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  Discussion on Heel Elevation??
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Member:
Thomboy

Posted on Saturday, Jun 25, 2005 - 2:00 am:

Frustrated owner, farrier, and vet seeking advice!!

I have a 16-year-old QH mare. My farrier has been doing her feet for the past 8 years. 4 years ago, before I owned the mare, and while the farrier was away for the Army, the owner had another farrier come shoe this mare. This farrier cut off all of the heel on both front feet and the mare came up lame. When the regular farrier returned, he went to work correcting the problem that had been created. He applied a wedge pad, and within a few shoeings, her right front had grown back to trim out at a 50 degree angle, but her left front never did. When I purchased the mare, she still required a wedge pad to keep her sound. A few months after I purchased her, the neighbors dogs decided to come "play" with the horses and got them all to running around in the pasture pretty hard. The mare again came up lame. She was diagnosed with a pulled suspensory on the left front. The vet worked with the farrier and instructed him to raise the heel on the left front to match that of the right front. The right front was trimming out to a 58 degree angle at this point (back to where the angle looked more correct), so the farrier wedged her up on the left front to within 1/2 a degree (rather than cutting down the heel of the right front to 50 degrees). This has been going on for about 3 months now. A couple of weeks ago, she became so lame, she could barely walk. I took her to A&M so they could ultrasound the suspensory if necessary. The said her suspensory was absolutely beautiful, and the lameness was in the foot (they did a block) with some minor shoulder soreness. They took x-rays of the foot, and everything looks fine internally, but her heel (what little she did have) had completely collapsed. At this point, they told me it was up to the farrier.

The farrier first cut off all the heel again, and rebuilt it with acrylic; this caused the heel bulbs to become sore causing more lameness. He removed the acrylic and tried an eggbar shoe and wedge pad, which offered no relief. She seems the most comfortable back in her aluminum wedge shoe with a wedge pad, but my question is this...if her heel collapsed before with this configuration, won't the pressure cause it to collapse again? The farrier had me start her on hoof supplement, but he is at a loss as to what to do next. She is still lame, but much better than she was. She is not toeing out and seems to be walking with only a slight head bob; however, she is noticeably lame at the trot still. The farrier and vet are out of ideas.

Christos, what are your thoughts??
Member:
Christos

Posted on Saturday, Jun 25, 2005 - 5:50 am:

Melissa, we are supposed to ask DrO, he is the specialist. I am not a farrier or vet. However, since you ask, I'll tell you what I think and DrO can correct whatever may be wrong.
For the first part of the story, DrO has explained it recently, raising the heels for a (suspected) suspensory injury is wrong. It increases pressure to the suspensory.
It is also fundamentally wrong to trim the hoof to match the opposite one or to trim for an "ideal" angle. I am very surprised that professionals suggested such an adjustment. You trim the hoof to align to the pastern/leg it belongs to and that's it.
Temporary wedges work well in rebuilding the heel, but I think it is necessary to bring the breakover as far back as possible at the same time, while paying attention that the frog gets adequate support. Applying wedges while the breakover is way out in front and the frog has no support will, at best, have no effect in correcting the heels.
I think cutting the heels in order to grow them better only works if it is contraction / too little frog support that causes the heels to run under. I have seen this performed a couple of times, but is too drastic for my skills and I have never attempted it. What I have seen required a lot of toe sole to be removed afterwards in order to somehow balance the hoof (Ouch!). I prefer beveled shoes to expand a contracted heel.
Cutting the heels in order to raise them again with acrylic or wedges makes no sense to me.

Can you post a picture or two of this hoof?
Member:
Thomboy

Posted on Saturday, Jun 25, 2005 - 10:47 am:

I'm sorry. I am typing this at midnight and so much is going through my head it can't all reach my fingers...hahaha.

The farrier cut off the heel because it had literally collapsed and folded over on top of itself bruising the bars terribly. With the way it was folded over, there was no choice but to trim it off. And he is not trimming it to match the other foot (that's what he had been doing for 4 years) and the vet had him wedge to the proper angles for her, which happened to be 1/2 degree (the right front trims to a 58 and the left front should sit between 57 and 58. In creating this angle, he is adding the wedge pad, an aluminum wedge shoe, and creating the best breakover possible on the front. I think I need to have the farrier himself here while I am typing to you guys, because I am definitely not a farrier.

Didn't mean to offend Dr. O, but assumed this board was to get input from all the wonderful and knowledgeable members as well, and all my vets around here tell me they are not farriers, they are vets. Leave this one to the experts, and the one vet that is working with the farrier has made the suggestions above. I would like input from everyone on this issue.

