Eleanor Kellon, VMD
That report brought tears to my eyes. The bullnose right front is chronic but I'm sure if the other hoof changes were present then she would have noted it. The other changes I noted on RF are chronic too. It's amazing he has been comfortable with a fragmented sesamoid bone but that's very chronic too and my best guess without being able to see the horse is that it is indeed his feet but I doubt it's laminitis. By all means test insulin and ACTH but my first suspicion is still white line disease and very poor horn/lamellar quality.
He appears to have medial/lateral imbalance but there is so little hoof to work with you really can't correct that. I'm suspicious of a collateral ligament rupture on the RF at the coffin joint because the joint space is not even from side to side.
IMO he needs:
- a protein correct, mineral balanced diet based on hay and/or pasture analysis
- weightbearing taken off the hoof wall all the way around https://hoofrehab.com/DistalDescent.htm
- put him in casts with pad and dental impression material underneath
Any chance you can get that original examining vet to evaluate him now?
Eleanor in PA