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Discussion on Help-White line and lameness (part 2)
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Moderator:
DrO
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Posted on Tuesday, Oct 6, 2009 - 11:55 am:
This is a continuation of Help-White line and lameness (part 1).
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Member:
marieanh
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Posted on Monday, Oct 5, 2009 - 12:24 pm:
Ok, got the xrays, reviewed with the vet this morning-not sure I can get them posted, I have compatibility problems, but the good news is that there is no apparent rotation-we had three sets of eyes, measurements, etc, vet said he had no concerns about the location of the coffin bone inside the caspule, or concerns about the appearance of the coffin bone itself.. There is a noticable incline from the front view, inside to outside, but he felt looking at that it appeared the glue was built up higher on the outside (he showed this to me on the film) , and he recommended the shoe be reset. The joint spaces above the coffin bone were even, no signs of compression on either side. Adequate sole Overall, pretty clean. Who've thunk it?
So, now what. At the vets, Robie trotted almost sound on the blacktop, if you didn't know him you would say he was sound just a slightly shorter stride on the right front, but no head bob. He has been off bute since last Tuesday. Yesterday on the lunge was similar, just not quite right. I had a number of other experienced horsewomen out there with me watching him, one suggested maybe a shoulder issue, but there was a girl there trained in equine massage, and she couldn't get him to flinch around his shoulders, so i don't think that is where the problem is.
So this is my plan. I am going to go with glue on shoes on the front, at least for the next two cycles, in conjunction with the equiicast. I will discuss pulling the back shoes, and using equicast, to see if we can get the walls in better shape in the back. Vet agreed this sounded reasonable. Once I get the shoe reset, I am going to put him back into light work.
Thoughts?
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Member:
marieanh
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Posted on Monday, Oct 5, 2009 - 1:07 pm:
Just an fyi, for what its worth, the vet gave me a hard copy of the x-ray and I have compared it to images of others on this site, including Hank's before and after, as well as the images in the derotation article, and Robie's look like the normal images (at least to this inexperienced eye).
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Member:
rtrotter
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Posted on Monday, Oct 5, 2009 - 2:08 pm:
Marie anne,
The vet that took the xrays, does he know what your horses feet look like without the shoes and equicast? and if yes, what does he think you should do?
Rachelle
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Member:
marieanh
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Posted on Monday, Oct 5, 2009 - 2:13 pm:
Yes, he examined Robie at the barn, while he was lame, after he threw the shoe, so he knows what they look like, also I had with me today the photos I took, some of which I have posted here. He agreed with my plan as outlined above.
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Member:
scooter
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Posted on Monday, Oct 5, 2009 - 3:42 pm:
Marie if you have the hard copy hang them in a bright window and take a picture of them, that's what I do.
If your vet thinks it's a good idea and so do you, then go for it . If it works great, if not then you will have to figure out another way.
Sometimes it's trial and error, hard to believe the inside of those hooves don't have a problem, how much sole depth did he have?
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Member:
marieanh
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Posted on Monday, Oct 5, 2009 - 3:57 pm:
thx Diane, I'll try that. But really I pushed the vet (one more image etc.) he was very polite, but thought i was a bit nuts. We did not do a navicular view because of the shoes, but this horse has never presented like a navicular case (and unlike white line, I have had experience with chp).
I am not sure how to measure sole depth, but from the tip of the coffin bone to the shoe is a shade more than 3/4 inches. (1/4 inch above the shoe clip)
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Member:
marieanh
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Posted on Monday, Oct 5, 2009 - 4:23 pm:
okay, here is a pic of the x ray, I'm afraid some of the detail was lost, but you can see the angle of the coffin bone.
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Member:
ajudson1
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Posted on Monday, Oct 5, 2009 - 4:47 pm:
Glad it seems to be good news. So, my take on it is just the shoe and equicast is not put on the best, causing some uneveness?
Hopefully DrO can shed some light, (tee hee) on the x-ray, and make a guess as to sole thickness too.
