Spontaneous hoof capsule loss following lacerations of the equine distal limb

In this article, 3 cases of an infrequent complication of lower limb trauma that presented as a cellulitis and deteriorating comfort a few days after lower limb laceration are described. All 3 horses sloughed the hoof capsule 10 days after initial trauma to that particular limb. Development of subsequent cellulitis/lymphangitis contributed to deterioration of distal limb perfusion. The exact pathophysiological mechanisms remain unknown but clinicians should be aware of this unusual but major complication following limb trauma.     

An investigation of the shape of the hoof capsule in hindlimbs,its relationship with the orientation of the distal phalanx and comparison with forelimb hoof capsule conformation

There is limited information documenting hind foot conformation. The objectives of the study were to describe the shape of the hoof capsule of hindlimbs from the lateral aspect in horses of variable breeds, and, within horses, to compare the conformation of the hoof capsule of forelimbs and hindlimbs and determine the orientation of the distal phalanx within the hoof capsule in hindlimbs. Lateral photographs of the fore and hind feet (n = 225) and lateromedial radiographs of the hind feet (n = 29) were obtained. Differences among breed and shoeing status groups were assessed using multivariable mixed-effects linear regression models. Angular parameters and ratios of linear measurements were compared between fore and hind feet; angular radiological variables and photographic parameters of the hind feet were compared. The mean dorsal hoof wall angle for hind feet (50.9°±3.7°) was smaller than forefeet (51.8°±3.9°) (P = 0.04). The mean heel angles for hind feet (36.4°±9.6°) were smaller than forefeet (40.1°±9.3°; P < 0.001). Dorsal hoof wall (P < 0.001) and heel (P = 0.002) angles were larger in unshod than shod feet. In the hind feet, the dorsal hoof wall was parallel to the dorsal aspect of the distal phalanx. The median angle of the distal phalanx to the horizontal (angle S) was 0.6° (interquartile range: −1.4, 2.3°). There was a positive relationship between angle S and the hoof wall angle (W); each 1° increase in angle S was associated with 0.6° increase in angle W (P < 0.001). Angle S was also positively associated with photographic heel angle; each degree increase in the angle S was associated with 1.8° increase in the heel angle (P < 0.001). It was concluded that the angle of the distal phalanx to the horizontal in hindlimbs is smaller than published values for forelimbs. The orientation of the distal phalanx in hindlimbs is correlated with external characteristics of the hoof capsule.     

Evaluation using hoof wall strain gauges of a therapeutic shoe and a hoof cast with a heel wedge as potential supportive therapy for horses with laminitis

OBJECTIVE: To evaluate using strain gauges, a hoof cast with heel wedge, and a therapeutic shoe with unsupported toe for their effectiveness in redistribution of load from the dorsal hoof wall. STUDY DESIGN: In vitro biomechanical study. SAMPLE POPULATION: Twenty forelimb specimens. METHODS: Rosette strain gauges were placed on the dorsal and lateral hoof wall of 20 normal shaped hooves. Limbs were loaded vertically using a tensile testing machine with a 1 Hz sinusoidally cycling load up to 3000 N during 15 seconds. Mean values of principal strain and direction at 2500 N load were calculated for 3 experimental conditions (unshod, therapeutic shoe with unsupported toe, and hoof cast with heel elevation) and tested by ANOVA (P<.05). RESULTS: Vertical limb loading in an unshod hoof leads to a biaxial compression of the dorsal wall with high longitudinal compression (epsilon2 = -1515 microm/m). Principal strain at the dorsal wall (epsilon2) was decreased by 23% with the therapeutic shoe and by 59% with the hoof cast. On the lateral hoof wall principal strain was unchanged with the shoe, but increased by 34% with the cast. CONCLUSIONS: Strain measurements indicate unloading of the dorsal hoof wall by both methods with the cast being more effective than the shoe. CLINICAL RELEVANCE: The hoof cast with wedge offers substantial unloading of the dorsal wall, but increases load on the quarter. Therefore a hoof cast would likely be most helpful in acute laminitis when palmar structures can still bear load. The therapeutic shoe offers rehabilitation and regrowth of the dorsal wall without increased load on the quarter wall.     

