Re: Saraphina new rads, help Lavinia


Lavinia Fiscaletti
 

Hi Cyndi,

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

https://ecir.groups.io/g/CaseHistory/album?id=266150

The last trim made a good start on getting the toe backed up but there's still more to come off. Her heels need to be lowered as well so that the bony column rotation is corrected.  Absolutely NO touching of her soles for any reason. Also nothing off her frogs. Only take bar off if it ends up extending beyond the wall/heel height, in which case lower them just enough to be a few millimeters below the wall height. LF shows flaring in the walls , which should be removed and her walls should be beveled so she isn't standing only on the walls.

RF dorsal composite: on the radiograph, the green lines follow the walls down toward the ground. Solid blue areas are where the flaring is.The yellow lines are the bottoms of the walls - which are partially hidden by the block she was standing on as the rad was shot thru the block.  Blue Xs are where to bevel the walls off the ground. The red arrows point to a few of the lines that run across the entire toe area. These are part of the laminar wedge, which has a somewhat spaghetti-like look.
On the photo, the green lines are the same as on the radiograph. The solid blue areas are the flared material that can be beveled off. t\The light colored arrows point to some of the spaghetti-like laminar wedge material.

RF lateral composite: On the rad, the green line is a visual (NOT a trim line) as to where the dorsal wall would be if the hoof capsule were correctly aligned. The pink line follows the bony column alignment and ends on the ground where the breakover should be - which shows that her soles are too thin right now as the line ends below where her actual sole depth does. Purple line follows the actual bony column alignment - see how the tip of the coffin bone dips down away from the pink line, due to the bony column rotation that is present. The solid blue line at the toe is where to back the toe to, with the blue Xs marking the excess material that can be removed.. The red line, which stretches from the breakover point back to about mid-foot, is the DO NOT TOUCH area along the bottom. The dashed yellow line is where the actual bottom of the foot is now - again, the rad was shot thru the block, so makes seeing the lower part of the hoof capsule difficult to see.The lime line is where to lower the heels from the mid-line of the foot back to correct the bony column rotation. When you are done, the bottom of the foot won't be flat like it would if a shoe was being applied - which may be odd looking but is what is needed right now. Yellow line #1 runs thru the coronary band, yellow line #2 points to the extensor process. The distance between them denotes the amount of sinking.
On the photo, the lines and Xs correlate to the same ones on the radiograph.

LF lateral composite: Same general concept as the RF. Back the toe to the blue line, lower the heels along the lime line. Again, leave the soles, frogs alone.

LF sole: Solid blue line corresponds to the blue line on the rad and the lateral hoof photo. Blue hashed areas are the material that needs to be removed: back the toe, lower the heels, bevel the flared, detached wall out of weight bearing. Don't touch anything inside the solid blue line.

Great news that she is moving better. Experiment with boots and pads to find what makes her the most comfortable. Any boot she wears should have an aggressive bevel added to the treads at both the toes from 10-2  and across the backs of the heels.

You need to take her of the Equioxx as she is on Gastrogard due to suspected ulcers. All NSAIDs are going to exacerbate ulcers, plus combining the Gastrogard with an NSAID is doubly dangerous.

--
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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