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  Discussion on Long heels and bruising
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Member:
Sryder11

Posted on Saturday, May 13, 2006 - 11:57 am:

my TB dressage horse was intermittently lame several weeks ago. My vet and farrier examined him together and found bruising on the RF quarter. The farrier said he had been trying to grow more heel on the horse and now his heels were crushing onto his feet. The vet prescribed bute and rest but did not suggest any shoeing changes. He currently wears a 3 degree wedge pad. After 3 weeks off the farrier hooftested the RF and said we could put him back to work. Now he is lame on the LF, same symptoms. His heels look underrun to me. Do you have any suggestions as to trimming and shoeing - should we trim the heels more often - are the wedge pads the right solution? My vet does not seem to have any suggestions.
Member:
36541

Posted on Saturday, May 13, 2006 - 12:35 pm:

Probably the first question to ask is - does he have to have the shoes? I had many of the same problems you describe in my 2cnd level trak-TB cross, and over the three years he had shoes I watched the structure of his feet change for the worse. 3 months ago I pulled his shoes all around, and though he was intermittently lame on the fronts for about 6 weeks, he is sound now and the foot structure is overall very different. I did this primarily because of all my reading on this site, and my surprising(to me) investigation into the barefoot philosophy. Because of what I have learned from the Pete Ramey site and tribeequus.com, I became emboldened enough to trim Han's feet myself every 3 weeks. The close maintenance and shaping have already helped the sole become more concave, and I am seeing heel for the first time in years. My farrier is supportive - he knows I won't be able to do all five of them so no threat to him!!
I was always told that this horse had thin walls from his TB half and would always have shoes, but I am finding this untrue at this point. Needless to say, I am thrilled at the change. No longer do I go out on the one or two days I have to ride to find a shoe off. Good luck to you, there is a wealth of info on healthy foot shape and trimming out there.
Member:
Hwood

Posted on Saturday, May 13, 2006 - 5:14 pm:

Amen, Stacy . . . I hadn't gotten to your post, yet, in my inbox, but I was going to recommend the same thing. Pete Ramey's book deals with the long and underrun heel issue . . .
It's definitely worth checking out.
Moderator:
DrO

Posted on Sunday, May 14, 2006 - 8:42 am:

Hello Susanne,
It is difficult to make recommendations without completely examining the foot but the problem is a common one and I think I can give you food for thought.

In general if the heels are being crushed but the angle of the foot near OK with the help of the wedge pads, too much weak heel has been left. It might be that as he let the heels grow out that if he lowered the wedges this would not have occurred, but I have always had poor luck correcting low heel problems this way. The reason is the whole foot is out of balance leading to the growth of heels that are weak, mainly because of the acute angle that they grow with respect to the ground.

Often the best way to correct such a foot is by shortening the anterior aspect of the foot: the toe needs to be squared and rolled in the front. This leads to stronger more upright heel growth over the next 10 to 12 months.

All damaged tissue should be paired away then the foot balanced with wedges, if you want to continue shoeing, and usually the wedges can be removed as you get more upright growth at the heels. This can be done without the wedges or bare foot as noted above but the horse might travel better and be less prone to injury in the interim with the wedges and the shoes.
DrO
Member:
Sryder11

Posted on Sunday, May 14, 2006 - 11:53 am:

Dear Dr. O, thank you so much for this input. I have a meeting with the farrier tomorrow morning so this will help me talk with him. He is not a horse that can go barefoot even temporarily; I had asked the vet about this.

How often would you expect the farrier should need to work on him - meaning, should he have corrective trimming during the course of the shoeing cycle? thank you again.
Moderator:
DrO

Posted on Monday, May 15, 2006 - 7:48 am:

Unless you have problems that develop between regular shoeing or all the defective horn cannot be removed in the next trimming, I am not sure extra trimming would be required but this will best be answered by your farrier.
DrO
Member:
Dwinans

Posted on Tuesday, May 16, 2006 - 12:41 pm:

Susanne,

I have a TB with similar feet. He is shod in 3 degree wedges also. His feet are very thin-walled and prone to bruising. Last summer I turned him out to pasture for a couple of months and he threw all four shoes in the first week. It was a week before the farrier could get out there and I was freaking because I envisioned a crippled horse. When the farrier finally arrived Remy's feet were so short there was space for only 2 nails per shoe (on the front feet). Somehow the shoes stayed on and it ended up being the best thing that could have happened. Because the toe was pulled back my farrier has been able to keep it short and the heels are much better. His angles are almost perfect in the 3 degree wedges whereas before he would have needed 6 degree wedges to correct the angle.

That has always been key with my horse - if the toe isn't kept short he gets quarter cracks and trips on flat ground all the time. Now he doesn't trip at all! It is also extremely important to keep the shoeings at 5 week intervals.

I don't know if I would suggest pulling the shoes but I do know that a short toe is what fixed my horse's feet.
Member:
Miamoo

Posted on Wednesday, May 17, 2006 - 8:25 am:

Dr. O,

Don't you need to be careful with taking away wedges if the horse is used to them. Won't this put too much pressure on the deep flexor tendon as the horse is not used to the lower heel? How do you get to the point of wedges to barefoot while making sure that the DFT can handle it?

