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EQUINE VETERINARY EDUCATION / AE / SEPTEMBER 2017
a)
b)
c)
d)
Fig 2: a) Day 10 after the initial trauma when the hoof sloughed. Solar surface of the foot with partial exposure of the distal phalanx of the right hindlimb. b) Hoof capsule that sloughed spontaneously from the dorsodistal third phalanx. c) Venograph revealing the lack of perfusion at the distomedial aspect of the distal phalanx indicated by arrow. d) P3 sequestrum that was demarcated 9 days after the hoof sloughed.
was initiated and continued throughout the entire hospitalisation. Footbaths to aid debridement of necrotic tissue and a change of support bandage were performed daily. The foot was placed in a container filled with a warm solution of 0.025% sodium hypochlorite for periods of 20 min. On Day 9 post hoof capsule loss a sequestrum (3 9 3 cm) was removed from the dorso-distal solar margin of the distal phalanx (Fig 2d). An acceleration of growth of granulation tissue was observed thereafter. A total of 17 days after the hoof capsule loss, the distal phalanx was covered by a healthy bed of granulation tissue. The contralateral limb was cooled by application of crushed ice in an attempt to prevent support limb laminitis during this period. The owner requested euthanasia on Day 26 because of financial constraints and a poor prognosis for a sporting career.
Case 3 A 12-year-old Quarter Horse mare was referred because of a suspicion of septic arthritis. The mare had been found 10 days previously in a paddock with multiple trauma to the lower right hindlimb. At the farm, the wound was managed by clipping the hair, cleaning and a sterile intra-articular injection of saline
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into the proximal interphalangeal joint to verify communication with the joint. Amikacin (Amyglide-V)1 (500 mg) was injected into the proximal interphalangeal joint on the day of injury. A second intra-articular injection was performed later, but the exact time was not noted in the record. Nonsteroidal anti- inflammatory drugs (phenylbutazone5 2.2 mg/kg bwt per os q. 12 h), gentamicin (Gentocin)3 (6.6 mg/kg bwt i.v. q. 24 h), procaine penicillin (Depocillin)3 (22,000 iu/kg i.m. q. 12 h) were administered for an unspecified period. Clinical examination on admission to our hospital
revealed a fistula at the dorsolateral aspect of the coronary band with a malodorous, foamy, haemorrhagic fluid emanating from it and a cold hoof capsule. The horse did not exhibit signs of pain on application of hoof testers. The mare was 4/5 lame at a walk (AAEP lameness grade [Anon 1991]). Radiography revealed a radiolucent line between the hoof capsule and distal phalanx and sinking and rotation of the distal phalanx on both lateromedial and dorsoproximal- plantarodistal 60°
oblique projections. Fistulography
employing 20 ml of iopamidol7 confirmed a complete separation of the hoof wall (Fig 3). The mare was subjected to euthanasia immediately because of financial constraints
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