Evaluation of Skin Bacterial Flora Before and After Aseptic Preparation of Clipped and Nonclipped Arthrocentesis Sites in Horses

Objective —This study evaluates skin bacterial flora before and after aseptic preparation of clipped and nonclipped arthrocentesis sites in horses. Study Design —The hair over one midcarpal joint and one distal interphalangeal joint on each horse was clipped. The contralateral joint served as the nonclipped comparison. Animals or Sample Population —Twelve adult horses. Methods —A prescrub sample for microbial culture was taken from the dorsal surface of all four joints for each horse. Each site was aseptically prepared with povidone iodine and 70% alcohol, followed by postscrub sampling for microbial culture. Colony forming units (CFUs) were determined for each sample, 24 hours after inoculation of blood agar plates. Results —There was no significant difference (P >.05) in number of postscrub CFUs between clipped and nonclipped skin over the midcarpal or distal interphalangeal joints. Percent bacterial reduction (mean ± SD%) after aseptic preparation differed significantly (P=.02) between clipped (99.8 ±.003%) and nonclipped (96.2 ±.05%) skin at the midcarpal joint, but not at the distal interphalangeal joint (clipped, 98.5 ±.03% and nonclipped, 97.8 ± 0.21%). There was a significant difference (P=.009) in number of prescrub CFUs obtained from clipped and nonclipped skin for the midcarpal joint. There was no significant difference in number of prescrub CFUs between clipped and nonclipped skin at the distal interphalangeal joint. Bacteria isolated from both clipped and nonclipped skin sampled postscrub included Bacillus sp, nonhemolytic Staphylococcus sp, and Micrococcus sp. Conclusions —The presence of hair over the midcarpal and distal interphalangeal joints does not appear to inhibit the ability of antiseptics to effectively reduce bacterial flora to an acceptable level for arthrocentesis. Clinical Relevance —Aseptic preparation of the skin over the midcarpal and distal interphalangeal joints can be accomplished without hair removal in horses.     

Evaluation of iodophor skin preparation techniques and factors influencing drainage from ventral midline incisions in horses.

OBJECTIVE: To document natural bacterial flora on the ventral aspect of the equine abdomen, to compare 2 preparation techniques, and to identify potential risk factors that may contribute to incisional drainage. DESIGN: Prospective study. ANIMALS: 53 horses undergoing exploratory celiotomy. PROCEDURE: Group-1 horses (n = 26) were prepared with povidone-iodine and alcohol. Group-2 horses (27) were prepared with a film-forming iodophor complex. Numbers of bacterial colony-forming units (CFU) were measured before and after surgical scrub, following skin closure, and after recovery from general anesthesia. Swab specimens to identify normal skin bacterial flora and potential pathogens were obtained by swabbing a 4 x 4-cm area. Variables that might affect incisional drainage were also investigated. RESULTS: For both techniques, there was a significant reduction in bacterial numbers after skin preparation. Incisional drainage was observed in 14 (26%) horses (8 group-1 and 6 group-2 horses). Preexisting dermatitis, poor intraoperative drape adherence, high number of bacterial CFU obtained after recovery from anesthesia, and high number of CFU obtained from the surgery room environment were the main risk factors associated with subsequent incisional drainage. Bacillus spp, nonhemolytic Staphylococcus spp, Micrococcus spp, Corynebacterium spp, Streptomyces spp, other nonenteric genera, and nonhemolytic Streptococcus spp were the most common isolates obtained before surgical scrub. CONCLUSIONS AND CLINICAL RELEVANCE: Both skin preparation techniques were equally effective in reducing numbers of bacterial CFU by 99%, and a significant difference was not found in incisional drainage rate between groups. Protection of the wound during recovery from anesthesia and the immediate postoperative period may reduce incisional drainage after abdominal surgery in horses.     

