Retrospective study of keratoma lesions
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2017-10-04
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O queratoma é a neoformação do casco diagnosticada com mais frequência em cavalos. Resulta da proliferação anormal das células do epitélio estratificado, produtoras de casco. Pensa-se que esta proliferação anormal seja causada por agressão crónica dos tecidos do casco, por exemplo, por abcessos submurais, doença da linha branca ou fissuras do casco. Não existem raças, idades ou géneros predispostos para o desenvolvimento destas lesões. Uma vez que são lesões expansivas, vão exercer pressão nas lâminas do casco e na falange distal, resultando no aparecimento de claudicação.
Depois de diagnosticado, o tratamento preferencial é a excisão dos tecidos anómalos. A excisão parcial ou total do casco deve ser realizada de acordo com a lesão e o animal em causa. Se todo o tecido anómalo for removido o prognóstico é bom.
O objetivo primário desta tese é o estudo das particularidades dos queratomas e lesões semelhantes. Este estudo consiste na revisão de 21 casos, do hospital de grandes animais da Universidade de Gent, diagnosticados e tratados para lesões de queratoma, entre 2008 e 2016. Os registos destes cavalos foram revistos em relação a idade, raça, género, história clinica, achados clínicos, membro afetado, grau de claudicação e pulso digital. Os estudos radiográficos também foram revistos, e o tipo de anestesia e complicações durante a hospitalização foram registados. Foi realizado um questionário por telefone de forma a recolher informação sobre o resultado da excisão parcial da lesão para cada cavalo. Neste questionário informações como atividade, tipo de alojamento, tipo de ferração, tempo de recuperação e crescimento do casco, complicações e recidiva, foram recolhidas.
Nesta revisão de 8 anos, 52% dos animais apresentaram história clinica de abcessos do casco e 87% tinham alterações radiográficas compatíveis com a presenta de queratoma. Cinquenta por cento dos cavalos desenvolveu conformação de casco anormal após a excisão mas só 20% mantiveram a claudicação. A recorrência das lesões foi mais alta do que esperado, com 60% dos animais a apresentar recorrência 1 a 4 anos após a excisão. Esta elevada taxa de recorrência pode ser devia a uma incompleta ressecção das lesões.
Keratomas are the most common hoof neoformation diagnosed in horses. They are the result of abnormal proliferation of the squamous epithelial cells, producers of horn. It is thought that this proliferation is caused by chronic insult to the hoof caused by recurrent abscess, white line disease, and hoof cracks, for example. There is no breed, gender or age predisposition for the development of this lesions. Being an expansive lesion, the keratoma will exert pressure on the hoof laminae and distal phalanx, resulting on the horse presenting lameness. After diagnosing the lesion, the treatment of choice is the excision of the abnormal hoof tissue. The total or partial excision can be performed according to the case. If all the abnormal tissue is removed the prognosis is good. This thesis primary objective is to study the particularities of keratoma or keratoma-like lesion. The study consists on the review of 21 cases, from the University of Gent large animal hospital, diagnosed and treated for keratoma lesions between 2008 and 2016. The records of this horses were reviewed regarding age, breed, gender, clinical history, clinical findings, affected leg, grade of lameness, and digital pulse. The radiographic studies of the horses were also reviewed, and the register of type of anaesthesia and hospitalization complications was made. A telephone questionnaire was performed to collect information about the outcome of each horse after the partial excision of the lesion. In this questionnaire information like activity, housing, shoeing, time of recovery and hoof growth, complications, and recovery were collected. In this review of 8 years, 52% of the animals presented clinical history of hoof abscess and 87% had radiographic findings compatible with the presence of a keratoma lesion. Fifty percent of the horses developed an abnormal hoof conformation after the resection, but only 20% did not return to soundness. Recurrence of the keratoma was higher than expected, with 60% of the horses displaying recurrence 1 to 4 years after the excision. The high rate of recurrence could be due to incomplete resection of the lesion.
Keratomas are the most common hoof neoformation diagnosed in horses. They are the result of abnormal proliferation of the squamous epithelial cells, producers of horn. It is thought that this proliferation is caused by chronic insult to the hoof caused by recurrent abscess, white line disease, and hoof cracks, for example. There is no breed, gender or age predisposition for the development of this lesions. Being an expansive lesion, the keratoma will exert pressure on the hoof laminae and distal phalanx, resulting on the horse presenting lameness. After diagnosing the lesion, the treatment of choice is the excision of the abnormal hoof tissue. The total or partial excision can be performed according to the case. If all the abnormal tissue is removed the prognosis is good. This thesis primary objective is to study the particularities of keratoma or keratoma-like lesion. The study consists on the review of 21 cases, from the University of Gent large animal hospital, diagnosed and treated for keratoma lesions between 2008 and 2016. The records of this horses were reviewed regarding age, breed, gender, clinical history, clinical findings, affected leg, grade of lameness, and digital pulse. The radiographic studies of the horses were also reviewed, and the register of type of anaesthesia and hospitalization complications was made. A telephone questionnaire was performed to collect information about the outcome of each horse after the partial excision of the lesion. In this questionnaire information like activity, housing, shoeing, time of recovery and hoof growth, complications, and recovery were collected. In this review of 8 years, 52% of the animals presented clinical history of hoof abscess and 87% had radiographic findings compatible with the presence of a keratoma lesion. Fifty percent of the horses developed an abnormal hoof conformation after the resection, but only 20% did not return to soundness. Recurrence of the keratoma was higher than expected, with 60% of the horses displaying recurrence 1 to 4 years after the excision. The high rate of recurrence could be due to incomplete resection of the lesion.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Cavalo , Doença dos pés , Queratose , Cirurgia ao pé , Excisão total