Equine Hoof Care and Management Quiz

Approach to Conditions of the Equine Hoof

• Alissa Cooper, lecturer in equine clinical practice at the University of Surrey, presented this lecture.
• The lecture covered common equine hoof conditions, including sub-solar abscesses, solar penetrations, and laminitis.

Learning Objectives

• Students will gain awareness of common hoof conditions.
• Students will learn about clinical presentations, aetiology, and treatment options for sub-solar abscesses.
• Students will grasp the diagnostic approach to solar penetrations, including understanding severity.
• Students will understand diagnostic approaches and prognostic indicators for laminitis.
• Students will outline the first-line treatment for acute laminitis.

Reading List

• Essential reading includes Pascoe's Principles & Practice of Equine Dermatology, Chapter 17, covering hoof injuries and diseases.
• Another reference is O'Neill & O'Meara (2010), In Practice, which details diagnosing and treating penetrating hoof injuries.

Approach to Hoof Problems

• Initial presentations often include lameness, heat in the foot, visible cracks, or foul smells like thrush.
• Increased digital pulses signal potential issues.
• Further examination uses hoof testers to identify pain.
• The foot is pared to asses all elements.
• Visual assessment, radiographs, and MRI aid identifying problems.

Common Conditions of the Hoof

• Hoof conditions arise from neglect/poor trimming, environmental factors, or trauma.
• Images in the lecture illustrate these factors.

Hoof Cracks

• Hoof cracks include toe, quarter, heel or sole cracks.
• Severity varies with crack depth.
• Grass Cracks originate from the ground up. They often stem from poor foot conformation.
• Sand Cracks extend distally from the coronary band. They are linked to coronary band lesions.

Hoof Cracks - Treatment

• The underlying cause should be identified and treated.
• Essential elements for treatment include good quality nutrition, improved hoof horn quality, hoof hardeners, and moisturisers.
• Biotin (15-20 mg/day) is a supplement for better hoof quality.
• Crack stabilization involves debriding, using farrier clips/wire, and filling with synthetic resin.
• Good shoeing is also crucial.

Thrush

• Thrush is a bacterial dermatitis in the sulci frog.
• Poor hygiene and overgrown feet are common causes.
• Fusobacterium necrophorum is the associated bacteria.
• Debridement of the necrotic frog is a key treatment step.
• Improved hygiene, topical treatments (povidone-iodine, formalin, H2O2), and antimicrobials are further treatment considerations.

Trauma

• Trauma to the hoof is a serious issue.
• Pictures illustrate different stages of the injury, including bleeding and healing.
• Foot casts are often employed for support, sterility, and pain relief.

Sub-Solar Abscess

• The lecture termed this condition "Pus in the foot".
• It's among the most common causes of horse lameness.
• The condition results from ascending bacterial infection in the chorium (solar dermis).
• Risk factors include poor foot conformation, seedy toe, wet conditions, and in both shod and unshod horses
• Chronic laminitis and PPID can contribute.

Sub-Solar Abscess - Diagnosis

• The condition often presents as acute and severe unilateral lameness.
• Increased digital pulsation ("bounding pulses"), heat in the hoof, and distal limb swelling are common signs.
• The condition exhibits repeatable pain responses on application of hoof testers.

Sub-Solar Abscess - Treatment

• Treatment aims to encourage drainage.
• Key steps include removing shoes, paring and cleaning the sole, exploring discoloured areas.
• Sedation and nerve block may be involved (but rarely).
• Poultices are used for softening the hoof prior to curetting and to maintain drainage.
• Poultices are typically changed once daily.
• Pain relief with NSAIDs (like phenylbutazone) is crucial.
• Antibiotics are typically not needed for uncomplicated abscesses.
• Tetanus prophylaxis is important.

Sub-Solar Abscess - Chronic/Purulent Abscess

• Chronic abscesses might rupture at the coronary band or heel.
• Drainage encouragement is key, possibly requiring repeat flushing.
• Purulent abscesses involve deeper/sensitive structures.
• Thorough diagnostics (radiography) and extensive surgery may be necessary.
• Antimicrobial therapy is indicated.

