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PODIATRY
CONTENTS
Preface Stephen E. O’Grady The Role and Importance of Farriery in Equine Veterinary Practice Jay G. Merriam
xi
273
There is a lot of room for us to become the central source of medical information regarding shoeing and lameness in our own practice area. This takes a good bit of effort and a real ‘‘outreach’’ to client and farrier. It can be done with the one tool we are best at—the acquisition and careful dispensing of information that we can put together regarding the health of the foot.
Form and Function of the Equine Digit Andrew Parks
285
The list of possible diagnoses derived from matching anatomic structures or tissues to pathologic processes is inevitably broad in nature. Understanding and observation of distal limb function, conformation, and balance is the basis of identifying where the greatest abnormal stresses within the distal limb are likely to occur. This is key to focusing the diagnostic process and, in some instances, to treating the horse when a definitive diagnosis cannot be achieved.
Examination of the Equine Foot Tracy A. Turner
309
The examination of the foot must be based on observations of the hoof, followed by a careful determination of areas of pain and an assessment of the biomechanical forces on the hoof and limb. Finally, imaging gives insight into the nature of the injury and allows the examiner to prognosticate the outcome.
VOLUME 19
Æ NUMBER 2 Æ AUGUST 2003
v
Proper Physiologic Horseshoeing Stephen E. O’Grady and Derek A. Poupard
333
Adherence to the basic principles of physiologic horseshoeing is essential to maintaining hoof health and soundness. Most horses do not require special trimming or shoeing techniques. Becoming familiar with a few basic concepts can help the veterinarian to recognize when changes in trimming or shoeing might be expected to help the performance of a sound horse or might help to restore the performance of one that is lame. Sound physiologic horseshoeing can only be achieved by a thorough knowledge of, strict adherence to, and skillful application of basic principles, such as hoof angle, hoof-pastern axis, and mediolateral balance. Only then does the art of farriery truly approach being a science.
Natural Balance Trimming and Shoeing: Its Theory and Application Gene D. Ovnicek, Barbara T. Page, and Gayle W. Trotter
353
The principles and techniques of natural balance trimming and shoeing are designed to optimize the efficiency and function of the foot. The basic guidelines have evolved in part from wild horse hoof imprint studies done in 1986 through 1987 and first presented in 1995. Further research has contributed to these principles and guidelines to make them applicable to domestic horses.
Radiographic Imaging of the Equine Foot Ric F. Redden
379
Radiographic examination of the equine foot can provide the veterinarian and farrier with a wealth of information. Positioning and selection of exposure factors are of central importance if one is to produce radiographs of maximum diagnostic value.
Chronic Laminitis: Current Treatment Strategies Andrew Parks and Stephen E. O’Grady
393
Laminitis is divided into four different phases: developmental, acute, subacute, and chronic. The focus of this article is on treating the laminitic horse after the cessation of therapy for the acute phase, that is, usually 2 to 4 weeks after the onset of clinical signs.
Diagnosis, Treatment, and Farriery for Horses with Chronic Heel Pain Robin M. Dabareiner and G. Kent Carter
417
Horses with heel or navicular area pain vary, and no one treatment option is suitable for all horses. Each horse must be evaluated individually to determine which structure in the palmar aspect of the foot is injured, severity of disease, horse and hoof conformation, vi
CONTENTS
and horse use and level of performance expectation before a treatment plan can be developed. Overall, there are many treatment options to help these horses to perform.
Hoof Capsule Distortion: Understanding the Mechanisms as a Basis for Rational Management Ric F. Redden
443
Understanding the basic mechanisms of hoof capsule distortion enables the clinician to unravel the sometimes complex mix of abnormalities, identify early warning signs, and manage existing problems more effectively. Distortion of the hoof capsule can often seem like a complicated puzzle by the time the veterinarian is called to examine the lame horse. Evaluating each of the components of the hoof capsule, both individually and as an integrated unit, allows the clinician to tease apart the tangle of primary and secondary problems and come up with effective options for countering or attenuating the forces responsible for the distortion. Using high-quality radiography and developing an eye for detail regarding the physical and radiographic characteristics of the foot allow the clinician to identify subtle abnormalities, thereby averting a clinical problem or addressing the problem while it is still reversible. With existing problems, developing these skills enhances the clinician’s ability to interpret the degree of damage accurately and to devise mechanical solutions that create an environment in which healing and restoration of function are maximized.
Hoof Wall Defects: Chronic Hoof Wall Separations and Hoof Wall Cracks William Moyer
463
Hoof wall injuries, defects, and secondary damage from a wide variety of causes are common. The incidence of such problems seems to have increased over the past few decades. Hoof wall cracks, loss, and separations often require veterinary and farrier attention beyond regular shoeing. The repair and management of these problems require an accurate appreciation of the severity and extent of the problem, a thoughtful approach with regard to dealing with the potential causes, and a solid working relationship with a farrier. This article discusses the diagnosis, management, and treatment of these common hoof disorders.
