(Palmar nerve and Palmar metacarpal Nerve block)
Prepare skin as discussed previously
- Ensure adequate restraint of horse to do this procedure with the foot on the ground.
- Palpate DDFT and the SL. Avoid digital sheath by measuring a hand's breadth above fetlock joint.
- Insert needle parallel to the ground and perpendicular to the skin between the DDFT and the SL. (22gx1" needle
- Insert needle to the hub, check for blood and deposit 2-3mL mepivicaine. This will anesthetize the medial branch. Withdraw the needle until it is subcutaneous on the lateral side and deposit 2-3mL.
- Palpate the bell (button) of MC 4. Insert needle distal to bell of splint bone, pointing slightly upwards. (25gx5/8" needle) Check for blood and inject 2-3mL mepivicaine. Support hub of needle with one hand and inject with the other. Repeat on medial aspect of limb.
- All structure of previous block (all of structures distal to the location of nerve block)
- Navicular structures
- Soft tissue structures of pastern and foot
- Sole, Laminae
- Three phalanges
- Coffin and Pastern and Fetlock joint
- Distal Digital tendon Sheath