I've added a comparison of X-rays for Ford (severe IR) from 6/2015 and 1/2016 in his folder on Echistory 8. He's doing much better than last June, but his sole depth still is not good (he has lost sole depth in one foot). I've added pea gravel in the past couple of weeks, hoping that will help. Here is the information I received from the vet clinic. I'm hoping Lavinia and/or Dr. Kellon will have some thoughts on his progress/suggestions for the future. He is on a balanced diet and I'm able to ride him a couple of times a week.

"Talked to the Dr. about the Xrays on Ford and he agrees on the fact that he looks really good.
Alignment in general is really good and balanced in both lateral and DP view.
On LEFT foot the measurements are:
* Sole depth: 7.7 mm
*Digital Breakover: 29 mm
*Horn-Lamellar zone: 19.08 mm / 19.48 mm
*Palmar angle: 4 degrees

Some comments: Ford has mild arthritis in the coffin joint and pedal osteitis on tip of the coffin bone but he said that looks chronic and a lot of older horses have it and do not cause problems.

On the RIGHT measurements are:
* Sole depth: 79 mm
*Digital Breakover: 29.23 mm
*Horn-Lamellar zone: 18 mm / 19 mm
*Palmar angle: 4 degrees
Also some pedal osteitis but chronic the enlarged vessel canal can be due to the chronic pedal osteitis.

He said than even if the lamina looked inflamed and more radio-opaque since ford looks comfortable he is not concerned.

The trimming has had a positive change (I FIRED MY FARRIER AND HIRED A TRIMMER). X-rays look better and angles are good. The only area of concern would be the sole depth. He still has really thin soles, so that's the reason he is sore when he steps over rocks. We think that the boots will help him providing some extra "cushion" when he walks over rocks (I ASKED ABOUT WHETHER HE SHOULD WEAR BOOTS WHEN RIDDEN). Sometimes, and I know is not your ideal plan, we have to put the horses with thin soles on shoes, at least for a while to help them grow some sole."

Yeah - that's not happening (shoes). I look forward to your comments/suggestions.

Fran and Ford in Texas
7/2005

ECHistory8

 

https://groups.yahoo.com/neo/groups/echistory8/files/Ford%20Case%20History/

I'll let Lavinia speak for herself, but she will probably ask for photos too.

I think you are making good progress. I look more at ground clearance ( = sole tissue + concavity) rather than "sole depth" since sole depth means different things to different people.  Anyway, ground clearance is definitely improving.  Images are too small for viewing some details but I'm assuming the reason for the coffin joint arthritis comment is the increased joint space/fluid, more obvious on the left, but some of that may be from distal descent/"sinking".

One thing I would suggest is that because you still have some dishing to the hoof wall might try bringing the bevel on the toe back a bit more so that it is begins under the tip of P3.

http://www.thelaminitissite.org/uploads/8/1/1/4/8114761/8685446_orig.jpg

 

http://www.thelaminitissite.org/uploads/8/1/1/4/8114761/156395_orig.jpg

 

You're already close but could come back a bit more.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001

Thank you, Dr. Kellon. I just uploaded the full-size x-rays in his file for better viewing.

Fran and Ford in Texas
7/2005

ECHistory8

 

Hi Fran

Definitely see good progress being made. Very helpful that the dorsal wall/coronary band was marked. It highlights that there is some sinking, which would contribute to difficulty in getting more sole depth. The pea gravel will be a bonus for him. Although I'm not a fan of shoes in general, sometimes when thin soles are a problem and the trim is good, a couple of rounds of a well-placed composite shoe with appropriate packing can make the difference in getting over that last hump. They are a tool in the toolbox but need the trim itself to be (and remain) correct first and foremost. Can also try boots with a gel-type pad. Remember that when using boots, the breakover needs to be in the right place - most styles will need to have that rasped into the boot to be correct as out-of-the-box they are too far forward. The goal of boots/pads and shoes/packing are to replicate the pressure-and-release cycle on the sole that leads to better internal mechanics.

Where are his heels now, in relation to the widest part of the frog? The coffin bones are a tad more ground parallel than would be ideal but again, the sinking is playing a part in this. Because there is still a bit of dish to the dorsal wall, would suggest that the toe come back a bit more and the bevel/mustang roll start under the tip of the CB to really ease the break over forces.

I've uploaded photos of Ford's feet taken yesterday. These were taken just before putting on glue-on shoes. Looking forward to hearing your comments.

