Conditions & Treatment


I came across this post on my new favorite blog, Good Horsekeeping and thought I would share it.  The focus is on the two extremes – from very unheatlhy to very healthy, but there is a lot of room in between the two. It is important to learn to recognize what hoof rings are telling you. It usually means there is some form of inflammation going on inside the hoof.

An  upset in the horse’s metabolic system eventually shows itself in the hoof wall texture and horizontal rings.  The hoof becomes a mirror of the internal imbalances.
MMP enzyme, (matrix metalloproteinase) controls the growth and direction of the laminae in the hooves.  This enzyme is well regulated in a healthy system providing flexibility in the connective tissues of the hoof wall.

The cecum, in the hind gut is part of the digestive process.  It is a fermentation sac containing microbials that assist in breaking down the forage.When the diet is high in grains and sugars this causes the bacterial population of the hind gut to rapidly increase damaging the lining of the colon and releasing toxins into the bloodstream.

Eventually the toxins reach the hoof causing MMP’s to be released.  In efforts to process the excess toxins MMP which is normally well regulated is released in abundance. The result is a separation of laminae.  This is a painful and serious condition.  The results are seen as horizontal warped rings on the hoof wall.  See photo below.

rings
The next photo is of a healthy hoof.  You will notice no rings, a smooth surface with the coronary band even and  smooth.  There is about a half inch of new growth below the coronary band.  This too is healthy and smooth.

fergust LF lateral 2

There can be other causes for horizontal hoof rings; improper trimming, shoeing, concussion, abscesses, circulation issues and other metabolic syndromes.

A diet high in sugars, grains, and starches is one of the main contributing factor to hoof growth deformities and other health issues in the horse.  The horse needs a diet high in fiber.  They are grass eaters, not grain eaters.

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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I ran across this old article recently in the May 1999 issue of Anvil Magazine. It is a writeup from the Bluegrass Laminitis Symposium from the same year. It summarizes the talks that were presented, one of which was by Dr. Christopher Johnston, DVM, PhD, on the study of the effect of shoes on hoof expansion:

Christopher Johnston, DVM, PhD, spoke about Impact in the Athletic Horse; about Heel Expansion; and also about Objective Biomechanical Testing of Horseshoes. Dr. Johnston finds that a softer surface may absorb as much as 90% of the impact forces. In his laboratory studies, as much as 80% of the impact force on the limb is absorbed in the hoof, before it reaches P2.

Dr. Johnston outlined three possible explanations for heel expansion of the hoof under load: the frog pressure theory, the depression theory, and the hemodynamic theory. Every one of these may play a part. Using a thin wire attached to the heels and a potentiometer, Dr. Johnston found about 1 mm (1/24 of an inch) expansion at the heels under load, followed by contraction of the heels as the hoof approached breakover during motion. Shoes decreased the amount of expansion and contraction.

I found this short blurb interesting in that it states matter of factly that shoes prevented expansion of the hoof. There’s no way to tell what if any discussion was generated at the symposium, but this study is over ten years old and it appears to have died a quiet death. I think this is a far more significant finding than there is credit being given, as most farriers and authors will dispute that shoes prevent hoof expansion.

I have not been able to find anything on the original study by Dr. Johnston. If anyone is familiar with where to locate it, please post.

Link to article:

http://www.anvilmag.com/farrier/bls.htm

Club Foot

Club Foot

Not Club Foot

Not Club Foot

These are X-Rays of the front feet of a yearling filly.  The first figure is the right foot, the bottom is the left. The top photo depicts a classic clubfoot, the bottom is a normal foot.  The external evidence indicating it is a clubfoot is the curved, dished wall of the foot. The coffin joint angle is the radiographic evidence showing it’s a clubfoot. The angle between the coffin bone (P3) and the short pastern (P2) is ‘broken’, whereas in the non-clubfoot, the angle is smoother, more of a straight line. The clubfoot even shows a ski tip already from high heels and rotation putting pressure on the coffin bone tip.

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.

2lhsolebf.JPG      1lhsolebf.JPG         3lhsole.JPG

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.

1body.JPG

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. 

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