The effect of hoof angle variations on dorsal lamellar load in the equine hoof

Reasons for performing study: In the treatment of laminitis it is believed that reducing tension in the deep digital flexor tendon by raising the palmar angle of the hoof can reduce the load on the dorsal lamellae, allowing them to heal or prevent further damage. Objective: To determine the effect of alterations in hoof angle on the load in the dorsal laminar junction. Methods: Biomechanical finite element models of equine hooves were created with palmar angles of the distal phalanx varying from 0–15°. Tissue material relations accounting for anisotropy and the effect of moisture were used. Loading conditions simulating the stages in the stance where the vertical ground reaction force, midstance joint moment and breakover joint moment were maximal, were applied to the models. The loads were adjusted to account for the reduction in joint moment caused by increasing the palmar angle. Models were compared using the stored elastic energy, an indication of load, which was sampled in the dorsal laminar junction. Results: For all loading cases, increasing the palmar angle increased the stored elastic energy in the dorsal laminar junction. The stored elastic energy near the proximal laminar junction border for a palmar angle of 15° was between 1.3 and 3.8 times that for a palmar angle of 0°. Stored elastic energy at the distal laminar junction border was small in all cases. For the breakover case, stored elastic energy at the proximal border also increased with increasing palmar angle. Conclusions and potential relevance: The models in this study predict that raising the palmar angle increases the load on the dorsal laminar junction. Therefore, hoof care interventions that raise the palmar angle in order to reduce the dorsal lamellae load may not achieve this outcome. See also correspondence by Redden See also correspondence by Curtis     

Bilateral traumatic optic nerve avulsion in a Thoroughbred gelding

This report describes an unusual case of acute blindness following traumatic head injury in a mature horse. The horse fell over backwards and subsequently presented with bilateral blindness and epistaxis. Vision did not return following medical supportive therapy and euthanasia was elected. Post mortem findings revealed a basisphenoid fracture and bilateral optic nerve avulsion rostral to the optic chiasm, an uncommon presentation of traumatic blindness not previously reported in the horse.     

Low‐field magnetic resonance imaging of keratomas of the hoof wall

Standing low‐field magnetic resonance imaging (MRI) was used to image the feet of 21 horses affected by keratomas. The animals had variable clinical histories including acute, chronic or recurrent lameness. Of the 21 horses, only 14 (66%) had radiological changes suggestive of keratoma. Standing low‐field MRI revealed a smoothly demarcated hoof wall lesion in all horses, with deformity of the adjacent surface of the distal phalanx in 15 cases. The signal characteristics of the keratomas varied, with most showing either hypointensity or heterogeneous mixed signal intensity in T1‐ and T2*‐weighted images and hypointensity in STIR sequences. An intermediate or high STIR signal intensity was present in the trabecular bone of the adjacent region of the distal phalanx in 5 cases. Surgical debridement was performed in 16 horses. Recurrence was common, especially in cases where the lesion was ill‐defined; the prior MRI appearance of these cases tended to be of heterogeneous signal intensity.     

The effects of limb posture on relationships between in vitro radial hoof strain,load and joint angles

Reasons for performing study: Radial strain in normal hooves has been found to vary with strain gauge location, limb posture and sample limb but reported magnitudes were considered to be low. More accurate measurement of radial strain may enhance the understanding of hoof function. Objectives: To explore in vitro radial hoof strain in relation other kinetic and kinematic variables that may be related. Methods: Five normal forelimbs were removed at the proximal articular surface of the third metacarpal bone (McIII). The limbs were loaded using a modified Instron test machine. Six calibrated infrared cameras captured movement from markers on the hoof and bone fixed markers on the second and first phalanxes and McIII, whilst radial hoof strain was measured using a calibrated instrumented plug. Change in strain, joint angle and load were found at simulated walking postures and bivariate correlations were used to compare the relationships between them. Results: Radial strain was moderately correlated with proximal interphalangeal joint (PIPJ) rotation (r =?0.519). Large reductions in radial strain were found in loading and midstance with 10° of heel lift postures. Conclusions and potential relevance: PIPJ rotation has previously been linked to the magnitude of deep digital flexor tendon (DDFT) loads and it is therefore suspected that these loads may have the greatest influence on radial strain magnitudes. Further investigation of radial strain is needed to describe the patterns fully during the stance phase in vivo.     

Locally invasive melanoma in the internal laminae of the hoof of a bay mule

An 8-year-old bay mule was presented with moderate right forelimb lameness and dark discolouration of the white line. Histopathology of the dark material indicated a melanoma. Extensive resection and debridement were not curative and the mule was subjected to euthanasia 70 days after presentation.     

