Author of text and photographs: Ladislav Kontár
Place of work: SK
Veterinary care: MVDr. Zuzana Bartová
1.Title of the article (Diagnosis):
Name L / Z 1
Breed: gipsy horse.
Age: estimated 9 years
Work use : hobby horse
Stabling: box with all-day paddock
Frequency of hoof treatment: irregular
2. Patient data:
The owner reports recurrent inflammations of the hooves over a period of about three years. The mare was long-term medicated Danilon equidos 1.5 g (Suxibuzonum) twice a day 1 sachet.
The previous attending veterinarian considered hoof cancer to be a disease, and the previous veterinarian also treated her for this disease. He applied cisplatin to the affected sections of the hoof. Cisplatin was applied every other day for two weeks to the area of the collateral groove. According to the owner, the hoof is said to have temporarily improved.
At my first examination, the horse showed a 4/5 lameness on the right forelimb. The subcutaneous tissue distal to the carpal joint was roughened and scarred. The hoof was palpably hot and the coronary band margin was filled with fluid all around. The white line was widened and wet, see. Fig. no. 1.
Based on my examination, I recommended calling a veterinarian. MVDr. Zuzana Hollá Bartová x-rayed the hoof to exclude the rotation of the coffin bone. Rotation of the coffin bone was not visible on the lateral (lateral) projection of the hoof, but the presence of an extensive hollow in the wall was evident. As a result of these findings, after consulting with a veterinarian, we decided to ablate the hoof wall.
Obr. č. 1.
In general sedation and local anesthesia in the heel area (nn. Palmares), I performed wall ablation approximately from the center of the dorsal part almost to the inner heel. Under the wall was a large amount of pus mixed with soil and manure. The cavity extended approximately 1 cm below the edge of the short pastern bone.
I cleaned the exposed corium with Betadine sol solution and removed all necrotic and purulent parts. The corium bled very heavily during the treatment so we placed the esmarch tourniquet over the fetlock joint.
The exposed corium was covered with metronidazole powder and then a pressure bandage was applied. After a few days, it became clear that the pressure exerted by the pressure bandage on the exposed corium was insufficient. The tissue began to proliferate, the newly formed tissue was very painful and did not allow the upper edge of the hoof to grow normally downwards, see. Fig. 2., 3.
Fig. No. 2.
Fig. No. 3.
I therefore decided to remove the newly formed tissue (under sedation and local anesthesia) along with further ablation towards the outer, lateral side of the hoof. This was necessary due to the ongoing festering process, viz. Fig. No.4. The veterinarian prescribed antibiotics (doxycycline) for 6 weeks.
Fig. No. 4
The site of the first ablation after about 6-8 days, in the healing stage.
Place of new ablation after trimming the overgrown tissue and after stopping the bleeding.
To achieve a higher pressure on the hoof corium, I made a three-point fixator from a plastic bucket and a stock bar. In the heel parts I attached the cut part of the plastic with small teeth so that it is possible to create pressure on the dorsal side of the hoof by means of a forged stock, see. Fig. No. 5., 6., 7. Every other day we changed the bandages and tightened the fixator so that the effect of pressure was constant.
Fig. No. 5.
Fig. No. 6.
Fig. No. 7.
The veterinarian sent samples from the cut tissue for histopathological examination, which ruled out the infectious and tumor process. It was hyperplasia of the corium.
After 4 weeks, we removed the fixator and continued to dress the hoof only with pressure bandages. The corium has hardly grown. Subsequently, however, there was a sudden deterioration in the health of the mare. She was unable to load the limb at all. Due to the suspicion of the penetration of the purulent process into the coffin joint, the veterinarian performed an X-ray examination of the distal part of the affected limb in several projections with an inserted metal probe into the lesion. Fortunately, the examination ruled out communication with the coffin joint, but revealed the absorption of the coffin bone branch, see. Fig. No. 8, 9, 10.
Fig. No. 8, 9, 10. X-ray - Absorption of the branch of the coffin bone
After sedation and local anesthesia, I found a limited necrotic lesion in the area of the lateral frog (where cisplatin was applied in the past) which passed through the frog to the bottom of the lateral heel. In cooperation with a veterinarian, I removed the necrotic tissue, applied a bandage soaked in Chlum solution through the cavity and bandaged the hoof. In Figures 11, 12, 13, the hoof is 8 weeks after treatment.
Fig. No. 11., 12., 13. - Hoof 8 weeks after treatment.
Fig. No. 14.
After this treatment, the hoof was only repeatedly dressed about every 4 days and the condition of the mare gradually improved, see. Fig. No. 14. Currently, the mare is without bandages and is not lame. Her doses of Danilone are gradually being reduced. She moves only in a dry enclosure, in case of bad weather in the indoor arena.