Petite parenthèse dans les commentaires sur Pin
pour répondre à la question de clochette11:
Citation :
Rien d'encourageant quand les tissus lâchent alors :/
Lors d'une perforation de la sole, même si c'est plus compliqué du fait d'un risque d'infection qu'il est toutefois tout à fait possible de maîtriser, la réhabilitation est possible. Voir ce lien :
http://www.thelaminitissite.org/feet-faq/solar-penetration
dont sont issus les paragraphes ci-dessous que je traduirai dès que possible :
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Prevention
Every step should be taken to prevent solar penetration. On page 351 of Care and Rehabilitation of the Equine Foot, Pete Ramey says "At the first signs of laminitis, restore P3 to a more natural ground plane, relieve pressure on the walls, and pad the sole with foam rubber ? vertical sinking and destructive pressure to the solar corium can be prevented?....."Do not wait. Immediate action to eliminate constant pressure on the solar corium and separational forces on the laminae and the coronary papillae can be more important than anything else you do."
See Sole Support and EVA foam pads for suggestions for padding the soles.
Trimming
Trimming the foot with P3 penetration of the sole is not particularly different to trimming any foot with rotation:
restore the palmar angle to normal and provide a good base of support at the back of the foot, encouraging the heels, frog and bars to bear the horse's weight.
remove the detached wall in front of P3 from weight bearing and further separation, by bringing breakover back to just in front of the perforation, without invading true sole, and beveling the outer wall.
protect the sole (never remove true sole material in the front of the foot) and relieve pressure on the exposed area with padding, possibly with an air hole directly beneath the rim of P3.
See Laminitis and the Feet. Well marked lateral radiographs should always be taken to guide the trim, but if not available, as the sole grows from and is an extension of the bottom of P3, everything behind the exposed P3 is likely to be sole, and everything in front is likely to be laminar wedge/toe. Collateral groove depths should guide the trim.
Treatment
Horses with solar penetration will usually require soaks and/or poulticing and/or topical applications to prevent or treat infection in the foot, and the feet may need to be kept covered. Baby nappies (diapers) can be useful for draining exudate away from the foot and providing cushioning.
Several professionals report good results from soaking solar penetrations with CleanTrax (available from Equine Podiatry Supplies in the UK). CleanTrax contains a proprietary hypochlorous compound which is non-necrotizing and has no adverse effects on normal, healthy cells but eliminates infection from bacteria, fungi and spores. CleanTrax is used on humans to treat deep-seated nail infections and on open wounds/surgeries to eliminate the risk of secondary infections.
Other treatments suitable for sub-solar abscesses should be suitable for treating P3 penetrations, such as White Lightning, 50% apple cider vinegar:50% water, warm water and Epsom salts (magnesium sulphate) - see Abscesses.
5 of the 14 horses in Dr Debra Taylor's published rehabilitation protocol had solar necrosis/prolapsed solar coriums (all of the horses recovered). Their soles were treated with topical tetracycline and/or metronidazole. During periods of active abscess formation and/or drainage of exudates from the sole, owners were advised to soak the feet 3 to 5 times weekly in either magnesium sulfate solution or 50% acetic acid solution (TLS comment: we suspect this means 50% apple cider vinegar:50% water solution).
See: 2.6. Management Protocol: Medication
Taylor D, Sperandeo A, Schumacher J, Passler T, Wooldridge A, Bell R, Cooner A, Guidry L, Matz-Creel H, Ramey I, Ramey P
Clinical Outcome of 14 Obese, Laminitic Horses Managed with the Same Rehabilitation Protocol
Journal of Equine Veterinary Science Volume 34, Issue 4, Pages 556–564, April 2014
With every case of laminitis, it is essential that the cause has been correctly identified and removed/treated, as well as that the feet are correctly realigned and supported. See Laminitis, EMS or PPID - start here.
For help and support, join Friends of The Laminitis Site.
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