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Discussion Starter #1
My 9 year old mare. As a yearling she tried to run through a cattle guard and pretty much ripped her foot off. We bought her as a two year old under the agreement that if she wasn't sound in 6 months they'd buy her back. Well, obviously after that we were irrevocably in love with her and doing all we could to figure out out to make her more comfortable. Obviously we have know we'll never ride her, and we're fine with her being and expensive pasture ornament. I want to make it clear that if this severely affected quality of her life she would already have been put down. She limps, but I've never seen her generally in pain, she has never missed a meal or the chance to buck or run. Vet said x-ray are virtually unchanged since the last. I honestly just want to hear what everyone sees, everyones opinions. Please, If you have anything negative to say keep it semi polite, I do understand this is a forum so of course any opinions are welcome.

*I know her toes are long in the x-ray but her hoofs grow extremely fast (this was 6 weeks after last farrier visit) and our farriers were standing their as the vet took the x-rays, and trimmed her up right after he left.


 

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Now I can't read an x-ray at all, but what I see is the heel may be too high, the toe too long (as you mentioned) and she is standing unevenly -- due to uneven trim? due to pain? Also, with a large grain of salt, is that bone deterioration in the back of her P3? Is this possibly a club foot as the angle of her pastern is very steep as well?

Has a local been given to try to isolate if the pain is in her foot, or her pastern, or higher up? Please post pics of her post-trim feet and conformation shots.
 

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What you appear to have is a 'founder' situation. She has severe rotation of P3. It needs to be stabilized or it could come down through the sole of her foot. It looks pretty severe. I also see a lot of calcium on her long and short pastern bones (both P2 and P1), but that is minor compared to the rotation of the Coffin Bone (P3).

Could you take photos of her hoof as she stands? Did your farrier have any suggestions after he saw her x-rays? Did the Vet take a x-ray from the front looking down? That view would also be helpful. You need a really good corrective shoer or a really, really good barefoot trimmer. Both are hard to find that can deal with a hoof in this bad a shape.

My first guess (without seeing her hoof) would be to get some support under the frog and heel. With all of the weight on her long toes, she just keeps pushing her P3 farther down through her hoof. As you can see, her Coffin bone is rotated 12 - 15 degrees away from her hoof wall. They should be firmly attached to each other and parallel from the top to the bottom of her hoof.
 

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Six weeks or not, I think you need a new farrier. It's not just the length but the angle and slippering that's very bad, and can't be helping matters in the slightest.

Now, for the radiographs, I am NOT a vet or farrier, but I'm going to give it a go, and you tell me if I'm right.

I see sidebone developing. Is that from soft tissue injury? Also, her legs are crooked--conformational shortcomings? Joints don't "line up." What is with the ballooning-out areas of the pastern bone on the lateral (left) side of the second view? In the first view, is that the same thing on the front (right)? It looks like an arthritic lip. Ringbone? Her coffin seems to have an excessive angle to it, but I'd be willing to blame some of that on your farrier, as her heels are way too high. Has she foundered in the past?

Edit: Just saw Cherie's post. Maybe a great minds thing, maybe not.... :wink:
 

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Discussion Starter #5
She does have clubbed feet but not from the injury itself, its from years of bad shoeing we thought was helping her (natural balance). If kept her comfortable, but kept any progress that could have been made early on from happening and messed her up in the long run. We are slowly trying to take her heal down without causing her soreness (2 years in the process of that).
The reason it may look uneven is because the x-rays weren't taken at the office, but rather with a transportable x-ray machine, maybe that could have caused the way she is standing. Or possibly because she was standing without shoes and is very sore without them.
As for the deterioration, I honestly don't know. The vet did mention the onset of arthritis, and a couple of years ago we were told her bones had grown deformed because of the injury being so early on in her life. Maybe that's it?
As for pain, she's very, very rarely in pain so extreme she needs to be medicated, though she is on a low dosage of pain medication that is in the only supplement she takes that we swear by. She never has problems walking, trotting, cantering or running though her gaits are different, stiffer and like I said she does limp. She's has had abcesses in the past, and and thrush rather recently and those are the only times we've had to use pain meds to help her out, and the only time any vet has recommended we use pain killers.

I'll try and remember to take pictures tomorrow of her hoofs.
 