Hoof Wall Surgery in the Horse: Approaches to and Underlying Disorders Clifford M. Honnas, Robin M. Dabareiner, and Betsy H. McCauley
479
Because of the hoof capsule, surgery of the equine foot is often perceived to be quite difficult. Knowledge of the specific disease entities that require surgical intervention as well as an in-depth
CONTENTS
vii
understanding of the anatomy of the tissues beneath the hoof capsule is a definite prerequisite to successful surgical treatment. This article details the surgical approaches used to treat septic navicular bursitis, septic pedal osteitis, infection of the collateral cartilages, and keratomas. The principles used to treat these conditions can be applied to a variety of other conditions for which access through the hoof wall is required.
Foot Management in the Foal and Weanling Timothy R.C. Greet and Simon J. Curtis
501
Foot management and hoof care of foals, weanlings, and yearlings tends to be considered a specialist job. Many farriers and veterinary surgeons have little exposure to young and growing stock. Nevertheless, a variety of angular and flexural limb deformities can benefit from simple podiatry techniques, which can be performed provided that a few basic rules are followed. The combined skills of the farrier and veterinary surgeon offer many young horses with angular or flexural limb deformities a chance of a future athletic career.
Hoof Repair and Glue-On Shoe Adhesive Technology Hoyt S. Cheramie and Stephen E. O’Grady
519
When the structural integrity of the hoof wall is breached or compromised because of disease, trauma, treatment, or surgery, lameness often results. Veterinarians and farriers have been using artificial composite adhesives for more than three decades to treat these conditions or to apply shoes to hooves not able to accept nails. Recently, significant advancements in composite adhesive technology have made hoof repair/reconstruction and glue-on shoeing techniques easier, more cost-effective, and much more functional.
Foot Pain and the Elusive Diagnosis Sue Dyson and Daniel Marks
531
New information about foot anatomy, effects of local analgesia, and advances in diagnostic imaging (ultrasonography, nuclear scintigraphy, MRI, CT, and endoscopy) has opened the way for more specific diagnoses of lameness. New questions have been raised, however, and some older ideas are now in doubt. This article discusses some of these findings in the light of our own clinical experiences as they relate to diagnosis of the causes of foot pain.
Index
viii
567
CONTENTS
CONTENTS
Preface Stephen E. O’Grady The Role and Importance of Farriery in Equine Veterinary Practice Jay G. Merriam
xi
273
There is a lot of room for us to become the central source of medical information regarding shoeing and lameness in our own practice area. This takes a good bit of effort and a real ‘‘outreach’’ to client and farrier. It can be done with the one tool we are best at—the acquisition and careful dispensing of information that we can put together regarding the health of the foot.
Form and Function of the Equine Digit Andrew Parks
285
The list of possible diagnoses derived from matching anatomic structures or tissues to pathologic processes is inevitably broad in nature. Understanding and observation of distal limb function, conformation, and balance is the basis of identifying where the greatest abnormal stresses within the distal limb are likely to occur. This is key to focusing the diagnostic process and, in some instances, to treating the horse when a definitive diagnosis cannot be achieved.
Examination of the Equine Foot Tracy A. Turner
309
The examination of the foot must be based on observations of the hoof, followed by a careful determination of areas of pain and an assessment of the biomechanical forces on the hoof and limb. Finally, imaging gives insight into the nature of the injury and allows the examiner to prognosticate the outcome.
VOLUME 19
Æ NUMBER 2 Æ AUGUST 2003
v
Proper Physiologic Horseshoeing Stephen E. O’Grady and Derek A. Poupard
333
Adherence to the basic principles of physiologic horseshoeing is essential to maintaining hoof health and soundness. Most horses do not require special trimming or shoeing techniques. Becoming familiar with a few basic concepts can help the veterinarian to recognize when changes in trimming or shoeing might be expected to help the performance of a sound horse or might help to restore the performance of one that is lame. Sound physiologic horseshoeing can only be achieved by a thorough knowledge of, strict adherence to, and skillful application of basic principles, such as hoof angle, hoof-pastern axis, and mediolateral balance. Only then does the art of farriery truly approach being a science.
Natural Balance Trimming and Shoeing: Its Theory and Application Gene D. Ovnicek, Barbara T. Page, and Gayle W. Trotter
353
The principles and techniques of natural balance trimming and shoeing are designed to optimize the efficiency and function of the foot. The basic guidelines have evolved in part from wild horse hoof imprint studies done in 1986 through 1987 and first presented in 1995. Further research has contributed to these principles and guidelines to make them applicable to domestic horses.