Quantitative assessment of increased sensitivity of chronic laminitic horses to hoof tester evoked pain

Reasons for performing study: To evaluate quantitative sensory testing (QST) of the feet of laminitic horses using a power‐assisted hoof tester. Hypothesis: Hoof Compression Thresholds (HCTs) can be measured reliably and are consistently lower in horses with chronic laminitis than in normal horses. Methods: HCTs of chronic laminitic (n = 7) and normal horses (n = 7) were repeatedly measured using a hydraulically powered and feedback controlled hoof tester. Data from 2 tests, at 3 sites in both forefeet, during 3 sessions were collected and statistically analysed using linear mixed models. Results: The mean ± s.e. HCT for the laminitic horses was 29.6 ± 3.5 kg/cm² and for horses in the normal group was 59.8 ± 4.3 kg/cm². Residual variance was the largest of the error components and was greater (P<0.001) for the normal horses; none of the other components significantly differed between the 2 groups. Averaging of HCTs from each foot could produce a test with intraclass correlation coefficients of 0.83 for the normal group and 0.87 for the laminitic group, with an estimated sensitivity of 0.94 and a specificity of 0.93. This test would permit detection with 80% power and 95% confidence of a reduction of over 40% in the difference in mean HCTs between laminitic and normal horses following effective treatment provided that the experimental groups are of 9 or more horses. Conclusions: HCTs can be safely and reliably measured experimentally using this hoof tester. The level of variability found indicates that, under these conditions, treatments may need to produce at least a 40% improvement to be detected. Simplification of the hoof tester, training of the horse and repeated testing may permit the method to be used clinically to detect changes in the HCTs of individual laminitic horses but these potential improvements will require further investigation. Potential relevance: Measurement of HCTs can provide an additional means for assessing the effectiveness of treatments for alleviation of chronic equine laminitis.     

Influence of different exercise regimes on the proximal hoof circumference in young Thoroughbred horses

Reasons for performing study: Most lameness in horses relates to foot problems and may be associated with changes in hoof shape, but there is a lack of information on the influence of normal exercise on hoof shape. Objectives: To investigate the effect of training on proximal hoof circumference in young Thoroughbred racehorses being prepared for racing. Methods: Thirty‐seven young Thoroughbred racehorses were included in this study. Front hoof circumference immediately below the coronary band was measured weekly with a measuring tape in all horses present at the stable. Most horses accomplished a minimum of 2 training periods at the stable separated by periods of rest on a paddock. One sample t tests were used to evaluate if the mean change per week differed from zero. To estimate the repeatability coefficient, the left proximal hoof circumference of 25 horses was measured 3 times in a random order on one day. Results: Most horses showed a similar pattern of change. The proximal hoof circumference decreased during the training periods (P<0.0001) and increased when the horse was rested (P<0.0001). The decrease of the circumference during the first training period was ?0.66 mm/week on the left and ?0.64 mm/week on the right. During the second training period, this was ?0.58 mm/week on the left and ?0.57 mm/week on the right. During the rest period, the circumference increased by 1.03 mm/week on the left and 1.12 mm/week on the right. The repeatability coefficient for the left circumference was 1.8 mm. Conclusions: Horses showed a decrease in circumference during race training that reversed when they were rested. Potential relevance: Measurement of front hoof circumference is a simple method to assess change in hoof shape. It provides an opportunity to investigate the relationships between specific training, hoof shape and soundness.     

Skeletal forelimb measurements and hoof spread in relation to asymmetry in the bilateral forelimb of horses

Reasons for performing study: Research has highlighted a high frequency of skeletal asymmetries in horses. In addition, research into hoof asymmetries has shown that within a bilateral pair, the hoof with the smaller angle is often subjected to greater loading. There has been limited attention paid to understanding compensatory mechanisms for skeletal asymmetries in the horse; the dynamic structure of the hoof could potentially be acting in a compensatory capacity. Objectives: To investigate the relationship between morphometry of forelimb segments and hoof spread and their incidence of asymmetry. Methods: Ten bilateral measurements of the hoof and forelimb were taken from 34 leisure horses. The relationship between hoof spread and forelimb segment measurements were analysed using a generalised linear model (GLM). Results: In relation to left hoof spread, the GLM identified significant negative relationships with left side measurements (third metacarpal length, elbow height), and significant positive relationships with right side measurements (fetlock height, third metacarpal length, elbow height). In relation to right hoof spread, the GLM identified significant negative relationship with left elbow height, and significant positive relationships with right side measurements (fetlock height, point of shoulder). The difference between the number of horses larger to the left or to the right was found to be significant for point of shoulder height (X²= 4.8, P<0.05), and highly significant for heel height (X²= 9.53, P<0.01) and the third metacarpal length (X²= 7.26, P<0.01). Conclusions and clinical relevance: The study demonstrated considerable asymmetry in left‐right morphometry of the equine limb. The fact that measurements of hoof spread were significantly associated with limb segment measurements could possibly indicate that an interaction exists. Any asymmetry in hoof spread measurements may suggest unequal loading of the limbs, which in turn may contribute to injuries and reduced performance.     