Evaluation of Surgical Scrub Methods for Large Animal Surgeons

Objective— The objective of this study was to determine the effectiveness of a 5–minute surgical scrub using either a one-brush or a two-brush technique in clean and dirty surgical procedures, and to compare the efficacy of povidone iodine with chlorhexidine as surgical scrub solutions. Study Design— Prospective clinical trial. Methods— Nine veterinarians scrubbed their hands on eight separate occasions using either povidone iodine or chlorhexidine gluconate. A 5-minute scrub and either a one-brush or two-brush technique used in both clean and dirty operations were evaluated by taking glove juice samples before scrubbing, immediately after scrubbing, and 30, 60, 90, and 120 minutes after scrubbing. Glove juice samples were cultured and the colonies were counted. Percent reductions of bacterial forming units were calculated for all eight scrub procedures. Results— All scrub procedures provided an adequate percent reduction in colony forming units (CFU) during the 2–hour sampling period. The number of CFU immediately after scrubbing were significantly lower than prescrub. At 120 minutes, there were significantly fewer CFUs than presecrub, but there were more than immediately after scrubbing. No significant difference in reduction in CFUs were detected between one-brush and two-brush techniques. Both chlorhexidine and povidone iodine scrub solutions adequately reduced bacterial colony counts for 120 minutes after scrubbing regardless of the amount of contamination before skin preparation. Conclusions— Bacterial counts after a hand scrub procedure using a one-brush technique were not significantly different than after a procedure that used a two-brush technique. Povidone iodine and chlorhexidine are equally effectively in decreasing bacterial numbers on the skin, given a variety of contamination levels present before the scrub procedure. Clinical Relevance— Surgeons may use either chlorhexidine or povidone iodine for antiseptic preparation of their hands before surgery. A two-brush technique is not necessary.     

Comparison of three dorsal techniques for arthrocentesis of the distal interphalangeal joint in horses

OBJECTIVE: To compare 3 dorsal techniques for arthrocentesis of the distal interphalangeal joint in horses with regard to ease of performing the technique and to determine the role of operator experience in ease of performing these techniques. DESIGN: Observational study. Sample Population-Forelimbs from 17 equine cadavers and 12 horses (16 joints) undergoing arthrocentesis for therapeutic or diagnostic purposes. PROCEDURES: In both forelimbs from 7 of the equine cadavers, 3 arthrocentesis techniques (dorsal perpendicular, dorsolateral, and dorsal inclined) were performed in random order by a single experienced individual, and number of attempts needed to successfully insert the needle into the joint was recorded. For the forelimbs from the remaining 10 cadavers, veterinary students without experience in arthrocentesis performed each of the 3 arthrocentesis techniques (2 limbs/student) in random order, and number of attempts was recorded. In the clinical patients, arthrocentesis was performed by means of the dorsal inclined technique. RESULTS: For both the experienced individual and the veterinary students, number of attempts needed was significantly lower with the dorsal inclined technique than with the dorsal perpendicular or dorsolateral technique. Arthrocentesis was successful with the dorsal inclined technique in all 16 joints in the clinical patients; synovial fluid was recovered from 14 of the 16 joints. The procedure was well tolerated in all horses, except one that reacted to needle insertion. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the dorsal inclined technique for arthrocentesis of the distal interphalangeal joint was easier to perform than was the dorsal perpendicular or dorsolateral technique, regardless of experience level of the operator.     

Comparison of two pre-surgical skin preparation techniques.

A one-step iodophor skin preparation solution was compared to chlorhexidine gluconate application as a pre-operative skin preparation method in 100 animals undergoing elective ovariohysterectomy. Pre-operative and intra-operative skin cultures demonstrated no difference in antiseptic efficacy. No animal in the study demonstrated signs of systemic infection, and no adverse local effects from either antiseptic were seen. The iodophor solution evaluated (DuraPrep) is a safe and effective pre-operative skin preparation agent in small animal patients undergoing clean surgical procedures.     

Intraosseous gentamicin perfusion of the distal metacarpus in standing horses

OBJECTIVE: To report tissue gentamicin concentrations after intraosseous (IO) perfusion in standing horses. STUDY DESIGN: In vivo study. ANIMALS OR SAMPLE POPULATION: Twelve horses. METHODS: Sedated horses had a cannulated cortical bone screw inserted into the dorsolateral aspect of the treated metacarpus and a tourniquet applied proximally. Gentamicin (2.2 mg/kg) diluted in sterile saline solution (0.1 mL/kg) was infused through the screw. Two horses were euthanatized at each time interval: 0, 2, 6, 12, 24, and 36 hours. Synovial fluid and bone samples were collected distal to the screw from both forelimbs. Gentamicin concentrations were measured using fluorescence polarization immunoassay. RESULTS: The highest synovial fluid gentamicin concentrations were 385+/-273 microg/mL (mean+/-SD) in the metacarpophalangeal joint, 225+/-205 microg/mL in the proximal interphalangeal joint, 215+/-205 microg/mL in the distal interphalangeal joint, 382+/-195 microg/mL in the digital flexor tendon sheath, and 206+/-161 microg/mL in the navicular bursa. The highest bone concentrations of gentamicin were 55+/-30 microg/g in the distal metacarpus, 34+/-27 microg/g in the proximal, 16+/-15 microg/g in the middle, and 16+/-2.2 microg/g in the distal phalanges, and 27+/-17 microg/g in the proximal and 24+/-11 microg/g in the distal sesamoid bones. CONCLUSION: Standing IO perfusion of gentamicin resulted in local antibiotic concentrations in the synovial structures and bones of the distal aspect of the limb that exceed the reported minimum inhibitory concentration of pathogens commonly implicated in equine orthopedic infections. CLINICAL RELEVANCE: Standing IO perfusion of gentamicin in the distal aspect of the limb should be considered for treatment of orthopedic infections of this region in horses.     

