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Discussion on CHRONIC HEEL PAIN IN FOUNDER PRONE HORSE
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New Member:
merahern
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Posted on Friday, Jul 31, 2009 - 3:20 pm:
I have never posted before, but my 22 year old arab gelding needs some help. I hope I can explain this situation clearly, because it can be confusing: Bandy is very founder-prone—I have to feed him a really bland, low carb diet to keep him comfortable. About six months ago, (during the winter), his frogs began to atrophy, and even parts of them would slough off. He began standing on his toes on all fours, with both his front and hind legs standing ‘way under his belly. I’ve heard this called “standing in a teacup.” He did very little walking, and even while he did walk, it was always on his tippy toes. I took him to the vet, and he told me that his digital cushions were exposed, so that is why he had so much heel pain. I asked why this happened, and was told that sometimes these things just “happen.” He was sent home with no treatment plan. It did not get better, so I did some research, and over the past six months have been treating his frogs for a fungal/bacterial infection. There was no thrush, I assure you. We are in a DrOught here in Texas, so I was baffled. Still, I used the Pete Ramey mixture of ½ antifungal, ½ antibiotic ointment and inserted it into his central groove every evening (I read that covering the entire frog was not necessary). I also bought Clean Trax, and soaked his feet according to directions. That seemed to help a little. As his frogs began to heal, he seems to be in less pain, so I was happy that I was making a little bit of progress. THEN, he began standing with his front legs in front of the vertical just a little—it looked like a mild case of founder. He had bruising on his soles in the toe area (any wonder? After months on his tiptoes, I would’ve been surprised if there hadn’t been any bruising.) I pulled him in from the 200 acre pasture (which I thought was “safe” because of our DrOught), and put him in a more controlled smaller one. Now my story again takes a turn for the worse: three weeks ago, even though his frogs are looking so much better (I’m still treating them with the Ramey mixture), he is again “standing in a teacup,” with incredible heel pain! I began to look for something that could explain his regression ,and the only thing I can come up with is the beans that grow on the mesquite trees here are too rich for his system, and he must have been eating some of them. We have mesquite trees everywhere, but most horses leave the beans alone. Anyway, while I am trying to untangle this mystery, I put Bandy back in a stall, and that is where he is right now. He is currently standing on his toes (no doubt re-bruising his soles), his diet is strictly limited to hay and a feed called “One and Only" (which is glorified hay pellets). In closing, I actually think the heel pain trumps the founder pain, but that both are an issue. But why all the heel pain if it’s a founder problem? This is like a crazy loop that I can’t seem to get under control. Thanks for any help!
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Member:
scooter
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Posted on Friday, Jul 31, 2009 - 10:13 pm:
Hi Mary, welcome to HA. From my experience a horse that stands the way you describe, with a history of founder....is foundering in all 4 hooves. That usually brings on the "tea cup" stance. He probably has bruising at his toes from the founder. It stretches the white line tearing the lamanie away and that is usually the bruising you see.
Try putting some VERY deep bedding in his stall, give him some bute (if he can have it) and keep him on the low carb diet (grass hay..no grain) at least until he is stable. If you give him bute he may LOOK like he feels better and he probably does, but until he is stable withOUT bute don't move him around too much. Radiographs would be a very good thing so you know what kind of rotation you are dealing with and can help a farrier know how to trim him.
I'm not so sure you have as much heel pain as you think if you are just going by his stance. My uneducated guess is he is foundering in the rears also FWIW. Hope your horse feels better soon
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Moderator:
DrO
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Posted on Saturday, Aug 1, 2009 - 8:07 am:
Welcome Mary,
Are the sensitive tissues of the sole exposed or painful again? You describe his current stance as standing in a tea cup. How is his current walk and trot? When you say he stands on his toes I am uncertain what you mean: does he really stand with his heels elevated? Could we have a picture of his stance of flat ground?
Instead of putting too much emphasis on the stance as a possible diagnostic indicator you should have the feet carefully examined and the pain localized to the particular tissue. To say he has remarkable heel pain does not localize it to a particular structure in the heel, an important first step to figuring out what is going on and what the best treatment is.
DrO
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New Member:
merahern
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Posted on Tuesday, Aug 4, 2009 - 5:07 pm:
Thank you, Dr. O and DianE for you help. Attached is a picture of Bandy that was taken yesterday. He has been confined for four days now, so his movement has been limited. He isn’t lying down as much in the evening, so I think a tiny bit of progress has been made. To answer some of the questions: He does indeed elevate his heels on the back feet, but not on the front feet. The underside of his hooves look surprisingly good—not much bruising this time. His white line is stretched in the toe area on all four feet about 3/8 inch. The frogs are normal , and the sensitive tissue is no longer exposed. His feet land toe first on both his hind feet at the walk, and his heels do not seem to touch the ground at any point while he is walking. He wouldn’t trot, so I didn’t push him. His attitude is pretty good, and he is eating normally. He does shift his weight on his hind feet from one foot to the other while at rest, so it seems that both are bothering him. He is on maintenance Bute for his knee (mild arthritis, the vet wants him to be able to keep moving.) Thanks again, and if there is anything else I can add, please let me know.