Radiographic Imaging of the Equine Foot Ric F. Redden
379
Radiographic examination of the equine foot can provide the veterinarian and farrier with a wealth of information. Positioning and selection of exposure factors are of central importance if one is to produce radiographs of maximum diagnostic value.
Chronic Laminitis: Current Treatment Strategies Andrew Parks and Stephen E. O’Grady
393
Laminitis is divided into four different phases: developmental, acute, subacute, and chronic. The focus of this article is on treating the laminitic horse after the cessation of therapy for the acute phase, that is, usually 2 to 4 weeks after the onset of clinical signs.
Diagnosis, Treatment, and Farriery for Horses with Chronic Heel Pain Robin M. Dabareiner and G. Kent Carter
417
Horses with heel or navicular area pain vary, and no one treatment option is suitable for all horses. Each horse must be evaluated individually to determine which structure in the palmar aspect of the foot is injured, severity of disease, horse and hoof conformation, vi
CONTENTS
and horse use and level of performance expectation before a treatment plan can be developed. Overall, there are many treatment options to help these horses to perform.
Hoof Capsule Distortion: Understanding the Mechanisms as a Basis for Rational Management Ric F. Redden
443
Understanding the basic mechanisms of hoof capsule distortion enables the clinician to unravel the sometimes complex mix of abnormalities, identify early warning signs, and manage existing problems more effectively. Distortion of the hoof capsule can often seem like a complicated puzzle by the time the veterinarian is called to examine the lame horse. Evaluating each of the components of the hoof capsule, both individually and as an integrated unit, allows the clinician to tease apart the tangle of primary and secondary problems and come up with effective options for countering or attenuating the forces responsible for the distortion. Using high-quality radiography and developing an eye for detail regarding the physical and radiographic characteristics of the foot allow the clinician to identify subtle abnormalities, thereby averting a clinical problem or addressing the problem while it is still reversible. With existing problems, developing these skills enhances the clinician’s ability to interpret the degree of damage accurately and to devise mechanical solutions that create an environment in which healing and restoration of function are maximized.
Hoof Wall Defects: Chronic Hoof Wall Separations and Hoof Wall Cracks William Moyer
463
Hoof wall injuries, defects, and secondary damage from a wide variety of causes are common. The incidence of such problems seems to have increased over the past few decades. Hoof wall cracks, loss, and separations often require veterinary and farrier attention beyond regular shoeing. The repair and management of these problems require an accurate appreciation of the severity and extent of the problem, a thoughtful approach with regard to dealing with the potential causes, and a solid working relationship with a farrier. This article discusses the diagnosis, management, and treatment of these common hoof disorders.
Hoof Wall Surgery in the Horse: Approaches to and Underlying Disorders Clifford M. Honnas, Robin M. Dabareiner, and Betsy H. McCauley
479
Because of the hoof capsule, surgery of the equine foot is often perceived to be quite difficult. Knowledge of the specific disease entities that require surgical intervention as well as an in-depth
CONTENTS
vii
understanding of the anatomy of the tissues beneath the hoof capsule is a definite prerequisite to successful surgical treatment. This article details the surgical approaches used to treat septic navicular bursitis, septic pedal osteitis, infection of the collateral cartilages, and keratomas. The principles used to treat these conditions can be applied to a variety of other conditions for which access through the hoof wall is required.
Foot Management in the Foal and Weanling Timothy R.C. Greet and Simon J. Curtis
501
Foot management and hoof care of foals, weanlings, and yearlings tends to be considered a specialist job. Many farriers and veterinary surgeons have little exposure to young and growing stock. Nevertheless, a variety of angular and flexural limb deformities can benefit from simple podiatry techniques, which can be performed provided that a few basic rules are followed. The combined skills of the farrier and veterinary surgeon offer many young horses with angular or flexural limb deformities a chance of a future athletic career.
Hoof Repair and Glue-On Shoe Adhesive Technology Hoyt S. Cheramie and Stephen E. O’Grady
519
When the structural integrity of the hoof wall is breached or compromised because of disease, trauma, treatment, or surgery, lameness often results. Veterinarians and farriers have been using artificial composite adhesives for more than three decades to treat these conditions or to apply shoes to hooves not able to accept nails. Recently, significant advancements in composite adhesive technology have made hoof repair/reconstruction and glue-on shoeing techniques easier, more cost-effective, and much more functional.
Foot Pain and the Elusive Diagnosis Sue Dyson and Daniel Marks
531
New information about foot anatomy, effects of local analgesia, and advances in diagnostic imaging (ultrasonography, nuclear scintigraphy, MRI, CT, and endoscopy) has opened the way for more specific diagnoses of lameness. New questions have been raised, however, and some older ideas are now in doubt. This article discusses some of these findings in the light of our own clinical experiences as they relate to diagnosis of the causes of foot pain.
Index
viii
567
CONTENTS