Comparative Evaluation of Two Surgical Scrub Preparations in Cattle

One hundred seventeen cattle that had undergone surgery were assigned randomly to two preoperative skin preparation protocols. Group 1 (60 animals) skin preparation was with povidone-iodine soap and isopropyl alcohol, whereas group 2 (57 animals) had skin preparation with chlorhexidine gluconate and isopropyl alcohol. Quantitative microbial culture plates were used to estimate the number of colony forming units (CFUs) before skin preparation (prescrub), after skin preparation (postscrub), after surgery (postoperative), and in room air (environment). A significant decrease in CFU occurred postscrub for both skin preparations ( P <.05). Chlorhexidine and alcohol preparation resulted in significantly fewer CFUs (LSMean ± SE = 2.79 CFU ± 1.74) and a greater percentage reduction in CFUs (98.64%± 2.01) postscrub than povidone and alcohol (LSMean ± SE = 10.27 CFUs ± 1.51, 93.29%± 1.85); ( P <.005). Group 2 had a significantly higher frequency of negative cultures postscrub (49.1%) compared with group 1 (18.3%) ( P <.001). The number of postoperative CFUs were not significantly different between the two treatment groups. Wound infection frequency for clean surgical procedures was not significantly different between the two skin preparation protocols (group 1 = 9.8%, group 2 = 10.7%), however, infection frequency was significantly higher for surgical procedures with a ventral abdominal approach (5 of 14, 35.7%), compared with a flank approach (1 of 41, 2.4%) or other approaches (orthopedic procedures) (1 of 16, 6.3%) ( P <.05). Both skin preparation protocols were effective and safe in decreasing the skin microflora population of cattle before surgery and although preparation with chlorhexidine gluconate and alcohol resulted in less CFUs immediafly postscrub, the frequency of surgical wound infection was similar for both protocols.     

Comparison of Two Methods for Presurgical Disinfection of the Equine Hoof

OBJECTIVES: To determine for equine hooves the normal resident aerobic bacterial population and the efficacy of 2 methods of disinfection. Study Design-Measurement of total bacterial, gram-positive bacterial, and gram-negative bacterial surface populations from the frog, sole, and hoof wall after each step of 2 different preoperative surgical disinfection techniques. ANIMALS: Six adult horses. METHODS: Hoof wall, sole, and frog samples were collected for quantitative bacteriology before, during, and after 2 multistep antiseptic preparation techniques: Method A-6-minute scrub with povidone-iodine soap, followed by 24-hour submersion in povidone-iodine solution-soaked cotton; and Method B-initial removal of superficial layer of hoof capsule before completing Method A disinfection procedures. RESULTS: Removal of the superficial hoof layer, application of the povidone iodine scrub, and completion of the povidone-iodine soak all significantly (P < .0008) decreased total bacterial numbers. Method B had significantly lower bacterial counts than method A at each consecutive step. Final total bacterial counts remained greater than 10(5) bacteria per gram of tissue regardless of preparation method. CONCLUSIONS: The hoof surface hosts a broad spectrum of aerobic gram-positive and -negative bacteria, many of which are potential pathogens. Bacterial numbers can be significantly reduced by removal of the superficial hoof surface, by application of a povidone-iodine scrub, and by use of a 24-hour povidone-iodine soak. However, bacterial populations >10(5) g per tissue persist after these disinfection procedures. CLINICAL RELEVANCE: Regardless of the preparation methods used in this study, bacterial populations capable of inducing wound infection remain on the hoof capsule.     

