Trimming from X-rays, URGENT


gentpony
 

Can anyone describe how a proper trim from X-rays is done?
Mel, 27 y.o. 12 H, IR Hackney pony, is having a new bout of
laminitis. This is our first set of X-rays.

The written radiology report on his front feet is very vague:

"Lateral - slight tipping of P3 on both hooves
" Ant-Posterior - no abnormal findings
"Treatment: Corrective trimming - lower heel, allow toe growth,
"then dub toe
" Corrective shoeing if necessary
" Anti-inflammatories as needed.
" Our aim is to make Mel comfortable."

The farrier is coming 8am THURSDAY MORNING, (Sept 27),
new to us, but recommended by the vet who took the pics. How
is he to get a ground parallel P3 from these directions?

When I picked up the X-rays and radiology report the vet said all
(4 views each foot) were "very good for 27 years--no sign of
sidebone or ringbone, no spurs on P3, sesamoid bones and
lateral cartilages were good. He was very surprised given how
his feet actually look.
He felt LF had 1-2 degree rotation, so take 1/8 " off heel;
RF around 5 degrees, so 1/4" off heel, dub toe 1/4-1/2".

(Would you trim heels this amount for this degree of rotation?
Does it matter if ground surface (solar, seat of corn(?)) at the
heel is not a'flaking" down to this depth? Toes are already at the
white line. Any more back up would be behind the white line--Is
this OK?)

He thought RF sole under P3 approx. 1/2"--a bit thin, looking for
3/4". Is this what we would want for his size?

Rotation angle was determined by drawing a line along the
anterior edge of P3 and the anterior edge of the hoof. Is this
correct procedure?

Does the farrier take a measurement of existing toe angle using
a hoof protractor and then trim at the heel to achieve the 5
degrees (or 2') less? How far up towards the toe would he trim?

How do you determine how much to back up the toe? Currently
both fronts are at the white line.

For medal-lateral balance to be correct, are we looking for the
vertical growth line (tubules) to be 90' to the ground at the centre
of the toe? (Drawing a line down the centre of pastern will not
give equal width of hoof on both sides. Walls are more vertical
medially and more angled laterally). Currently RF is not 90'.
Does this affect the toe angle when it is corrected?

The X-rays themselves clearly show the sesamoid bones and a
"skinny" P3 that is more narrow than where the sesamoids
appear. P3 looks like the sharp rounded tip of a knife blade.
The wrap-around sides that i've seen on other x-rays are not
apparent. Why is this?

What do they put on the hoof to get the anterior edge of the toe
and under the sole to be more defined? We do not have any
such landmarks to go by.

Hopefully with your input we can make sure Mel gets a good trim.
Tlhank you many times over to anyone who can respond.

Eva and Mel

P.S. I have no idea how to get these regular X-rays posted. I
plan on taking "before" photos tomorrow (alas, film camera).
Will update his history ASAP. Sorry if this topic has been dealt
with before. Have not been able to log on since April--still
computerless and have no time to do a search.


Mandy Woods
 

Eva,
Do you have the xrays in your possession?   Do you have a digital camera?  IF yes to both questions,  tape the xrays to a sunny window and photograph them.   Download them into your computer and then enter them in the photos section.
Hopefully Abby or Claire will guide  you with lines drawn on the xrays. 
IF you don't have the xrays, ask your vet if you can take photos of them in his office on his light box.  If he has them digitally have him send you a copy!
Mandy and Asher in VA


Abby Nemec
 

---- gentpony <gentpony@...> wrote:

The written radiology report on his front feet is very vague:

"Lateral - slight tipping of P3 on both hooves
Yes this is very vague ... since we don't know if it means "separation from the dorsal wall" or "deviation from ground parallel". Either way, you will want to correct it though.


" Ant-Posterior - no abnormal findings
That's good - that means that your joint spaces are straight, so you probably don't have to make drastic mediolateral corrections to get P3 balanced.

"Treatment: Corrective trimming - lower heel, allow toe growth,
"then dub toe
Pretty nonspecific! But then, you really can't be more specific than that from just xrays. The changes to be made to the foot depend somewhat on what you find when you start cutting.


" Corrective shoeing if necessary
" Anti-inflammatories as needed.
" Our aim is to make Mel comfortable."
If you can get alignment straightened out and eliminate the laminitis flares, you should be able to get more than "comfortable" ... (she says blithely without having seen either feet or xrays)


The farrier is coming 8am THURSDAY MORNING, (Sept 27),
new to us, but recommended by the vet who took the pics. How
is he to get a ground parallel P3 from these directions?
That's a tough one, but really the biggest concerns for the farrier are "is there adequate sole depth so I have something to work with?" and "HOW MUCH is P3 deviated?". In addition, it matters where the tip of P3 is in relation to the bottom of the foot, so we can know how far back to bring the breakover point.


