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Discussion on Thrush in white line
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Member:
Skeller
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Posted on Sunday, May 29, 2005 - 10:46 am:
I believe I've discovered the cause of my horses hoofs chipping despite the fact that the horn quality is fairly good.
I board and unfortunately the farrier normally comes during the day when I'm at work and shoes about 6-9 horses in a 20 horse barn. However Cody my horse with laminitis was getting his first set of "corrective" shoes so I took off work to be there. After the farrier trimmed I picked up each foot to see how wide his white line was (it looked wide to me, 1/8 - less than 1/4 of an inch. Also there were areas of black in the white line which from reading the article I'm thinking are probably thrush infections. (He had some nasty thrush in his heels when we got him 3 years ago which I still treat regularly to prevent coming back).
My mare got trimmed the same day but she was done by the time I got there. Looking at her white hoof, I can see darkened areas extending up about 1 - 2 inches which are around the nails on the sides. I'm guessing this is thrush invading the white line also.
My questions are:
1) what is the normal width of the white line?
2) how should I treat this? I know it should be bared out if possible, but what if it goes too deep. I'm sure it's in the black hoofs to, just easier to see in the white ones.
3) what topical products are the most effective. I found that iodine worked better for me than thrush buster on previous thrush infections but that may be because it was cheaper I applied it more liberally.
4) My horses have a stall mat in the center of their stall, with shavings. I position the stall mat to cover their wet spot and normally when I clean there's a layer of dry shavings on top of the wet (but it's soaked shavings underneath). They are cleaned 6 days a week. Should I remove the stall mats and lime the stall?
5) What should I tell my farrier? It's obviously something he is ignoring right now. I worry that it's setting the stage for something more aggressive (white line).
Thanks in advance for your answers/suggetions.
Sandi
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Moderator:
DrO
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Posted on Monday, May 30, 2005 - 10:09 am:
Skeller I am having a little difficulty picturing exactly what you are saying other than you have some defects in the white line. These dark areas may actually be stains left behind by the steel nails. Certainly thrushy areas of the white line, normally a few mm's thick, should be addressed but that can be difficult under a shoe.
The most useful thing I have seen is to pare out a good bit of it then pack the crater with cotton soaked in formaldehyde and put the shoe over it. Every couple of days a tipped syringe can be used to get up under the shoe and recharge the cotton. If the feet are kept clean and dry the thrushy area will grow out with this process.
DrO
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Member:
Skeller
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Posted on Monday, May 30, 2005 - 9:27 pm:
Looking at it again tonight it is located where the nails are in the side of the shoe. From the top of the nail hole down, the area is darkened (easily seen through a white hoof). I'm believe this corresponds to the black areas in the white line. Could this much darkening be stains from the steel nails? The darkened areas viewing from the bottom of the hoof are about 2-3 mm thick. The white line if 5 - 6 mm thick.
What is the normal width range for the white line? I'm watching for changes right now on my gelding to see if there's any damage from his recent laminitis. (which got me noticing this - he also has black areas, has been shoeless since the middle of March but of course these would be from an older shoeing if they are stains)
If there is a change in the white line, how many trims does it normally take to see it?
I was very happy that he was not sensitive at all during his first shoeing following the laminitis episode and is trotting sound.
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Moderator:
DrO
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Posted on Tuesday, May 31, 2005 - 9:30 am:
The white line is normally just a few mm thick so it sounds like you have widening from the founder. 2 to 3 mm width of darkening could correspond to the nails.
I am uncertain what you mean by how many trimmings, if you mean from the founder it would depend on the severity but with a relatively mild amount of rotation you could see the change in as little as 2 months.
DrO
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Member:
Skeller
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Posted on Tuesday, May 31, 2005 - 12:35 pm:
Thanks, that's exactly what I needed to know.