Septic Arthritis of the Distal Interphalangeal Joint in 12 Horses

The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (one horse), intraarticular injection of antimicrobial drugs (five horses), curettage of the distal phalanx (one horse), and cancellous bone grafting to promote fusion (one horse). Five horses were euthanatized. Ankylosis of the affected joint developed in five horses, four of which are pasture sound. Two horses treated medically are sound although one underwent subsequent palmar digital neurectomy for treatment of navicular syndrome.     

Effects of 6 degree elevation of the heels on 3D kinematics of the distal portion of the forelimb in the walking horse

REASONS FOR PERFORMING STUDY: Understanding of the biomechanical effects of heel elevation remains incomplete because in vivo studies performed with skin markers do not measure the actual movements of the 3 digital joints. OBJECTIVE: To quantify the effects of 6 degree heel wedge on the 3-dimensional movements of the 4 distal segments of the forelimb in the walking horse. METHODS: Four healthy horses were used. Kinematics of the distal segments was measured invasively with a system based on ultrasonic triangulation. Three-dimensional rotations of the digital joints were calculated by use of a 'joint coordinate system' (JCS). Data obtained with heel wedges were compared to those obtained with standard shoes during the stance phase of the stride. RESULTS: Heel wedges significantly increased maximal flexion of the proximal (PIPJ) and distal (DIPJ) interphalangeal joints and maximal extension (mean +/- s.d. +0.8 +/- 0.3 degrees) of the metacarpophalangeal joint (MPJ). Extension of the PIPJ and DIPJ was decreased at heel-off. Few effects were observed in extrasagittal planes of movement. CONCLUSIONS: Heel wedges affect the sagittal plane kinematics of the 3 digital joints. POTENTIAL RELEVANCE: Controversial effects previously observed on the MPJ may be explained by the substantial involvement of the PIPJ, which was wrongly neglected in previous studies performed on the moving horse.     

Heel bulb lacerations in horses: 101 cases (1988-1994)

OBJECTIVE: To determine clinical history, structures involved, treatment, and outcome of lacerations of the heel bulb and proximal phalangeal region (pastern) in horses. DESIGN: Retrospective study. ANIMALS: 101 horses. PROCEDURES: Medical records of horses with lacerations of the heel bulb and pastern were reviewed, and follow-up information was obtained. RESULTS: 75 horses were Quarter Horses. Most horses were not treated with antimicrobial drugs prior to referral. Mean +/- SD time from injury to referral was 24 +/- 45 hours (range, 1 to 168 hours). Lacerations were most frequently caused by contact with wire or metal objects. In 17 horses, lacerations involved synovial structures; the distal interphalangeal joint was most commonly affected. One horse was euthanatized after initial examination. Wound treatment consisted of cleansing, lavage, debridement, lavage of affected synovial structures, suturing of fresh wounds, and application of a foot bandage or cast. Fifty-six horses were treated with systemically administered antimicrobial drugs. Follow-up information was collected for 61 horses. Fifty-one horses returned to their intended use and had no further complications; 10 horses had complications associated with the wound, and of those horses, 5 were euthanatized and 1 horse died from an unrelated cause. Horses with lacerations that involved synovial structures had worse outcomes than horses with lacerations that did not involve synovial structures. CONCLUSIONS AND CLINICAL RELEVANCE: Horses that sustain heel bulb lacerations can successfully return to their intended use. Involvement of the distal interphalangeal joint is associated with poor prognosis.     

Evaluation of surgical scrub and antiseptic solutions for surgical preparation of canine paws