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Member:
scooter
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Posted on Monday, Oct 5, 2009 - 5:20 pm:
Marie do know if the opaque stuff at the front of the hoof was started right at the hair line?
I don't know much about x-rays either so hopefully Dr.O. can set me straight here, and it really depends on a lot of things, but I was wondering if it didn't show a tiny bit of sinking and or rotation?? The shoes and equicast could be making this appear this way even the angle I guess. So don't go by me!
( I can't draw very straight lines yet!)
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Member:
scooter
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Posted on Monday, Oct 5, 2009 - 8:50 pm:
OK I figured out the straight line thing
I think Robies hoof looks very similar to Hanks when he first foundered, my vet said he had minimal rotation at that time I believe it was around 5 degrees or less. Hank had a much longer toe tho.
I'll be curious what Dr.O. says figuring out rotation has always been a mystery to me.
Robies hoof
Hanks hoof 2006...it did get much worse thru 2007
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Moderator:
DrO
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Posted on Tuesday, Oct 6, 2009 - 11:51 am:
The radiograph above it is not as diagnostic as it could be do to lack of contrast but there is information there.
The first thing I note is that your have good horn everywhere, there is plenty of sole and wall to work with and lameness following trimming do to solar sensitivity would be surprising with this much sole.
The second thing noted is the amount of toe wall out front of the tip of the coffin bone. Diane's lines overemphasize what is a small amount of "rotation". The coffin bone line should not be drawn on top of the extensor process but parallel to the body of the coffin bone. I think this actually represents pulling away of the wall due to overloading at the toe.
I also note there appears to be a small osteophyte on the pastern joint, not diagnostic for pain, but an indication that further localization needs to be done to rule the pastern joint out if lameness returns.
One question I have is was the horse standing square for the image? The above radiograph also shows a remarkable a-p imbalance but if the horse is standing over the hoof this could be artifactual. Your full body shot of the horse on the 28th of Sept does not show such imbalance but it is hard to say do to the long shot at that angle. On the other hand the solar angle looks to be less than 6 degrees and though some horses have them it would make be reevaluate the ap balance.
In short there is not a clear reason for your horses recurring lameness in the above radiograph but it argues against the cause being tender soles. However it clearly shows one reason you are having trouble with the walls chipping away at the toes. The toe wall has pulled away from the laminae so I should consider dubbing the toe back (I think this will take you into the white line) and moving breakover back as far as reasonable to help relieve the chipping and allow a more normal toe wall to grow out. Be sure to review the poor quality horn subtopic of Diseases of Horses » Lameness » Diseases of the Hoof » Wall Cracks and Thin Sensitive Soles and be sure you following the recommendations there.
I do think that the horses long pasterns put the hoof further out in front of the horse creating extra strain in the digit. If you wish to continue to shoe this horse I would consider the use of egg bar shoes to further help support the horse behind. At the least be sure the heels are fully supported.
marie can we see the straight on frontal radiograph? I am interested in this shot because of the remarkable foot distortion evident in the Sept 28th shot of the sole. The question is whether the coffin bone reflects this distortion or is the wall pulled away from the bone.
Lastly I need to note the above comments are derived from the limited amount of information available and a good examination and review of all the original radiographs may change my opinion. I still remain uncertain why your horse is lame following shoeing but think your step up of reevaluation by the farrier every three weeks a good initial step.
DrO
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Member:
marieanh
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Posted on Tuesday, Oct 6, 2009 - 1:09 pm:
Thank you Dr. O,
I'll try and post frontal view.
No, he was not standing exactly square.
What do you mean by dubbing the toe?
Could the stress put on the wall at the toe after he pulled the shoe, maybe causing a greater separation, cause the lameness-so that now that now that outward pressure is removed, the lameness resolves?
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Member:
erika
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Posted on Tuesday, Oct 6, 2009 - 1:49 pm:
Dr. O, I am following this thread with interest. You noted the abundance of hoof wall and sole. I believe from past posts that the radiographs were taken with the casts on the hooves, weren't they? Does the cast possibly show up as if it were hoof wall/sole? I ask because perhaps it is an illusion, since Marie Anne said he is not lame with the casts.
