Relevante Trim


Lavinia Fiscaletti
 
Edited

Hi Lynn,

I've added mark-ups to Relevante's album:

https://ecir.groups.io/g/CaseHistory/album?id=36909&p=pcreated,,,50,2,50,0

First, thanks for getting new radiographs as it's been a year since we last looked inside. As it turns out, it was extremely lucky that you were able to include ones of the hind feet as well as the fronts. Rads show that the front feet are hugely improved, really only needing some minor tweaks to get them as optimal as they can be. There's still pastern arthritis present in all four legs but it hasn't progressed. Still battling thinner than ideal sole depth and underrun heels all around but Relevante is now moving soundly so that's huge.

The hinds rads show some serious issues that no one had any idea were present. The only hint that something might be amiss is that the fetlocks appear to be thicker than you would expect, but that could also be just be the way they appear in the photos. Unfortunately, the bony column alignment is totally out of whack and is putting a huge amount of strain on the tendons/ligaments. So now, we need to shift the focus to alleviating these issues using the same techniques you were applying to get the fronts back into shape. The current trim on the hinds is already really close as your farrier has been carrying over the same work he's been doing on the fronts. Unfortunately, there were hidden issues that needed even more specific attention. The HPAs are severely broken back so will need to add more height to the back half of the hoof capsule to help support everything inside and assist in pushing it back up into the correct position. While the trim is taking shape, using wedge pads with frog support inside of the hoof boots will help (know you've already gotten this part in place).

LF lateral composite: On the rad, the pink line follows the bony column alignment to the ground. Although there is less sole depth than would be optimal, the toe length just needs a bit stronger bevel at ground level (blue line). Red line indicates where the bottom of the hoof should be if everything was ideal. On the picture side, the blue area corresponds to the blue line on the rad. Orange line shows where the heels should be to provide the most support.

Front dorsals: Both front feet are high laterally. Pink lines are level while the yellow lines show what is currently happening. Need to lower the lateral walls to get the medio-lateral balance corrected. Have a read here for more in-depth info:Z

http://www.hoofrehab.com/Balance.html

LF sole: Blue hashed area in the toe is where to add the bevel. Blue hashed area along the lateral wall is where to address the excess lateral wall height. Yellow hashes along the bars point to the need to lightly remove the cracking, crumbling material as it is ready to let go. Blue areas at the back of the heels are overgrown frog/periople that is detaching from where it was covering the heels and can be trimmed off.

RF lateral composite: Same general idea as the LF, except that the HPA is still slightly broken back. This means really watch that no heel height is removed while working to get the heels to stand up straighter to provide better overall support. Orange line on the picture side is where to add the ramp/bevel to the back of the current heel buttresses to help those heels stand up more. Also have a read here for specifics:

http://www.hoofrehab.com/HeelHeight.html

RF sole: Same idea as the LF.

LH lateral composite: On the rad, the pink line shows how the pastern bones should line up, while the purple line follows where they actually do. The HPA is severely broken back, with the weight of the horse squishing down behind the coffin bone. This has displaced the digital cushion out behind instead of under the horse, the heel bulbs have leaned back and been crushed under. All Support for the bony column is behind, rather than under it. The yellow dotted line is an idea of where the back of the heel bulbs would be if everything was neatly tucked in where it belongs. Red line shows where the bottom of the foot needs to be for appropriate sole depth heel height. Blue line is where the toe needs to be beveled under - not a lot of excess toe length but every little bit matters right now. Lime arrow indicates the need for the entire bony column to be lifted up and into its proper orientation. Imagine if you attached a string to the front of the P2-P3 joint (like a Marionette) then lifted. As we can't do that, we need to place support underneath to help realign everything until the soft structures in the back of the foot can be coaxed back in where they belong.
On the picture, the blue area corresponds to the blue line on the rad. Orange line is where to add the ramp on the heels.

LH dorsal: Laterally high, same as the fronts.

LH sole: Blue hashed area at the toe corresponds to the blue on the lateral photo. Bevel this under to help bring the breakover back further. Blue hashed areas on the outer edge of each heel buttress are where to bevel the wall inward.Orange areas are where to add the bevels on the backs and sides of the heels.

RH lateral composite: The angle of the rad is not a true lateral as it was shot somewhat from below the hoof, aiming upward (you can see part of the sole). Otherwise, same discussion here as for the LH.

RH dorsal: This one is medially high so need to lower that medial wall slightly.

RH sole: Same idea as the LH: bevel the toe under, rocker the backs of the heel buttresses while maintaining their current location and height.

If possible, ask your farrier to slightly shave the very outer perimeter of the pads so that the hoof wall is unloaded, esp. in the heels. That way, the heels can relax more while the weight bearing is concentrated onĀ  the sole, bars, frogs. Mark the boots left and right so that they don't get switched once you do this.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR

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