The purpose of the prospective study reported here was to evaluate surgical preparation of canine paws. Three combinations of surgical scrub solutions and antiseptic solutions were used: (1) 7.5% povidone-iodine scrub/10% povidone-iodine solution; (2) 2% chlorhexidine acetate scrub/2% chlorhexidine diacetate solution; and (3) tincture of green soap/70% isopropyl alcohol. The control was warm (38 to 42 C) tap water. Four microbial colony counts were used to evaluate surgical preparation of 4 paws of 8 dogs. Specimens were obtained from the paws for a baseline microbial flora count. After surgical scrub was performed, additional specimens were obtained for bacteriologic culturing. Antiseptic was applied followed by collection of another specimen for bacteriologic culturing. A final specimen was obtained following a 24-hour period under a sterile occlusive bandage. The 3 scrub solutions and the tap water control resulted in lower colony counts following scrubbing of the paws; however, only the 3 antiseptic solutions resulted in further colony count reduction after their application. Evaluation of residual colony counts isolated from specimens taken after a 24-hour period under a sterile occlusive bandage revealed chlorhexidine and povidone-iodine scrub/antiseptic combinations to be similar in antibacterial activity, with significantly (P less than or equal to 0.05) lower colony counts than those from specimens of paws treated with either the tincture of green soap/isopropyl alcohol combination or the tap water control. The lack of a significant difference between the bacterial counts immediately after surgical preparation with povidone-iodine and chlorhexidine and their respective 24-hour residual counts, indicated no particular advantage to surgical preparation and occlusive bandaging 24 hours prior to surgery.(ABSTRACT TRUNCATED AT 250 WORDS)     

Radiographic evolution of the forelimb digit in Ardenner horses from weaning to 28 months of age and its clinical significance

Ossification of collateral cartilages is a common radiographic finding in draught horses and indication of a high frequency of interphalangeal osteo-arthropathy have been found in Ardenner horses. This study first aimed at following the evolution of the digits of the forelimbs on radiographic images in a group of 32 Ardenner horses from weaning to 852 +/- 19 days and, secondly, at evaluating the clinical significance of the observed radiographic changes. At 250 +/- 21 days, only 23% of the horses presented a small separate ossification centre of collateral cartilages above the level of the distal sesamoid bone or at the level of the proximal half of the middle phalanx. At 852 +/- 19 days, 100% of the horses presented an ossification of collateral cartilages but at different stages and grades. The presence and the extent of the ossification of the lateral cartilages were not significantly associated with lameness. Phalanges changes appeared at the average age of 1 year and they were represented by entheseophytes on the dorsal surface of the middle and distal phalanges. The frequency of affected horses increased with age as well as the size of the entheseophytes. This may reflect mechanical stresses applied to the interphalangeal joints. A significant association with the presence of lameness was pointed out. The presence and the severity of phalanges changes could be of importance, in combination with a clinical examination, in improving the selection of horses able to assume work and/or leisure activities.     

Concentrations of serum amyloid A in serum and synovial fluid from healthy horses and horses with joint disease

OBJECTIVE: To determine serum amyloid A (SAA) concentrations in serum and synovial fluid from healthy horses and horses with joint disease and assess the effect of repeated arthrocentesis on SAA concentrations in synovial fluid. Animals-10 healthy horses and 21 horses with various types of joint disease. PROCEDURES: Serum and synovial fluid samples were obtained from each horse. In 5 of the 10 healthy horses, arthrocentesis was repeated 9 times. Concentrations of SAA were determined via immunoturbidometry. RESULTS: Serum and synovial fluid SAA concentrations were less than the assay detection limit in healthy horses and did not change in response to repeated arthrocentesis. Synovial fluid SAA concentrations were significantly higher in horses with suspected bacterial joint contamination or infectious arthritis, or tenovaginitis than in healthy controls, and serum concentrations were significantly higher in horses with infectious conditions than in the other groups. Neither serum nor synovial fluid SAA concentrations in horses with low-inflammation joint conditions differed significantly from those in healthy controls. Concentrations of SAA and total protein in synovial fluid were significantly correlated. CONCLUSIONS AND CLINICAL RELEVANCE: Synovial fluid SAA concentration was a good marker of infectious arthritis and tenovaginitis and appeared to reflect changes in inflammatory activity. The advantages of use of SAA as a marker include the ease and speed of measurement and the fact that concentrations in synovial fluid were not influenced by repeated arthrocentesis in healthy horses. Further study of the SAA response in osteoarthritic joints to assess its usefulness in diagnosis and monitoring of osteoarthritis is warranted.     

