Lameness examination
Examined at a distance, then up close by hands-on.
Footrot (interdigital necrobacillosis, infectious pododermatitis)
This is the most popular owner diagnosis but only really accounts for 15-20% of lameness. The etiology is as follows: maceration
of intedigital skin via trauma, followed by invasion by Fusobacterium necrophorium and Bacteroides melanogenicus.
Clinical signs include swelling, redness, pain , skin fissures and necrotic tissue in the interdigital space. If allowed
to persist, infection commonly invades deeper structures. (ie: DIP joint)
Treatment options include:systemic and/or topical antimicrobials and removing necrotic material that is unattached. As for
vaccination, Fusobacterium necrophorum bacterin administered as 2 doses, 3-4 weeks apart followed by a yearly booster may decrease the severity and incidence of
infection.
Interdigital dermatitis
Interdigital dermatitis is nothing more than an acute to chronic inflammation of the interdigital skin. It does not extend
into subcutaneous tissues. Chronic inflammation can result in heel horn erosion and undermining of the heel bulbs.
Etiologies:Continuous wet and unhygienic conditions, laminitis, Bacteroides nodosus and a spirochete
Clinical signs include: slight to moderate lameness – paddling?, mild to severe redness of the skin and mild to moderate swelling
with pain to the touch.
Papillomatous digital dermatitis (hairy heel warts)
Transmissible dermatitis on the plantar/palmar surface of the pastern and on the heels. There is complete erosion of the
epidermis that is replaced by granulation tissue.1
Etiologies: Moisture, Bacteroides, Campylobacter, Spirochete (Treponema)
Clinical signs include: Lameness and weight shifting – one small lesion can be extremely painful to touch, ulceration around
the coronary band in the bulb area and papillary hyperplasia of epidermis – fronds (fingerlike projections)
Treatment options include: cleaning, topical oxytetracycline or lincomycin spray, oxytetracycline under a bandage, foot baths
(agents in footbaths are frequently inactivated by organic debris, therefore, the baths need to be fresh- can get expensive
to properly maintain)
Injectable oxytetracycline – not very effective
Subsolar abscess
Etiologies include, puncture wounds, concrete or grinder burns, white line disease and bruising. Basically anything that
compromises the horn. Clinical signs are obviously mild to severe lameness and an alteration of stance to shift weight, however,
there is usually no swelling unless there is joint, tendon or soft tissue involvement above the hoof. Treatment and diagnostic
modalities include:
Curettage all undermined horn. Protect unaffected sensitive laminae.
Explore all tracts, especially those areas with erupting granulation tissue.
Radiographs to examine deeper structures.
Place a wooden block on good claw
Bandage?
Systemic antibiotics if deep tissue is involved
Tenosynovitis
The etiology of this condition usually includes an extension of digital disease into the deeper structures to involve the
flexor tendon sheaths. However, trauma due to lacerations or punctures directly involving these structures also commonly
occurs. Owners often consider lacerations that don't immediately make the animal lame as something they can treat themselves,
however, when the trauma involves the tendon sheaths, it often progresses to something far more serious.
Clinical signs of tenosynovitis include:
Severe lameness
Swelling and/or draining of synovial fluid from tendon sheath
Distended sheath – usually unilateral (remember, the digital flexor tendon sheaths don't communicate)
Ultrasound works well to differentiate between infection in sheath and surrounding tissue
Treatment
