DISEASES OF THE TENDONS AND TENDON SHEATHS. 
761 
Chronic purulent inflammation of this tendon sheath may also follow 
cutting or brushing.” Acute infective inflammatory processes are 
heie paiticularly dangerous; very often they take the form of acute 
cellulitis due to local infection or local gangrene (cracked heels). 
Diagnosis is sometimes difficult because of the swelling which always 
exists aiound the bursa. One symptom which always accompanies 
inflammation of the tendon sheath should, therefore, be particularly 
remembered, viz., lifting of the limb, as in 
gonitis; in this case, however, the foot is 
advanced further in the direction of the front 
foot of the same side (fig. 286). This peculiar 
position is common, and seems absolutely 
pathognomonic. Accurate diagnosis is very 
important, because treatment is scarcely 
advisable, except in valuable horses. The 
treatment, which consists in daily cleansing 
of the parts, washing out with disinfectants, 
and bandaging, is not often successful, lami- 
nitis generally occurring in the other foot, and 
carrying off the animal. In a few instances, 
however, recovery occurs, though the fetlock 
usually remains somewhat upright; two 
cases, recorded show that perfect recovery 
is possible, even after acute suppurative 
inflammation of the tendon sheaths. 
Chronic septic inflammation of these sheaths 
is also seen in the horse. The clinical symp¬ 
toms are not well marked; swelling is 
moderate, because the connective tissue sur¬ 
rounding the tendon sheath is not much 
affected. Pain is not so great as in the acute 
disease, but a turbid synovia, mixed with pus, 
is continually discharged. Very great diffi¬ 
culty is found in closing the wound in the 
tendon sheath : healing is almost always 
prolonged, and often the horse is found one 
morning standing almost on its fetlock, and with the toe pointed upwards, 
the flexor pedis perforans tendon being ruptured. The condition seems 
incurable. The ends of the tendon, being necrotic, are incapable of 
regenerative processes; on section, the necrotic part is distinguished by 
its yellow, opaque appearance, from the glistening, satin-like, healthy 
portions. Not infrequently demarcation has commenced, and can be 
detected by the vascular condition of the parts bordering on the necrotic 
f 'J))l 
Fig. 285.—Enlargement of the 
bursa ol the extensor pedis 
tendon (i, in schema of the 
tendon sheaths of the fore 
limb, fig, 203). 
