Re: Strawberry new rads :( (Currently in extreme discomfort)


Lavinia Fiscaletti
 

Hi Nicole,

I've added a couple of mark-ups to Strawberry's album:

https://ecir.groups.io/g/CaseHistory/album?id=267559

As I mentioned before, the biggest thing is to get the toes backed up. This will require backing thru what may look like the "white line" at ground level. Need to leave the rest of the sole alone. Frogs and bars also need to be left alone, at least for this round, as the bony column alignment is fine but the sole depth is not. There is capsular rotation, which is the laminar wedge pushing the hoof capsule away from a tight alignment with the bony column. This needs to be addressed thru the trim. There is also sinking, which is contributing to the compromised sole depth. Once the underlying causes of the laminitis are removed (high insulin), then the lamina will stop being assaulted and can start to heal. Setting the trim up to support that mechanically is another important step. Have a read here for more info:

https://www.hoofrehab.com/Breakover.html

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

https://www.hoofrehab.com/HorsesSole.html

https://www.hoofrehab.com/FrogTrim.html

RF lateral composite: On the radiograph side, the pink line shows the bony column alignment and stops at ground level where the breakover should be. There should be no hoof capsule touching the ground beyond this point. There is barely adequate sole depth, so not a millimeter to spare. Green line follows the angle of the new growth coming in under the coronary band toward the ground and indicates where the dorsal wall should be, if it was well attached and there was no laminar wedge. This is a visual marker, not a trim line. Blue line at the toe shows where the toe should end, with the blue X being the excess horizontal length at ground level. Red line indicates that NOTHING should be removed from the bottom of the foot behind the blue line. Yellow line #1 runs thru the coronary band, #2 points to the extensor process. The distance between them indicates the amount of sinking.
On the photo side, the green line is the same as the one on the rad. The blue area corresponds to the blue X on the rad. Red line means nothing off the bottom o the foot. Orange line shows where the heels should line up eventually, once they are no longer underrun.

LF lateral radiograph: Same general discussion as the RF except that here, the sole is thin so really need to preserve every millimeter that exists, This means no removal of anything behind the blue line, even if it appears to be exfoliating or appears lumpy.

Strawberry should be in boots and pads at all times until she is comfortable without. Which pads to use depends on what makes her comfortable. If a pad squishes down and conforms to all the crevices;collateral grooves in her foot, leave that pad and just add another one underneath that one to increase the cushioning benefits. You want the pads to support the contours of the foot to be the most effective.

--
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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