On raising the heel for the suspensory, I printed out the articles and posts on this board and presented them to the vet and farrier, and they both explained to me that they were not raising the heel to help the suspensory, they were raising the heels to balance the foot. It was just the first time the vet had examined this horse's leg. This is the first I have heard someone mention frog support. Should we try supporting the frog?
Member:
Christos

Posted on Saturday, Jun 25, 2005 - 5:51 pm:

I can't tell without pictures, Melissa, but I think that a hoof that has been wedged several degrees (shoe plus wedge) is likely to need some frog support to function properly.
If the frog is raised so that it does not contact the ground at all, I am afraid the heels may contract if you don't provide some frog support.
Frog function is also essential for blood circulation and building strong walls.
Member:
Thomboy

Posted on Sunday, Jun 26, 2005 - 12:01 am:

The lack of frog support makes sense. It was exceptionally rainy here this year and much of my pasture is a swamp, so the farrier cut the center out of the wedge pad to keep the pad from getting full of mud where I couldn't keep it clean. Although we got much better sole growth, it was not long after this that she came up lame. Would the pad alone be enough support, or would a heart bar shoe do better?
Member:
Christos

Posted on Sunday, Jun 26, 2005 - 3:27 am:

I don't know, Melissa. My amateur idea is to give the frog something to press against only when the foot is bearing weight. Pressure should be released when the foot is in the air.
All heartbars I have seen have too rigid a "tongue", so they'd press against the frog constantly, which I am reluctant to believe is beneficial. I also do not know how much pressure they should be set for, so I have never used them.
Packing the hoof and applying a full pad is a good alternative, I believe. If the problem is because of an unsupported frog, that is.
The thin plastic bridge of a wedge is too weak to support the frog, I think it is only there to keep the wedge in one piece for easier application. I always cut it out.
Again, I am not a farrier and this is just a discussion. Do not take it too seriously, I may be horribly wrong.
Once you mentioned swamps, keep in mind that now is the time to prepare for the next winter. Work those hooves, toughen them, punish them a bit to grow strong and thick and healthy. By November your horse can have a new set of very tough hooves on, then two-three months of mud are not enough to create major problems.
But you have to address the lameness first. Lame at walk is very lame, and I do not think your farrier can take it from "the lameness is in the foot". He's not a magician, is he?
Moderator:
DrO

Posted on Sunday, Jun 26, 2005 - 9:53 am:

Hello All,
Concerning suspensory strain, elevating the heels is OK if it balances the foot. It is when the heels are elevated above the point of being balanced that stressed is introduced.

Concerning the collapsed heels I think if the heels are collapsing under the pressure of the build up yes frog pressure can be introduced to help disperse pressure while they grow back. The acrylic is a two edged sword: yes it can fill in defects and build up the heel but the wall under the acrylic will soften in time, making a future collapse more likely. So perhaps it is good the acrylic was removed. I agree that a metal heart bar will be hard to make work do to the constant pressure.

Frankly I think a prolonged period of bare foot is a very clean stall with deep bedding may be the best treatment here. The enforced rest prevents suspensory injury and the foot can grow out strong and healthy while the bruising heals.

If this is not practical I would use one of the "heart bar" type plastic pads for this job of trying to spread out pressure. It should be fitted to be flush with the frog when put on then supported by filling in the bottom of the shoe with silastic sealer so that when the horse stands there is pressure on the pad.
DrO
Member:
Thomboy

Posted on Friday, Jul 22, 2005 - 4:00 pm:

Just an update on my mare...

The farrier applied a frog support pad and she was IMMEDIATELY sound at the walk. After a few days, I rode her for the first time in months! She has remained sound with the pad in place; however, due to the massive growth, we are having to reset the shoe and pad every 2 weeks. The hoof wall is thickening, the sole is growing beautifully as are the heels. The mare is so energetic, she doesn't know what to do with herself. We have restarted our slow work on barrels, and with the above-mentioned energy level, this is a challenge. She is running and playing in the pasture with the other 20+ horses and acting like a little filly again! I can't thank you guys enough for all your help! The farrier asked me to thank you as well!!!!! He loves this mare almost as much as I do. The vet is looking into joining the site now. He had never heard of it until I was showing him the other day.

Thanks again to all!!!!
Moderator:
DrO

Posted on Saturday, Jul 23, 2005 - 9:36 pm:

What a great report but I must ask why did you go with the pads instead of barefoot?
DrO?
Member:
Thomboy

Posted on Sunday, Jul 24, 2005 - 2:54 am:

Barefoot she is completely lame on that foot. The angle is just too bad. Unfortunately, we have torn down the old barn to make room for the new barn and all I currently have (aside from the stallion barn and paddocks) to keep her stalled is a 20 x 20 covered paddock. From this, she can see the other horses in the pasture and this drives her nuts. She bucks, rears, paces, runs, etc. I had to turn her out in the pasture for her suspensory to heal,as she just acted a fool in the only place I had for her. Luckily, 4 of the 20 apparently realized she was not well and kept the others from bothering her until she was better. Now they are all playing like a bunch of kids.

As an extra, we ran a 4-D barrel race tonight and the old girl (extremely out of practice, but back in good shape) placed 2nd in the first "D" out of 106 riders...not bad! She seemed to be so happy to get back to work. When we got home tonight, as I was trying to put away the tack, she kept walking into the tack room and nudging at my elbow as if to say "let's go again, Mom." She used to go hide in the pasture when she saw the farrier's truck...now she runs up to the fence and "talks" to him as he gets his tools out!

You have no idea how good it feels to have my girl back!!! My grandfather always told me that you always love your horses, but there is going to be 1 "special" one...she is my "very special" girl, and thanks to all your help, she is feeling better. Thank you again, so very much!!!!
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