On Wed, Nov 7, 2018 at 09:16 PM,
Lavinia Fiscaletti wrote:
1. Getting the toes backed up will start the process of developing more sole depth.
2. Make sure there is a substantial bevel added to the treads of any boots she wears, both at the toe and at the heels as there are NO boots made that have enough of a bevel on them right out of the box.

Lavinia, can you explain #1 and how that works to grow more sole and also how to apply the bevels to the boots?  From the topside or from underneath?  I need to do this to Sadie's boots as well.  Thanks

 

--
June
Oregon, USA
Oct 2012
Case Histories for Sadie and Chip
Sadie's Photos 
Chip's Photos 
Ω

Hi Patty,

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

https://ecir.groups.io/g/CaseHistory/album?id=27571&p=pcreated,,,20,2,0,0

The biggest issue is that all the toes are too long horizontally at ground level. Her heels are underrun, with the frogs elongated, narrow and atrophied. There is only a bit of minor wall flaring, which seems to have had bevels added that are taking those areas out of weight bearing - great. The Oct 2017 radiographs show that the toes were much too long at that time, soles were thin and the RF was showing some sinking and it doesn't appear as if there has been any real change in the situation since then. The goal needs to be to get control of the toe length so that the breakover gets set in the correct place. For now, you are going to need to leave the underrun heels where they are as there isn't any vertical height to work with to move them without making the coffin bone become more ground parallel than it should be. Getting the toes backed up will start the process of developing more sole depth. All of the central sulci are much deeper than they should be - in part because of the underrun heels that are dragging the heel bulbs down and forward - and are open up into the live tissues of the heel bulbs. Doing weekly soaks with 50/50 apple cider vinegar+water and then applying a mixture of triple antibiotic cream that contains the pain relief ingredient + anti-fungal foot cream (generic varieties are inexpensive)

LF dorsal: The green line follows the angle of the new growth toward the ground.The area in blue is the slightly flared wall that can be brought in ward in the lower 1/3 so that the damaged material is actually being removed.

LF lateral: Green line follows the angle of the new, more tightly attached growth coming in under the coronary band. The blue area is the excess toe that needs to be removed so that the breakover is set at the point where the bony column needs it to be. The orange line is where the heels should be - note how much further forward they are. The green and orange lines are parallel and are also running at the same angle as the pastern above. Can't do anything about the heels at this time except to add a bevel/rocker to the very back of the current heel buttress to help ease the landing. Any attempt to bring them back now will lower the back half of the foot relative to the front half, thereby making the coffin bone sit flatter than her conformation needs it to be.

LF sole: Blue hashed area corresponds to the blue area on the lateral view and is the excess toe length that needs to be removed. This may appear to be backing thru the white line but in reality it is only removing stretched laminar connections - aka laminar wedge. The actual healthy white line is much further back. More info here:

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

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

Leave the soles, bars and frogs alone as they need to add depth and callous off. As you bring that toe back, the elongated tip of the frog will eventually shrivel up and can be nipped off. Finish the toe off with a bevel under/mustang roll so that she can breakover as easily as possible.

RF lateral: Same idea as the LF.

RF sole: Same as LF.

RH dorsal: The green lines are following the tighter new growth down toward the ground. You can see that the slightly flared walls have had the ground surface beveled to deflect forces. Just get a bit more aggressive in bringing the lower 1/3 of the wall itself inward to align with the better growth above.

RH lateral: Same excess toe length that needs to be backed up but the overall condition of the hoof capsule is healthier than in the fronts.

RH sole plane: The yellow circle encloses the really deep central sulcus - it should stop at the level of the sole, not continue up into the live tissue in the heel bulbs. Notice this is present in all four feet.

RH sole. Blue hashed area corresponds to the blue area on the lateral view = the excess toe length that needs to be removed. Again, although the heels are to far forward, leave them alone at this time as they are currently sitting to low relative to the front half of the foot.

LH lateral: Same discussion as the RH. Notice the slight convex curve of the dorsal wall and how steeply the coronary band drops off moving from front to back. This is a red flag for the likelihood that the coffin bone is sitting ground parallel or even negative plane. Also note how the horn tubules lie flatter as you move from the front to the back of the hoof capsule. They should be running parallel to the orange line, which is where the heels themselves should be.

LH sole: Same as RH.

Boots with pads in them should be used at all times to encourage her to land heel first. You will need to experiment to find which pads will make her the most comfortable. Adding a cushioned wedge pad temporarily to the hinds may help to compensate for the underrun, crushed heel situation. Make sure there is a substantial bevel added to the treads of any boots she wears, both at the toe and at the heels as there are NO boots made that have enough of a bevel on them right out of the box.

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team

Thanks for the update, Patty.

I'll wait for the added pix then do the mark-ups for you.

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team

Jaini, Thank you so much for taking a look at her hoof photos and commenting. You and Lavinnia have confirmed my suspicions and now I need to be a better advocate for Penny. The comments from you and others ie long toes/clown shoes/pulling on fingernails analogies are very helpful. I truly appreciate the help and support as I try to get all the pieces of DDT-E in place. 

