Computed Tomography or Magnetic Resonance Imaging-Assisted Partial Hoof Wall Resection for Keratoma Removal

Liberty M. Getman DVM, Diplomate ACVS, Elizabeth J. Davidson DVM, Diplomate ACVS, Michael W. Ross DVM, Diplomate ACVS, Midge Leitch VMD, Diplomate ACVS, Dean W. Richardson DVM, Diplomate ACVS
Veterinary Surgery
August 2011

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.