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Discussion on Chronic rotation
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Member:
ceceb
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Posted on Saturday, Feb 23, 2008 - 5:31 pm:
My mare is 28 yrs old and has severe rotation in her front right hoof. She probably foundered about 10 years ago, I've had her for six years. My farrier has been trying to work with the hoof for the last 6 years but it seems to be taking a turn for the worse. I had an xray done today and her vet said it's completely rotated. I've been able to ride her, mostly walking and trotting but noticed her favoring her right side. There's been a lot of rot and a recent abcess which came out of the coronary band. Here's photos from this week. I can email xray once vet emails them to me. I read your article and my biggest concern is how to deal with this at her age. She's learned to compensate and has not shown much lameness, only recently. I'm afraid too extreme action may be too much. Besides her hoof she's in great condition, people can never believe she's as old as she is. Her vet is thinking about what's the best approach and is getting back to me later, but I wanted to get a second opinion.
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Member:
scooter
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Posted on Saturday, Feb 23, 2008 - 11:48 pm:
Hi Cecelia What does your vet mean by completely rotated? I have a foundered horse also and always trying to learn. Just from the pics it looks like her heels are quite high with quite of bit of a dish. Is it possible she has WLD? Looking at your second picture her hoof looks kind of "mealy" which can cause on going rotation. Is her other hoof OK?
If she is rotated severely shouldn't she have some kind of digital support? These are just my observations. I'm sure Dr.O can help you much better. . Good Luck with your mare.
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Member:
ceceb
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Posted on Sunday, Feb 24, 2008 - 12:59 am:
HI Diane, I'm learning myself, but when I saw the xray on the screen, her coffin bone was pointing straight down. He's concerned about it coming through the sole of the hoof. What is WLD? Her other hoofs are all ok. This one has always been off, some friends remember her from over 10 years ago being kicked out of a sorting event because she was so lame. It use to be way more of a club foot, farrier has been working on it, but in the last 6 months it's been looking worse. This past week I felt her favoring it. Here's a shot of her last year. She's in unreal shape for 28 years old. 
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Member:
scooter
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Posted on Sunday, Feb 24, 2008 - 7:19 am:
She is very nice! I have a 28 yr. old also and most people think she's the youngest in my herd. The seniors are worth their weight in gold.
WLD= white line disease. Dr.O. has an article in here about it and it's relationship to founder. Is that hoof truly a club foot? Since she has only foundered in the one hoof it makes you wonder if something mechanical is going on . Tho I think a true club foot will x-ray differently than a normal hoof.
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Moderator:
DrO
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Posted on Sunday, Feb 24, 2008 - 11:07 am:
Hello Cecelia,
You present a confusing diagnostic picture with unilateral founder in a club footed horse but if we take the diagnosis of severe rotation as the cause of the problems you are having at it's face value you should review our approach on how to correct it in the article that is the parent page to this discussion. I would also be sure that there is no remaining problems with the abscess as once it has been allowed to pop out the top occasionally ongoing problems are created see, Diseases of Horses » Lameness » Diseases of the Hoof » Hoof Abscesses, Bruises, and Gravels for more on this.
If you could post a concise description of the examination and a good image of the radiograph it may help us assess the diagnosis. Having the front of the toe wall clearly marked with a radiopaque marker is likely to make interpretation more accurate.
DrO
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Member:
ceceb
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Posted on Tuesday, Mar 4, 2008 - 4:45 pm:
HI Dr. O
I met with my vet and he feels this rotation has come about originally from a club foot and she's been this way for quite a while. She is walking fine, very briskly after her bath the other day and only showed some lameness when trotting to the right. Her current farrier does not want to do corrective shoeing and all the other farriers on the island have been in Kentucky at a clinic and they are due back today. I would appreciate your advice. We are concerned about doing too much as she as adapted to this condition. Thanks, Cece
 
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Member:
scooter
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Posted on Tuesday, Mar 4, 2008 - 5:03 pm:
Thanks for posting the x-rays cecelia. I don't know anything about club feet, but that hoof looks pretty bad. Whether it is the club foot making it look bad I don't know. She is not lame at the walk /trot?
I'll be curious what Dr.O. has to say also
Good Luck with your sweet girl.
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Moderator:
DrO
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Posted on Wednesday, Mar 5, 2008 - 6:12 am:
Excellent Cecelia, the radiographs are very typical for a club footed horse (ie contracted DDF tendon) that has been trimmed and shod over the years in an attempt to try and create "toe". I agree with your farrier: attempting to correct the rotation caused by a contracted DDF tendon is futile without surgery transecting the DDF first. A surgery I would consider a last ditch attempt at pasture sound in a horse this age. I do think the current trimming and shoeing practice could be improved to make the foot more functional and sturdier however.
But first, I am confused about where your mare is at right now. In your first post she has taken a turn for the worse and in your last post you seem to describe her as mildly lame. What has been normal for your horse over the last year? Has the hoof been positively identified as the location of the lameness and has the pain in the hoof been further defined with hoof testers?
DrO
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Member:
ceceb
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Posted on Wednesday, Mar 5, 2008 - 11:51 am:
The past year I've ridden her 2-3 times a week, walk and trot. She has shown no lameness until recently and I've not ridden her since the radiograph, only walked her around (week and half). I saw her trotting in her pasture yesterday and saw no lameness. There's been more rot on the hoof and a couple of abcesses in the past year. The middle photo above shows the recent abcess at the coronet band where the crack ends. There was no lameness prior to the abcess coming thru. No hoof testers were used.
How would you improve the trimming/shoeing?
Thanks for all your help. I've been confused and learning a lot through all of this.
Cece
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Moderator:
DrO
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Posted on Thursday, Mar 6, 2008 - 8:17 am:
In short, I would stop trying to create a toe on this horse by allowing the distal wall horn to be pulled away from the sensitive laminae. It sets up a weak nonfunctional toe wall that is so evident in the above photos (the flare and cracks) and pulls on the healthy laminae during breakover. This has lead to lack of support of the sole at the toe and may cause further rotations of the coffin bone. And that last problem creates a question about trimming that is going to be a bit of judgement call: exactly where should this toe bone be for optimal soundness.
Most of the rotation of the coffin bone is likely do to the toe creation effort: letting the toe grow long and during breakover tear the insensitive laminae from the sensitive laminae. This creates the flare that gives the illusion of a more normal foot. But now there may be some rotation secondary to the flare...
This will take an experienced farrier and veterinary team to work through and all final judgements need to be made by those who can examine the horse.
A general plan would be:
I would start by removing the flare and any degenerative horn in the front. This is going to remove a lot of wall and expose insensitive lamina up to about half way up the hoof. Not only will this ease the breakover but will stop the abscesses that breed in the unhealthy laminae situation. I would shoe with a fairly thick rim pad to get the sole off the ground.
Questions I have would be:
Is the defective laminae reaching deep into the quarters. If so the toe may already be so destabilized that a synthetic wall needs to be built back until healthy wall grows out.
Where do I want to place the solar plane of the coffin bone in relation to the ground surface: can there be some small amount of derotation that gets the tip of the toe a bit further from the sole. One of the key indicators this needs to be done would be remodeling of the tip of the coffin bone. Unfortunately we cannot see the tip in the radiographs above.
DrO
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