I apologise if you’re browsing my blog whilst eating dinner, or breakfast, because this post will have some gory pictures later on.
Today we’re going to talk about keratomas, which must be one of the worst ailments a horse can suffer from because of the lengthy recovery time and the difficulty in keeping it infection free.
A keratoma is a tumour within the inner layers of the hoof wall. They are benign and therefore do not spread to other parts of the body.
Keratomas originate at the coronet band, and grow down to the toe, extending out to the white line when it reaches sole. They are usually situated at the toe, occasionally the quarter, at any height between the coronet band and sole.
No one knows what causes keratomas, but it has been suggested that chronic irritation of the internal, sensitive laminae from injury or infection could be the cause.
Due to the fact the tumour is encapsulated within a rigid structure a keratoma cannot be easily seen or felt. The first sign of a keratoma is lameness, possibly with a bulge of hoof wall at the coronet band. Depending on the rate of growth of the keratoma, the lameness can be sudden onset, progressive or intermittent.
To diagnose a keratoma, the vet will use hoof testers to find areas of pain, check the white line for flaws or signs of separation. X-rays and MRI scans provide a definite diagnosis and allows the vet to identify how advanced it is and if there is any damage to the pedal bone. They can also take a biopsy too for confirmation.
The next step is to remove the keratoma. This requires surgery, when the hoof wall is cut out and removed over the keratoma so that the tumour can be taken out completely. Afterwards the vet will pack the wound with antiseptic gauze, and fit a hospital plate to the shoe (I actually have one of these!) to help protect the foot. A bandage around the foot helps to keep the wound clean and dirt-free. The patient then needs a course of antibiotics.
Post surgery, the horse has to stay on box rest, in as clean a environment as possible, with the wound being checked and re-dressed every couple of days until a hard layer of horn has formed. Once the hospital plate and bandage are defunct, then the horse will need remedial shoes to best encourage the hoof to grow, and to stabilise and support the weakened area. The foot needs to be kept clean and dry until the hoof has completely healed, which takes many months when you consider that it takes twelve months for hoof to grow from the coroner band to the sole, the recovery rate for a keratoma is slow to say the least! The prognosis is usually good, and providing the keratoma is completely removed, the risk of reoccurrence is very slim. You just need a lot of patience, a good farrier, and a horse who likes his stable!