Hoof radiographs uploaded


Stephanie Stout
 

Hi All, 

I got an x-ray of King's front right hoof this morning since he has been very sore on it recently. I would love your corrections/thoughts on what you see besides significant rotation - I have the farrier coming out ASAP to do some correctional work. Besides taking off a significant amount of toe(he is 2 weeks past due right now since he was too sore to reset his shoes before), what angles would you change? Is there a specific shoe you would put him in? He must have shoes and pads on, unfortunately. The vet wants to remove toe, and take down his heel significantly(about 4 - 5 degrees) and then put him in wedge pads and slowly reduce the wedge every couple weeks. He has significant tendon damage so it also makes it challenging. Do you agree? 

I took a picture of the x-rays off my phone so sorry about the reflection on the photos. They are suppose to send me a JPEG copy so I can post that here when I get it. (I posted 2 different pictures of the same x-ray so hopefully one will work for you guys to see) Have you seen stress fractures of the P3 like this before? (Please say yes!!) 

https://ecir.groups.io/g/CaseHistory/album?id=1402

Thank you very much. 

--
Stephanie & King
October 2014
Oregon
Case History 


Eleanor Kellon, VMD
 

He has advanced ringbone and arthritis of the coffin joint.  No P3 fracture suspicious on this view - and cannot diagnose them on this view anyway.
--

Eleanor in PA

www.drkellon.com

EC Owner 2001


Stephanie Stout
 

Hi Dr. Kellon,

Thank you very much for looking at his x-ray! What do I do for the ringbone? Do you agree with the vet's instructions to reduce dorsal hoof(toe), and lower the heel(then shoe with pad wedges to slowly realign)? Or not? The vet isn't very experienced in dealing with hoof issues. Is there anything I can give him to help? 

The vet recommended that I start him on Previcox, 1/2 of a 227mg tab per day, for his pain but I'm hesitant since I know that Previcox can damage hoof growth, and can cause more IR issues since it is an NSAID(correct?). He is hobbling around but in very good spirits. Do you think I should give Previcox, or is there something else for pain that I can give him that is safer/more effective?

King and I say thank you very much for all your help. I can't imagine what I would do without your advice. 

--
Stephanie & King
October 2014
Oregon
Case History 


Eleanor Kellon, VMD
 

I think your vet's plan is reasonable, although the wedging and gradual lowering (at each shoeing interval) doesn't always work.  Agree with the stated trim goals.  I've seen ringbone be remodeled after correct hoof form is in place but the changes in the coffin joint are likely permanent.  That dose of Previcox is too high.  Should be half that.  NSAIDs have the potential to interfere with bone healing and circulation but have no effect on IR.  All things considered I'd say he is a candidate for Previcox but you could also try high dose Devil's Claw instead.  I'd combine that with 200 mg/day hyaluronic acid.  The coffin joint changes aren't going to stabilize though until those heels come down and no wedging.
--

Eleanor in PA

www.drkellon.com

EC Owner 2001


Stephanie Stout
 

Is there a specific reason why gradual lowering by slowly lowering the wedges at each reset doesn't work? The vet also said that she would like King in Natural Balance shoes with the wedge pads - agree or disagree? Would you reset every 4 weeks? 

Where would I get the Devil's Claw that is IR safe? I know the local feed store has BL Solution/Bute-Less that has Devil's Claw but it also has Yucca in it. Should I give both Previcox and Devil's Claw at the same time? Where would I get pure H/A also? Also, he is on J-herb, and ALCAR so should I take him off the herbs? 

On the film, the tip of his P3 has 2-3 'tips' instead of one solid point. What are those different tips? Is that arthritis?

Thank you so very much. I will post the actual x-ray image when I get it so it's clearer to see. 
--
Stephanie & King
October 2014
Oregon
Case History 


Stephanie Stout
 

I just uploaded the x-ray image from the vet to his photo folder with the vet's marks on what to trim off. It is much clearer than my cell phone pictures. Thank you again. 

https://ecir.groups.io/g/CaseHistory/album?id=1402

--
Stephanie & King
October 2014
Oregon
Case History 


Eleanor Kellon, VMD
 

On Fri, Jul 29, 2016 at 03:40 pm, Stephanie Stout wrote:

Is there a specific reason why gradual lowering by slowly lowering the wedges at each reset doesn't work?

If the heels have been high for a prolonged period, especially if there is also pain involved, the tendon-muscle unit is often shortened.  When you add injury and possible scarring it's even more complicated.  Shaving a bit off the heels every few days may be easier for the horse to take than a 3 to 5 degree change every 4 to 6 weeks, although honestly there is no guarantee that would work either.

The vet also said that she would like King in Natural Balance shoes with the wedge pads - agree or disagree? Would you reset every 4 weeks? 

There is a lot we don't know about his feet and haven't even seen photos from all angles so I don't feel comfortable saying much beyond general principles.  Why does he need pads and shoes?  Has he always had long upright feet?  Any abscessing?  What is the nature of the tendon injury?  Why was he so lame recently?  A natural balance shoe without a natural balance trim is not helpful.  The heels have to come down to a normal height and P3 in about a 5 degree angle with the ground before that system can be effective.

Where would I get the Devil's Claw that is IR safe? I know the local feed store has BL Solution/Bute-Less that has Devil's Claw but it also has Yucca in it.

Phyto-Quench is now Devil's Claw based.

Should I give both Previcox and Devil's Claw at the same time?

No.

Where would I get pure H/A also?

You were getting it from My Best Horse before.

Also, he is on J-herb, and ALCAR so should I take him off the herbs? 

Jiaogulan won't work with Previcox.  The ALCar is for neuropathic pain and can be continued.

On the film, the tip of his P3 has 2-3 'tips' instead of one solid point. What are those different tips? Is that arthritis?

Movement artifact and/or remodeling. Arthritis occurs at joints.


 
--

Eleanor in PA

www.drkellon.com

EC Owner 2001


Eleanor Kellon, VMD
 

Toe is good but heels eventually have to be much lower if possible.
--

Eleanor in PA

www.drkellon.com

EC Owner 2001


Stephanie Stout
 

Thank you for looking, Dr. Kellon. Would you also recommend Natural Balance shoes for him? The farrier is coming on Tuesday to reset, and start the process. 

I will get some HA from My Best Horse since it looks to be pure HA. Where do I get the Devil's Claw? I did give him 1/4 Previcox this morning until I can get the Devil's Claw and get his shoes/angles reset. 

What are the multiple points on the very tip of his P3? Is that arthritis/ringbone or ?

Thank you again so much. 

--
Stephanie & King
October 2014
Oregon
Case History