1054 DISEASES OF THE FOOT. 



Provided injury is confined to the surface of the sensitive frog, 

 no bad results usually follow ; but should the plantar cushion be 

 involved, diffuse purulent cellulitis may set in, suppuration may 

 extend to the perforans tendon, and be followed by necrosis of the 

 latter and by suppuration in the navicular bursa. The condition 

 is then excessively dangerous, and animals may succumb if treatment 

 be delayed. The rapidity of the process is largely determined by 

 the virulence of the infective material. 



Prognosis depends, therefore, firstly on the position of the injury, 

 and afterwards on its extent and the character of the infection. The 

 depth of the wound may be determined by the length of the foreign 

 body removed, and sometimes by probing ; but as the probe may 

 easily become the vehicle for introducing infective material into 

 the depths of the wound, it should be used with considerable care. 



The position of the injury is important, the most dangerous spot 

 being the centre of the frog, immediately above which lies the navicular 

 bone covered by the flexor pedis perforans tendon. Injuries at the 

 point of the frog may extend to the lower surface of the os pedis, 

 causing necrosis, which, however, is seldom so dangerous as disease 

 of the tendon or bursa, because necrosis usually remains confined 

 to one spot, and healing occurs after exfoliation, even though the 

 latter occupy a considerable time (three to four weeks). Severe 

 lameness, and symptoms of diffuse purulent inflammation of the 

 plantar cushion, are always grave. On attempting to bear weight 

 on the foot, the latter shows excessive volar flexion, swelling appears 

 in the heel, and pain is exhibited on forcibly flexing the toe. 



Treatment. The chief indications are to prevent infection, to dis- 

 infect the wound, and to limit inflammation. After carefully 

 removing the foreign body and taking precautions against any particles 

 being left behind, the entire hoof must be pared as for shoeing, and 

 any loose fragments of horn removed from the sole or frog. The 

 track of the nail should then be cut out until the injured tissues are 

 exposed. The funnel-shaped opening, and, if possible, the wound 

 of the tissues, are then washed out with a a disinfectant (a 

 syringe is useful) ; or the parts can be swabbed with a tampon saturated 

 with 10 per cent, chloride of zinc solution or hydrogen peroxide. 

 As the chief object is to keep the wound disinfected, a dressing 

 moistened with some disinfecting fluid is applied over all. 



Should pain increase during the next few days, the wound should 

 be cautiously opened up, and imprisoned discharge allowed to escape, 

 after which the foot is immersed twice a day, for one to two hours 

 at a time, in a bath containing some disinfectant. Plenty of clean 



