I added two markups of the RF to the album
Based on the x-rays of a few months ago, we know that the sinking has taken that CB about as low as it can go within the hoof capsule. On the outside, it appears there is a huge amount of heel to come off, but when looking at the x-rays, one can see that the palmar processes, the back 'wings' of the CB, are sitting at the level of the bars. It's probable that the palmar processes can't come down any lower to effectively derotate the CB...like a teeter-totter...if the back goes down, the front goes up and vice versa. Not certain the processes can actually lower any more.
You also need to have a toe wall that can actually contribute to holding the dorsal or front surface of the CB 'up' via laminar connections. Right now, there is a large wedge in the way. This in and of itself usually isn't that much of an issue in realignment trimming. Couple that with the sinking, with the CB and bony column taking on a 'spear' shape, there are some problems to overcome.
The heels need to come down. I truly can't tell you just how much based on the photos. It's one of the things that seeing the foot in person would help. They definitely need to come down to at least be even with the surface of the frog.
Toe needs to come back. It appears that you have rockered the toe somewhat up and out of the way (yellow lines on the lateral view). Good! But it sure looks as if the dead 'slab' of sole in the 11-1 o'clock position is on the ground, and thus making for a long toe. Back that or rocker that.
The goal of course is to keep him comfy and to try to encourage wall growth in the pillars area. That blasted ACTH of his! And now we're in the seasonal rise. Just started upping the dose for Pap. I would be of the opinion, and its just that, an opinion, that the ACTH is the major culprit.
EC Primary Response