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  Discussion on Lame pony after shoeing
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New Member:
Ellenmk

Posted on Wednesday, Apr 13, 2005 - 7:12 pm:

I'm hoping someone might be able to help with my daughter's pony. He had been on and off very slightly lame on right front for past 2 weeks. Only noticed on tight circle on hard ground. He was due for shoes to be reset and I mentioned to farrier that his heels seemed high--right front more than left. He has moderately upright feet and right front was described as being "slightly clubby" by another farrier. I said do what he thought best. Next day, pony very lame right front at trot. I noticed he had a very deep crack in center of frog that went up between heel bulbs. I started soaking foot and treating for thrush and packing the crack to try to open it up to "air it out". Seemed to get a little better after 2 days stall rest, then had to turn him out because he was going crazy and next day sore again. (pony is used to 24/7 turnout). Paddock is dry now so shouldn't contribute to thrush if that was a problem. One week after original trim, a different farrier came out and looked at him--still very sore at trot on soft ground. He said the pony was trimmed way short, and shoe was too small at heels (sitting insided edge of heel, no expansion room.) tested all nails-no apparent pain there. Removed shoe and replaced with properly fitting shoe with pad. Said give it a few days and see if it helps. That was yesterday. Today pony was tearing around paddock at full gallop, but when trotted in soft arena-still as sore as ever. My questions are-if original farrier let heels get high, then tried to trim them down to normal all at once-would that cause lameness? When we first got him a different farrier said his RF heel was a bit high and she would bring down slowly! Should he maybe just have a higher than normal heel on that side if that foot is slightly clubby? Would trimming it make him lame? He seems to be very sore in the heel bulbs when I push on them--even a little above the heel bulbs. A few people have said he has heat in foot especially aroung heels--I really can't tell. No obvious throbbing pulse though. Vet has been called but can't come out until next week. If it is just a too short trim, how long should it take for him to be sound? Will pad help? Thanks for any info or advice.
Ellen
Moderator:
DrO

Posted on Thursday, Apr 14, 2005 - 8:23 am:

Definitive answers to your dianosis and questions on proper trimming of the pony requires an exam. That said, the trimming too close when attempting to lower the heel is a very plausible explanation of the history you present. I have had some of these take up to 6 weeks to get over the problem without significant brusing and longer if the foot becomes badly bruised. For more on treatment see the article associated with this forum and be sure to follow the links.
DrO
New Member:
Ellenmk

Posted on Friday, Apr 15, 2005 - 9:24 pm:

Hi Dr. O,
Thanks for your quick reply. Pony has had pad on for 4 days now and no real improvement, but from what you said if could take awhile. I do have a few more questions. I talked to original farrier, and he said that foot was slightly more upright than the other, and he lowered the angle by 2 degrees, from 55 to 53 degrees. Is that enough to stress tendons and/or ligaments? I am wondering if I should have a wedge pad placed to bring his heel back up. Also, after 2nd farrier took off too small shoe, he had me trot pony around and pony was significantly worse without the shoe. I guess that could point to sole soreness from too close trim. But pony doesn't seem very ouchy when walking on gravel or hard ground, and canters and gallops around his hard dirt paddock without much apparent lameness. The lameness is most apparent when trotting in deep, soft footing of the arena. And he is very sore in there--head bobbing, etc. We haven't been trotting him much--just enough to monitor his progress (or lack of) daily. I still have the vet scheduled for next week, I just hope he isn't doing any additional damage in the meantime. I can't really keep him in stall--all other horses are kept outside, and he goes crazy when he is in the barn by himself. I thought he was going to kick through the door when he spent 2 days inside. Thanks for your help, my daughter and I are very worried about her pony.
Ellen
Moderator:
DrO

Posted on Saturday, Apr 16, 2005 - 10:42 am:

Yes but I think you would see swelling in those tissues if stressed to the point of lameness. Perhaps the one exception might be a proximal suspensory strain. Though your above history is more suggestive of soft tissue strain, it is the results of a good exam that answers your questions. Was the pony sensitive to hoof testors, was the sole thin feeling? If there is a question a block of the foot will definitively localize the lameness.
DrO
Member:
Chrism

Posted on Monday, Apr 18, 2005 - 5:20 pm:

As far as stall rest, can you leave one of the other horses in with the pony where they can see one another?

