Keratomas in horses: seven cases (1975-1986).
Authors: Lloyd, Peterson, Wheat, Ryan, Clark
Journal: Journal of the American Veterinary Medical Association
Summary
# Keratomas in Horses: Clinical Recognition and Surgical Management Keratomas are benign epithelial tumours arising within the hoof capsule, yet their rarity and non-specific presentation often result in delayed diagnosis and unsuccessful treatment attempts. Lloyd and colleagues examined seven cases across an 11-year period, documenting the clinical presentation, surgical approach and outcomes for horses ranging from 2 to 20 years old, all presenting with lameness and a history of previous hoof trauma that had failed to respond to conventional farriery or veterinary intervention. Most lesions (six cases) developed beneath the hoof wall as firm, solitary masses of 1.5–5 cm diameter with characteristic histological rings of squamous epithelial cells; radiographic changes included discrete circular or semicircular defects in the distal third phalanx in three horses. Surgical excision—achieved by hoof wall resection, undermining, or sole excavation depending on lesion location—yielded encouraging results: all six horses evaluated were sound by one year post-operatively with no recurrence, and hoof defects healed completely within 6–12 months with appropriate post-operative care using antiseptic dressings and treatment plates. For equine practitioners, this case series emphasises that recurrent lameness following hoof trauma, particularly when standard treatments fail, warrants thorough investigation and consideration of keratoma in the differential diagnosis, as successful outcome depends on early recognition and complete surgical removal.
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Practical Takeaways
- •Keratomas should be suspected in chronically lame horses with a history of unresponsive hoof injuries; surgical excision is curative when confirmed histologically
- •Radiographic examination may reveal a characteristic circular or semicircular defect in the distal phalanx; definitive diagnosis requires microscopic verification
- •Post-operative management with daily antiseptic treatment, bandaging, and therapeutic shoeing supports complete healing and return to soundness within one year
Key Findings
- •Keratomas presented as firm solitary masses (1.5–5 cm diameter) in 7 lame horses, with 6 having prior unresponsive hoof injuries
- •Lesions occurred beneath the hoof wall in 6 cases and beneath the sole in 1 case, with radiographic defects visible in the distal third phalanx in 3 horses
- •Surgical excision via hoof wall removal or sole excavation followed by iodine treatment and bandaging resulted in complete healing in 6–12 months with no recurrence
- •Histological confirmation showed characteristic rings of squamous epithelial cells with keratin; concurrent purulent exudate and inflammatory infiltrate were common