Based on the latest rads, DO NOT put any wedges onto her boots (or in any other way). Her bony column alignment is good, with no bony column rotation. It's her trim that is deteriorating, with the toes are being allowed to get further and further out ahead of where they belong. The sole depth has decreased, likely because there is sole being taken off during trims. She has sinking but it doesn't appear to have changed much since at least Feb 2021, based on the rads. She has some medio-lateral imbalances (laterally high RF, medially high LF) which again, have been present in all the rads.
Her insulin and glucose results in June had her in the diabetic range, with an insulin over 200uIU/ml and glucose at 177mg/dL. That insulin level is the driving force behind her foot pain, with the increasingly poor mechanics exacerbating the situation. Getting that insulin down is what will stop the ongoing pain.
If you can get me a full set of photos today, I can get you some mark-ups for the trim on Friday. She doesn't need to pick up her feet to get the toes backed up: you can stand each hoof on a 2x4, with the toe hanging over the edge to back up the toe; stand her in deeper footing (like sand or thick bedding), then rasp right thru the sand/shavings to back up the toes. Also can address the M-L imbalance the same way. There's nothing that needs to be done to the bottoms of her feet right now, except to leave them alone.
Use padded boots with level pads in them, NOT a wedge.
Hang in there.
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI