Date
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New Hoof Photos Request for mark ups
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Lesley Bludworth
Lavinia, I need a private consult so I can pay you.
She was sore after I took the toes back. I soaked her yesterday in vetericyn hoof soak and that seemed to help. Ordered cleartrax to soak again. I am waiting for new cloud boots for the hind feet, I ordered the wrong size. The hinds are currently in gloves with 12 mm soft green pads. The sole and frogs have not been trimmed in anyway, the front frogs have fallen off while swimming and I put soft frog shaped pads in the frog area so the frogs are weightbearing while in the cloud boots. She is sore as you can see in the photos she will not stand square, I do not know if it is from the trim I did, abscesses, or because her insulin was up to 172 last week after I stopped soaking the hay, or maybe she got grass roots under the fence or some neighbor gave her a treat. I will have insulin checked again tomorrow. She is walking willingly in her turn out and we walk 10 min at the moment but she stops at times and her ears are back for most of the walk. -- Lesley Bludworth Phoenix, AZ 7/2022 Sophie TWH mare https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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Hi Lesley,
For the time being,it sounds like she prefers not to be walking.I'm thinking of her ears back and how sore she is. If she were here I would also go back to soaking hay,judging from what you have noticed. I know how frustrating this is. Seven of my herd of 9 (years ago)were PPID/IR. We just do the best we can with the information we have. We're lucky to have Lavinia . -- Lorna in Eastern Ontario 2002 |
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Lesley Bludworth
Thank you Lorna,
Yes, I am soaking the hay again and the blood work will look to see if that is enough or if she needs other medication. Lesley Bludworth Phoenix, AZ 7/2022 Sophie TWH mare https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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Hi Lesley,
Can you contact Lavinia privately to request the next round of markups? You can do that by replying to one of her posts, but choose "Private" (grey button next to the red "Discard" button below your message) and change the title of the message to reflect your request. Then hit "Reply to Sender" below your post to send your message. -- Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album Snickers' Case History Snickers' Photo Album |
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Lesley Bludworth
Kirsten,
I did do that last week per your instruction and I did not get a response so I tried it again this way. -- Lesley Bludworth Phoenix, AZ 7/2022 Sophie TWH mare https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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Hi Lesley,
Lavinia has you on her list and now has your Oct 16 photos and Oct 9 rads downloaded. When is your next trim date? Great job on taking clean pictures! -- Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album Snickers' Case History Snickers' Photo Album |
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Lesley Bludworth
Hi Kirsten,
Thanks ;) husband helping makes all the difference! Trimmer is coming Tuesday nov, 1st. Lavinia, contacted me. I think she put the date in her calendar. Got some cloud boots for Sophies hind feet and she is walking about a mile with ears mostly forward, visiting the other horses in the neighborhood. She is turing better with all 4 feet moving vs just walking her fronts around her hinds. I rasp a little at a time... her poor feet :( I'm hoping she can get more comfortable. Will do insulin test again Monday with hay soaked again. -- Lesley Bludworth Phoenix, AZ 7/2022 Sophie TWH mare https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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Lavinia Fiscaletti
Hi Lesley,
I've uploaded the mark-ups from Nov 1st into Sophie's album: https://ecir.groups.io/g/CaseHistory/album?id=277749 The pads are designed to conform to the bottom of the foot so that the load is distributed across the entire bottom of the foot: soles, frogs, walls. In a healthy foot, the sole, frog and bars are supposed to carry 85% to 90% of the load, with the walls taking the remaining 10% to 15%. When the laminar connections are compromised, the walls can't even support that amount, as they are detached from the coffin bone: they need to be removed from weight-bearing entirely until the hoof capsule has time to regrow with healthy attachments. It sounds as if things are working as they should in the fronts but that she is having issues behind. The rads are hard to interpret on the hinds because she wasn't weight-bearing on the LH when the view was taken. If she had been, it looks like her coffin bone may have been negative plane, which is not going to be comfortable for load-bearing at all. Both have heels that have run forward to where the heel buttresses are currently sitting almost at mid-foot. Fronts appear to have been in a similar situation but have improved to some degree.
Her toes have moved back a lot - GOOD! - but aren't quite there. In addition to backing them up, also bevel them from the bottom to creep the breakover back even further. All around flaring has improved substantially so keep at it until it is totally gone. All four show distal descent (aka sinking) and the fronts have some mild side bone developing. RF coffin bone has developed a bit of a ski tip. Soles are borderline to thin. Frogs are all elongated but appear to be responding to the trim and booting changes by becoming more robust. The elongated tips will release at some point - snip them off then.
