Multiple Hoof Issues Options

[Crazy trail adve...]

Hi,

I usually stick to trail but would like some input and here a variety of opinions so I can weigh everything. We have a 13 y/o Impressive bred Appendix Quarter horse. He's used for pretty heavy duty trail riding. He's prone to laminitis and at one point, his feet started cracking so bad he couldn't hold shoes. We've had off and on lameness over the course of the past 4 years. We already treat him as though he has a metobolic disorder, no greens, min sugars, etc.

Well, he came up lame again. So we did a whole series of ex-rays. The results: Pedal Osteitis, degeneration of the center of the Navicular bone and Navicular spurs in both front feet.
We've already put him into wedges with a set back shoe and a rolled toe. He's also padded with some cushion to help with the slightly dropped coffin bones. Our vet is suggesting Coffin bone injections to help with the Pedal Osteitis. His prognosis is guarded as there are so many different issues going on with the hoofs. Not to mention that as a result of this, his tendons have stiffened up and caused him to become over in the knee.

I'd like some general input and opinions regarding Coffin Joint injections and experiences with this treatment, if anyone has any. I would also be very open to hearing any other suggestions. We really love this horse and want him to be comfortable. If he's a pasture pet, so be it, but we don't want him in pain. Nerving is not an option.

[..::Felda::..]

It's my understanding that steroid injections in a horse that is already laminitic or percieved laminitc will actually make the situation worse. This is because of the already high level of cortisol in the body due to pain. It has a negative affect on the horse by altering glucose metabolism in the blood and therefore the laminae by causing a laminae necrosis event, if I understand it right. The first article may help, although it focusses on only one common steroid.

Article

Radiology & Laminits

Source Site

The best defense a horse is a well educated owner. Due to the laminitis aspect of your horse, it may be time go over your treatment regime again to make sure no loop holes are there. It may also be advisable to go back to the vet and talk about different shoeing techniques as well. Since he's in wedges now, they'll help with pain. IMO, wedges in the long term will actually be detrimental to the horse unless they are being used to restore center of balance and articulation to the coffin joint. Have you taken radiographs with the wedges in place? That would be a check on my list. If it is found that the wedges are actually interfering with the COA, I'd pull them and replace the shoe with bar or heartbar shoe with a pad that encompasses the rim of the hoof at least. You may want to add packing on the sole, but that has it's own double edge too as a hard packing material will actually cause a laminitic horse more pain due to increasing pressure on the sole.

I know alot of folks here will say boots and pads. My opinion about treating with these is somewhat guarded due to my own experiences with a horse that rather eat them than wear them. Because I know others on this board have that science down and can explain the steps much easier than me, I'll leave it up to them. Cough...Missy, Ahab, Jumpin,... cough.

This post has been edited by ..::Felda::..: Nov 7 2009, 12:38 PM

[missyclare]

What I believe he needs and what I know he needs are two different things and the difference between the two is pictures. Is he overweight? Is he on grass? What's the diet? Is the white line stretched? Is thrush present? Is the trim helping or promoting pathology? If he's standing over at the knees, that suggests weight on his toes to get off sore heels and that the onus is on the toes and not helping the white line. Putting wedges on his heels jams them up, won't allow him to get off his heels and tipping his weight more on the toes...tipping P3's nose further in the direction it was already going. Laminitis is soreness at the toes and the horse pointing his feet forward to get off his toes. Chipping at the walls suggest the trim. So, I'm getting conflicting information.

What is needed is balance, proper mechanism, protection, nutrition and movement. The balance has been dictated to by the wedges. The mechanism/circulation is non existant because of the shoe. The protection padding is secondary as the hoof hangs from the weakened white line and weighted on the walls. The movement will not promote if the first ones mentioned are not achieved....just painful steps.

Laminitis is a sick white line. Its hold is decomposing. It is promoted by the trim allowing torque that stretches that sick white line...letting thrush in, the chipping confirming it. The circulation has been compromised for a couple of reasons, hence shoes not holding on....brittleness...lack of circulation. It takes all the things mentioned above to promote circulation. I'm shaking my head as to why they stuck a shoe back on when the hoof is not holding a shoe in the first place?