Marie Anne, "dubbing" the toe would mean taking it back with a vertical rasping. Not from the bottom, but from the front, with a rasp pointed perpendicular to the ground when the horse is standing on the hoof. (Of course you couldn't rasp it while standing,but that is how it would end up looking.)
Erika
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Member:
scooter
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Posted on Tuesday, Oct 6, 2009 - 2:59 pm:
Dr.O. could the toe pull away from the lamanaie due to WLD. Robie does not seem to be the poster child for founder, he is in good body condition, young, ect.
I knew I would get my lines wrong!
If he has WLD can not that make the "attachment" let loose and possibly lead to slow sinking and/or rotation and a sore horse as it slowly pulls away.
Marie has he actually been diagnosed with WLD?
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Moderator:
DrO
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Posted on Wednesday, Oct 7, 2009 - 7:56 am:
marie anne, dubbing the toe back, is to rasp the front of the toe back to bring it in line with the normal position of the toe using the existing wall before it flares out (proximally) and the front of the coffin bone as the guidelines. No I don't think pulling on the wall itself is likely to cause lameness itself but the flare results in increased effort to break over and the crumbling wall that increases sole exposure.
Erika, that is certainly possible and must be assessed by those who applied the Equicast.
Diane, I have really not seen anything in the recent posts that suggest WLD.
DrO
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Member:
scooter
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Posted on Wednesday, Oct 7, 2009 - 8:15 am:
I guess I assumed he had WLD from the title and and the header in which she posted, never assume I guess.
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Member:
marieanh
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Posted on Wednesday, Oct 7, 2009 - 8:24 am:
thanks all
the equicast was applied over the shoe, so I don't think it would be confused with sole, it would be level with or below the shoe on the x ray.
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Member:
marieanh
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Posted on Tuesday, Oct 13, 2009 - 9:44 pm:
Just a brief update. Robie is now 100%, even on a small circle to the right and in his big saddlebred trot. The farrier was out today, and we had a what I believe was productive discussion of where to go from here (I even used "dubbing" in a sentence without being too self conscious). He was very receptive and I think we have a plan in place to address the imbalance in the front feet and the toe. We are going to continue with glued on shoes in the front and make changes slowly, with a check every three weeks.
This discussion would not have been possible without all of the helpful advice and education I received here.
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Moderator:
DrO
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Posted on Wednesday, Oct 14, 2009 - 9:05 am:
That is great marie but I still think we have several important issues that remain open.
1) What is the nature of the recurring lameness if it is not solar sensitivity? This will have to wait to see if it it recurs then a thorough exam with the first goal to localize where the lameness is coming from.
2) The lateral imbalance in the foot demonstrated by the irregular shape of the sole imaged in your previous post. What is the current status of the thought on this and is anything being done to address the problem?
DrO
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Member:
marieanh
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Posted on Wednesday, Oct 14, 2009 - 5:56 pm:
I did talk to the farrier about the lameness, he remains convinced this was because when he threw the shoe there was no wall support. I do not know if this is right but the lameness resolved relatively quickly after he was reshod-even the farrier was surprised he was as sound as he was yesterday. I have started a notebook with dates and photos, symptoms etc so at least I will have something other than memory in case the lameness re-occurs.
We also discussed the lateral imbalance. Yesterday, based on the x ray, he built up the inside slightly with glue and equicast and we will reevaluate in three weeks when the shoes are due to be reset. As he is sound, I did not want to pull the front shoe now if we could find a temporary fix, in case pulling it did further damage to wall we are trying to grow.
As you said above, this is going to take time to address and fix.
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Moderator:
DrO
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Posted on Thursday, Oct 15, 2009 - 8:26 am:
Well it sounds like you feel you are on the right track marie ann. I continue to worry about the imbalance in this foot as demonstrated in the solar view:
This is more remarkable than I can remember seeing in a while and I continue to have trouble picturing what is going on underneath that horn.
