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Discussion Starter #1
Hello! My horse has been battling a lameness for a month now. Farrier came out and drained small abscess. Week later still lame. Vet came out a week later and noticed some bruising, WLD (not enough for lameness though) and soft sole. So farrier came back out pad and shod horse. Showed some improvement but went back to being pretty lame.

Vern back out for X-rays and here they are :) she said foots in good shape (he's 20 and raced). She thinks it's still the original abcsess that's the culprit and it needs dugged out/hospital plate. It looks like it might of been originally drained. Closed up and went towards coffin bone.

Anyone else see anything alarming?
 

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Hello,

Unfortunately, with the pics all being skewed angles and no markers, that makes things rather unclear, inaccurate. Bit frustrating, as accuracy is a major reason for getting rads. Should you ever get more done, ensure they're taken squarely, and also that the vet marks the foot, so you can tell exactly where the dorsal wall, the hairline and the apex of the frog are, in relation to the rads.

In the lateral view, it appears the toe is a bit 'stretched' - dorsal angle of P3 is not quite parallel with wall, toe a little long - and the shoe is set too far forward. There's a tiny 'ski tip' on P3, indicating that he's got/had thin soles and stretched toes long term. Opacity of P3 could indicate lack of bone density, although the way the rads were taken effects that, so can't be sure. Distal borders of P3 however are very unclear, indicating lack of density. With the angle of pic & no marker, not sure where coronary border is in relation to P3, whether it's a little low in the capsule now.

The D/P view shows wider joint spacings on the right side(of the pic), and quite a big difference in the angle of the distal border of P3(ground surface). Seems to be quite a bit of M/L imbalance there. Tho again, pic being skewed angle, can't say how much that's effecting the appearance.

The solar margin view also appears that there may be a fair bit of flared foot the shoe is attached to(tho again, angles effect this). Also appears that there is a LOT of erosion of P3 on the right side of the toe and further around to that quarter. Is that where the abscess(es) have been? Is that where the worst of the WLD is? Did the vet cut out(resect) the WLD?

I'd say it's been a long standing, deep & serious problem which has either reappeared recently, or has been going on 'subclinically' without anyone noticing. Unfortunately, especially when they're shod, so feel their feet less, horses can go a long time & progress quite severely before obvious significant lameness is noticed.

I'd be really interested to see photos of this horse's hooves/hoof if you'd care to post. You need to take the pics squarely from side & front, from ground level. Not much point in solar view if he's got plates on, unless you can take them off first.
 

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Discussion Starter #3
I think you helped me with previous thread :). I've only had the shoes on for two weeks to see if it was some bruising that was causing the lameness.

Vet is 100% certain it's a coffin bone infection. Which is why the tip is flared. See photo where she thinks the infection is located.

Sorry the rads aren't the greatest. I'm pulling the shoes tomorrow and having her come back out to surgically remove the infection and hopefully that's what is causing the lameness. He's only showing it in the sand areas. He isn't as sore on hard ground.

The farrier intially pulled out some stuff right where vet thinks the infected coffin bone is so I'm guessing it closed back up and went upwards?

He had mild lameness two months ago and was on and off now he's very lame. I'm guessing it could of been going on for a while. He actually went almost sound after shoes and pad were put on but came out week later to find him lame again.
 

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Well from the shoddy rads I see(seriously what kind of vet xrays with shoes on?!) I see contracted heels, sunken coffin bone and the nails are in the laminae.. He has way too much toe. All these are leading to the abscesses... My first thought before surgery on the horse would be having a proper trimming job done on the feet because right now they are a mess. Soak them 3x a day if possible then use a flax poultice on them.

The coffin bone does not regenerate. Please don't start letting the vet dig around in it!! Get a second opinion!
 

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NB, I agree that it's far better to do rads without shoes, but plenty do. I sus from the quality(or lack of), the vet isn't very experienced at all at taking them tho. Sorry to say, madison. Due to the xray angles, I don't believe you can say anything definite about contracted heels, sunken P3(altho as said, I suspected, & now pretty sure about that after seeing pics & other rad), and you certainly can't tell from the rads if he's been 'hotnailed', although the horse would tell you something like that with severe lameness very quickly IMO.