Effects of barefoot trimming on hoof morphology

Objective To monitor changes in hoof morphology in response to barefoot trimming. Methods Seven horses were trimmed every 6 weeks according to barefoot trimming principles, which involved levelling the hoof to live sole, lowering the heels, bevelling the toe and rounding the peripheral wall, while leaving the sole, frog and bars intact. A 4‐month period was allowed to lower the heels sufficiently to achieve a hoof shape representative of the barefoot trim. This was regarded as the starting point for morphological adaptations in response to maintenance of the trim. Hoof morphology was measured from lateral, dorsal and solar view photographs and lateromedial radiographs taken at 0, 4 and 16 months. Changes from 0 to 4 months represented differences between a natural hoof shape and the trim, while changes from 4 to 16 months represented adaptive effects during hoof growth. Results Establishment of the barefoot trim involved significant shortening of the toe, heel and medial and lateral walls, with increases in angulation at the toe, medial and lateral walls, but not at the heel. Maintenance of the trim resulted in a palmar/plantar migration of the heels, with increases in support length, heel angle and solar angle of the distal phalanx (P3). Conclusions Bevelling the toe and engaging the frog and bars in the weight‐bearing function of the foot resulted in elevation of the heel angle and solar angle of P3. These changes may be beneficial in treating under‐run heels and negative solar plane angulation of P3.     

A preliminary study into the correlation of stiffness of the laminar junction of the equine hoof with the length density of its secondary lamellae

Reason for performing study: The relationship between mechanical behaviour and microscopic structure of the laminar junction of equine hooves under testing conditions requires elucidation. Objectives: To determine mechanical parameters and 2D length density of profiles of secondary lamellae of the laminar junction in the dermal region and to assess possible correlations. Methods: Specimens (25 samples in total) of the laminar junction were taken from front, quarter and heel parts from 3 equine hooves and exposed to a uniaxial tensile test until rupture to obtain Young's moduli of elasticity, ultimate stress and strain. Neighbouring specimens to those used for the biomechanical experiment were processed histologically to assess the length density of laminar junction basement membrane using stereological grids. Results: The estimated median (interquartile range) length density of the laminar junction basement membrane was 0.024 (0.020–0.027)/µm. Young's modulus of elasticity was 0.15 (0.11–0.35) MPa in the small deformation region, and 7.58 (6.14–8.68) MPa in the linear region was. The ultimate stress was 1.67 (1.41–2.67) MPa, and the ultimate strain was 0.50 (0.38–0.70). The Young's modulus of elasticity in the region of small deformations has a moderate correlation with the length density of the laminar junction basement membrane. Conclusions: As with most soft biological tissues, the laminar junction has a nonlinear mechanical behaviour. Within the range of small deformations, which correspond to physiological loading of the laminar junction, a higher length density of the laminar junction basement membrane is correlated with a higher resistance of the laminar junction against high stresses transmitted from the distal phalanx to the hoof wall. Potential relevance: The condition of the laminar junction apparatus may be easily quantified as the length density of profiles of secondary dermal lamellae. This quantification provides a simple tool that could be used for comparing the proneness of the various parts of the laminar junction to initial stages of laminitis.     

Quantitative morphology of the equine laminar junction in relation to capsule shape in the forehoof of Standardbreds and Thoroughbreds

