Ritmeester A M, Blevins W E, Ferguson D W, Adams S B
Veterinary Associates Equine and Farm, Takannini, New Zealand.
Equine Vet J Suppl. 1998 Sep(26):111-8. doi: 10.1111/j.2042-3306.1998.tb05129.x.
Nuclear scintigraphy was used to assess digital perfusion before and after treatment in 10 horses with clinical and radiographic evidence of chronic laminitis. Horses were evaluated for lameness, degree of distal phalanx rotation, and heel-toe hoof wall growth ratio, and randomly divided into two treatment groups. Group 1 horses received only egg bar-heart bar shoeing; Group 2 underwent egg bar-heart bar shoeing and coronary grooving. Horses were re-evaluated for digital perfusion, lameness, degree of distal phalanx rotation, and hoof wall growth at 6 week intervals over the 18 week follow-up period. Prior to treatment, relative scintigraphic activity at the dorsal laminar area was decreased and relative scintigraphic activity at the toe and adjacent solar area was increased. Egg bar-heart bar shoeing was associated with significantly increased dorsal laminar scintigraphic activity and significantly decreased solar scintigraphic activity over the 18 week period. Coronary grooving, in combination with egg bar-heart bar shoeing, resulted in a significantly lower heel-toe hoof wall growth ratio but did not enhance digital perfusion. Seven of 10 (70%) horses were responsive to treatment, defined as an improvement in lameness by at least one grade. Horses that were refractory to treatment had significantly lower dorsal laminar scintigraphic activity and higher palmar coronary scintigraphic activity prior to treatment than horses that responded to treatment. Our results are the first to demonstrate that egg bar-heart bar shoeing is associated with improved dorsal laminar perfusion, and support the use of this technique. In addition, we found that pre-treatment nuclear scintigraphy was predictive of clinical outcome in horses with chronic laminitis treated with corrective shoeing.
采用核闪烁扫描技术评估10匹有慢性蹄叶炎临床和放射学证据的马在治疗前后的蹄部灌注情况。对马的跛行、远节指骨旋转程度和蹄跟至蹄尖蹄壁生长比率进行评估，并随机分为两个治疗组。第1组马仅接受蛋形条-心形条蹄铁术；第2组接受蛋形条-心形条蹄铁术和冠状沟切开术。在18周的随访期内，每隔6周对马的蹄部灌注、跛行、远节指骨旋转程度和蹄壁生长情况进行重新评估。治疗前，背侧蹄叶区域的相对闪烁活性降低，蹄尖及相邻跖面区域的相对闪烁活性增加。在18周的时间里，蛋形条-心形条蹄铁术与背侧蹄叶闪烁活性显著增加及跖面闪烁活性显著降低相关。冠状沟切开术与蛋形条-心形条蹄铁术联合使用，导致蹄跟至蹄尖蹄壁生长比率显著降低，但并未增强蹄部灌注。10匹马中有7匹（70%）对治疗有反应，定义为跛行至少改善一个等级。治疗无效的马在治疗前背侧蹄叶闪烁活性显著低于对治疗有反应的马，而掌侧冠状闪烁活性则更高。我们的结果首次表明，蛋形条-心形条蹄铁术与背侧蹄叶灌注改善相关，并支持该技术的应用。此外，我们发现治疗前的核闪烁扫描可预测接受矫正蹄铁术治疗的慢性蹄叶炎马的临床结局。
