The pathogenesis and treatment of osteomyelitis and laminitis in a stallion after the prolonged topical application of formalin to the distal phalanx.
Authors: Dart, Pascoe
Journal: Australian veterinary journal
Summary
# Editorial Summary A 12-year-old Quarter Horse stallion developed severe osteomyelitis and secondary laminitis after prolonged topical application of 10% formalin to the distal phalanx, presenting with a 3 cm sole cavity that had eroded through to bone. Initial surgical management included sequestrum removal and curettage of infected bone under general anaesthesia, followed by bilateral heart bar shoeing; however, radiographic assessment at eight months revealed progressive rotation of the distal phalanx despite this intervention. The authors then employed a two-pronged approach combining hoof wall resection at the toe—to relieve pressure from the laminar wedge—with continued heart bar support, achieving approximately 30° realignment of the distal phalanx towards normal skeletal alignment within 26 days of the second procedure. This case demonstrates that aggressive laminitis management requires addressing both the underlying pathology and biomechanical factors, and that dorsal wall resection can be an effective adjunct to farriery-based stabilisation when radiographic evidence indicates ongoing rotation. For practitioners managing similar cases, the findings suggest that while conventional heart bar shoeing alone may be insufficient to reverse established rotation, combined surgical and farrier-based interventions can substantially improve outcomes in valuable horses warranting intensive rehabilitation.
Read the full abstract on PubMed
Practical Takeaways
- •Avoid prolonged topical application of formalin to sensitive structures; consider safer alternatives for distal phalanx treatment
- •Heart bar shoes alone may be insufficient for managing secondary laminitis with significant phalangeal rotation; dorsal wall resection can be a valuable adjunct to restore proper biomechanics
- •Aggressive surgical intervention combined with appropriate shoeing can achieve substantial realignment of the distal phalanx in select cases
Key Findings
- •Prolonged topical application of 10% formalin to the distal phalanx resulted in osteomyelitis and sequestrum formation in a 12-year-old Quarterhorse stallion
- •Surgical removal of the sequestrum combined with heart bar shoeing resulted in marked rotation of the distal phalanx (8 degrees) by 8 months post-operatively
- •Dorsal wall resection at the toe removed laminar wedge pressure and achieved realignment of the distal phalanx approximately 30 degrees closer to normal skeletal axis within 26 days
- •Combined surgical and farriery interventions demonstrated effective treatment of secondary laminitis when animal value warrants investment