b'SPONSORED BYThis can lead to hock inflammationTurner. Addressing these asymmetries is and more need for hock injections. Itjust as important for treating or prevent-might also cause stifle and/or gluteal pain. ing lameness as it is in the front hooves. Underrun HeelsAbnormal heel confor- In closing, he stressed the importance of mation should be easy to recognize, saidX rays when assessing rear imbalances, Turner. The horse will have a broken- keeping in mind the natural differences in back hoof-pastern axis and a bull-nosedrear hoof shape andalignment.dorsal hoof wall. The horses frog isusually large and pushed down below theDetecting Soft-Tissue Injuries in hoof wall, bearing the horses full weightHooves: Ultrasound vs. MRI when placed on the ground. When horses sustain injuries to the Fortunately, said Turner, damage tosoft-tissue structures within their hooves, the hind heels is usually easier to correctveterinarians rely on imaging for diag-than damage to the front, possibly duenosis. Unfortunately, said Myra Barrett, to the difference of the load encounteredDVM, MS, Dipl. ACVR, the foot is par-on the hind limbs vs. the forelimbs. ticularly challenging to imagethere are Medial-Lateral ImbalanceWhen theonly so many ways we can see it.horse moves, his hind limbs naturallyThe gold standard is MRI. However, have a slight rotation to them. This isits cost-prohibitive for some owners and necessary to ensure that the feet are widernot all veterinarians have access to a unit. than the forelegs when galloping, TurnerRadiography can reveal problems, but its said. In many animals this causesthemore useful for bony structures than soft hoof capsule to be high on the inside. tissue. And ultrasound is useful for imag-This uneven wear can lead to suspen- ing tendons and ligaments in other areasCOURTESY DR. MYRA BARRETTsory injuries, fetlock lameness, and hockof the body, but it hasnt been clear how itUltrasound could help vets screen for DDFT and tibia (the long bone between thestacks up to MRI for imaging the hoof.lesions. MRI and ultrasound of this horses hoof capsule reveal a tear in that tendon. hock and stifle) pain. So Barrett, an assistant professor of The goal when addressing this imbal- veterinary diagnostic imaging at CSU ance, he said, is to get the horse to bearand colleagues compared the two in atissue growth) its sensitivity was 47%, weight evenly and equally on his hind feet. prospective study.specificity 78%, and accuracy 61%; Rear hoof imbalances are not well- The researchers performed ultrasound For diagnosing CLS enlargement, understood. Instead of causing foot painon horses that underwent MRI at CSU toultrasound had 42% sensitivity, 78% directly, rear feet seem to cause manycompare injuries to the deep digital flexorspecificity, and 61% accuracy; andmore problems higher up the legto thetendon (DDFT), collateral sesamoideanDDFT tearing below the navicular bone hocks, stifles, glutes, sacroiliac joint, saidligament (CSL), and the navicular bursawas evident on MRI in 27 limbs, 20 of (NB) within the hoof. They placed the ul- which also had DDFT damage above trasound transducer between the horsesthe navicular bone that was apparent heel bulbs to view the internal structures. on both MRI and ultrasound.Barrett said they hypothesized that ul- Barrett said its common for horses trasound would detect fewer lesions thanto sustain soft-tissue and bony injuries MRI, which could cause veterinarians towithin the hoof simultaneously, which are Hoof Wraps underestimate the severity of the injuries. difficult to differentiate on ultrasound.@HoofWrapsThe team evaluated 70 ultrasound andUltimately, Barrett said, the team MRI exams of 45 horses. They found that: determined that ultrasound is a useful Look at these little hooves Ultrasound allowed veterinarians to di- screening tool for assessing DDFT le-at the @AAEPHorseDocsagnose DDFT tears with 85% sensitivitysions, especially moderate to severe ones trade show! (the ability to correctly identify thoseand those that occur above the navicular with the ailment), 60% specificity (thebone, but it could cause veterinarians to ability to correctly identify those with- underestimate NB and CSL lesions. hout the injury), and 70% accuracy. With it they accurately diagnosed 36% of mild lesions, 74% of moderate lesions, and 100% of severe lesions; e For diagnosing NB effusion (swelling),Visit TheHorse.com/AAEP2017ultrasounds sensitivity was 65%, speci- ficity 69%, and accuracy 67%;A Shorter RLP Application Time Is Still Effective, For evaluating NB proliferation (excessTheHorse.com/40218March 2018THE HORSE AAEP Wrap-Up TheHorse.com/AAEP2017 A21'