Terapia del cheratoma nella specie equina: esperienza personale

Abstract

Keratoma is a benign and hyperplastic mass of keratin, it develops below the hoof wall, or in the thickness of the wall itself or of the sole (Hamir, Kunz, and Evans 1992). The clinical symptomatology is characterized by pain, lameness and consequently poor athletic performance. Among the foot diseases, this is one of the most frequent indications for proceeding with a surgical therapy (Reeves, Yovich, and Turner 1989). The present thesis is intended to be an in-depth study of the pathology of keratoma in the equine species, paying particular attention to surgical therapy and post-operative management. Three cases of horses suffering from keratoma were monitored in the period between November 2018 and September 2019, at the Teaching Hospital of the Department of Veterinary Sciences of the University of Parma. The diagnostic and surgical approach used for mass removal have been standardized. Post-operative therapy has been instead customized, based on the need for treating the surgical site. Furthermore, the efficacy of platelet-rich plasma (PRP) to speed up healing time has been tested, applying it to the surgical site on a biocompatible scaffold. Two patients were hospitalized for the removal of a keratoma, they were observed during the whole period of hospitalization, monitoring and documenting all the phases of convalescence. A third patient had previously undergone surgery at another facility to remove a keratoma, he was hospitalized to definitively restore the lesion following the development of complications. The clinical examination of the distal limb and the radiographic examination of the distal phalanx are reliable diagnostic methods for verifying the presence of a keratoma. Complete hoof wall resection guarantees excellent results for removing a keratoma. Hospitalization after surgery is a necessary condition to minimize the risk of complications. The use of platelet concentrates in order to speed up healing time after complete hoof wall resection is conceptually valid, however it would require a larger number of clinical records to assess the actual benefit derived from this practice. The time needed for complete recovery has been recorded: it takes about 6-7 months for the removed hoof wall to regrow completely.