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  Discussion on Research Summary: Hoof Keratoma and Advanced Imaging Techniques
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DrO

Posted on Saturday, Jul 23, 2011 - 5:40 pm:

Goodness CT and MRI imaging for a hoof keratoma. I can certainly see where this would make surgery a lot easier but may be a bit of an overkill if the diagnosis has been made radiographically already. The study is also interesting in that it gives some prognostic guidelines to follow in all cases along with the recommendation of using hoof wall replacement products and shoeing.
DrO

Vet Surg. 2011 Jul 19.
Compute d Tomography or Magnetic Resonance Imaging-Assisted Partial Hoof Wall Resection for Keratoma Removal.
Getman LM, Davidson EJ, Ross MW, Leitch M, Richardson DW.
Source

Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, PA.
Abstract

Objectives: To (1) describe the computed tomography (CT) and magnetic resonance imaging (MRI) appearance of keratomas; (2) describe a CT- or MRI-assisted partial hoof wall resection technique for removal of keratomas; and (3) evaluate the morbidity and postoperative outcome of these horses. Study Design: Case series. Animals: Horses (n=10) with keratoma. Methods: Data retrieved from medical records included signalment, lameness duration and grade, physical and diagnostic evaluation findings, CT and MRI technique and findings, surgical details, histopathologic diagnosis, postoperative treatment, and complications experienced. Long-term outcome was obtained by telephone interviews of owners. Results: Complications including excessive granulation tissue formation and infection were seen in 2 horses (20%). No keratoma recurrence occurred. Follow-up information was available for 8 horses; 7 were sound and had resumed work. Mean time until they became sound was 2.7 months, and mean time until work resumed was 3.6 months. Conclusions: CT and MRI can be used to accurately identify the location of keratomas. Postoperative complications may be decreased by creating smaller hoof wall defects, filling the defects with antimicrobial-impregnated polymethylmethacrylate, and placing a shoe early in the postoperative period.
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