Quittor
Also Known As: Phalangeal Cartilage Necrosis — Lateral Cartilage Necrosis — Third Phalanx Cartilage Necrosis — Distal Phalanx Cartilage Necrosis — Subcoronary Abscess — Coronary Sinus Injury
Introduction
Quittor is a chronic, purulent inflammatory disease of the lateral cartilages of the third (distal) phalanx.
Infection of the cartilage is caused by injury to the coronet, sole, heel or pastern regions, allowing deep introduction of infection. This causes abscesses to form and sinus tracts to extend from the diseased cartilage, breaking through the skin in the coronary region.
Distribution
Quittor is now rare.
Signalment
Quittor was historically common in working draft horses.
Clinical Signs
The first sign of quittor is inflammation and swelling over the alar cartilage'. The consequent abscess may be visible or pain may be exhibited on palpation of the area. Quantity of purulent discharge varies, so may only be detectable as matting of the hair or may stream freely down the hoof.
Lameness occurs during the acute stage of disease although both pain and lameness may be intermittent, particularly early in disease progression.
Without treatment, infection, abscessation and necrosis will extend to deeper structures and prognosis is grave.
Diagnosis
Diagnosis is often based on clinical signs, history of injury to relevant areas and the absence of any other cause of lameness.
Plain and contrast radiography will assist in assessing the extent of the damage.
MRI and CT imaging may be diagnostic if available.
Diagnosis is often confirmed at surgery.
Treatment
Surgery is required to remove the diseased tissue and all infected cartilage under general anaesthesia.
Antibiotics and specialised dressings such as those impregnated with silver may assist more rapid healing.
Early lesions treated aggressively often respond well but involvement of the coronary band or joint capsule and chronic lesions carry a poor prognosis.
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References
Knottenbelt, D. C., McGarry, J. W (2009) Pascoe’s Principles & Practice of Equine Dermatology 2nd ed. Elsevier, UK, 372-373.
Merck Veterinary Manual, Quittor, accessed online 24/07/2011 at http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/90727.htm
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