Solar Penetrations

• A presentation on diagnosing and treating penetrating hoof injuries in horses.
• References include Henry O'Neill and Bryan O'Meara's 2010 article in In Practice.
• A first principle approach if nail/wire is in place: leave it, support the leg, and radiograph if possible.
• Second principle if nail/wire is already removed: identify the track, pare the sole to expose the chorium, clean the lesion and be aware of delay in lameness. Further investigations with probes, contrast radiography and MRI are required for any suspicion of complications.

Solar Penetrations - Potential Sequelae

• Potential consequences include pedal bone damage, soft tissue damage, insertion damage to deep digital flexor tendons, impar ligament, synovial infection, navicular bursa, and distal interphalangeal joint or digital tendon sheath trauma.
• Prognosis considers the number of complications and the time to treatment.

Solar Penetrations - Treatment

• Simple, uncomplicated penetrations involve paring, poulticing and antibiotics only if an infection is present.
• Judicious use of analgesia and NSAIDs is advisable.
• Synovial penetration cases require broad-spectrum antimicrobial therapy (e.g., penicillin and gentamicin).
• Surgical intervention, like arthroscopic synovial cavity lavage, is sometimes necessary.
• Tetanus prophylaxis is also essential.

Neoplasia - Keratoma

• Presentation of hoof growth abnormalities.

Laminitis

• A review lecture on the condition.
• It is a multifactorial disease process linked to laminar degeneration.
• Various categories include endocrinopathic (including insulin dysregulation and PPID), inflammatory (caused by systemic disease and retained fetal membranes) and traumatic causes (excess weight on one limb).

Laminitis - Clinical Signs

• Various clinical signs of laminitis include acute onset lameness, shifting weight, rocking onto heels, reluctance to walk, short/choppy gait, bounding digital pulses, heat through the dorsal hoof wall, and pain on hoof testers.

Laminitis - Diagnostics

• Diagnosis relies on clinical signs and history.
• Radiography is critical. It's used to assess severity, progression, prognosis, and response to treatment.
• Time since the onset of laminitis is crucial when taking radiographs.

Laminitis - Radiography

• Normal angles and measurements from radiographs (dorsal, palmar, coronary band-extensor process distance, sole depth) are critical for proper assessment.

Laminitis - Prognosis

• Poor prognosis often stems from severe rotation of the pedal bone (P3) (>15%), sinking of P3 into the capsule, pedal bone displacement, Mediolateral Rotation, chronicity, and undiagnosed of untreated underlying conditions.

Laminitis - Principles of Treatment

• Treatment prioritizes supporting the pedal bone.
• Strict rest is essential during acute stages.
• Soft bedding (like sand or shavings) aids in supporting the foot, while shoes might need removal.
• Sole and frog supports should support the foot.
• Cryotherapy can also help by reducing inflammation.

Laminitis - Suppress Inflammation and Provide Pain Relief

• Non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., phenylbutazone) are used to reduce inflammation in the early stages.
• Monitoring is recommended, including careful consideration of the multimodal approach (incorporating other pain relief options, if necessary).

Laminitis - Dietary Restriction

• Limiting forage quality (e.g., transitioning away from low quality/soaked hay) and stopping grains help in preventing further problems.
• A balancer (vitamin and mineral supplement) should be provided.

Laminitis - Underlying Condition Diagnosis/Treatment

• Conditions like pituitary pars intermedia dysfunction (PPID) are diagnosed and treated appropriately.
• Insulin dysregulation cases might involve resting hyperinsulinaemia and in-feed glucose tests alongside diet and exercise protocols, once the horse has recovered.
• Investigating medications, like Metformin/Canagliflozin is also mentioned.

Laminitis - Remedial Farriery

• Rebalancing of the hoof is critically important for appropriate weight bearing.
• Providing long term support using frog/sole support and reduction of breakover is also essential.
• Remedial farriers work with hoof growth for 6-8 months aligning hoof growth to pedal bone positions.

Laminitis - Further Reading

• Several references including relevant online resources are mentioned to assist further research into equine hoof care and specific conditions. References include the Laminitis Site, the Laminitis Trust, specific journal articles, and other papers.