening of toe or bevelling of shoe > Phenylbutazone (NSAID analgesic and anti-inflammatory) > Shock wave therapy (high energy ultrasound waves) > Tiludronic acid (Tildren - bisphosphonate that binds to sites with high rates of bone remodelling and reduces this. Given as IV infusion) > Surgical e.g. PD neurectomy or Navicular suspensory desmotomy |
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List assorted conditions of the equine foot |
1. Solar bruising 2. Puncture wounds of the equine digit (shoeing associated or other) 3."Seedy toe" 4. Hoof wall cracks (vertical and horizontal) 5. Corns 6. Keratoma 7. Mud rash (mud fever, greasy heel) 8. Thrush 9. Canker 10. Quittor 11. Pedal Osteitis 12. Fractures of 3rd Phalanx (Pedal Bonee) and Fractures of Navicular Bone 13. Osteoarthritis of Distal Interphalangeal Joint 14. Sheared Heels |
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What are the emergencies of the Equine Foot? Think about how each can be treated. |
> Coronary band laceration > Heel bulb laceration > Avulsion of the hoof wall >Fracture of the third phalanx or navicular bone >Sub-solar abscesses (acute 10/10 lameness) |