Absolutely agree there's a bit too much toe & horse needs a good trim. If that last rad is accurate of how they are balanced now, he's also got too high heels, altho that should be changed gradually.

Vet is 100% certain it's a coffin bone infection. Which is why the tip is flared. See photo where she thinks the infection is located.
Is that where you're pointing with the nail in first pic? About mid foot?? What about the front? Or do you think that's old stuff? And where's the WLD? And I don't understand what a bone infection has to do with a flared foot?

If there is a bone infection, it is absolutely imperative it's dealt with ASAP. No, bone doesn't 'regenerate' as such(well, it can, but...), but it can continue to be eaten away by infection if it's not treated, and that infection can also poison the blood & make the horse ill/dead, not just seriously lame.
 

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Yes his LF has always been clubby. A farrier two months ago made too much change to the angles IMO. That's when I started having these issues. Lameness was suddle. Vet is pointing to where the coffin bone infection is st that the farrier needs to look at today when he takes shoes off. Which is also where an an original abscess was drained. The toe is where the seedy toe and white line disease is however she didn't think that's what's causing the lameness neither did farrier. I just started working with him and he wants to see that foot naturally grow back to how it wants since its clubby.

Once shoes are off she's coming back out to remove the infected area.
 

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IF the current seedy/WLD is related to the erosion of the bone at that point, that is pretty severe & is absolutely a likely cause of lameness. Yes, now you mention clubby, went to look up other thread... that explains the 'ski tip' to P3. I think I said so in that thread too, that while heel walls may 'need' to stay high, the bars and quarters shouldn't be excessive as well, and it's best if the frogs(& so DC's) are given extra support - as in a pad, but NOT under the walls to create even more height/pressure, just the frog.

What makes the vet certain it's a bone infection that needs surgery? As said, if it is, I recon prompt and assertive treatment is imperative, but I'd want to be pretty **** certain before I went that route - the horse will have some very intensive care needs until it heals too. I'd want a second opinion before doing so.
 

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Discussion Starter #9
The dark spot in the coffin bone on X-rays suggested an infection. She thinks the original abcess is causing it. She doesn't think it's the seedy/toe WLD, and the farrier said the WLD wasn't that bad he's seen worse it was just a little separation.

I'll have farrier take shoes off, and maybe when vet come back out and reevaluate before digging. She was highly recommended as a lameness vet as she worked at the racetrack. The vets I normally use have been known lately to misdiagnos foot problems.
 

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Not sure where the idea that the horse has contracted heels comes from. There's no sign of that in the one picture where you can only kind of half see the heels. Also the sunken p3, really guys? Where do you get these ideas from?

That's what a sunken P3 looks like. Of course I can't tell the exact distance from the xray, the vet would have had to do that at the time of the xray, but I can pretty well tell you, that hoof looks extremely good internally and externally.

I can almost guarantee the horse wasn't hot nailed too just based on where the nails come out, but I can't be 100% on that. I wouldn't even be able to tell for sure necessarily if I could pull the shoe and see the nails and holes in person.

I believe the vet in this case, being that there radiographs look good to me, and the hoof looks pretty good externally from what I can see. I would put my money on abscess/other infection and be soaking the hoof/poulticing it.
 

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From the rads I can see unbalance. From the pics, contracted heels, and an upright, overloaded hoof.
 

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Discussion Starter #12
Farrier came out yesterday and looked at the rads, and pull his shoe. He's already aware the foot needs balanced and we're working on it. He did think his heels were high in the rads, and trimmed the inside down a bit to start that process. Didn't feel comfertable digging for the infection, which I think is my issue. He got out a small abscess a month ago but just a little pressure, and it closed up and traveled to the bone. He also warned me about the vet digging around. I can see there is fuzziness around the coffin bone and am anxious to get rid of the infection.

Fingers cross she can look into it today. I paid emergency call fee to get the shoe off for her -_-
Farrier is coming back out Monday to do rest of the barn and hopefully put hospital plate on if my horse can get looked at.
 