Here are some links to more reading on these issues:
LF dorsal: Green lines follow the angle of the new, healthier growth down to the ground. Blue areas are the remaining flared material that can be removed. That "hairy-looking" material at the toe is damaged lamina that are residing in the "laminar wedge" that makes up the extended toe. Once you back thru all of that, you will be where the toe actually should end.
LF lateral radiograph: This foot wasn't loading squarely when the view was shot, which makes it more difficult to interpret as the relationship between the various structures changes with positioning. The coffin bone is ground parallel instead of sitting at a steeper angle. Green line follows the angle of the new growth toward the ground. Blue line show where the toe should end and how there should be a bevel under it, rather than being flat. Blue X is the excess toe. Red line denotes the need to leave the bottom of the foot alone as there is already too little sole . It slopes down as it moves toward the heels to show that more vertical height is needed in the back half of the foot, Orange line shows where the heels should be lining up. Yellow line #1 runs thru the coronary band, #2 points to the extensor process. The two lines should be adjacent - the distance between them denotes the amount of sinking.
LF lateral: Orange and green lines are the same as on the rad. Blue area corresponds to the blue X on the rad = the excess toe that needs to be removed.Pink line shows how the bony column should be lining up. Note that the green and orange lines are parallel to the pink line - which is what happens when the hoof capsule is sitting properly under the leg.
LF sole: Back the toe to the solid blue line. Blue hashed area corresponds to the blue X on the rads. Purple hashes run along the leading edges of the bars, which can be cleaned up until they are at sole level. Orange hashes are where to add rockers to the back of the current heel buttresses. Lime hashes are on the area of the frog that can be snipped off as it appears that this material has detached. Nothing else off the sole or frogs. Measure both collateral groove depths at their deepest points - looking for both to be the same and for that amount to be 1". If they're deeper, the heels can be lowered to the correct depth If not, leave the vertical height of the heels alone.
RF dorsal: Her stance is quite splayed, so hard to determine what is going on. Pink line follows the bony column alignment down thru the leg. Yellow line follows the coronary band. The two lines should meet at 90*, which they obviously don't. Whether this is due to the medial wall being taller is unclear but needs to be checked. The entire hoof capsule appears to be twisted slightly medially, which wasn't the case back in Sept. Slight flaring remains on the medial wall.
RF lateral rad: Similar discussion to the LF. Pink line shows the bony column alignment and stops where the sole should be and where the breakover should start. Orange line shows where the heels should be. Red denotes NOT to remove anything from the bottom of the foot, as there isn't enough there now.
RF lateral: Same idea as the LF. RF sole: Solid blue line is again where to take the toe back to. Orange hashes are where to rocker the backs of the current heel buttresses. Blue hashes along both walls in the heels mean that the walls need to be taken out of weight bearing in the buttresses while leaving the bars and rest of the buttress as is. This encourages the walls to relax down and back while preserving the vertical height. Nothing else off the bottom of the foot.
LH lateral rad: The foot was not load-bearing at the time of the view. But the HPA is still broken back - which means when it is weight-bearing, the coffin bone is likely negative plane: the back half is lower than the front half. That could be playing into her reluctance to stand on the foot. Toe needs to move back more, which has the added bonus of helping lower the front half of the foot relative to the back half, thereby increasing the plantar angle a bit.
LH lateral: Foot is placed forward, rather than being squarely under the horse. This position is going to be more comfortable as it allows the foot to sit flat on the ground to accommodate the likely negative plantar angle. Back the toe in the blue area. Pink, green and orange lines are the same as on the rad.
LH sole: Again, back the toe to the solid blue line. Lightly clean up the bars along the purple hashes. Add rockers to the backs of the current buttresses along the orange hashes. Leave the frog and sole untouched.
RH dorsal: Clean up the remaining flares in the blue areas.
RH lateral rad: Same general discussion as the other three feet. Purple line follows the actual alignment of the bony column, while the pink line shows what the bony column wants to do. There is a tiny bit of rotation, so need to lower only the heels a bit to correct it. Leave the rest of the bottom of the foot alone as the sole is already too thin.
RH lateral: Bring the toe back in the blue area - which corresponds to the blue X on the rad.
RH sole: Same as the other three - back the toe to the solid blue line. Blue hashes at the heel buttresses mean take the walls out of load-bearing in those areas. Lime hashes are on a bit of frog that is covering the heel - snip that off, then add rockers along the orange hashes. Leave everything else alone.
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR) Nappi, George and Dante Over the Bridge Jan 05, RI Moderator ECIR |
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