REASONS FOR PERFORMING STUDY: Differences in hoof morphology have largely been underappreciated in the literature until recently, and it is these that hold the key to interpreting functional adaptation in the hoof. HYPOTHESES: Primary laminar morphology correlates with hoof capsule shape; and breeds with different hoof shapes and loadings show different patterns of correlation. METHODS: Seventeen measurements of capsule shape and 3 of primary epidermal laminae (PEL) morphology (spacing, orientation and curvature) were made on right and left front hooves from 27 Standardbred and 25 Thoroughbred horses, and tested for breed differences. Three laminar variables (spacing, orientation and curvature) were measured on each hoof for samples of 25 PEL in 5 circumferential and 4 proximodistal locations. Pairwise correlations of capsular and laminar measurements were compared within breeds. Significant correlations were mapped onto the 20 sampling sites. RESULTS: Capsule shape differed significantly between breeds in 7 measurements and in a multivariate test. Between breeds, PEL differed in orientation and spacing primarily at the medial quarters and heels, and in curvature at both quarters (P<0.05). Significant correlations between several pairs of capsule and laminar variables were found at sample locations that differed markedly between breeds. CONCLUSIONS: Laminar morphology, hoof capsule shape and correlations between them differ between Standardbreds and Thoroughbreds. These results support the concept that remodelling of PEL is, at least in part, stimulated and directed by varying stress or strain levels in the laminar junction. POTENTIAL RELEVANCE: Understanding the biological responses of hoof tissues to stress should add to the ability to prevent lameness involving the hoof and maintain its health.     

Consistent detection of bovine papillomavirus in lesions, intact skin and peripheral blood mononuclear cells of horses affected by hoof canker

Reasons for performing the study: Equine hoof canker is a chronic proliferative pododermatitis of as yet unknown aetiology. Like equine sarcoid disease, canker is a therapy‐resistant disorder characterised by hyperkeratosis, acanthosis and a marked tendency to recur. Hypothesis: There is an association of sarcoid‐inducing bovine papillomaviruses of types 1 and 2 (BPV‐1, BPV‐2) with hoof canker disease. Methods: Using PCR‐based techniques, we assessed canker tissue, intact skin and/or peripheral blood mononuclear cells (PBMCs) of 25 canker‐affected horses for the presence of sarcoid‐associated BPV‐1 and ‐2. Results: Conventional PCR revealed BPV‐1/‐2 DNA in 24/24 canker, 12/13 skin and 10/11 PBMC DNA isolates. Using inverse PCR, full‐length BPV episomes were detected in 1/5 canker specimens. Sequencing of viral early and late genes amplified from canker, intact skin and PBMC DNA of 2 cases revealed an overall identity of 98% to BPV‐1. Viral DNA loads amounted to ≤16 copies per cell in canker tissue and intact skin, and to ≤0.35 copies per PBMC, as determined by quantitative PCR. Using RT‐PCR, the viral major oncogene E5 was shown to be transcribed in 2/4 canker tissue specimens and 5/7 PBMC isolates. Immunocapture PCR from 7 canker and 6 skin extract supernatants revealed capsomere‐associated viral DNA in one canker and one skin sample. Hoof tissue, skin and PBMCs collected from 13 individuals with no signs of canker or BPV‐related malignancies scored negative throughout the experiments. Conclusion: These findings suggest that the observed presence of BPV‐1/‐2 in canker‐affected horses is not coincidental but indicative of an active contribution to hoof canker disease. Potential relevance: The use of antivirals and/or immune modulators may help improving canker therapy.     

An investigation of the relationships between angles and shapes of the hoof capsule and the distal phalanx

Reasons for performing study: There is little scientific evidence to support the premise that poor foot conformation predisposes to foot pain and lameness. Objectives: To determine relationships between external characteristics of the hoof capsule and angles of the distal phalanx; to determine variability in shape of the distal phalanx; and to investigate association between distal phalanx angles and the injury causing lameness. Materials and methods: Feet were documented photographically and radiographically. Linear and angle measurements were obtained for the hoof capsule and distal phalanx and compared statistically. Horses were categorised according to injury group, and angles and linear ratios were compared between groups. Results: There was modest correlation between hoof wall and heel angles and angles of the distal phalanx. There was variation in shape of the distal phalanx. There was no significant association between injury type and angles of the distal phalanx, although there was a trend for the angle of the dorsal aspect of the distal phalanx with the horizontal to be smaller in horses with injuries of the podotrochlear apparatus or deep digital flexor tendon compared with other groups. Conclusions: There are variations in shape of the distal phalanx largely due to differences in orientation of the concave solar border and the solar border to the horizontal. Variations in shape of the distal phalanx were not accurately correlated with external characteristics of the hoof capsule. There were weak associations between injury groups and angles of the distal phalanx. Clinical relevance: Further work is required to elucidate risk factors for foot‐related lameness.     

Traumatic brain injury manifested as optic neuropathy in the horse: A commentary and clinical case

Blindness from head trauma is a serious debilitating disease in the horse. It appears that blunt trauma to the skull results in intracranial injury to the optic nerve at the optic chiasm from mechanical and vascular mechanisms. Systemically administered iron and calcium chelation therapy may enable some horses to recover vision.