Case Studies


This is a moderately severe case of founder, with coffin bone visible. The horse had been shod as a two-year old show horse for years, but barefoot trimmed for several years prior to the founder. He had undiagnosed metabolic issues that became apparent when he foundered.

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Left                                                                                      Right

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A 5 yo Hanoverian/TB X gelding

Shoes were removed in December ’08.  The images represent his progress over the course of the next 5 months.

Left Front Foot

  Dec082lf      Mar09lf   

         Fig. 1                                                              Fig. 2

  Apr09lf          May09lf

       Fig. 3                                                              Fig. 4

    The long toe is progressively coming back into better proportion.

A better hoof/ pastern alignment is visible in the subsequent views.
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What a Little Good Trimming Can Do

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The horse in question, an 18 yo Appaloosa was retired from showing because of the non-specific diagnosis of caudal heel pain syndrome.  Xrays confirmed the presence of ‘changes’ that were attributed to his discomfort.  He was shod according to proper conventional veterinary standards for navicular, which did help to make him comfortable, but he still seemed stiff, definitely not agile, and, at the bottom of the pecking order would allow himself to be cornered and bullied rather than try and run away.

In examining his feet, there was nothing obvious or terrible about them that would be making him sore but the owner decided, with much trepidation, to give barefoot a try. As it turned out there was quite a bit of fine tuning to do on his feet and with each trim his gait and comfort level improved. In particular his toes were able to be shortened much more than they could be in wedge shoes even though short toes is the standard shoeing protocol for ‘easing breakover’.

Right Front Leg Lateral View

1may07b.jpg           2may07b.jpg         3my07b.jpg

a.  With shoes                          b.  Shoes Just Removed            c.  First Trim

In the shoes with wedge pads, the toe length looks acceptable, but without it, the excess length is more apparent.  While a wedge does improve breakover, it comes at the cost of shifting the weight of the foot and leg pathologically onto the toe.  With one trim, the toe length is improved and the bulge in the hairline is relaxed and straighter.

11jun07b.jpg    12ajuly07b.jpg   dec.jpg                        

d.  Growing out holes           e.  4 mos. later                     f.  7 mos. later 

As the trim progresses, the hairline bulge continues to improve, the toe continues to come back, the heel stands up a little, and the foot comes ‘under the leg’ in balance.  In the last photo, the hairline angle approaches the ideal as toe height improves, and the toe length is nice and short. The horse is standing comfortably with the cannon bone nicely vertical, with all his weight visibly placed onto that leg and into the heels.   

Note the difference between figs. c and f.  In the later photo, the heel has been brought back more underneath the boney column, providing a better base of support which is helpful in a navicular diagnosis (as in all cases since the balance is better).  The toe is shorter in lenght but has more depth from coronary band to ground, which improves comfort.  In general the whole shape of the foot is much improved, without having made any drastic changes. 
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OR POOR HOOF FORM? 

The Morgan mare is believed to be about 15 yo.  She was found at auction in MA. Due to her severe lameness (grade5/5 at a the walk), no one wanted her and for several weeks she wasted in the auction pens.  She was shod, but according to the sellers it did not help, and even with Banamine she was completely lame on some days.  She was in danger of getting picked up by a slaughter-bound truck when by chance the current owner found her and purchased her for $400. 

(Click on thumbnails for larger views).

  lily002.jpg                      lily-fink0003.jpg

        Left Hind AP                            Left Hind Lateral

This horse clearly has a very advanced case of high, apparently articular, ringbone.  According to the veterinary diagnosis, it was the most severe case ever seen by that vet and the horse would never be sound for riding.

lhringbone.JPG        lhbfrb.JPG   rlh.JPG

Left Hind

The ringbone is clearly visible even without radiographs and the mare frequently favored the Left Hind.

Moving on from what is visible on radiographs, the obvious confronts the viewer: the horse’s hoof form is terrible and overgrown, the result of neglect or ignorance. There is certainly more than enough cause here for lameness of some degree.

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LH before, fig. 1                    LH before, fig. 2             LH after, fig. 3

The bars on the Left Hind are clearly overgrown to the point where they are actually above not only the level of the sole but the wall as well, meaning the bar would be the first structure to bear the horse’s weight, upon weightbearing rather than the walls and sole.  Since the foot is somewhat contracted and the wall and bar material are very hard (as is typical in Morgans), the bars are not folding over onto the sole, the effect for the horse being like stepping onto the dull edge of a knife with each step.  No wonder she refused to put any weight onto that foot.