My farrier put a rocker toe egg bar shoe on Cody. He is moving nicely. (he was sound barefoot also). I asked him about the derotation process as described in the article. He didn't want to change any angles since the horse is sound. I got the xrays from my vet for him to look at and one foot is 5 degrees the other less than 3 degrees.
The big question now is to figure out if I should leave it alone or pursue the derotation? Since the founder resolved so quickly the vet is thinking that the rotation was from a previous episode. I'm watching the white line to see if there are any changes that would indicate a newly changed angle.
She's worked with this farrier before and feels confident in his abilities. However he's never done the derotation, as described in the article.
What do you think? Should I insist on the derotation (if necessary go elsewhere to get it done); or should I continue on the same path since he's sound and see if he has any problems later?
The xrays showed some slight lipping on the LF (5 degree rotation) of the coffin bones. My concern is to make sure that there's no additional disintegration. His foot is dished and several sources have said that the lipping is common in a dished foot (hmm, so what came first the dished foot or the rotation?).
Am I crazy wanting to pursue the derotation even though the horse is sound (and moving better than ever).
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Member:
Unicorn
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Posted on Wednesday, Jun 1, 2005 - 3:50 am:
I normally chase down any rotation of the hoof wall, as any rotation can lead to long term minor problems, they may show up as bruising or stiffness. If the hoof wall is not in the right position it can point the pedal more towards the ground than is normal and will maintain a small separation at the white line as the forces are not balanced.
The white line should be 2-3mm and uniform all the way around the hoof.
Here is a pic of a very good hoof that has done 100miles in just over 9 hours then washed for a photo by the vets.
If the rotation of the hoof wall is not brought back to the same alignment as the bone then the stresses will keep it at that angle or it might get worse.
One horse I saw had a few more degrees of rotation and after work could have semi circular bruising in the sole from the tip of the pedal bone. This little pony never went much faster than a walk. After derotating the hoof wall the pony was able to canter down the concrete drive within 6 weeks, not bad for a pony that had foundered 3 years earlier.
I always consider the horses feet as vitally important to their health and any future lamenes should be halted before it starts.
Regards
Darren
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Moderator:
DrO
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Posted on Wednesday, Jun 1, 2005 - 7:12 am:
There is a question here you have to answer before you go forward: what is the coffin bones relation with the rest of the pastern and the ground. Some types of chronic rotation actually occur not by the coffin bone DrOpping away from the wall but the wall pulling up from the coffin bone. Derotation is aimed at restoring a radiographically normal balance between the coffin bone and pastern. If the wall is pulled up what you are doing now will probably cure the rotation over time. The developing deformity in the tip of P1 suggest to me you have the coffin bone tipping downward.
When the coffin bone is rotated down, I agree with Darren, I think the horse's foot is more stable with derotation for the reasons you and Daren outline above: First the smaller tighter laminae are better able to handle the normal strain. Second the tip of the coffin bone is further away from the ground surface making bruising and even degenerative processes in the toe unlikely, and lastly you don't have to put up with the seedy toe that predisposes to abscesses in the white line.
However I am worried that your farrier does not feel this way suggesting he is uncomforable with the procedure. Perhaps he could find someone who has done this or work closely with the vet. Radiographs following your process really make decisions on trimming pretty easy. The key is to go slow and avoid thinning the sole at the toe excessively, this is outlined in the article.
DrO
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Member:
Skeller
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Posted on Wednesday, Jun 1, 2005 - 1:05 pm:
Thanks, I feel much better persuing the derotation. I have a tendancy to want things "perfect" so I wanted to make sure it was the right decision.
Wow Darren, what a gorgeous foot. I'm jealous! And after 100 miles!
Cody has always been ouchy after trims, not lame, but off and reluctant to move out. Since he has the one coffin bone with lipped tip (that we weren't aware of until the xrays), it sounds like he may have a situation going on that's similiar to the pony's. Let's hope he does as well!
Dr. O., I'll reread the derotation article. I missed the importance of the pastern bone alignment. (duh, but should have known anyway). I do think his coffin bone is pointed down, but want to double check.