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Discussion Starter #6
This is the only hoof picture I have on hand, and for sure not the best. From last farrier visit (6 weeks).

And the only rather good conformational shot I have on hand, from early this year. Very short, upright pasterns and littler bone to her legs.

And no, we have never had a foundering problem.
 

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Discussion Starter #8
She has padding that go between shoes and silicone goes between to keep out rocks, water, etc. The tapes left on for 2 days afterwards to let the silicone set up properly than taken off. That is why she developed thrush recently because the silicone came out.
Please excuse my ignorance about this but how is founder related exactly? We know she has laminitis, mild at that, and has rotation so were does the founder come in because its never been mentioned.
 

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Discussion Starter #9 (Edited)
Another question, you mentioned soft tissue damage. As far as we know, for the year between the injury and until we bought her she was turned out on pasture, no farrier work, no vet treatment at the time of the injury. Could walking around on the injury when there was no hoof cause the tissue damage your talking about?
 

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Laminitis is inflammation of the laminae of the hoof. It caused the coffin bone to separate from the surrounding tissues. When the coffin bone sinks or rotates, the clinical term is founder. Although in common usage, a lot of people, including some vets, use the two terms interchangeably. I've found farriers to be far more specific in their language.

I wonder if your farrier could use some kind of antimicrobial treatment or pad under the silicone to prevent the thrush problems.

I mentioned soft tissue because I misread the OP and thought she was just now a two-year-old, and I couldn't see how a horse that young could develop sidebone without some kind of serious problem. But it makes more sense with her being nine, and just chronic concussion or whatever. Though yes, if she was walking on her hoof wrong, or even in the initial hoof-tearing injury, that could definitely be enough to cause significant soft tissue damage.
 

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It is hard to believe that she is 'reasonably' sound. The 'clubbed feet' explain the rotation of her P3. Many club footed horses have severe rotation. It means that you may well not be able to do much with her problems.

I have never been able to lower the heels on a mature horse with clubbed feet. Any time I tried, they went lame and we had to let them stand at their natural angle. I have a mare with an 80 degree angle on one foot. Her feet were normal until she was almost 2. She was briefly lame and from that point on, her right front got more and more clubbed looking. We had her x-rayed and she had a little rotation. Vet said to try lowering her heel and the instant she went lame we were to stop lowering her heel. Well, she went lame right away, so she has an 80 degree perfectly sound foot.

This mare has so many conformation problems, it is hard to say what caused what. I would say that the upright pasterns and clubbed feet are not related to the injury. When both feet are clubbed and both pasterns are that upright, it is usually from nutritional deficiencies during pregnancy and as a foal or are inherited from bloodlines known to produce bad legs and feet.

Her knees (or at least her left knee) is a poster child for an off-set cannon or bench knee as it is sometimes called. This is a major inherited conformation fault.
 

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Discussion Starter #12
Ah yes, the makes a whole lot of sense with me, foundering has always stood out in my mind has improper feeding.
The silicone generally stays put, but we had so many wet days in the last 2 weeks that it slipped, so now we have it on hand in case it does happen again.
And for walking on her foot wrong all these years, yes she has. I'm not going to lie and beat around the bush about it, we, our farriers and vet does see it, but its not because of our current farriers. 6 years of improper, horrible shoeing takes a long time to fix. We have to be very careful on how much heel/toe comes off at one time or else she'll be lamed up for weeks. It's been a very slow process trying to fix her, but if i remember right she's gone from pretty much three inches of heel and no toe to a something that looks like a hoof, with toes that grow to faster than what is needed.
 

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It is hard to believe that she is 'reasonably' sound. The 'clubbed feet' explain the rotation of her P3. Many club footed horses have severe rotation. It means that you may well not be able to do much with her problems.

I have never been able to lower the heels on a mature horse with clubbed feet. Any time I tried, they went lame and we had to let them stand at their natural angle. I have a mare with an 80 degree angle on one foot. Her feet were normal until she was almost 2. She was briefly lame and from that point on, her right front got more and more clubbed looking. We had her x-rayed and she had a little rotation. Vet said to try lowering her heel and the instant she went lame we were to stop lowering her heel. Well, she went lame right away, so she has an 80 degree perfectly sound foot.