If you alternate his baby sitter buddy, it may placate without being too much of a burden on the buddy.

Also give the confined horses frequent small amounts of hay to simulate grazing.
New Member:
Ellenmk

Posted on Wednesday, May 4, 2005 - 12:27 am:

Hi Dr. O,
Well it has been 4 weeks and this pony is still lame. He seemed to get better with pasture rest and a pad on sore foot, but now he is headbobbing lame again. Vet came out 2 weeks ago and did a lameness exam. He was still off on that foot but not as lame as he had been. She blocked the heel and according to her he did improve--stride got longer. I thought he still looked a little off but she said it was because only 1 foot had a pad so he was off balance a bit. Anyway, she seemed convinced it was a foot lameness and scheduled for him to get x-rays of both front feet the following week. By that time he seemed sound but he hadn't been exercised in 3 weeks. Shoes had to be pulled for some of the x-rays, so she arranged for a farrier that she recommended to come out the following day. She didn't see anything significant on x-ray other than RF still a little upright. So she recommended taking heel down a little bit more and reshoeing with more room in heels for expansion. My daughter rode him the next day (walk and trot only) and he was pretty good--just slightly off. Same thing the next day. Then headbobbing lame again the next day which has continued the last 3 days. Bute is not helping. Still unsure what is causing lameness--sole soreness from trim and removal of pad that was placed after initial acute lameness. Or something more sinister. I am concerned that he has a DDFT strain. The right front has always (well at least since we bought him 1 year ago) been more upright and smaller. And farrier that trimmed him right after we bought him commented on his high heel on that foot and she was going to bring it down slowly. A short time later he was off on that RF but I didn't attribute it to the trim. He improved with 2 weeks off, and in that time we switched barns and farriers. There was no more talk of that right front and I really don't know how farrier was trimming it. But then when he started to have on & off slight lameness on RF I mentioned to farrier that heels seemed high on both fronts--RF being worse. Thats when he lowered angle by 2* and pony went very lame. So I am wondering if he could have a shortened DDFT in this leg which would explain tendency for higher heel and contracted foot. Then lowering the heel really strained DDFT. I understand that it is important to trim heel and bring coffin bone into proper alignment within hoof capsule. But if DDFT cannot handle that lower heel, maybe he should have a wedge pad placed. I think this would be better than just letting a lot of heel grow, throwing bones out of alignment. This is so frustrating, especially because I cannot afford MRI to see exactly what is going on in that foot. Would it be worth it just to have coffin joint injected and see if that helps pony? Or navicular bursa? or even DDFT? How involved are those procedures? I don't want to jump the gun and just start treating something when we don't really know what is wrong, but I understand that it can be really hard to diagnose foot lameness. And I hate the thought of a lot of inflammation going on somewhere in that foot that can be doing futher damage to the foot. We are willing to give him more time off if that is what he needs, but he has already had 1 month off and he is no better. I understand you can't diagnose over the internet, but what are your thoughts on all of this?
Ellen
Moderator:
DrO

Posted on Wednesday, May 4, 2005 - 9:26 am:

The lack of clear localization (still head bobbing lame after the foot being blocked) leaves open all the possibilties you describe above and others. The lameness must be accurately localized and you are a long way from needing MRI. If this can't be done by physical exam local anesthesia should progress until the lameness is improved by at least 2 grades. When the first results were questionable the exam should have proceeded upward, once localized the next step is usually obvious. I would repeat the PDN then work upward until accurtely localized and if your veterinarian does not feel cofident doing this should refer to a lameness clinic.
DrO
New Member:
Ellenmk

Posted on Wednesday, May 4, 2005 - 10:48 am:

Hi Dr.O
I guess I was not clear in my post. the horse was only very slightly headbobbing lame before the PDN. After the pdn he improved. I still thought his gait looked slightly choppy but the improvement was enough that the vet was convinced pain was localized to heel area. But that still doesn't tell us exactly where in heel area, and with further diagnostics there is still a good chance we won't be able to localize it any better. I have been reading your info on club feet with interest. He does not have a "true" club foot on that side because the angle it seems to want to be at is 55*. But it is more upright than the other with narrow heels, and shoulder on that side is les muscled. He ALWAYS stands with that leg back when grazing, which is something that seems to go along with club foot and shortened DDFT. You say not to try to lower the heels on club feet as this may cause tendon strain--couldn't this be true with a foot resembling a club foot but not a "true" club foot. He never points this foot which goes more with navicular. You also say to trim a club foot for proper pastern/foot alignment, does that mean all club footed horses have a more upright pastern to match the upright foot? What about coffin bone alignment? Is the bottom of the coffin bone supposed to be almost parallel to the bottom of the foot? In a club foot with an upright angle and high heel, wouldn't that put the coffin bone tipped more down at toe and up at heel? My pony's x-rays showed the coffin bone of RF to be tipped more down at toe compared to LF so vet wanted heel lowered even a little more. But lowering the heel is what caused lameness in first place. Also she said navicular bone seemed to be "jammed" into p3 (or is it p2-I forget). On the x-ray I can see that the navicular looks to be rotated up and pushed into bone that is in front of it. Couldn't that be a sign of too much DDFT tension. If this is the case, is it best to just leave more heel on this foot and let coffin bone stay somewhat tilted within hoof capsule, or trim foot for proper alignment then wedge back up to relieve DDFT tension? I will point out that pony wasn't completely sound on RF before trim. He didn't like to pick up that lead, and was occasionally slightly off. I can't help but wonder if that was from repeated concussion of tilted coffin bone on toe. Lots of questions I know, but I am trying to gather as much info as I can.
Thanks,
Ellen
Moderator:
DrO

Posted on Thursday, May 5, 2005 - 7:18 am:

No I think you were quite clear before: the horse was still lame following the block. The fact that it was very mild to start with increases the uncertainty of the finding, not decrease it, in my mind. I still question how well this has been localized but you were there so you should decide whether it's significant improvement or not. As stated before I like to see an improvement of 2 grades. The grading system is explained in the Diagnosing Lameness article.

Anytime a horse's heel is lowered more than his conformation is built for he might receive tendon strain and if done by changing the angle of the sole from toe to heel also thins the toe's sole dangerously. The pastern alignment is one of the best indicators whether an upright foot is correct for a horse, it's position and alignment with the foot is a indicator of tension and force distribution of the flexor tendon.

In the normal foot the coffin bone tips forward slightly with respect to the ground and the solar surface makes a slight angle with the ground. A club footed horse would tip forward more. I have never tried to manage one by maintaining the normal average relation between the bone and ground and do wonder if this would not lead to flexor strain and excessive thinning of the sole at the toe.

I would have to see the navicular positioning to make any judgements about this as I have not seen a "jammed" navicular bone. It's positioning is remarkably effected by the stance: was the horse standing square when the picture snapped? Again I have not ever had to manage a club foot by the appearance of the navicular bone.

Rather than trying to judge the problem by radiographic changes that are of uncertain significance you would be better to judge with the results of a good exam that evaluates history, conformation, the results of a good physical exam including hoof testors and a well defined localization. If following a careful reevaluation you think the problem is improper trimming I would let the foot return to its "normal" shape. It cheaper and if you lose a shoe it will not cause stress or bruising. While lame I would enforce rest the pony to prevent long term damage to the foot.
DrO
Member:
Miamoo

Posted on Thursday, May 5, 2005 - 8:39 am:

Had an old arabian who had one (clubby) foot. The only time he was ever sore was when we tried to make the feet look the same. When we let it grow the way it wanted (which was a bit different from the other foot) he was completely sound. My blacksmith said it was just him and we should not try to make the foot be something it wasn't. We were happy, sound pony even if the foot looked a bit upright.

Ella :-)
New Member:
Tiffney

Posted on Sunday, Aug 28, 2005 - 9:01 am:

need help please got a 2 1/2 yr old stud stiff as a board after trimming not getting any better possible treatments?
Moderator:
DrO

Posted on Monday, Aug 29, 2005 - 8:48 am:

Hello tiffney,
You will find the article associated with this discussion helpful, back up one page using the navigation bar at the top of this page and you will see the article. Following reading it you can post any questions you have. We suggest you start your own discussion, rather than at the bottom of someone else's discussion. You will get more and quicker responses. The button to start a new discussion is on the bottom of the list of discussions on the article page.
DrO
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