Page 127 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

102 CHAPTER 1

VetBooks.ir 1.175 1.176

1.177 1.178

Figs. 1.175–1.1.178 Quittor. (1.175) Lateral swelling and a draining sinus immediately proximal to the
coronet, indicative of quittor. (1.176) Lateral view of an elliptical incision proximal to the coronet and a trephine
hole in the lateral hoof wall to provide drainage; the position of the probes confirms communication between
the proximal wound and the white line at the distal aspect of the wall. (1.177) The proximal incision has been
sutured, but the wound created by the trephine must heal by secondary intention. (1.178) Several weeks after
the surgery both wounds are completely epithelialised, but the defect in the stratum medium created by the
trephine will not be replaced until it grows out past the distal surface of the wall.

the capsule of the DIP joint, which lies immediately Prognosis
medial to the ungual cartilage. Postoperatively, the The prognosis for elimination of the infection
distal limb is bandaged, systemic antibiotics are is guarded to fair because recurrence is possible
continued until all surfaces are granulating, anal- regardless of the surgical technique, but if successful,
gesia is provided as needed and tetanus prophylaxis return to normal athletic activity can be expected.
administered. Once healed and dry, the residual
defect that occurs in the wall after the underlying NAVICULAR DISEASE
wound has epithelialised may be filled with a com-
posite as needed. Definition/overview
A promising alternative to surgical resection of Navicular disease results in lameness associated with
the affected cartilage is maggot therapy, which obvi- pain arising from the navicular bone, the collateral
ates the need for surgery and hence reduces the asso- sesamoidean and distal impar ligaments and the
ciated risk. However, it does take longer as multiple navicular bursa. Concurrent degenerative change
treatments may be necessary. of the DDFT can be present. There are four basic