Page 14 - November 2008 The Game

14 The Game, November 2008 WHITE LINE DISEASE
A problematic hoof condition with no sure cause or cure, white line disease is approaching epidemic pro- portions, some researchers say.
Your farrier has just removed your horse’s shoes and is trimming away some excess hoof, when he nds an area of whiteish-gray, chalky horn along the white line, that crumbles when he probes it with a hoof knife. Though he’s a man of few words, you recognize the furrowed brow, as he follows the channel upward and brings forth more crumbly stuff, as less than good news. “What is that?”, you ask.
He means separation as in white line disease, a separation between the hoof wall and the sole, which compromises the protective function of the junction between the two structures and allows bacteria and fungi from the surround- ing environment to enter the hoof. The progressive deterioration of the inner hoof wall that results has been called many things over the years – wall thrush, seedy toe, stall rot, hollow foot, and onychomycosis just to name a few – and its most common current name is a bit of a misnomer as well, because it’s not really the white line which is involved, but the non-pigmented hoof horn at the junction between the stra- tum medium (the middle layer of the
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Canada’s Thoroughbred Racing Newspaper
by Karen Briggs
hoof – a crack, an abscess, sometimes even nail holes from shoeing – allows pathogens to enter and begin to feed upon, and destroy, the keratin tissue
of the hoof wall. It’s believed that areas in the hoof where there is dried blood (such as an area of bruising near the white line) can provide a growth medium for the causative organism(s) to take hold and thrive.
* chronic infections (hoof abscess) * direct hoof trauma with bleeding * white line disease can also
softer, and more irregular than in a normal hoof
He replies, “Looks like you’ve got some separation here.”
Most researchers believe there has
to be some sort of mechanical stress
on the hoof for white line disease to begin. That mechanical stress can vary from very upright feet (club foot) to hooves with long-toe/low-heel syn- drome, to hooves with ares developed by turn-out in soft, wet conditions.
* once damage is extensive, the hoof is painful and white line disease can mimic laminitis both clinically and on radiographs (x-rays).
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hoof capsule) and the laminar horn. White line disease is thought to begin when a physical defect in the
provides a growth medium for the causative organism(s)
In its initial stages, white line disease doesn’t cause lameness, but that can change as it progresses and begins to compromise the inner structure of the hoof, causing symptoms very much like laminitis (including possible rota- tion of the cof n bone as the laminar connections disintegrate).
or anti-fungal medication is likely to kill them off. Researchers do agree, though, that the organisms responsible are anaerobic (they thrive in an oxy- gen-poor or oxygen-free environment).
DIAGNOSIS:
White line disease is usually discov- ered during a routine trim. A chalky area that may seem minor on physical examination is sometimes much more extensive when viewed radiographi- cally – the diseased area will appear as an air density between the hoof wall and the third phalanx (cof n bone). Rotation of the cof n bone is some- times observed when the disease is advanced.
TREATMENT:
RISK FACTORS FOR WHITE LINE DISEASE:
* in the early stages, white line dis- ease appears as a localized chalky area along the hoof wall/sole junction
* hot, wet, humid conditions
* unbalanced feet
* improper trimming
* long toe/underrun heel confor-
* can progress to involve a much larger area, along the toe (“seedy toe”), heels, or quarters of the foot
Early detection and aggressive treat- ment are the keys to beating white line disease. Treatment begins with resec- tion (removing the outer hoof wall in the affected area to expose the diseased tissue to the air) and debridement (removal of the diseased tissue). The exposed areas continue to be debrided very 10-14 days, until there is a solid junction between the inner hoof wall and the laminae.
mation, which increases the shear forces on the hoof wall
* external hoof wall is brittle and dry, and hoof has dif culty holding onto a shoe
* contracted tendons and/or club foot
* a dish forming along one side of the hoof, with a bulge on the opposite site directly above the affected area
If the resection to the hoof wall is extensive, therapeutic shoeing can help protect the integrity of the remaining hoof. The exact type of shoe depends on the location of the damage, but it should provide full support while still allowing for regular debridement of the affected area.
* hoof cracks which involve the white line
* poor consistency of horn along the white line (crumbly or ‘cottage- cheese-like’)
occur secondarily to laminitis episodes which compromise the laminae and associated hoof wall.
* there may be black, nger-like striations in the non-pigmented white layer
Despite extensive research, scientists have yet to isolate a single causative organism for white line disease. Vari- ous bacterial and fungal agents have taken the blame at various times, but the truth is that it probably takes a synergy of the right (or wrong) organ- isms, opportunistically combining their energies, to create a case of white line disease. That can make treatment very frustrating, for no one anti-bacterial
* separation at the white line may appear small but, when probed, may open into a larger channel or cavity
SYMPTOMS:
* tender soles (noticeable with hoof testers) and/or heat in hoof wall
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* soles becoming atter over time
* sole or toe bruising near
the white line where dried blood
* hoof makes a hollow sound when the outer hoof wall is tapped with a hammer
* when hoof is viewed from the sole, the white line is noticeably wider,
In some cases, where it’s im- perative that the horse go back to work, the defect can be temporar- ily repaired with an acrylic patch, but many vet- erinarians feel that patching the hole can be detrimen- tal, because it doesn’t allow air to circulate to the diseased area.
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