I felt the same way when the farrier was uncomfortable with changing the angle. He really needed the trim but I didn't want to push the farrier into doing something just to please me. The rocker toe was an ok intermediate solution. I'll talk with my vet and see if she can guide this or if I should go elsewhere.
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Member:
Skeller
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Posted on Thursday, Jun 2, 2005 - 9:53 pm:
Just to come full circle (and hopefully erase some of my ignorance). Here's a picture of the white foot I was talking about. Are these black stains left from the nail (they seem pretty extensive), or is there possibly something creaping out from the nail holes. FYI I'm planning to ask the farrier to NOT use putty so I can put chlorhexidine in the holes. (also we caught her with her knee bent so her angles do match the pastern)
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Member:
Unicorn
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Posted on Friday, Jun 3, 2005 - 5:43 am:
This looks like a case of seedy toe, don't know what the medical terminology is. It can progress all the way up to the coronet band without affecting the laminae, it can be painfull and makes the hoof sound hollow if you tap on the wall.
Seedy toe is where the hoof wall itself seperates enough to allow dirt and bacteria in between the two or more distinct layers. This is likely to start between the hoof outer wall and the waterline or unpigmented wall. In this case it seems to be accelerated by frequent nailings weakening the outer wall and allowing dirt to be driven in. Over time this weakened wall will break away completely that is when farriers reach for the putty.
The fact that it is visible from the outside means it is not deep inside the wall like white line disease. This is one of the reasons people thought white feet were weaker than black feet. It is just that the damage is visible.
Red Rectangle Seedy Toe in the wall
Blue Ellipse WLD in the White Line :-)
White line disease is similar in formation but is more likely to be driven by bacteria affecting the soft tissue of the laminae.
There is something else odd with this foot, the growth changes direction about 1/4 of the way down. This indicates levels of stress in the hoof wall.
At the risk of annoying others I would love to see a perfectly side on shot from the ground and a head on shot.
Regards
Darren
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Moderator:
DrO
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Posted on Friday, Jun 3, 2005 - 8:53 am:
Though I would have to look at the bottom of the foot to be sure I don't think Darren is right. I believe this is some sort of odd staining, though seedy toe may also be present. Seedy toe does not usually stain a hoof wall like this, though nails don't usually either. Note how the stains center around either present nail holes or past nail holes, stopping right at the top. If this were an odd seedy toe I would expect the staining to be widest at the bottom. Instead the staining worsens higher where the nail becomes more superficial, perhaps if the nail hole is infected with thrush? I would like to see a picture of the cleaned bottom of the foot next time the shoes are changed.
Concerning Darrens post, there are a few corrections. Seedy toe is not typically a seperation in the wall but a seperation between the wall and sole: it is a defect in the white line created by founder or allowing a wall to get excessively long. For these reasons it almost always is worse at the toe. In his photo above the white line is widened weakening it and causing seperation between the laminae that have become impacted with dirt and moisture and then developed thrush. The blue area actually is seedy toe and the blue area hard to judge, possible some broken out areas of the wall that have become impacted with dirt. For more on this and WLD see the corresponding articles in the hoof lameness section.
DrO
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Member:
Skeller
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Posted on Friday, Jun 3, 2005 - 1:05 pm:
Thanks Dr. O, I'll be sure to get pictures when she's reset, probably in 4 weeks as she was just done last week. What I remember looking at the bottom is that it doesn't appear as a widened crack, It's smooth, but there are black areas in the quarter that has the nail holes. I was thinking about asking him to trim her back more than he normally does. As you can see, she has plenty of foot.
The hoof wall here is more fragile and tends to split. She's on a 20 mg biotin supplement. I'm upping that to 40 mg.
Darren, this mare was barefoot for 3.5 months this winter. She was first shod again the middle of March. Could that be the cause of the line that's about 1/4 of the way down?
Thanks for all the input. - Sandi
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