Posted by M. W. Myers, D.V.M. on June 21, 2003 at 17:45:48:
In Reply to: Re: Resection protection posted by Frank on June 18, 2003 at 23:26:52:
: : : : : : I am working on a case that needs a severe resection of the toe (accute founder) was wondering what everyone else was using for protection I have been using hoof build but was wondering if anyone else has a better trick
: : : : : : Frank
: : : : : Can I answer your question with a question?.....if the breakover is correct and the support is adequate, why is a resection necessary
: : : : : I work on foundered horses all the time and the last time I dealt with anything remotely close to a resection was a total hoofwall ablation where the hoof capsule was going to be sloughed anyhow......which opened up an entirely different can of worms :)
: : : : : ...just trying to understand the thinking behind the resection....thanks
: : : : : Derin
: : :
: : : :
: : : : That is the whole issue the support is not even remotly close to adequate the hoof is going to be basically supported by a cuff and vettec
: : : : Frank
: : : ps this is far from a regular founder case for I have done plenty and would give anything to have this wonderful horse to have a straight foward regular founder she is probally one of the cutiest and nicest mares that I have come across in a long time
: : : Frank
: : If you can post some pics and radiographs, we could be of more assistance. Resections are rarely necessary except in high scale cases or older ones in which there is considerable hoof wall separation. High scale cases require experienced veterinary assistance.
: : M. W. Myers, D.V.M.
: I do appreciate your concern but I already have three vets and the entire EDSS team in CO. helping on this case. I posted asking if anyone had any better ways to provide protection for the foot. The vets in this case have about sixty years combined experience, and everyone agrees that a resection is needed. The complications in this case are to numerous to detail and list here. But again I do apprecaite your concern
: Frank
If you have all this help, I might as well add some myself.
The approach will depend on what is found during the resection, or what you know you will find.
If the wall is separated, and the underlying tissue dry and only requiring cleaning, no protection of the tissue is needed, however, support of the hoof may be in order to prevent collapse of the pillars. This can be accomplished by either apply clips (if possible) or support of the caudal portion of the hoof while unloading the cranial portion. Rockering mechanisms do a very good job of unloading the cranial portion of the hoof. High wedges are sometimes selected for this purpose if more total support is needed and less motion is desired.
If the underlying tissue is wet, then a dressing may be desired which can be formed from casting material over an absorbent dressing that can be easily replaced. The best tape I have found for the hoof is Elasticon. Nothing (not even good old duct tape) can hang onto a hoof like this product. You can get a bit more exotic if there is available hoof wall and attach with screws or place screws and wire the "prosthesis" to the front wall. Hoof support is still paramount, so don't let those pills collapse laterally or there will be additional problems in recovering the hoof.
More information on the case would result in more assistance.
Venograms are very helpful in telling you what you may find during the resection.
M. W. Myers, D.V.M.
P.S. The EDSS team is aware of my credentials and I may be able to add some creative assistance if I have more data to work from. I am noted for "thinking out of the box".