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Discussion on Intermittent lameness made worse with shoeing
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New Member:
Maeve04
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Posted on Wednesday, Sep 15, 2004 - 10:49 am:
Apologies for this longish story but I'd be so relieved if anyone can shed some light on the list of lameness symptoms my 8 yr old mare has had over the past 6-8 months. She has been suffering from intermittent lameness and until this week the lameness has never been accompanied by any swelling or heat and can disappear as quickly as it appears (- usually too quickly for the vet to ever see it!). During the past 3-4 months she can sometimes be head-noddingly lame for the first 5 mins warming up and then work through it perfectly sound. This can happen for a couple of days and then disappear for weeks. During her sound periods she has been competing well in dressage competitions.
This last week, however, things have changed. I had a couple of days with uneveness when warming up and then she went quite badly lame immediately after shoeing. This time there was quite a lot of heat in the hoof and strong digital pulse. I called the vet over and he nerve blocked her. No response with the first block (sorry don't know the technical terms) but improved noticably with the second which the vet said numbed the coffin joint and front of the foot. I then took her to the surgery the next day i.e. yesterday (at which time the lameness was beginning to ease off) for x-rays. These were perfectly normal. During this procedure the farrier removed and then replaced her shoe. Today she is more lame than I've ever know - can hardly bare to place any weight on the foot. It seems that the flexing or banging of the hoof has aggravated something.
The symptoms seem so specific that I was wondering if there was anyone out there who has had similar experiences? My vet is going to refer her for a bone scan.
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Member:
Parfait
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Posted on Wednesday, Sep 15, 2004 - 12:42 pm:
Maeve,
You didn't say if this is the front foot? I think that's what you mean. Sometimes coffin inflamation can respond that way...to shoeing changes and foot imbalances. I just recently had a horse with unexplained, ongoing coffin troubles (we had her toes short, break-over set back and m/l balance OK) but she remained sore. Her back was sore and we thought that was the cause, but she eventually showed us an occult soft tissue stifle problem on the diagnal of the sore side. She only showed lame in the stifle going one direction at the trot after both coffins were blocked. It took five hrs of careful examination by a great vet. Good luck!
Kerry
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Member:
Maeve04
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Posted on Wednesday, Sep 15, 2004 - 4:12 pm:
Dear Kerry
thanks very much for your prompt response! Hope your mare came sound in the end.
Yes, my horse's problem is the inside fore and I doubt that foot balance is an issue as I have had two very good farriers attending her. Nevertheless there is something that the shoeing is aggravating and this time very dramatically. Is it possible that this could be something to do with the laminae or coffin joint?
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Member:
Parfait
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Posted on Wednesday, Sep 15, 2004 - 4:48 pm:
Hi Maeve,
Dr O can help you with your horse. I know he hates it when we compare cases because my horse's thing is nothing like your horse's deal. What I was trying to communicate is that these issues can sometimes be more complex than we think! I initially thought it was coffin inflamation, due to hoof imbalance or throwing herself onto her front-end due to a sore back. Her x-rays and all are clean. She is on stall rest with the inside heel of a pad cut out for relief. We will re-evaluate in a month. She gets scoped then too.
kerry
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Member:
Maeve04
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Posted on Thursday, Sep 16, 2004 - 4:53 am:
Dear Kerry
it will be interesting what Dr O thinks. Intermittent lameness can be so frustrating but with my mare the symptoms not only seem to be getting worse but are pretty specific. The vet seems very confident that the problem is in the front of the foot (because of the positive response to the second nerve block - within 10 mins). Also one would have thought that the extreme response to having the shoe taken off and replaced would also narrow the range of possibilities.
Lets see.....
Hope things work out with your horse
Maeve
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Moderator:
DrO
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Posted on Thursday, Sep 16, 2004 - 7:33 am:
Hello Maeve,
I am uncertain this bout of lameness is the same or related to the vague problem you have had in the past. The rapidly progressive lameness of the foot to the point of being non-weight bearing and increased digital pulse strongly suggest a solar abscess to me. Has someone thoroughly examined the hoof with a set of testors while the shoe was off? See Equine Diseases » Lameness » Diseases of the Hoof » Hoof Abscesses, Bruises, and Gravels.
DrO
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Member:
Maeve04
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Posted on Thursday, Sep 16, 2004 - 9:27 am:
Dear Dr O.
read the article and well it has now got me thinking! She has been a horse prone to abscesses in the past but I guess we ruled it out this time because of the history of intermittent lameness that preceeded it. With this bout of lameness the vet did use a hoof tester (no response) but come to think of it with the shoe on.