I just spent 6 months getting a heel down and working on a horse that had wedge heels. I've been pulling his heels back down from his armpits, where the wedges put them.

The bottom line is that you want him better, when all you have to do is help him get himself better. That means putting the right things in place and giving him a chance to get his own ducks in order.....faith. It's a faith that turns into amazement when you see the changes and improvement.

Good post Felda! I'm going to have to read those links more closely when I get a chance. The white line is already in a necrotic state, mad and swollen like a toothache and if the injections promote this, then its not helping, to me. Also invasive enough to worry about resulting bone infection. I need to find out more about it, but as its hitting me right now, knowing how the horse can heal himself....invasive, dangerous, unnecessary and the whole treatment plan downright expensive.

Post pics according to the sticky at the top. Atleast we'll get an idea of what's going on, even if the shoes are on. Xrays as well, if you can. Also a body shot showing his preferred stance. Information about his diet and how he spends his days. No use casting about....need to get specific if we're going to help you.

[Crazy trail adve...]

Both excellent responses. Thank you.
I will work on getting some photos for you.
I can tell you that. He is not on grass, not overweight, he is fed low sugars, he's in an open pen that is dirt. He does not have thrush or sign of any other bacterial issues going on in any of his feet. We're very diligent about keep all of our horse feet clean and bacteria free, even when it rains. (Which isn't much here in So Cal).

He does in fact, have two conflicting issues going on. He's essentially got a boxing match-Coffin Bone issues versus Navicular Spurs. I will also try to load the graphs.

[M. Daniels]

I'm sorry, "boxing match coffin bone issues"?...I have no idea what this means.

[..::Felda::..]

I'm sorry, "boxing match coffin bone issues"?...I have no idea what this means.

She was being sarcastic. The coffin bone and the navicular spurs are problems in this horse right now and apparently it's not clear which is the worse of the two.

[kitten-kat]

is it possable a softer thicker synthetic type shoe would help a lot in this horses case? plastichorseshoes.com her some nice ones, I used them for my own navicular horse, they have not only the heart bar and the egg bar for heal support, but also have the softer cushion effect to them and allow to keep the sponges and fillers out and still keep the feet dry, they are easy to paintain, go on like a regular shoe and can be fully customized for the horse.. they also promote a good heal toe movelent, as well as minimizing the impact on sore joins and feet.

[Ahab]

Hi,

I have no experience with coffin bone injections, so I can't give any usefull feedback, other than re-inforce what Felda said, stay away from the steroids.

You definitely want to get rid of the inflammation - It's the cause of the Pedal Osteitis AND of the Navicular syndrome. But the veterinary recommendation is to use non-steroid anti-inflammatories, so keep that in mind.

Now, I would be carefull not to focus too much on fixing the symptoms and end up opening up a can of worms. Try to pinpoint the root cause...

He's used for pretty heavy duty trail riding.

This could very well explain the inflammation.

He's prone to laminitis and at one point, his feet started cracking so bad he couldn't hold shoes. We've had off and on lameness over the course of the past 4 years.

I'm with MissyClare, it would be helpfull to see pictures of the feet, details on the diet, etc. Otherwise everything below is just based on my assumptions that we aren't missing any important information.

I'm not saying that you're doing anything wrong at all - It can be that this worse simply can't handle the heavy work. In that case, like you said, you can just let him slow down.

But there may be other aggravating factors, like long toes, thin soles (carved by a farrier), or naturally thin soles that need boots, or something in the diet.

Many times people are doing things that have a detrimental effect on their horses and not even realize it, because it works with all their other horses.

Well, he came up lame again. So we did a whole series of ex-rays. The results: Pedal Osteitis, degeneration of the center of the Navicular bone and Navicular spurs in both front feet.
We've already put him into wedges with a set back shoe and a rolled toe. He's also padded with some cushion to help with the slightly dropped coffin bones. