Summary
It is recognised in the literature that keratomas are a rare form of lameness. This has resulted
in them appearing to be an enigmatic lesion with little understanding as to their definition,
aetiology and pathogenesis. Commonly they are only diagnosed after an extended period of
recurrent lameness, with repeated treatments and subsequent loss of use.
Farriers are in a unique position to flag up erroneous areas of horn that they see in hooves
which match the visual symptoms of keratomas, before the onset of lameness.
It was felt prescient therefore to conduct an in-depth literature review and an information
gathering exercise which may provide a path for further discovery about keratomas.
The leading veterinary practices in the UK were contacted for examples of keratomas and
appeals for examples of erroneous horn in hooves that matched the symptoms of keratomas
were placed in the three most widely read farriery journals in the northern hemisphere.
The in depth literature review discovered anomalies between authors.
Two of the examples collected from the journal appeals resulted in radiographs of the
concerned hooves. Both examples had no history of lameness but displayed an osteolytic area
in the pedal bone consistent with the presence of a keratoma. The first of these examples was
operated on successfully to remove the lesion. The second example awaits surgery. Future
lameness has been avoided.
Acknowledgments
This work would not have been achieved without the following-
i
Sarah Boys Smith MA VetMb CertES(Orth) DipECVS MRCVS
Jacob Butler AFA CertJF
Mark Caldwell FWCF
Chris Colles BVetMed,PhD,HonFWCF,MRCVS
Mikel Dawson AFA CertJF
Debra Fews BSc BVM&S Cert VA DipRCPath MRCVS
Amanda Gamble
Tim Greet MS MVM CertEO DESTS Dip ECVS FRCVS
S. Claire Jones BA Hons PGCE
Witney Linnenkohl MRCVS
James Tipp MRCVS
Professor John Reilly BSc (Hons), BVSc, PhD, MRCVS
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Decleration
I hereby declare that the work within this dissertation is my own and is not the collaboration
of others. Any sources used have been duly referenced.
Signed
Name of student
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List of Contents
Section and sub section
Page
1.0 Introduction
2
1.1 Reasons for Performing the Study
1.2 Aim
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2.0 An Overview of Current Thinking on Keratomas
2.1 Definition
2.2 Area of Occurrence
2.3 Diagnosis
2.4 Histopathology
2.5 Imaging of the lesion
2.6 Differential diagnosis
2.7 Treatment
2.8 How keratomas cause lameness
2.9 Types of keratoma
2.10 The relation between keratomas and abscesses.
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3.0 The Literature Review.
3.1 Introduction
3.2 The earliest writings
3.3 The term ‘keratoma’
3.4 The definitions in the literature of keratomas
3.5 Where keratomas occurr
3.6 Shapes and types of keratomas
3.7 The Origin of the Germination of the Keratoma
3.8 Aetiology – Trauma
3.9 Aetiology - Abscesses
3.10 Farriery Treatments
3.11 Recovery Post Surgery
3.12 Histopathology
4.0 The information gathering exercise
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4.1 Introduction
4.2 Cases Gathered
4.3 Discussion of the Cases Gathered
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5.0 Conclusions
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6.0 Reference List
7.0 Glossary
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List of Figures
Figure Number
Page
1. Holly. Lesion in a sound foot
2. Dillon. Confirmed keratoma
3. The masses have been extirpated.
4. Three spherical keratomas removed.
5. Inward deviation of the whiteline due to pressure from the clip of the shoe.
6. Hoof grooving
7. Toe ‘bows’ out
8. Appeal in the Europeam Farrier’s Journal.
9. Mikel’s lesion at the toe
10. Mikel’s lesion at the toe close up
11. Dillon’s lesion.
12. Dillon’s lesion close up
13. Dillons radiograph
14. Pepper’s haemorraging in the sole and cavities from abscesses, 27/08/2010.
15. Pepper’s haemorraging in the sole and cavities from abscesses. 30/09/2010.
16. Radiograph of Pepper’s hoof- “suggestive of a space occupying lesion”
17. Rosco. Pre.operation solar view
18. Rosco’s operation
19. Mass removed
20. Rosco’s subsequent histopathology report.
21. Inward deviation of the whiteline in Holly’s off hind.
22. Holly’s erroneous lesion in the whiteline, 28th April 2009
23. Holly’s biopsie of horn, 28th April 2009
24. Holly’s foot 2nd March 2010.
25. Holly’s histology report
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