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Member:
scooter
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Posted on Tuesday, Aug 4, 2009 - 10:24 pm:
Poor Guy he looks very uncomfortable. Mary when my horse foundered a couple years ago in all 4's he stood very similar to this. Your posts point to founder, but that stance can not diagnose anything really. Sounds like you need to find another vet if the one you have doesn't have any suggestions for you.
In the mean time to be on the safe side I would treat as an active founder since he has the history of it. Does he walk any better on VERY soft ground? Have you tried padding his hooves to see if it helps?
Read the articles in here on founder and see if you can get your vet involved.
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Moderator:
DrO
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Posted on Wednesday, Aug 5, 2009 - 7:35 am:
Thanks for the picture MaryA it truly is worth a thousand words. I think the back legs are forward not so much to unload the rear feet in any particular manner but mainly to unload the front feet. So why are the front feet back? I agree this looks like an attempt to unload the front heels. Your history suggests disease has returned to the front heels. But this is all conjecture on a uncommon presentation and there may be some unusual disease process, a primary founder in the rear legs perhaps, that might present this way.
The next step is to get out the hoof testers and examine all four feet. Find what part of the foot is painful and then follow it up with a thorough examination to discover which tissues are diseased in the sore regions. If leg localization remains uncertain I would consider bilateral blocks starting on the fronts to confirm which hooves are painful.
Until a diagnosis made I second Diane's recommendation of stall rest and antiinflammatories as described in the Lameness First Aid article.
DrO
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New Member:
merahern
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Posted on Thursday, Aug 6, 2009 - 4:32 pm:
Thank you both again for your advice. I am now treating this as an active founder; I will post in a week or so to let you know how Bandy is doing. I'll test his hooves, and see if I can get some additional information. And, he does indeed walk better on softer ground. I have to read the articles you suggested, so I have some work to do. Thank you!
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New Member:
merahern
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Posted on Tuesday, Jun 8, 2010 - 5:47 pm:
Well, it's about time that I repost. I seem to have the situation under control now, after much trial and error. Apparently, the mesquite beans were not the problem, because Bandy re-foundered in a very diet controlled environment. Originally, I didn't know which came first, the heel pain or the founder. Now, it is evident that the heel pain came first, then mechanical founder occurred due to the endless hours of the "teacup" stance. Things have gotten better since I have been soaking all four feet with CleanTrax every 2-3 weeks, and that is the key to my "success." If I don't soak them, then the situation gets worse. So, while I haven't truly "killed" the offending organisms in the soft tissue of the frogs and heel bulbs, at least I am keeping them in check, and thus he isn't standing on his tiptoes. Occasionally there would be sores on the heel bulbs, but the CleanTrax takes care of them. Bandy can once again trot and canter, even tho the previous founder episode has left his hooves slightly deformed. I keep a founder trim on him, and he is comfortable. If anyone has any ideas what the offending organisms could be, or whether he is just susceptible to hoof infections, I'd be curious. Thanks!
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Member:
vickiann
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Posted on Tuesday, Jun 8, 2010 - 8:26 pm:
I can't say that I have any fool proof answers but my horse when stalled up with laminitis in deep shavings got very sore on the heel bulbs and the frogs were also affected.
I kept his environment so clean that I was surprised that his frogs and heel bulbs became so compromised.
I think that a big part of the problem was him being stalled up even though I cleaned his feet every day.
A horse turned out with well-balanced feet does a lot of "self-cleaning" and has better circulation to the feet.
I think that plenty of weight-bearing exercise is very helpful in preventing such infections.
It would seem that you ought to be able to control the infections with the Clean Trax.
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Moderator:
DrO
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Posted on Friday, Jun 11, 2010 - 8:27 pm:
Hello MaryA,
Would it be possible to post images of your horses soles and feet. I remain a little bit loss at what is going on.
DrO
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New Member:
merahern
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Posted on Monday, Jun 21, 2010 - 2:28 pm:
Here is a picture of one of his hooves (all four have the same problem, but this one is the worst.) The pic was taken immediately after a 45 minute soak in CleanTrax, so that explains the "bleachy look." The bulb and central groove are the areas that are "diseased" (I don't know what else to call it) and result in him putting the weight on his toes if I don't soak him every 2-3 weeks. (And, as I've learned, when he stands on his toes, he founders.) This soaking is keeping this "infection" at bay, but it is clearly not fixing it permanently. As you can tell from the picture, he has a few more trims before his sole looks normal, but it is vastly improved. As a final note, Bandy was not feeling well before I soaked him yesterday-- he was just standing there, with his "I'm not happy" expression. After the soak, he perked up and immediately started grazing. Also, he is out 24/7 now that the lush grass is all gone.