Ella :-)
Member:
Sswiley

Posted on Wednesday, May 17, 2006 - 10:05 am:

For one thing this horse was on vacation and barefoot during this transistion time. I am sure he was not blasting around with those ouchy bare feet. Not the best way to slow a horse down but in this case it worked out well.
My old (retired for several years)eventing mare was always plauged with thin soles, long toes and under slung heels. I have a lot of rocks here so I never let her go bare foot, but several years ago I had the opportunity of putting her in a beautiful pasture for the summer. We took her shoes off and she did very well. She has been back home for several years and is still bare foot. No bruises and her feet are better balanced than they have ever been. I always assumed that she would be in eggbars till the day she died.
New Member:
Banthony

Posted on Wednesday, May 17, 2006 - 11:12 am:

Susanne - I have a thoroughbred with the same problem. He kept camping up underneath himself and getting a sore back. My farrier kept trying to get him to grow a good heel.

My veterinarian explained to me that he didn't (and probably wouldn't ever) grow a good heel. Since it curled under as it grew out, it was better to cut it down and open up the foot (and establish normal weight bearing on the foot.) My vet was also adamant that the farrier put a big enough shoe on him to support the heel. (The shoe shouldn't close in and look "pinched" at the heel as you so often see.)

This was a major problem as the correct size shoe made it easy for the horse to pull it off with a hind toe. Bell boots were a must and even so sometimes it was hard to keep the front shoes on. I have found that getting a farrier to put on the correct size shoe is a major problem as they hate having to come back and put shoes on constantly. But I have to say my horse was much more comfortable with this strategy.

I finally let him go barefoot and had such a problem finding a farrier that would cut his heels down and correctly balance the foot that I frequently had to have my veterinarian come out and re-trim his front feet. As you can imagine that is very expensive.

I even had the farrier and vet meet so the vet could explain exactly what he wanted him to do and why. This only seemed to help my farrier through a few trims and then he was back to leaving the heel long.

After quite a few years I am still having a problem finding a farrier that will trim him correctly.
Member:
Sryder11

Posted on Thursday, May 18, 2006 - 5:58 pm:

Thank you all so much for your posts. Yes my farrier has suggested shoeing the horse at 5 weeks, even 4 if he needs it. Right now his RF seems fine but still having problems on the LF. The farrier examined his foot Monday and said there had been what he called some irregular hoof growth, the shoe wasn't fitting, and that he had to trim a lot of heel to get the foot balanced, and this was only 4 weeks or so from the last shoeing.

He seemed sound after this adjustment but now, a few days later, he seems to be sore from hoof testers on the LF all around, not only in the heels & quarters. The farrier has been using a frog-support wedge and today he tried replacing it with a plain one. He is going to work on the horse again Tuesday. I am very lucky that the farrier is coming so often to help me with this but the horse is still sore; we have not worked him but just jogged him a little on the longe to see what is going on.

I asked the farrier about lowering the wedges and he said essentially what Dr. O said in his post, that the foot was balanced correctly with the wedge.

Am I making a mistake expecting the shoeing adjustments to help him right away? Should I stall-rest him? I have been walking him lightly and as I said briefly getting him on the longe to see how he is. Should he have another vet evaluate him? Thanks again to all.
Moderator:
DrO

Posted on Friday, May 19, 2006 - 8:11 am:

Without examining the foot, I really cannot say what you should expect from the trimming/shoeing other than the foot should appear balanced when standing square and when traveling should land near flat, for more see Care for Horses » Hoof Care » Trimming and Preparing the Feet for Shoes. However if the horse is sound and only reacting to the hoof testers you should ignore the hoof testers: soundness on weight bearing is a far more sensitive indicator of what is going on.
DrO
Member:
Sryder11

Posted on Thursday, Jun 1, 2006 - 9:47 pm:

Dear Dr. O, I would like to update you on the situation with my horse. It has been a little scary and confusing. At the time of my last post my horse had recovered from a bruise on his RF but was lame on the LF. My farrier was working on him, trying to make adjustments for what he thought was soreness in the heels. We rested the horse and he was reshod last week on Wednesday. I came to find him quite uncomfortable about 3 hours after shoeing, with heat and pulse on the LF. I called the farrier who came back and found hot nails in both front feet bothering him, said he had noticed no problems while nailing but he thought the horse's feet must have "spread" after shoeing. I told him to pull the shoes.

I had scheduled an appointment with a new vet to get another opinion on what was going on, shoeing, etc. The new vet came 2 days later finding the horse very sore from hoof testers on the LF, the soreness he thought was concentrated in the heel area. Xrays showed some minor navicular changes, he called it calcification, at the wings of the navicular bone on the LF. The RF Xrays were normal, RF only mildly sore. Both coffin bones normal.

The vet diagnosed soft tissue inflammation on the LF and is recommending I rest the horse on bute, barefoot, keeping the feet wrapped. My farrier wants to put glue-on shoes with a 2 degree wedge on the horse but the vet says to wait on shoeing so I am following this vet's advice.