Retrospective analysis of distal limb conformation and lameness in mature horses after desmotomy of the accessory ligament of the deep digital flexor tendon for management of a flexural deformity

Mature horses that present with flexural deformity of the distal interphalangeal joint and lameness isolated to the foot may obtain long‐term benefits from desmotomy of the accessory ligament of the deep digital flexor tendon (ALDDFT). This retrospective analysis of medical records and radiographs included 13 horses, aged ≥2 years, presented for lameness isolated to the hoof region and diagnosed with flexural deformity of the distal interphalangeal joint. Radiographic angles of the hoof and distal interphalangeal joint and lameness scores were compared before and after desmotomy of the ALDDFT. Follow‐up data including the ability to perform the intended use were obtained at least one year after surgery. There was improvement in the angle between the dorsal aspect of the third phalanx and the weightbearing surface of the hoof, improved alignment between the dorsal hoof wall and dorsal aspect of the third phalanx, and improved alignment of the distal interphalangeal joint. Lameness was decreased in 9/13 horses and 10/13 horses were performing at their level of intended use. Evidence of improved hoof conformation and lameness following desmotomy of the ALDDFT in lame horses with flexural deformity of the distal interphalangeal joint would indicate this procedure should be considered in mature horses.     

Comparison of an Antimicrobial Adhesive Drape and Povidone-lodine Preoperative Skin Preparation in Dogs

The antimicrobial efficacy of an adhesive drape applied after a 1-minute alcohol scrub was compared to a povidone-iodine (PI) skin preparation technique in dogs. Each technique was applied to both sides of 15 adult anesthetized dogs on premeasured, clipped areas of skin. Skin bacteria were quantified before, immediately after, and 1 hour after skin preparation. Predominant skin bacteria were isolated by swabbing the skin. The percentages of bacterial reduction immediately after and 1 hour after skin preparation, percentages of negative culture results, cultures with more than five colony-forming units, and the frequency of skin reactions were calculated and analyzed statistically. Drape adhesion was assessed subjectively. The percentage reduction in skin bacteria was significant for both techniques and comparable to that reported in humans. The adhesive drape was significantly less effective in both the immediate and 1-hour periods. Lift occurred in 66% of drape applications but was not associated with high bacterial counts. Acute contact dermatitis was more frequent after skin preparation with PI. There was no difference between the techniques in recovery of potential skin pathogens. The authors conclude that application of this antimicrobial adhesive drape after a 1-minute alcohol scrub is not as effective in the reduction of skin bacteria in dogs as is PI preparation of the skin.     

Digital semiological anesthesia in horses: technique and elements of interpretation

Digital semiological anesthesia in horses: Technique and elements of interpretation. Semiological anesthesia of the pes is used during examinations for lameness in horses. Recent research data on the distal digital, distal interphalangeal articular, and podotrochlear intrathecal nerve blocks indicate that they are less than specific when considered in isolation. They should be used in combination to localize pain in the pes. A positive response to anesthesia of the distal interphalangeal articulation could also indicate that the source of the pain was in the podotrochlear apparatus or the dorsal part of the sole. Podotrochlear anesthesia also anesthetizes the dorsal part of the sole and, later, the distal interphalangeal joint. Distal digital anesthesia affects a large palmar area of the hoof and extends dorsally. Overall, basic research provides little support for the practical uses of semiological blocks.     

Three-dimensional kinematics of the distal forelimb in horses trotting on a treadmill and effects of elevation of heel and toe

REASONS FOR PERFORMING STUDY: Comprehensive understanding of the 3-dimensional (3D) kinematics of the distal forelimb and precise knowledge of alterations induced by dorsopalmar foot imbalance remains incomplete because in vivo studies performed with skin markers do not measure the actual movements of the 3 digital joints. OBJECTIVE: To quantify the effects of 6 degree heel or toe wedges on the 3D movements of the 4 distal segments of the forelimb in horses trotting on a treadmill. METHODS: Three healthy horses were equipped with ultrasonic markers fixed surgically to the 4 distal segments of the left forelimb. The 3D movements of these segments were recorded while horses were trotting on a treadmill. Rotations of the digital joints were calculated by use of a joint coordinate system. Data obtained with 6 degree heel or toe wedges were compared to those obtained with flat standard shoes. RESULTS: Use of heel wedges significantly increased maximal flexion and decreased maximal extension of the proximal (PIPJ) and distal (DIPJ) interphalangeal joints. Inverse effects (except for PIPJ maximal extension) were observed with the toe wedges. In both cases, neither flexion-extension of the metacarpophalangeal joint nor extrasagittal motions of the digital joints were statistically different between conditions. CONCLUSIONS: At a slow trot on a treadmill, heel and toe wedges affect the sagittal plane kinematics of the interphalangeal joints. POTENTIAL RELEVANCE: Better understanding of the actual effects of toe and heel wedges on the 3D kinematics of the 3 digital joints may help to improve clinical use of sagittal alteration of hoof balance in the treatment of distal forelimb injuries.