DrO
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Member:
marieanh
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Posted on Tuesday, Dec 8, 2009 - 11:47 am:
At Diane's request, just a brief update.
Robie is sound, and has been since the last post. We pulled the shoes on the back last week to see if we can't get some wall growth. The padocks were muddy for a time, and he was pulling the shoes. I was using boots when he threw the shoes, but he wouldn't keep them on outside, and I spent alot of time with a flashlight in the dark looking for them. Now the ground has frozen.
After speaking with my vet, who had no further recommendations other than to continue to experiment with glue on shoes, I contacted MSU, and they referred me to Corona Vista Equine Center. I have contacted them, and forwarded pics, and am awaiting their response. I also switched the hoof supplement to one with a higher biotin content.
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Member:
kpaint
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Posted on Tuesday, Dec 8, 2009 - 3:02 pm:
Thanks for the update Marie, I'll be anxious to hear what Corona says. What does it cost to have them consult online? I may do it!
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Member:
scooter
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Posted on Tuesday, Dec 8, 2009 - 3:34 pm:
Yes thanks for the update, I always wonder how these things turn out..Glad Robie is comfortable
Please let us know what you find out!
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Member:
marieanh
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Posted on Tuesday, Dec 22, 2009 - 12:12 pm:
Ok, this is the comment I received: Can anyone help translate:
"Yes, we've looked at your horses feet......our approach is very different to the current treatment Robin Hood is receiving!!!! We
would recommend pulling his shoes and changing his trim style and rehabing his hoof shape with the help of a conformable surface.....
His current hoof shape is a very unnatural one - high heels etc so we would work to create a more functionable hoof capsule and promote more
solar loading to allow the hoof wall to grow in a new attachment."
I have asked the source for a more detailed explanation of what they meant, but have not received a response. I am most curious about "conformable surface" : is that a boot/shoe or a reference to bedding.
Finally, in the pictures I have posted here, do you think he has high heels?
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Member:
rtrotter
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Posted on Tuesday, Dec 22, 2009 - 1:10 pm:
Marie-anne,
Let me see if I can read between the lines. They are saying they do not agree with your horses hoof form due to the way he is being shod and more or less agree with Dr. O as far as what his feet look like. When they say rehabing with a conformable surface. They would like to see him being rehabbed barefoot with styrofoam pads to allow his foot to go back to a more natural hoof form while in transition.
Rachelle
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Member:
scooter
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Posted on Tuesday, Dec 22, 2009 - 8:26 pm:
Sounds like they want him on soft surfaces basically. Footing or pads/boots that "conform" to his hoof and doesn't cause undo pressure. Something like what Vicki is doing now with Diva during her "transition" to barefoot and better hoof form.
Some horses transition with no problems and some get sore as the hoof is brought into better shape.
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Member:
kpaint
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Posted on Tuesday, Dec 22, 2009 - 9:27 pm:
I have read and reread too many discussions tonight...and I'm trying to figure out Marie Anne's problem and hope I'm not confusing it with other discussions in my head from reading too much tonight... There is NO White Line disease diagnosis--correct?
So is the problem still recurrent lameness of unknown origin and hoof(ves) that are unbalanced?
Hmmm. PU can definitely help diagnosing the lameness with all of their lab equipment. Not sure how expensive some of it is at the actual lab...
I live 30 min from Purdue and Dr. Hope, the PU equine vet, is who saw my mare Jan/Feb 09. He told me that more than likely she would have to be shod in the front due to thin soles. I had digital x-rays taken at that time. He read them on the spot as Purdue has a portable digital x-ray machine ($50K+ !!! Thank you Indiana taxpayers.) and burned a CD for me of the x-rays. Her lameness turned out to be severe toe bruising on both front feet. My local vet had thought perhaps founder since both feet were involved. So, no rotation. If we could not diagnose the lameness with x-ray, then I would have had to take Diva mare to PU to do the blocks, and whatever all the machines are they have for other testing. If I remember correctly, the cost was about $350-400 dollars for PU to send a vet, vet tech, two students, loaded w/ supplies truck, and their fancy brand new digital x-ray machine. They spent about 2 hours here and used a sedative on Diva so she would stand still to do the x-rays. I thought that was a very reasonable charge. I don't know where you are in Indiana Marie or how far PU travels.
