Lavinia, Could you review my new Xrays and Pictures we took yesterday 11/2/18 ?


Heidi Wright
 

Hi Lavinia,

Here are the updated xrays and pics from yesterday.  Could you take a look and let me know your thoughts?  I am happy that it looks like more sole is growing.  I know toes need to come back further but I had been concerned about doing that because I thought the tip of the coffin bone was so close to protruding on the LF, but I think it's possible that more sole has grown, which is great.

What is the best way to bring the toes back?  Rasp from underneath or above?
Have we corrected the bony column rotation? 
Should I bring the heels down more on the LF?    
How do I measure the palmar angle of the coffin bones?  Are we striving for 5%?

I might be wrong, but somehow I am feeling a little optimistic that we are moving in the right direction!

--
Heidi Wright
joined Aug 15, 2018
5130 State Route 38
Malta, IL  60150
815-761-2341

https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Skyler 

https://ecir.groups.io/g/CaseHistory/album?id=69604


Lavinia Fiscaletti
 
Edited

I see the latest rads but no hoof pix.

Definitely some increase in the LF sole depth - good.

Looks like the the dorsal wall on both has been thinned so the thickness of the laminar wedge has been reduced but no real change in the toe length at ground level. Need to actually shorten the horizontal length of the foot at ground level so that the breakover moves back.

The LF still has the same amount of slight bony column rotation - no change there - so yes, the heels need to be lowered slightly. But only the heels, leave the rest of the bottom of tat foot alone. Bringing the toe back correctly never makes the sole thinner - it will only help increase the sole depth.

There are two dark lines on the RF  - one in the dorsal wall, the second in the sole, running horizontally just below and ahead of the tip of the coffin bone. These may be air pockets or possible abscess tracks. The sole one has increased in size from what was present on the 10-2018 rads.

Never mind about what the measurement of the palmer angle is - the correct angle is whatever it takes for the bony column to be correctly aligned in that particular horse's case. In general, that ballpark number is 3-5 degrees.

You should definitely be optimistic :)

I can get you some mark-ups if you please post a full set of hoof pix for all four feet. Check here for what's needed:

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


Eleanor Kellon, VMD
 

This photo album is a good one for everyone to review.

The films from February are before laminitis. Notice the distance from the edge of the bone to the hoof wall on the lateral/side view.  This is the horn lamellar zone.  Look how much it has increased on the later films.  The dark line inside that area, parallel to the bone, on the October and Nov films is the junction between the hoof wall and the laminar wedge.  The laminar wedge is all that material between the bone and the hoof wall.  If you look at the sole view of the RF from 9-10, the last photo, it looks like you can't take the toe back any further but the radiographs show that's not the case. Under that dead sole at the toe is lamellar wedge, not live tissue.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Heidi Wright
 

Thank you for that feedback Lavinia.  My hoof pic upload must have failed, so am uploading dorsal and lateral views right now.   I didn't get sole plane but will get those tomorrow.  

Yes, the first farrier that worked on him thought "bevel" meant thin dorsal wall.  I started bringing the toe back this morning and noticed the wedge material is pinkish/reddish, like stained with blood.  Is that normal?  And do I need to do just a little at a time on the toe or can I go for it in one session?

My plan was to take a little off the LF heel every few days.  At what point should I get a fresh set of xrays?

Thanks much.

Heidi



He is moving well now but I can tell he is still sore as he gets uncomfortable when I trim him and he has to weight one front leg.  I would be interested in the team's thoughts on when it would be useful to hand walk him,  Given he has obvious gaps in his hoof wall and possible abscess spots, should I wait till that part of the hoof has grown out before walking even though he is walking sound?


Heidi Wright
joined Aug 15, 2018
5130 State Route 38
Malta, IL  60150
815-761-2341

https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Skyler 

https://ecir.groups.io/g/CaseHistory/album?id=69604