Computer Tomography for Removal of Keratomas

Clinicians at the University of California, Davis veterinary teaching hospital described the use of computer tomography (CT) for the diagnosis and presurgical planning of treatment for hoof wall keratomas in 29 horses and three mules from 2005 through 2016. Recurrent foot abscesses were the most common (88%) reasons for referral. Most (71%) of these animals had X-rays that indicated the presence of a keratoma prior to referral, and the others were X-rayed with similar diagnostic results at the teaching hospital.

The attending veterinarians used CT to precisely locate the tumors within the hoof and plan the surgical approach. Partial (30 animals) and complete (two animals) hoof wall resections were used to remove 35 keratomas from 33 feet of 32 animals. Two animals had two distinct tumors in one foot and another had keratomas in both front feet. Thirty of the cases were treated under general anesthesia (average duration was 148 minutes when combined with the CT exam), and two were treated during standing sedation. Regional limb perfusion with antibiotics was used on about half the animals.

Four of the animals developed complications including excessive granulation tissue formation during healing, worsening lameness, suspected regrowth at the surgical site due to incomplete removal and incomplete healing followed by coffin joint infection. Most of the animals (90%) successfully returned to their previous activity level.

Although X-rays along with the clinical history are usually adequate for diagnosing keratomas, the authors found CT useful for the presurgical planning of…