Surely if you email x-rays and photos to Purdue Dr. Hope will look at them for a fee? He is a very nice man. He has been to our farm several times.
It does appear to me that the people at Corona disapprove of the trimming/farrier work on your horse. I would assume a conformable surface would be styrofoam pads or gel pads with wraps.
I have no idea what they mean by "grow a new attachment"...do they mean grow a whole new hoof/horn--one with a better form after months of trimming differently from the current practice?
That is my very unexperienced take on your quote from them. And I don't know really what else they could say without seeing the horse...?
Do you have horse transportation to PU?
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Member:
kpaint
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Posted on Tuesday, Dec 22, 2009 - 9:40 pm:
Oh, and if I remember correctly, PU would not X-ray with shoes on.
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Member:
marieanh
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Posted on Wednesday, Dec 23, 2009 - 12:24 am:
Dr. O,
First, Robie is sound, but the state of his hoofs have not changed, still have signficant separation of the hoof wall on all four-its almost like he has no white line tissue at all, and he has very thin walls
I know in the case of white line disease you recommend resecting the wall to where there is a firm junction.-hypothectically, suppose that there was separation of the wall almost to the coronet band all around the hoof-if the wall was removed to that junction how do you then care for the hoof while it is growing out-would this require stall rest?
What factor's would you consider? Is it even possible?
What if any trimming of the sole would you consider as the wall was growing out? If he is on stall rest, there would be no natural wear.
We took Robie's shoes off the back, there is significant separation of the wall on both hind feet-I don't know if this is a result of white line disease or if its a mechanical separation, and I am not sure how far up the hoof it goes-but if I removed the wall it not just one area of the hoof, it effects the whole hoof, all the way around. Taping on styrofoam is all well and good, but I think it would take several months for the hoof to grow out, and I'm not sure that really is practical to tape styrofoam on for that length of time. I have not had much luck keeping boots on while he's turned out.
To remove the wall, do you recommend a rasp or some other tool-when we did it on the front the vet used a dremmel
How do you know when you have resected enough of the wall?
Suppose its not whiteline disease, would you still recommend removing the wall till there was a good junction?
If i do this, I'm going against the advice I'm getting here from my farrier so I need to have a firm plan.
I know I sound like a broken record-sorry.
Other than founder and whiteline disease, are there other biological explanations for a poor whiteline?
Finally, based on the picture's I posted, do you think he has high heels, as suggested in the advice I posted above.
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Member:
marieanh
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Posted on Wednesday, Dec 23, 2009 - 12:32 am:
Just as an aside, when I told the stable owners I received advice to take his shoes off, both had the same reaction-"his feet will fall apart." I used to tease my husband that he was holding our house together with caulk-now I'm holding my horse together with duct tape
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Member:
kpaint
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Posted on Wednesday, Dec 23, 2009 - 1:52 am:
Marie Anne, I reread some of my old posts and the cost for the farm visit was closer to $250--see how my mind goes?
I'm up late babysitting husband. He has the flu or food poisoning...so I'm getting my HA fix off and on tonight!
I need to read up on Equicast.
What type of boots have you put on Robbie that won't stay on?
I sure sympathize with you and your foot worries. I have many new gray hairs over it.
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Moderator:
DrO
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Posted on Wednesday, Dec 23, 2009 - 10:01 am:
Hello marie anne,
These are such good questions I have edited the article on WLD to include subsections on this. If after reading it you still have questions, post them here.
Concerning the questions that are not clearly WLD related. I think it is part of good farrier work to remove weak and nonfunctional sections of the horn of the hoof. Such areas tend to perpetuate further weakness.
I don't have see any images that clearly define you having high heels. Good current conformation shots of the horse's feet, and several images of the solar surface, particularly ones that demonstrate the relationship of the frog and bars at will better help us give you an opinion on this.
DrO
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