My posts aren't showing up again. It's happened two days in a row. In years past, they would typically show up very quickly. Is there anything that I can do differently? Are the posts here now being "approved" before they actually post, perhaps making it so that there is a 2nd process involved which may be contributing to the interference?

Thank you both, Nancy and Lavinia, for your replies.
If you would please tag Dr Kellon for me, I would very much appreciate it as well. She was trying to help us with this but I did not recieve any email(s) from her regarding HOW to lower Misty's heels, when she was not able to put them down, so perhaps she can inform me here?

Here is the Ultrasound Report at the onset of Misty's tendon issue. I have absolutely exhausted myself since, trying to get information on exactly what to do and HOW to do it after this plan {below} failed. We continued to try to lower her heels without success. A Tenotomy is not an option for us

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MISTY-FOLZ - Ultra Sound Report 05/10/2011

Misty has been doing better now that her feet are under control. Kirk has been doing an excellent job maintaining her
balance, etc. Misty did not grow any foot in the RF during the last trimming cycle. During her entire founder history, her
radiographs have always been "worse" on the LF foot. She has, however, always been more sore on the RF foot. Misty
has been more comfortable after the last few trims but she has been bearing weight abnormally on the RF foot.

Misty walks on the toe of the RF foot and does not drop full weight onto the fetlock nor lower her heel to the ground. Kris
mentioned that Misty will put full weight on the RF foot when she is on very soft ground (mud). Kirk and Kris had to stand
Misty in the mud the last time her feet were trimmed in order to pick up and trim the LF foot. Misty has not been making
hay piles to stand on in her stall. Misty's feet have been stable but she continues to have pain from some source,
especially in the RF limb.

Misty was mildly sensitive to flexion of the right knee. She has scar tissue present in the right check ligament and mild
inflammation around the RF deep digital flexor tendon about 4" distal to the knee. No sensitivity on palpation of the
proximal (upper) deep digital flexor tendon (DDFT), superficial digital flexor tendon (SDFT) or Suspensory ligament. Misty
exhibited increased sensitivity on flexion of the RF lower limb (fetlock, pastern, hoof). Misty also exhibited pain on
palpation of the plantar (back) aspect of her RF pastern. The RF pastern was also warm on palpation. Both hoof capsules
cool on palpation. Digital pulses within normal limits (quiet).

Discussed that the pain appears to be coming from the pastern region. Horses with injuries to the flexor tendons or
suspensory ligaments often exhibit the type of lameness Misty is displaying.

Misty is also exhibiting signs of a limb length disparity. These signs were not apparent previously due to her stance, gait,
and appearance of her feet. Now the RF foot is wider and more flattened in appearance. The LF foot is more upright.
When Misty stands square, the tops of her shoulder blades are not in alignment. She has varying distances between the
tops of her shoulder blades and her withers. Her RF limb is the tall limb (shoulder blade closer to the withers) and thus
bears more weight and has a flattened appearance to the foot. The LF limb is the shorter limb and thus bears more
weight. This altered weight bearing contributes to the more upright appearance of the LF foot. The limb length disparity
may be contributing to the continued stresses on the RF limb. Misty's acquired stance of placing the right front foot
forward also allows her to correct for some of the disparity. With the RF foot placed forward, her limbs are more equal in
length and she is able to relieve some of the tension of the flexor tendons in that limb.

An abaxial sesamoid (at the level of the sesamoids/fetlock) block was performed to desensitize Misty's lower limb. Due to
Misty's medical history, a small amount of antibiotic was added to the carbocaine.

Misty exhibited a 100% improvement in her way of going following the nerve block. She was willing to place full weight on
the RF limb and drop the heel. After the RF foot and pastern were blocked, Misty was actually a little more sore in the LF
limb.

Due to Misty's recent radiographs, we opted to start with an ultrasound examination of the pastern region.
Sesamoids and distal suspensory WNL (within normal limits). Misty exhibited scar tissue and fiber disruption in the DDFT
at the level of the pastern. She also exhibited a core lesion in the DDFT.

Plan:

1. We need to decrease pressure on Misty's DDFT and correct for her limb length disparity. 

2. Use double wedge cuff on the RF foot to decrease stress on the DDFT.
 
3. For the time being, use the single wedge cuff on the LF foot to help lift that limb. We will switch Misty to stacked thick
leather pads to provide a lift for the LF limb without the wedge effect.
 
4. Plan to keep Misty in the high wedge for about 3 weeks (unless she becomes more uncomfortable). After she has had
the double wedge on, we will place her in the single wedge to begin stretching the tendons and allowing more loading.

5. Misty has mild contracture of the flexor tendons around the knee due to her acquired stance and way of going.
 
6. Since Misty's feet have been stable, placing wedges is an option. We will still need to monitor her for discomfort and
change our treatment plan accordingly.

7. We briefly discussed glue on applications if needed to help decrease labor intensiveness of taping on cuffs and/or pads.
 
8. Misty will likely not require a lift pad on the LF foot indefinitely. Since the forelimbs are attached via muscles, her body
will compensate and help re-align the forelimbs. We can also leave the LF foot just a little longer to help compensate as
well.

Please call with any questions or concerns.

END OF REPORT

Kris & Misty
Central Ohio
Oct 2002