--
Patty and Penny in Mazon, IL
Feb 2018

Case history: https://ecir.groups.io/g/CaseHistory/files/Patty%20and%20Penny   

 

 https://ecir.groups.io/g/CaseHistory/files/Patty%20and%20Penny

https://ecir.groups.io/g/CaseHistory/album?id=27571. 

 

Lavinia, thank you so much - my trimmer postponed until Thurs 11-8. I will take improved photos Tuesday AM when I have daylight (I work 12 hours tomorrow) and upload them asap, and share all your information. Thank you again. 
--
Patty and Penny in Mazon, IL
Feb 2018

Case history: https://ecir.groups.io/g/CaseHistory/files/Patty%20and%20Penny   

 

 https://ecir.groups.io/g/CaseHistory/files/Patty%20and%20Penny

https://ecir.groups.io/g/CaseHistory/album?id=27571. 

 

Hi, Patty - Penny certainly is lovely!  I am just adding my complete agreement with Lavinia. Not only are the toes still too long, they are much, much too long. X-rays on the next visits are strongly recommended, so that your trimmer can see that a ton of toe has to come off. 

I hate to say it, but  the trim "progress" since March (a full 7 months, which should be half a growth cycle) is not progressing, but seems even to be moving backward a bit. After 7 months, assuming all the triggers for the laminitis were removed, it should look like half of a normal hoof sitting inside the growing-out damaged area, kind of like a person wearing galoshes.  With the long toes and high heels, the new foot doesn't get to grow down very far before it is distorted by the mechanics of the trim, so, as Lavinia says, the problem is just perpetuating itself.

The proof of the pudding is in the eating. Might be time to find a new trimmer.
--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
ECIR mod/support  https://bit.ly/2MlAtPd  

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193.
https://ecir.groups.io/g/CaseHistory/album?id=39711

Hi Patty,

Yes, her toes are still too long. Her heels are underrun as well. Setting the breakover in the correct location needs to be done asap - the longer you wait, the longer the horse deals with ongoing damage that the lever forces from the too-long-toes create. Gradual removal of laminar wedge generally translates into "never happens" because the wedge just keeps growing, outpacing the conservative efforts to control it.

Extending the trim interval to 5 weeks at this time is a mistake IMO because the trim isn't anywhere near where it should be to put the horse on a maintenance trim interval.

I can get you mark-ups in time for Tues if you will get a few retakes of some needed shots and add the missing ones: need sole planes of both hinds, all laterals need to be true laterals - they are currently obliques, meaning the lens is aimed at an angle that is more forward of the side. Also, if you move a bit further away so that the shot is clear and includes the lower cannon bone and pastern that would be really helpful. Having her standing square is also needed otherwise the leg and pastern angles get distorted.

Check out this link for the specifics:

https://ecir.groups.io/g/main/wiki/Hoof-Related-Photo-Instructions

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team

I have been silently following since March (getting hay/diet balanced, increasing exercise as able) but now need help in assessing progress. My new trimmer (since March 2018) was recommended by a Pete Ramey graduate, so I have been trusting her judgement with the trims. Penny is still tender when out of boots for anywhere from 4-24 hours. She feels very good in her boots ( I alternate between Cavallos and Clouds) and she is gaiting more than ever in her dry lot and when I ride (30 min, no circle work, and I try to keep her at a walk, but she is full of energy). She is still overweight. I used the weight tape on her yesterday and was disappointed that she has gained weight since June ( I now realize I should have been using the weight tape more frequently). She is in a dry lot with a senior horse and a mini-donkey and they are getting a total of 22-23# pounds of grass hay 2 x daily for all 3 of them. My husband said he will try to modify our horse shed so we can separate the senior horse from Penny and the donkey so we can more accurately determine hay consumption. I am using Stabul 1 as a carrier and Calif Trace Plus, adding Vit E, ground flax, Mg, Iodine per balancer and sprinkling plain salt in water on hay. Will ask Vet for updated labs, she talked me out of labs and x-rays at last visit saying "You are doing everything right, so the tests won't change anything". I will be more assertive in future. I will work harder on the diet - how is her trim looking? Are her toes still too long? Will she always have barefoot tenderness because I was not knowledgeable the first time she had acute laminitis (2017-Dec) and I wasted a year of her recovery by using Heiro and every different horse shoe/pad my farrier could think of?  Trimmer says laminar wedge needs to be trimmed gradually. She recently increased trims from 4 to 5 weeks. Hoof photos and body shots from Oct 31 just added. Thank you so much in advance. You are all my heroes for all the help and support you give. 

--
Patty and Penny in Mazon, IL 
Feb 2018

Case history: https://ecir.groups.io/g/CaseHistory/files/Patty%20and%20Penny   

 

 https://ecir.groups.io/g/CaseHistory/files/Patty%20and%20Penny

https://ecir.groups.io/g/CaseHistory/album?id=27571.