My questions are: could inflammation of soft tissue in the navicular area cause such a rapidly worsening lameness, especially when the horse was not at work? Could the navicular changes be the result, not necessarily the cause, of the inflammation? Could this be a case of supporting limb-type laminitis, combined with the heel soreness? Could this have been brought about by heel pressure? He had no symptoms of navicular problems before all this started 2+ months ago. Most of all is it safe for him to be barefoot after being trimmed for a 3 degree wedge pad last week?
I am comfortable with the new vet but it is a little mysterious to me how this seems to have escalated. Any of your observations would be welcome.
Moderator:
DrO

Posted on Friday, Jun 2, 2006 - 10:06 am:

Hello Susanne,
Again, without specifically examining your horse, neither I nor anyone else can accurately diagnose what is happening to your horse. We can help you understand the disease process your vet has diagnosed and the treatment better. There does seem to be a bit of conflict between what is says is wrong and his recommendations. Taking your questions in order:
  • Yes soft tissue inflammation can certainly present as lameness even in horses not worked.
  • I believe your vet is saying the tissues have been chronically inflammed resulting in calcification of the ligaments of the navicular bone. Once calcified they are more prone to inflammation so this becomes a cycle set up.
  • Usually supporting limb laminitis is seen only when the other leg is not weight bearing.
  • All horses have pressure on their heels but if the pressure is abnormal yes palmar heel pain can result.
  • As to whether to go ahead and use wedges or not should depend mainly on whether the horses angles are normal. If the heels remain low you will continue to have abnormal forces in the heels and if this is the problem it may continue.
Most of this is explained in greater detail at Equine Diseases » Lameness » Diseases of the Hoof » Navicular Disease / SynDrOme. By arming yourself with this information maybe you can better discuss with him why we does not want to correct the low heel problem, perhaps he sees something else?
DrO
Member:
Sryder11

Posted on Friday, Jun 2, 2006 - 7:49 pm:

thank you Dr. O - I will read the articles.

I should clarify that the vet wants the horse to be shod, he wants a consultation with the farrier. He is advising 10-14 more days stall rest without the shoes though saying he wants the inflammation to be relieved. The farrier questioned whether this would be better done with shoes and as you say, the angle is a factor, but I am doing what the vet says. The horse seems to be improving, he has a stall and run with soft footing. Thank you again, your comments and the articles will help me ask questions at the next vet appointment probably next week.
Member:
Sryder11

Posted on Saturday, Jul 1, 2006 - 6:23 pm:

Dear Dr O, I would like your input on the next step with my horse. He had 3 weeks rest without shoes, wearing foot wraps in his stall. The vet checked him and thought the inflammation had subsided and we could try putting shoes on him.

The vet and farrier wanted to put Sigafoos glue-on shoes on him since his walls were thin (he has the same walls he always had) and he had become very sore from the last shoeing which was done while the heel area was apparently inflamed.

I was not comfortable with the idea of glue-ons. The horse tends to interfere and I thought they could come off. Also they did not seem to address the issues, especially the possiblity of a navicular condition. I agreed to it since that was what they both recommended. The horse walked around comfortably in the shoes and I started giving him some very light exercise at the walk, then a little trotting, no turnout or longeing.
I observed the sole on the foot which had been sore was very sensitive and I just was not sure about the whole situation.

This morning I found one of the glue-ons coming off. He is also due to have the hind shoes redone so I think it is time for a more appropriate shoeing strategy, but I am not getting very much input from my vet. He thinks the 3 degree wedge pads contributed to the horse's problems and does not recommend using them again.

I met with a new farrier this morning who was talking about trying a flat bar shoe with a flat pad. He strongly felt the glue-on shoes were not suitable for the horse, that his soles needed protection and that the foot was too far forward (my vet and farrier had thought his angles were fine) which would lead to strain on the heels and tendons. I am not sure about bar shoes, wouldn't they might provide the same pressures as the wedge pads?

This is the second vet I have used and I am feeling a little frustrated that neither he nor the farrier I've been using for 3 years seem to know what to do for the horse, and that they would so heartily recommend something (the glue-ons) which may not be really safe or suitable for him.

I am considering trying this new farrier but I don't know. The horse seems sound right now but I don't want to put him in harder work until he has an appropriate shoeing strategy.

Let me know if you have any thoughts or suggestions Dr O. I appreciate your reading this and offering any advice.
Moderator:
DrO

Posted on Sunday, Jul 2, 2006 - 9:46 pm:

There seems to be no disagreement between your vet and the new farrier: they both don't suggest elevation of the heels but I don't know how to compare the conflicting judgements on the sole thinness and foot balance. Note that a bar shoe is nothing like a wedge pad, it provides protection with elevating the heels.

Susanne you have to educate yourself on foot balance and conformation so that you can decide what makes the most amount of sense when you get conflicting information like this. To do this see, Care for Horses » Hoof Care.
DrO
Member:
lilly

Posted on Wednesday, Aug 22, 2007 - 4:55 pm:

Susanne,
How is your horse doing? Could you post an update?

Ann
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