This mare has so many conformation problems, it is hard to say what caused what. I would say that the upright pasterns and clubbed feet are not related to the injury. When both feet are clubbed and both pasterns are that upright, it is usually from nutritional deficiencies during pregnancy and as a foal or are inherited from bloodlines known to produce bad legs and feet.

Her knees (or at least her left knee) is a poster child for an off-set cannon or bench knee as it is sometimes called. This is a major inherited conformation fault.

I've been led to understand buy some respectable vets that her knees and cannon problems are because of the fact she had no proper vet treatment or farrier work when it happened and grew deformed to compensate. As for the clubbed feet, as I've said, she didn't have clubbed feet it was shoeing that did it because it made her comfortable for a short bit- worst mistake we've made. Its really messed her up in the long run.
 

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Discussion Starter #14
Quick shots from her as a three year old(no conformational), in the very beginning of natural balance. Are the conformational faults as bad? I fully admit to not having the best eye with conformation, but to me her legs seem a great deal straighter than, then they do in the pictures I posted before that are current.





 

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My 9 year old mare. As a yearling she tried to run through a cattle guard and pretty much ripped her foot off.
High ringbone.

Low ringbone.

Bony changes of the navicular and coffin bones as well as the extensor process.

Lipping of the coffin bone.

Side bone.

Articular coffin fracture.

Possible tendon calcification or floating chip just below the sesmoids. (could be mud as well)

Possible infectious arthritis of the coffin joint.(trauma)

Mechanical rotation of coffin bone.

Lack of sole depth.

Flexor deformity (shortening).

Be happy w/ anything that is in the ballpark of mild lameness to intermittent soundness.:wink:
 

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Agree with most of what Bntnail shared. Few of the problems presented in the radiographs can be "fixed". Bone remodeling is forever.

Comfort is the goal and best nominal hope.

Focus on phalanx/hoof capsule alignment and sole depth. The "high heel, no toe" you described earlier is correct for this horse. Reduce as much DDFT pull and toe leverage as possible.

Generating sole depth will depend largely on any remaining functionality of the vascular bed. A venogram would provide a baseline for future reference.

Silicone is a poor choice for this horse; doesn't take two days to setup and should not require duct tape left on that long to address. A softer impression material or pour-in pad would better serve this horses need. Silicone is too firm. Include an antimicrobial to avoid soft tissue intrusion by opportunistic bacteria.

Frog support is an important aspect of management in a case like this.

... And no, we have never had a foundering problem.
Yes, you have. Your horse is currently "foundered". Chronic, mechanical laminitis. Shoeing protocol should include management for that condition.

Medial/lateral displacement of distal interphalangeal joint is significant. Wolff's law of bone remodeling intervened and remodeled the condyles to accommodate that imbalanced load effect. Shoe for medial support as much as possible.

Yep... she's a train wreck and been that way for a long time. It will take some pretty creative (translation: expensive) management just to keep her pasture comfortable.

Heartbar shoe; elevation as necessary to assure post-trim phalangeal alignment; heavy roll at the toe. Soft to medium pour-in pad with copper sulfate crystals in back half of foot. Short term Magic Cushion in front half to encourage sole growth. Mesh and leather to hold the whole thing together until some improvement in sole depth followed by long term full pour-in pad (vettec soft with antimicrobials). If the skills are there, a roller motion (banana) shoe with frog support might be a better long term solution than a generic heartbar. Let's the horse find it's own best comfort caudal elevation.

Best luck and, as always....

Cheers,
Mark
 

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Hypothetically, experts, would this mare be a candidate for a tenotomy, or is she too old and/or the damage too severe?
Might start with a check ligament desmotomy first. Tenotomy, dependent upon degree of change after desmotomy. Better to let a vet make those calls. Anything that will build sole depth would be high on my list or priorities towards making the horse more comfortable.

Too old? Not sure if age disqualifies a horse from pasture duty. As to "too much damage".... there's a lot of damage, much of it irreversible. This horse has some insurmountable challenges but if "pasture sound" is the goal, much of what has been already discussed would contribute towards that goal. In the end, it comes down to a measure of emotional investment. Presume about $1,600 to $2,000 per year in farriery maintenance plus up-front vet costs for diagnostics and any elective surgery.

Cheers,
Mark
 

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I agree w/ Mark. Age not so much of a factor. Another concern might be the changes present in the coffin joint. May cause problems after tenotomy/desmotomy.
 
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