Fran and Ford in Texas
7/2005

ECHistory8

 

Yahoo! Groups

 

Hi Fran,

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

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1214900120

Overall, there's been good progress made in getting the huge flares under control and the toes and heels backed into better positions. The orientation of the coffin bone is not quite as flat as it was due to the heels being moved into a more supportive position under the bony column. Soles are still thin, toes still too far out in front which are interfering with the efforts to gain more sole depth. It looks like the medial-lateral balance on the LF may have been a tad off, with the medial side a bit taller. Know that you had recently introduced pea gravel - the positive effects can be seen in the way the soles are exfoliating and there is generally more definition to the underside. This in turn is highlighting just how over-exuberant those bars still are.

LF lateral xray: The two yellow lines denote some sinking that is present - (1) is the coronary band and (2) is the extensor process. These two points should align or at least be close together. The distance between them denotes that there is some distal descent, so the bony column is sitting deeper inside the hoof capsule than is optimal. Blue line is the bony column alignment - note how the axis slightly broken back. The sinking and out-of-position heels are both contributing factors. Purple is where the CB wants/needs to break over in motion. Green is where the toe needs to come back to and get a strong bevel. RF is generally the same but med-lat balance appears ok.

LF lateral: Green line highlights that the toe is still a tad too far out in front.

RF sole: Got into the big box of crayolas here - hope it isn't too confusing. Green is where the entire hoof capsule needs to come in to - toes back, separating walls in. The built-up, crumbling sole at the toe, which covers the white line, is a RED FLAG that the toe is still too long. Yellow is where the heel buttresses need to be, just a bit further back than they currently reside. Blue circles are where the wall-bar juncture appears to be. Follow the blue arrows to see where it actually is, at the yellow "V" adjacent to the buttresses. Need to concentrate on gently opening this area up by removing the overgrown bar material that is crowding everything else and pushing all the structures to the outside. Purple is the overgrown bars that are leaning and pooling and making a general nuisance of themselves. Exfoliate the cracking, peeling material, esp on the top leading edge of those bars, to gain control of them over time. This will encourage them to stand straighter, allowing the heels to remain upright and centered under the bony column where they belong. Red is the true tip of the frog.

As I said before, there have been a lot of the right things happening. Many times it's the final stages, when things start getting close, that make feet pros get jittery cuz in their heart of hearts there is still that little voice that does the Mr. Bill "Oohh, Nooo!" thing. The knee-jerk reaction is to think you can't possibly back that toe anymore unless there is going to be a shoe added. Trouble is, shoes are only a band-aid when applied to a less-than-perfect trim as they will magnify the negative aspects while temporarily masking the detrimental effects. That's not to say that at times, a well-placed composite shoe cannot be a helpful bridge for a horse in need of that extra bit of support and comfort. Just that it cannot replace the necessary correct trim basics.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team

Thank you so much for your very detailed markups and explanation, Lavinia. The trimmer is coming again tomorrow and I have passed on these suggestions to her. How many of these changes can likely be made in one trim? I realize each horse is different, but I want to help encourage the trimmer in making the most progress each time she trims.

Thank you again for your guidance!

Fran and Ford in Texas
7/2005

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1214900120

 

Hi Fran,

Any necessary backing of the toe and bringing in the flaring all around should be fine as things are really close to where they need to be. Each time there is a trim, sneak the heel buttresses back a bit more with a swipe over them so as not to lose any more height than is absolutely unavoidable. Slivering the heel-bar juncture further back each time is also OK. Work the outer edge of the bars moving inward, without going too deep but removing anything that is flaking/cracked/loose.

Thank you, Lavinia.

The glue-ons were on for 4 weeks. When the trimmer removed them, the bars were flaking off on their own like crazy, which was lovely to see. It was too wet to glue on more shoes, but the trimmer felt Ford had made good progress and thought it would be good to see how he did without them (and glue them back on later if needed). He seemed to do ok at first, but today he is very lame. I expected it to be from something going on in the front feet, but it appears that it could be a back foot (or leg). I was able to get sole shots of both fronts. I also took lateral views, but they are sub-optimal due to light, position, and uneven ground (I didn't want to move him). I'll post in his folder.

Fran and Ford in Texas
7/2005

ECHistory8

 

Hi Fran,

The wet may be a factor in his being sore today - with the show removal and then the wet conditions, hooves likely absorbed a lot of moisture and got softer quickly so not a s supportive as they were. Plus, with removal of flaking material there was some loss of the barrier between live sole and ground, along with the shoe removal so a double whammy.

Put him in boots/pads and see how he feels.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team

Thanks, Lavinia. Will do. I just posted photos.

Fran and Ford in Texas
7/2005

ECHistory8

 

Hi Fran,

Just added mark-ups to Ford's album:

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1214900120

Lots of progress has been made since the start of this rehab   Now you need to build on that so things do not remain "status quo". When the shoes were going to be applied last time, the trimmer did a good job in backing the toes. Need to do the same thing every time there is a trim, not only when the shoes are going on. I know this has been a bit of a sticking point.