Re: To cushions & wedges & the like 🙂


Lavinia Fiscaletti
 

Good question, Joella.

In feet like these, all the necessary support structures in the back half of the foot are lacking in some way, including the digital cushion, lateral cartilage, frog, heels. The bull nose indicates that there is work being done to get a long toe back to where it should be. If the toes have always been kept short (horizontally speaking), then you won't necessarily have the bull nose as a rad flag. If the heels are underrun to any degree, you should expect to see a lower-than-ideal plantar angle on radiographs. Heel bulbs that protrude well behind the hoof and are softer and flatter are also an indication that the plantar angle is too low. The digital cushion is lacking in the sense that it is underdeveloped and is also displaced further back behind the foot. You can easily check its health by palpating it: a healthy digital cushion in an adult horse should have the firmness of a super ball. On too many horses, you'll find it feels much more soft and squishy.

There's a great example of this kind of foot that an ECIR member has been dealing with quite recently:

https://ecir.groups.io/g/CaseHistory/photo/36909/15?p=Created,,,20,2,0,0

https://ecir.groups.io/g/CaseHistory/photo/36909/16?p=Created,,,20,2,0,0

They're pretty dramatic and most cases are not nearly this badly out of alignment. Note the difference/improvement in both the bony column alignment and the heel bulbs from May to Aug. You can follow the specifics of Lynn and Relevante's journey on the Main ECIR Group.
 
A temporary wedging of the back half of the foot with padding that will support, but also allow for pressure-and-release, can be helpful while the underlying trim issues are corrected. Just using a firm wedge to elevate the heels doesn't solve anything in the longer term.The trick is to leave the actual walls at the heels unloaded so that they can relax down and back into their correct position. Otherwise, you just continue to apply constant pressure to the crushed heels, which maintains the status quo.

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Lavinia

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