Page 299 - The Veterinary Care of the Horse

Treatment and prognosis

Where there is extensive deposition of new bone or considerable loss of bone density, there is
VetBooks.ir no effective treatment and the prognosis is poor.

In less severe cases the horse may benefit from:

• a period of rest

• correction of any foot imbalance
• fitting of wide webbed shoes that are ‘seated out’ to protect the sole (see Figure 6.36)

• the use of egg bar shoes to maximize the weight-bearing surface

• the fitting of sole pads

• application of a topical iodine, phenol and formalin mixture to harden soft or thin soles
• modification of the exercise programme to avoid working on hard or stony ground

• administration of non-steroidal anti-inflammatory drugs such as phenylbutazone to

reduce the pain and inflammation.

If the above treatments are unsuccessful, a neurectomy may be considered as a last resort. If a
palmar digital nerve block completely abolishes the lameness, a section of the palmar digital

nerve supplying sensation to the foot can be surgically removed.

DISEASES OF THE COFFIN JOINT (DISTAL

INTERPHALANGEAL JOINT)

The distal interphalangeal or coffin joint has a complex structure. In addition to the joint
between the middle and distal phalanges, both of these bones articulate with the navicular

bone (see Figure 6.4). The joint may be affected by a number of problems which include:
• synovitis; this is inflammation of the synovial membrane of the joint

• osteoarthritis

• strain of the collateral ligaments joining the middle and distal phalanges

• fractures of the pedal bone which involve the joint
• septic arthritis (joint infection) from penetrating wounds

• subchondral bone cysts of the middle phalanx or the distal phalanx.

Signs of coffin joint pain