This is not the first time she's had this sensitivity to shoeing. Six weeks ago she was plainly uncomfortable when standing with the shoe taken off and then hopped around from one foot to the next for the rest of the day after being shod. She then came sound for me until now. Today although still quite lame she is much better - can atleast put weight on the foot.
If it was a solar abscess can they simmer for weeks like this and then flare up?
Do you think it is worth getting my farrier over the do a test without the shoe or should I wait for the bone scan?
Thanks for your advice
Maeve
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Member:
Suzeb
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Posted on Thursday, Sep 16, 2004 - 12:23 pm:
Hello Maeve,
A few things you might want to consider is:
You have two farriers shoeing your mare. Are they on the same page when it comes to shoe placement and trimming?
Has your vet made any comments or observations about the farrier work?
Has your vet and farrier(s) had a conference with you in attendance?
Anything else that may have changed in the last 8 months of this intermittent lameness...footing, riding style, new saddle, different shoe style or application etc.
Does the lameness seem worse right after shoeing or seems to hit about two to three weeks into the shoeing period?
You don't have to answer all of the questions above, but you might consider them for getting your mare's problems sorted out.
Hope this helps,
Susan B. 
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Member:
Maeve04
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Posted on Thursday, Sep 16, 2004 - 1:57 pm:
Dear Susan
I have racked my brains thinking what could have caused this. I did change my farrier about 18 months ago because the first altho' very good was incredibly unreliable. The second had qualifications up to his arm pits and by all accounts was supposed to be very good - even my vet saidso. But the problems started (and to be fair also started when I began to do more work with her). We thought it was thin soles to begin with and so she went with pads for several shoeings - but even then I did notice a slight uneveness at the start of work ... sometimes. She then went lame and I began to doubt my farrier and agreed with the vet to change which was about 3 months ago. I now have ONE farrier dealing with her and his comment to start with was that the previous farrier had 'pulled her toe back but failed to give sufficient support to the heels'. He has been shoeing to compensate for this.
In the last two shoeings the lamness has been worse immediately after shoeing and this time with the x-rays to a point that she could hardly walk the next day. We are now on day 3 since the x-rays and she is definently improving.
She has had her saddle and back checked and all OK there.
Cheers
Maeve
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Moderator:
DrO
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Posted on Thursday, Sep 16, 2004 - 9:44 pm:
Rack your brain no more: the answer is not in some little detail from the past. In the big picture it is a abscess until proved different. If the abscess has found a hole big enough to drain itself, yes it might improve without treatment. The idea of having a radiographs done (much less a gamma scan) before a thorough investigation of the foot with a set of hoof testors is so weird I don't have the words to express it. A thorough exam requires the shoes be off.
DrO
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Member:
Maeve04
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Posted on Friday, Sep 17, 2004 - 3:38 am:
Dear Dr O
sometimes it needs the obvious to be pointed out! I have had this worry that my vet has got entrenched in the idea that it is a navicular-type problem. So I am going to follow up your advise and get the hoof checked properly to eliminate the possibility of an abscess. If that is what it is I will be over the moon and ever indebted to you! - the vet has been painting such a gloomy picture should it be a coffin joint problem.
Anyway I will let you know the outcome.
Thank you so much for your sound advise and clear thinking!
Maeve
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Moderator:
DrO
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Posted on Friday, Sep 17, 2004 - 8:23 am:
I have my fingers crossed for you Maeve and let us know the outcome.
DrO
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Member:
Maeve04
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Posted on Tuesday, Sep 21, 2004 - 7:51 am:
Hello again
well I called the farrier out and he checked the hoof but said that very unlikely an abscess - the digital pulse by then couldn't be felt and her lameness had improved (about grade 3). He was reluctant to take the shoe off again because of the extreme response last time but did test her soles where there was some reaction (albeit rather small) around the toe. His diagnosis is that I have a horse with very sensitive soles and suggested that I tried pads on next time she is shod.
I'm not totally convinced by this and it does seem that an abscess is less likely now that she has improved without treatment and the pulse has disappeared. Am I right?
Since I seem to going round in circles with this one I've decided to have her referred for a bone scan and further checks.
Will let you know the outcome but in the meantime still interested in anyones thoughts.
Maeve
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Member:
Suzeb
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Posted on Tuesday, Sep 21, 2004 - 12:24 pm:
Hello Maeve,
A thought that I have is that your mare is a little sensitive in the toe, and this sensitivity is made worse just after shoeing.....hmmm. She could be landing on her toes causing some bruising or tenderness. A useful tool for some more "diagnostics" would be to have someone longe her while you and the vet and the farrier watch her way of going. Video tapes would be even better. Pictures can be worth a thousand words  .
