Re: New ACTH Numbers / Prascend Dose and Recent xrays

Lavinia Fiscaletti

Hi Hilary,

It seems the post I sent with the explanation for the mark-ups went "poof" so am re-posting.

I added the mark-ups to Angel's photo album:

In general, the toes are too long horizontally, heels under run and a bit too high, bars are somewhat excessive and tending to lean outward. There are medial-lateral imbalances which have been going on for some time and that have contributed to the development of the side bone as well as to the hoof capsules being displaced to the outside. Distal descent (aka sinking) that wasn't present in the January xrays, soles a bit thin (RF more so than left). Although it looks like there is too much foot vertically, there actually isn't any extra height due to the bony column sitting deeper inside the hoof capsule than it should be (sinking). The RF has a slightly clubby configuration but not the LF. Both are being exaggerated by the heels being left too high. I believe one of the pix that is labeled "RF sole resized" is actually a hind, likely the LH? All of the coronary bands show upward bulging to either side of the center of he toes, more pronounced on the fronts than the rears. This is a result of the toes being backed but the adjacent hoof wall areas not being adjusted as well. The breakover of the front feet has been shifted away from the true center of the leg, resulting in hoof capsules that are quite twisted. The unevenly run forward heelsare compounding this issue. It appears as if the feet are being trimmed to artificially face straight ahead even tho the legs do not. This is putting quite a bit of torque onto the joints.

RF/LF xrays: Purple line shows where the bony column alignment should be. Pink are the areas where is breaks back at P1-P2 juncture and forward at P2-P3. Purple arrow shows the shadow of the bars arching high under, and jamming, the wings of the coffin bone - need to lower both the heels and bars here to reduce the forward push on the P2-P3 juncture. Blue line follows the angle of the tight, new wall growth. Green is where the toe need to be backed in the horizontal plane and beveled gently under. Yellow 1 is where the coronary band is, yellow 2 is the extensor process. These two lines should coincide or be very close together. The distance between them denotes the sinking.

LF lateral: Green line follows the angle of the new growth. Gray is the excess toe and heel "erased" for an idea how it would look. Red is the DO NOT TOUCH HERE area on the bottom of the foot. Lowering the heels only means that this are needs to be left alone to protect the already thin sole under the leading edge of the coffin bone.The resulting hoof capsule will look a bit odd but that is what happens during rehab. If you trim following the current angle of the bottom of the foot in relation to the ground you don't make any corrective change. (RF same idea).

LF dorsal: Dark blue line is level. light blue are the bulges to either side of the center of the hoof that are due to the excess length in the hoof wall on either side of the area that has been trimmed back at the center of the toe. Purple are the flared, excess areas that are causing the bulges. Bring these back into their correct place adjacent to the backed toe area. The medial wall has actually collapsed in and then flared, resulting in the lateral wall now being functionally taller.

LF sole: Light blue is where the heel buttresses are currently located. Yellow is where they should be, even with the widest part of the frog and with each other. Need to move them gradually backward to their true location and reduce the overgrown bars at the same time. No bar amputation, just judicious taming over time as they are providing crucial support to the coffin bone due to the damage to the laminar connections. Red is the location of the true tip of the frog - anything beyond that is only stretched-forward old frog material that is moving along with the long toes and stretched sole like pieces on a conveyor belt. Light purple is where the outer perimeter of the hoof wall should be - needs to be brought inward by rasping from above. (RF sole same).

RH sole: Same as LF sole mark-up but note that the lateral buttress is further forward than the medial one. Need to work to get it back even with the medial one.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team

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