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Member:
merahern
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Posted on Monday, Jun 21, 2010 - 2:37 pm:
If the picture didn't post, I need some input: the pic is a JPG, and is less than 64K, so apparently I'm doing something wrong, but I'm getting no error messages. Thanks!
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Moderator:
DrO
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Posted on Tuesday, Jun 22, 2010 - 5:31 am:
Hello Mary,
The file you uploaded appears to be corrupted in a way that the browser cannot read the image. There is data in the image's file but the browsers cannot figure out what it is. This may be a problem on your end, during the upload process, or at out end. You should try again and be sure the file you are uploading is the one you want uploaded.
DrO
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Member:
merahern
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Posted on Tuesday, Jun 22, 2010 - 3:11 pm:
Another try: 
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Member:
scooter
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Posted on Tuesday, Jun 22, 2010 - 5:52 pm:
I can see the first picture? Mary it is kind of hard to tell much because of the lighting, could you get a couple better pics??
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Member:
lindas
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Posted on Tuesday, Jun 22, 2010 - 7:54 pm:
Ouch! My daughter borrowed a Tennessee Walking horse for a camp that had feet that looked exactly like that only two weeks before leaving for camp. The girl who was caring for her,(not the owner), had pulled her shoes to save money, and had put her out on rocky pasture. She was treating her for thrush, but I thought otherwise, and asked them to have her shod. Poor thing could hardly walk, but after proper shoeing was able to go to the camp and there were no signs of lameness. There have been no problems since. This horse might be holding her front feet back to take the pressure off of those heels. Obviously there may be other things going on that need checking out, but maybe it's time to bring a farrier onto the team.
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Moderator:
DrO
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Posted on Wednesday, Jun 23, 2010 - 7:27 am:
I too would like to see a better image MaryA. The bright background to the right and the foot in shade has produced a dark slightly out of focus image. To get a good exposure the whole image needs to be evenly lit and if dark use a flash. While the flash will illuminate the foot well it tends to take away some 3D cues. When in doubt try with and without the flash and decide which gives the best detail.
From what I see in this image I would also like some conformation pictures of the horses lower legs and hooves. These are taken from the side 90 degrees from the long axis of the horse and frame the hoof, pastern, and lower cannon in the center of the image.
To get back to your first question of Jun 8th the contracted heels and deep closed central sulcus makes your horses feet predisposed to infection (thrush) because of the dirt and moisture they trap. But I think there may be other things going on to that I hope better images will bring out.
DrO
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Member:
merahern
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Posted on Wednesday, Jun 23, 2010 - 10:56 am:
For many years, Bandy was kept shod; when he was about 16 (he's now 23), he developed navicular synDrOme, so the vet had the farrier keep his heels quite long, and had him hot shod (w/ the forge for a perfect fit). Things went from bad to worse, and he could barely walk on his front feet-- the hind were fine. The situation looked very grim-- so I began to look at alternative ways of dealing w/ navicular, and studied Pete Ramey's and Paige Poss's methods (barefoot, w/ emphasis on keeping the heels shorter for navicular horses). My sister and I learned to trim--we have 30 horses (most are rescues) and have had amazing results, even with the thoroughbreds who came to us flat-footed off the track-- but that's another post  . Bandy's situation improved, and he was NORMAL for about six years until this crud invaded his frogs. All our other horses are barefoot and sound, and our terrain is not rocky, so there's no problem there. I will try to get additional pictures. thank you all for your help and suggestions!
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Member:
vickiann
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Posted on Wednesday, Jun 23, 2010 - 4:39 pm:
Looking at the image of the bottom of the foot I was wondering if the heels are run under and if they have been kept too long, this indeed may have happened.
I've had a couple of horses who needed to have their heels gradually lowered so that they came back into the proper position.
This also resulted in proper remodeling of the soft tissue.
Well balanced feet, laterally and medially and heels that are not run forward are important to providing a good comfort level for a horse.
My oldest guy had been diagnosed with navicular and was lame off and on for years and he moved very poorly. If you hand walked him across a cement drive he would be in a great deal of pain.
Getting his underrun heels back where they belonged, letting his foot grow larger again (he had been over trimmed over the years) and a perfectly balanced foot was the key to making him sound.
He's going better than ever for the past few years ever since I got a better farrier instead of trying corrective shoeing, etc.
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