You have never mentioned what her hoof conformation is like and sometimes that can be very telling indeed.
I do understand your dilemma about removing her shoes for hoof testing and then having them nailed on again making her sore. I suppose if you have to go that route again, it might make sense to have the vet do some thorough nerve blocking at the same time to narrow down the source of the lameness. Near as I can tell it sounds like sore toes. Now all everyone needs to do is figure out why.
I have fingers and hooves crossed for you too.
Susan B.
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Member:
Onehorse
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Posted on Tuesday, Sep 21, 2004 - 2:33 pm:
Maeve:
PERHAPS, with all the shoeing and pulling of the shoes for testing and the re-trimming to put the shoes back on, the problem lies with the sole of the foot being extremely thin requiring nothing more than allowing it to grow. You mention that the lameness is subsiding which is a good sign. As long as she seems to be improving ... give her more time to heel before bringing her back to work or even doing the bone scan.
Remember ... horses heal progressively (particularly with hoof and leg problems). First, they appear okay at a walk and easy work, but when we ask for more the problem remains - due (sometimes) to the fact that we haven't given enough time for a complete healing process and we set the horse back unintentionally.
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Member:
Sunny66
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Posted on Tuesday, Sep 21, 2004 - 2:47 pm:
I found my horses' lameness due in part to the farrier setting the shoe too far back and he ended up standing on his coffin bone. The only way I found out was to take xrays with the shoes on.
Maybe you could take xrays before the shoes are removed as well as after they are removed to eliminate causes?
Rick....thanks for your post. I just bet that's what my guy is going thru. He is SO sensitive on his toes from the road founder. Maybe some keratex on his soles would help?
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Member:
Maeve04
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Posted on Wednesday, Sep 22, 2004 - 3:30 am:
Dear All,
thanks for your very helpful suggestions and sharing your experiences. I agree that sore toes could be a possibility as the nerve blocks taken over a week ago suggested that the location of the soreness was at the front of the foot.
Aileen... the x-rays were taken with and without the shoe. The xrays were very clear and 'clean' and suggested that my present farrier has got the foot balance perfect.
Susan B...her hoof conformation is not that bad at all - the right foot is slightly smaller than the left but then mine is also and I don't hobble around! (Although if I stubbed my toe....)
Rick...very good point regarding giving sufficient rest. I guess we can sometimes be a bit impatient after spending all those cold wet winter months (I live in Wales, UK!) preparing for the competition season only to have the horse go lame at the first mention of a competition. She is now being fully rested and boxed and will stay that way until better.
I will get back when I have any more news - hopefully when we've solved the mystery.
Bye for now
Maeve
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Member:
Sunny66
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Posted on Wednesday, Sep 22, 2004 - 10:33 am:
Good luck, Maeve!
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Member:
Maeve04
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Posted on Wednesday, Oct 20, 2004 - 2:27 pm:
Hi All
well have just returned from an intensive day at the veterinary hospital with the outcome that (i) my mare is actually lame in both front feet, just worse on the left and (ii) that they put it down to poor foot balance. Three nerve blocks were done on the left foot and the coffin joint block removed about 90-95% of the lameness. Having located the main source of pain the x-rays indicated some very slight changes around the coffin bone which were thought to have occurred because of the uneven loading (the outside of the foot landing before the inside). Anyway, she now has some heart bar shoes shaped in such a way to ecev loading over the foot, pads to raise her heels slightly (to bring P3 parallel to the sole) and the breakover pulled back a little. Hopefully several such shoeings will bring things back to normal.
As for the extreme response to recent shoeing, the farrier said this was not unsual if a horse has a shoe replaced several times in quick succession especially one with thin hoof walls. This then jolted my memory that my mare had in fact lost her shoe whilst away with my trainer, it was replaced and then she had her normal shoeing 2 weeks later - went lame was xrayed and had the shoe removed and replaced again! So 3 shoeings on the same foot in three weeks. I was told when a horse responds badly to several shoeings then it can take 2-3 weeks to recover soundness - exactly what my mare did! The advice he gave was if this happens the worst things is to remove the shoe - leave it and give the horse time to recover.
All in all a rather positive outcome as I feel my mare is finally receiving the treatment she needs and hopefully is on the road to a full recovery. So thanks to all that have contributed to this thread and hope some of this info. will be useful to others.
Maeve
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Moderator:
DrO
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Posted on Thursday, Oct 21, 2004 - 6:39 am:
That is great Maeve, let us know the outcome.
DrO
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