When I picked up the X-rays and radiology report the vet said all
(4 views each foot) were "very good for 27 years--no sign of
sidebone or ringbone, no spurs on P3, sesamoid bones and
lateral cartilages were good. He was very surprised given how
his feet actually look.
All that is good; it means you're probably not going to be dealing with a bunch of OTHER potential causes for lameness that may get awakened by messing around w/angles etc.

He felt LF had 1-2 degree rotation, so take 1/8 " off heel;
RF around 5 degrees, so 1/4" off heel, dub toe 1/4-1/2".

(Would you trim heels this amount for this degree of rotation?

I don't know - need to see both the feet and the xrays, but yes, I frequently take heels down that much (and more) with rotated feet.


Does it matter if ground surface (solar, seat of corn(?)) at the
heel is not a'flaking" down to this depth?

Not usually. There's often a hard, sort of callused sole material that prevents us from finding the live sole. Again, that's a "feely" thing that the farrier will mess around with as he works.


Toes are already at the
white line. Any more back up would be behind the white line--Is
this OK?)
Absolutely. Aggressive trimming behind the white line is very common with coffin bone rotation (and actually hoof rehab in general). I would say with most of the rehab cases I consult on where people get "stuck" in their progress the "white line barrier" is the most common thing in their way.

***Abby's #1 trimming rule: put the horse's footprint where you want the foot to grow to.****


He thought RF sole under P3 approx. 1/2"--a bit thin, looking for
3/4". Is this what we would want for his size?
That's actually a pretty good depth for a pony. Gives the farrier something to work with.

Rotation angle was determined by drawing a line along the
anterior edge of P3 and the anterior edge of the hoof. Is this
correct procedure?

There are many ways to say "rotated" and that's one of them. It's a clear deviation from normal, and reflects separation between the wall and the bone, so yes.


Does the farrier take a measurement of existing toe angle using
a hoof protractor and then trim at the heel to achieve the 5
degrees (or 2') less?
Probably not. Again, this is where the experience of the farrier is valuable. Hoof protractors are notoriously unreliable, but when learning to trim we need to depend on SOMETHING.


How far up towards the toe would he trim?
Depends.

How do you determine how much to back up the toe? Currently
both fronts are at the white line.
With a compromised foot, the breakover will probably be close to a vertical line dropped from the tip of P3. Eventually, with good growth and a toe callus, it will end up a little in front of that.


For medal-lateral balance to be correct, are we looking for the
vertical growth line (tubules) to be 90' to the ground at the centre
of the toe?
Theoretically, yes, but you have good M/L alignment according to the xrays, so it may be that these will straighten out for you as the foot starts to form new connections inside.

(Drawing a line down the centre of pastern will not
give equal width of hoof on both sides. Walls are more vertical
medially and more angled laterally).
That's normal, if the difference is slight. If it's a huge difference you may need some corrective/supportive shoeing once the laminitis rehab is well underway. Again, can't say without seeing the feet, the legs, how the horse stands,


Currently RF is not 90'.
Does this affect the toe angle when it is corrected?
Can't say.

The X-rays themselves clearly show the sesamoid bones and a
"skinny" P3 that is more narrow than where the sesamoids
appear. P3 looks like the sharp rounded tip of a knife blade.
The wrap-around sides that i've seen on other x-rays are not
apparent. Why is this?
I'm having trouble visualizing that explanation ... I'm presuming you mean "navicular bone" rather than "sesamoids" (technical term is sesamoids, but the colloquial term "sesamoids" are really in the fetlock joint) ... but even so I can't quite see what you're explaining ?


What do they put on the hoof to get the anterior edge of the toe
and under the sole to be more defined?


Either barium paste, a hypodermic needle, a paper clip, etc. on the dorsal wall. Usually a thumbtack on the tip of the frog. Without the marker on the frog it's hard to have landmarks for the farrier to trim by.


P.S. I have no idea how to get these regular X-rays posted. I
plan on taking "before" photos tomorrow (alas, film camera).

Can you get a cheapo disposable digital camera from the drugstore or WalMart or something? You'll be glad you did.

-Abby


--
---------------------
Abby Bloxsom
www.advantedgeconsulting.com


gentpony
 

Thanks for your swift and detailed replies Mandy and Abby!!!!
You gals are great!!!

Have finally made it to the the computer....2am.
The instructions and explanations from you both have clarified
alot for me. Hope the farrier knows as much as you--or is at
least open-minded.

I spent the best part of the day going to borrow a digital camera
and then looking all over town for a memory card (owner's was
full and misplaced the docking cable). Seems they have
discontinued the one I needed!!! I didn't know digital
disposables were available....too late now, all stores are closed.
Did pics with film. Will investigate getting them put to CD, but will
need help to post. This old computer has no photo software
(iMac). We're just not very techno savvy here at all.

Is there any point now in posting these x-rays and the "before
trim" pics? Or x-rays and "after trim" pics?

Wish us luck for tomorrow,

Eva and Mel