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  Discussion on 9 degrees difference in palmar angles LF and RF
Author Message
New Member:
zbgirl

Posted on Thursday, Jul 25, 2013 - 11:18 am:

We are currently in diagnostics trying to determine where in my horse's RF he is lame.
We have had fluroscopy, flexion tests, joint blocks up to the knee, and xrays of the hoof. The computerized lameness detector also points to the RF. My horse had been sound up until 6 weeks ago; there was a change in farrier and method of trimming last Nov. where his toes were slowly allowed to get too long and his heels, especially the left, has become too low.

I had exrays of the hoof taken Jul. 8. The report includes this comment:
The left front coffin bone had negative plane of 2 degrees. There was approximately 1 cm more in front of the centre of rotation of the coffin bone than behind. The right front hoof pastern axis was upright. The palmar angle of the coffin bone was 7 degrees. There was 5 mm more shoe in front of the centre of rotation of the coffin bone than behind.

Given that so far the blocks to date have not narrowed down the lameness (grade 2) are the xray angles mentioned imbalanced enough to create a lameness situation?

We are now back to our original farrier, but it sounds as if it will take a number of shoe cycles to help resolve the hoof angle issues.
Moderator:
DrO

Posted on Saturday, Jul 27, 2013 - 6:03 pm:

Hello Pat,
No they are not Pat. Can you tell me exactly what blocks have been done, the order in which they were done, and what exactly were the results? Usually this is expressed as the degree of lameness before the block and the degree of lameness 5 and 10 minutes after the block.
DrO
Member:
zbgirl

Posted on Sunday, Jul 28, 2013 - 11:49 pm:

In addition to fluroscopy of both front legs at the knee and below into the hoof, which did not reveal anything odd other than slight medial sesamoid bone remodellig on the Rf, we have had done in this order:
1. block of PDN, the heel of the RF
2. abaxial sesamoid block
3. r knee
4. the suspensory RF
The only change in soundness was a very minor improvement upon blocking the knee.

Two days ago, another series of blocks.
1. cannot recall name of block but it was to eliminate the sesamoid involvement
2. a series of 4 needles to, I think, rule out palmer, metacarpal, deep something/and suspensory.
No soundness on any of the above blocks, and we trotted sand ring/ straight line on hard ground.
The one block we did not do was the ulnar/radial nerve block. I am being referred to another vet who does this block with ultrasound.

The xrays were done separately and without any blocks. The angles that I quoted were from the case summary of the attending vet. That vet recommended wedge shoes, which we have been holding off for a bit (per my farrier and vet agree to not using wedges).

At this time my vet is thinking soft tissue injury (edit: above the knee and below the elbow), not a joint or hoof issue. My horse was on previcox for 20 days previous to any blocking and the lameness did not change.

I asked about the degree of coffin bone disparity along with a pastern that has become straighter over the past few months-- and I did not get much of an answer.

He did bring out the computerized lameness detector which consistently showed the horse weight bears on the LF on all tests, with some minor RH lameness becoming evident.
Moderator:
DrO

Posted on Wednesday, Jul 31, 2013 - 5:37 pm:

Pat if the PDN and abaxial sesamoid nerve blocks were done correctly on the lame leg it lets out the foot and most of the pastern as a cause of lameness. If a high 4 pt volar has been done correctly it rules out MOST of the leg below the knee. If the knee joint has been blocked correctly it lets it out as a cause. The fact that some improvement was seen suggests that perhaps the carpal canal may be the problem as anesthetic from the carpus sometimes defuses into the canal. For more on this see HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Upper Front Limb » Overview of Lameness of the Knee (Carpus).
DrO
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