Fig. 1 shows the edge of the too-long bar (red arrow) as well as the desired location of the bar (blue dashed line). Fig. 2 shows the bar grown all the way around the apex of the frog (red arrows), also a source for pain. Fig. 3 shows the bars lowered and removed from the sole.  After this trim the mare was much more willing to stand on this foot but was still lame on turns.

Having become more comfortable on the LH, she now exhibited more clearly lameness on the Right Front and is seen holding that foot behind her, a sign of pain.

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Further investigation revealed deeply imbedded bar on the RF front, which when removed, produced immediate improved soundness.

Right Front

1rfsolebf.JPG                        3rfsolaf.JPG   

Before                                                       After

 2rflatbf.JPG                   4rflataf2.JPG

Before                                                      After

Update:  The mare has been under the new owner’s care for about six months now.   After her first few trims she was able to place weight on her feet and move comfortably, so she was started on trail rides of increasing duration, sometimes as much as 4 hours long.  After the very longest rides she would show some signs of discomfort in her hind legs, which presumably was the articular deposits being worn away from the hours of movement. (This will be confirmed in the coming months with new X-rays).   But evn this discomfort is no longer present. It is apparent that the obvious pain and inability to place weight on the Left Hind was orginating from the large overgrown bar seen from the underside on the lateral side of the foot, even though this was never observed in the lameness diagnosis.  The lameness was all attributed to the ringbone.  She requires no boots on every kind of footing in the park where she trail rides. 

4 yo Shetland Pony Mare

The pony had not been trimmed much until the time she foundered, and grazed on lush grass while under the care of the previous owner, resulting in a combination of probable metabolic and mechanical founder. Her X-rays and laminar wedge closeups appear in the posts below.

Ruby Standing

A tight regimen of frequent trimming as well as limited access to grass (using a muzzle) has been implemented, resulting in improved hoof form and a healthier body weight.  The trimming focused on lowering the heels and backing up the toes, realigning the coffin bone parallel to the toe wall, as well as bringing it closer to a ground parallel orientation. The parallel hoof wall/coffin bone is a primary factor in the prevention of founder.

BEFORE

rfbefdecember-2.jpg   solebf.jpg

Somewhat difficult to see in the grass, but this is where the corrective trimming started, with high heels and very long toes.  The red arrows at the toe show imminent coffin bone protrusion, along with a wide gulf  separation between its edge and the wall. The bar, (red arrow), level with the frog, is high.

rfsole.jpg       rfsole0307.jpg       rfsolebl.jpg

1 mo.                                  3 mos.                                    6 mos.

As the hoof wall grows down, the separation (all the way around the edge of the hoof) diminishes, and the white line becomes healthy and tight, enabling it to suspend the coffin bone in the hoof capsule.

 rflat.jpg                                              rflatbl.jpg

1 mo.                                                                                   6 mos.

By 6 months most of the hoof wall has grown down with less prominent rings. The remaining separation at the toe (red arrows) corresponds to the separation on the sole at the same time frame and will grow out in another month or so.

The Laminar Wedge

is the space in the front of the hoof at the toe, where stretched and torn laminae have caused the coffin bone to rotate away from the hoof wall.   The space between coffin bone and hoof wall has widened at the bottom, relative to the top, and has filled with wound secretion, blood and torn and dead laminae.

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From the Front

The ‘dead’ laminae are black.  

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From the Top

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From the side. The tip of the toe no longer contacts the ground.

(the photos are of both front feet, both of which foundered).

This is a Left Front foot with the inside wall curving to the inside, in a bell-shaped fashion (red dotted line Fig. 2).  This is being caused in part by the sole at the inside toe which is  too high (Fig. 1) as well as the toe too long.

This young mustang, never shod, has very thick and extremely hard walls which do not break off with wear but continue growing in a distorted way, and altering the horse’s stance.

1alfbefmu.jpg    4lffrontmu.jpg

Fig. 1                                                          Fig. 2

The trimming treats this condition similarly to a flare but also lowers the toe on the inside (sole is removed). So, there are cases when sole forward of the frog does need to be rasped. The trimming is complicated by the inside-growing direction the walls have adopted. Now that the inside wall is growing more correctly, the outside wall needs to begin to start growing in a more outwardly direction (more visible in Fig 3 due to the angle of the photograph). Advanced trimming techniques such as floating the heel and the diagonal toe will allow this to occur.

2alfheelsnov1mu.jpg   5lffrontoctmu2.jpg

Fig. 3                                                     Fig. 4

   

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Fig. 5

A photo from an early trim shows how all the pressure was  put on the inside wall by the long toe, with all the compression rings on the inside only.
 

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