KERATOMA

The last time my horse was shod my farrier said she had a keratoma in her off fore foot and that I should just keep an eye on it. The only thing I know about keratomas is that they are a rare tumour like growth and that treatment can involve invasive surgery. As she is showing no distress in terms of pain or lameness I am reluctant to endorse such treatment at this stage.

A year and a half earlier she had a sandcrack grooved down to the pedal bone all the length of the hoof which my farrier says resulted in distortion of the laminae. I would like to know if this has anything to do with the presence of the keratoma and would like to know more about this condition; its treatment and prognosis.

Your instinct to avoid surgery if at all possible has my complete approval. If the mare is sound and well there is no compelling reason for surgery, which has its own risks, not to mention expense, and would entail a period of recuperation while she could not be ridden.

Although a keratoma is classed as a tumour it is benign and only causes problems because it takes up space inside the hoof and causes pressure on the adjacent structures, the sensitive laminae and the pedal bone. While the keratoma is forming this pressure often does cause lameness, but the pedal bone reabsorbs itself in that area leaving a smooth groove in its surface to accommodate the keratoma and reduce the pressure to normal. This groove can be seen on an X ray. Once a keratoma is established it tends to be fairly stable and not to increase in size. Nor do they spread and increase in number. I have never seen a horse with more than one keratoma, though it must happen sometimes. They don’t go away spontaneously though.

The only other way in which keratomas can lead to lameness is that they often become a site for abscesses to develop. The white zone, the junction between the wall on the sole on the bottom of the hoof, is quite a common place for infections to enter the hoof at the best of times as the horn here is quite soft. When a keratoma appears on the inside of the hoof wall the white zone is pushed inwards and its structure is distorted. This makes it an even less efficient seal against dirt and germs. Quite often the first time that a keratoma is noticed is when a horse gets pus in the foot. The usual treatment applies: drainage and poulticing, and applying a shoe with a pad afterwards. These abscesses tend to be only occasional though and I haven’t come across a keratoma that became infected on a regular basis.

The surgery involved in removing a keratoma is actually quite simple and involves stripping away the part of the hoof wall to which the keratoma is attached. You then have to wait for the hoof wall to regrow. It is probably worth considering in a younger horse, a horse that you may wish to sell or if you have insurance for vet bills and don’t mind the animal being out of work for a few months.

You’re just not very lucky with your horses hooves are you? Surely they didn’t groove it right down to the pedal bone, ouch! Just down to the laminae I trust! I wouldn’t have thought that the appearance of the keratoma has anything to do with the previous treatment for a sandcrack.

No special shoe is usually indicated. If the keratoma is where the nails would normally go it might be possible to place the nail holes in the shoe away from it, but if that is not possible then nail as normal. I have had no problems from nailing in an area where there is a keratoma.

BACK TO  Q and A Index

BACK TO  Humphrey Horseshoeing Homepage