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ADVICE FROMTHE VET by Jeremy Swan BVSc MRCVS of Bourton Vale Equine Clinic


known“navicular disease syndrome” is made up of manydifferentareas of damage within the hoof . Thejoints within the hoof can

also undergo degenerativechange and showsigns of arthritis. Sidebone is an old term fora

Pedal bone defectfromapenetrating stone cut.

is near the frog as the deep flexor tendon and navicular bursa are seateddirectly under this area. It is importanttoseek veterinaryadvice if thereisany doubt as to which structuresmayhave been involved in the case of apenetrating foot injury. Xrays using acontrast agent

thatcan be seen on the xray to delineate the course of the puncturemay need to be used. Treatmentofa puncturetothe

sensitivestructures of the foot will ofteninvolveusing arthroscopyto flush the infectedmaterial out.

“NOFOOTNOHORSE” Theequine foot is one of the most importantstructures and one that frequently causes lameness issues. It is importanttohavea knowledge of the underlying structures in order to understand the disease processes occuring in the foot. Thereare three bones thatare

associatedwith the foot; the pedal bone,the navicular bone which is similar to apulley over which the deep flexor tendon runs and the short pasternbone.These three bones articulate within the hoof capsule. Thereare collateralcartilages present extending fromthe wing of the pedal bone.Thereisa jointcapsule surrounding the distal interphalangeal jointand this is the articulation between the pedal bone,the short pasternbone and the navicular bone. Thereisalso abursa surrounding the deep digital flexor tendon when it traverses overthe navicular bone Thebones of the foot support

the horse’s weightvia the boney column inside the hoof capsule. Laminae attach the bones to the hoof capsule and thereare several ligaments and tendons inside the hoof capsule thatallowthe foot to be flexed and extended.

COMMONAILMENTS: LAMINITIS This very importantfoot disease has been covered in aprevious article.


This is averycommoncause of acute onset lameness.The bruising can sometimes be very deep and affect the pedal bone and this can oftentake some time to resolve; treatmentcan be as simple as applying apoultice to the foot forafew days to applying agel pad onto the sole of the foot to cushion the weightofthe horse,along with the use of anti-inflamatories. If the lameness persists then your vetwill oftenrequireradiographs to ensurethatthereare no fractures.


This will be one of the most common conditions thatwesee.“Pusinthe foot”can be fromadirectinjuryor fromapieceofgritthathas worked its wayintothe laminae.Although the application of apoulticecan be time consuming,Ithink thatwe all arerelieved when averylame horse suddenly has apocket of pus released.Treatmentconsists of releasing the infection, irrigating the hole and applying apoulticeuntil the infection has been completely drawnout.This can then be followed by packing the hole with iodine and putting apad on under ashoe oncethe infection has resolved. Penetrating injuries to the foot

can be lifethreatening and it is importanttoknowwhatstructures areunderneath the wound.This is especially so when the wound


Thereare several softtissue structures within the hoof capsule thatare commonly associatedwith lameness when they areinjured. One commonexample is atear of the deep digital flexor tendon as it coarses over thenavicular bone.Itis oftennecessarytouse arthroscopy or MRI to visualise this tendon.


Thebones and joints within the foot can undergo degenerative changes due to repetitiveloading thatisexacerbatedwith poor foot balanceand poor training surfaces. Theadventofthe lowfield MRI has allowedvisualisation of the changes seen and we nowknowthatthe well

condition thoughttobeassociated with foot trauma and this is seen by the collateralcartilages becoming ossified. Duringthis process the horse can be lame but oftenwhen the ossification has stopped the horse comes sound.


■ Clinical examination to trytolocalise the area of pain oftenusing hoof testers,increased digital pulse, visual assessmentofthe limb

■ Nerve blocks will allowthe vettoensurethatthe pain is coming fromthe foot and maybeused to moreprecisely locate the origin of the pain

■ Xray ■ MRI ■ Arthroscopy ■ Bone scan Treatmentofrepetitivestrain often

consists of resting the horse,reshoeing with corrective shoesand possibly the use of regenerativetherapy within the joints or tendon sheaths. Theuse of anti-inflamatories


Prevention consists of foot careand regular trimming of the feet if the feet areunshod,along with the application of protectiveapplications such as Stockholm tar,especially useful when conditions change fromdrytowet. If the cause of alameness is more longstanding then rebalancing the foot and shoeing will be very important.


JeremySwanBVScMRCVS qualified from Liverpool Universityin1983. He worked in mixed practices in Pembrokeshireand Upton-on- Severn beforejoining the BourtonValeEquine Clinic.Hebecame apartner in 1988. Jeremyhe has been actively involved with all aspects of the practiceincluding ahuge amountofstud and AI work as well as being the clinic’s main orthopaedic surgeon and dual colic surgeon. He set up the clinic’s scintigraphyunit to help with lameness investigations.These days he predominantly covers the growing racehorse base to the practice. ■ Formoreinformation on BourtonValeEquine Clinic, visit or call 01451 820137

d JULY2016For the latest news

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