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D'Arpe, Lorenzo (2009) Impiego diagnostico della venografia digitale in vivo in corso di laminite nel cavallo. Terapia biomeccanica. [Tesi di dottorato]

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Abstract (inglese)

The candidate has put in evidence the clinical exam diagnostic value of the Laminitic equine foot.
The physical examination has been associated with X-Ray and Venography exams.
The radiographic technique suggested by Redden R.F. (2002) has been used and partially modified in order to achieve more detailed measurements. An ex vivo study has been performed to compare the radiographic measurements (palmar angle, sole depth, wall depth, coronet-extensor distance, break-over) and the anatomy to evaluate the magnification and distortion effect. The Venography technique in the standing horse with an injection of contrast liquid provides the clinician a full diagnostic visualization of the micro vascular venous (arterials) foot architecture. The procedure described by Redden R.F. (1993) has been standardized and simplified in order to better evaluate the weight load force venocompression. This technique is an indispensable instrument in the clinical evaluation also of the inner phases of Laminitis and to monitor the Equine foot damage evolution.
Venograms interpretation has provided a better understanding of equine digit vascular abnormalities, damage extension, level and speed evolution. These precious informations provide the candidate the knowledge to set an innovative chronological table of the phases of Laminitis
(Developmental, Acute, Sub-Acute and Restitutio or Chronic Asymptomatic and /or Recidive). Venography study showed the dermo-epidermal gear separation severity inside the hoofcapsule giving a great standard of prognostic value in Laminitic horses. The cases reported showed that Venograms interpretation has given indispensable informations in the choice of the therapeutic protocol (biomechanical, surgical, pharmacological, nutritional, etc.) using a focused and high quality clinical approach. Currently, there is no single treatment that can be recommended for all cases of laminitis. Successful therapy of Laminitis requires teamwork between the horse, the owner, the specialist, the referring veterinarian and the referring ferrier. When this team is willing to spend the time and effort, treatment of these cases can be successful. However, without their joint dedication, treatment can be frustrating and usually ends with euthanasia of the horse.

Abstract (italiano)

Il dottorando ha evidenziato l’importanza diagnostica dei reperti forniti dalle indagini fisico/dirette del piede del cavallo in corso di Laminite. L’esame semiologico diretto è stato associato sia all’analisi radiografica che all’indagine venografica. E’ stata utilizzata la tecnica radiografica nel rispetto di quanto suggerito da Redden R.F. (2002) rettificando però il protocollo metodologico allo scopo di poter ottenere misurazioni ed informazioni più precise nell’interpretazione radiografica e confortando tali misurazioni (angolo palmare, profondità della suola, spessore della parete, distanza corona-estensore, punto di rullamento) con uno studio ex vivo. L’utilizzo dell’esame venografico ha permesso la visualizzazione nel cavallo in stazione quadrupedale del microcircolo venoso (arterioso) del piede tramite l’iniezione di liquido di contrasto ed ha consentito al clinico di poter completare il quadro diagnostico. E’ stato modificato il protocollo metodologico descritto da Redden R.F. (1993) allo scopo di standardizzarlo, semplificarlo ed ottenere informazioni più mirate alla valutazione dell’eefetto statico di venocompressione esercitato dalla Forza peso. Tale tecnica, scevra da effetti secondari, può essere ritenuta, in relazione alla casistica riportata, un indispensabile strumento nella valutazione diagnostica anche delle fasi precoci di Laminite e nel monitoraggio del danno podale. L’interpretazione dei venogrammi ha consentito di poter ottenere una visione completa delle turbe vascolari della circolazione digitale, della loro estensione, della loro gravità e della loro evoluzione consentendo di poter approntare una tabella cronologica riassuntiva innovativa delle fasi della Laminite (Sviluppo, Acuta, Sub-Acuta ed in seguito Restitutio o Cronica Asintomatica e/o Recidiva). La venografia ha permesso di quantificare il danno dell’ingraggio dermo-ungueale all’interno dell’ermetica scatola di matrice cornea ed ha favorito l’accuratezza di informazione prognostica nei cavalli laminitici. La casistica riportatata ha mostrato che i reperti venografici possono essere inoltre indispensabili nella scelta dell’intervento terapeutico (di ordine biomeccanico, chirurgico, farmacologico, alimentare, ecc.) consentendo al clinico di poter effettuare un approccio mirato e rigoroso. Attualmente non esiste un unico trattamento che possa essere raccomandato per tutti i casi di Laminite. Il successo della terapia nei casi di Laminite richiede una lavoro di squadra tra il cavallo, il proprietario, lo specialista, il veterinario referente ed il maniscalco referente. Quando questo gruppo di lavoro è pronto a spendere il proprio tempo e dedizione al trattamento di questi casi allora può essere vincente, altrimenti, senza una dedizione congiunta di tutti gli indidui del gruppo il trattamentopuò risultare frustrante e terminare con l’eutanasia del paziente.

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Tipo di EPrint:Tesi di dottorato
Relatore:d'arpe, lorenzo
Dottorato (corsi e scuole):Ciclo 20 > Scuole per il 20simo ciclo > SCIENZE VETERINARIE > SCIENZE CLINICHE VETERINARIE
Data di deposito della tesi:29 Gennaio 2009
Anno di Pubblicazione:2009
Parole chiave (italiano / inglese):venografia, laminite, cavallo, biomeccanica
Settori scientifico-disciplinari MIUR:Area 07 - Scienze agrarie e veterinarie > VET/08 Clinica medica veterinaria
Struttura di riferimento:Dipartimenti > Dipartimento di Scienze Cliniche Veterinarie
Codice ID:1725
Depositato il:29 Gen 2009
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