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Not sure where the idea that the horse has contracted heels comes from. There's no sign of that in the one picture where you can only kind of half see the heels. Also the sunken p3, really guys? Where do you get these ideas from?
I don't understand how you get the idea there's no sign of any contraction. Heels do look a little contracted in that one pic, also the one I attached from her other thread. They're not terrible in that regard tho. Perhaps, as with the rad you posted about P3 low in the capsule, it's a matter of degrees, that you don't recognise lesser effects. I agree you can't tell that from the rads tho. I also agree that you can't tell about hotnailing, but I wouldn't think so from what we've seen.

The pic of the hoof front on & the second lateral view rad is what tells me that (very likely) P3 is a bit low in the capsule. In the pic, you can see above the coronary border looks a bit swollen looking, esp on the left hand side. I marked the rad to show the discrepancy in level of the extensor process of P3 & where *I think*(as said, can't be certain of accuracy without marking) the top of the coronary border is. In addition, the ski tip on P3 tells of long term increased pressure/thinner sole at the toe.

In the d/p view, I've outlined the distal edges of P3, to show how uneven it is. Also the blue lines show the uneven joint spacings, and also the uneven distance on either side of the wings of P3. If you look on the other thread, you will see m/L imbalance there too. I think, from the rads, this looks to be a long standing imbalance, not, as I think we discussed Madison(didn't re-read last thread), that it was possibly the recent farriery that caused it.

My concern about the erosion to P3 is what I marked in the skyline view rad. After looking again at the other thread, that's not in the region of the current seedy toe *if the rad & pic are the same orientation. Perhaps that was a previous problem. As mentioned, as it depends on the lucency of the radiograph, can't be sure as to how much the transparency of the edges of P3 accurately reflects bone density either, although it appears there is some.

So all in all Naph, as said, I appreciate we can't be sure of details, accuracy, and as said, the degree of P3 being low in the capsule, the degree of contraction is anything but severe, but given other aspects as well, I don't understand how you get the idea the hoof pics & xrays look 'good'.
 

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Is there a chance he can be sound again if the erosion area is treated? I'm hoping we didn't treat this too late :(. I read they can lose some bond. Unless all this lameness is from imbalanced hoof.

Maybe with shoes off I can get her to take a clearer graph of the infection.
 

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Quite frankly it's because my education is not from sitting on my computer and googling stuff 12 hours a day. I learned from the best, so I'm pretty sure I know what I'm talking about.
 

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^well arent you wonderful then. All hail naph!

Obviously know everything, unlike me for eg, who has only been working in the industry for nearly 20 years. Quite frankly.

I could assume that because youre here, thats all you ever do, but that would be irrational.
 

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Is there a chance he can be sound again if the erosion area is treated? I'm hoping we didn't treat this too late :(. I read they can lose some bond. Unless all this lameness is from imbalanced hoof.

Maybe with shoes off I can get her to take a clearer graph of the infection.
Yes madison, there is a good chance, even IF it is all those things going on, that treated correctly, the horse will be ok. As i have tried to emphasise, theres not enough to go on, with skewed n unmarked rads to be accurate on much.
 

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Discussion Starter #18
Hero got worked on today. I was poulticing the hoof for few days to soften the sole and sure enough he reacted to hoof testers where as before he didn't flint for farrier. She didn't think it was from abscess but rather a puncture wound. She scraped a hole and got out some dark stuff I think (a lot of blood too) took some new graphs which I attached. To me looks less fuzzy but again I don't know what I'm really looking at. I hope this is the cure, along with getting the foot balanced over time.

My fellow equine friends horse is going thru similar situation but he's in a hospital with a perfusion? Then surgery route if that doesn't work.

So I hope poking a hole and scrapping the area did the trick for Hero along w oral antibiotics (I hear that doesn't really reach hoof area though so idk..)

Fingers crossed.
 

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Discussion Starter #19
Also I do notice the opacity in the coffin bone. Is that concerning? I'm guessing that's from the club foot. Will proper trimming prevent that from getting worse?
 
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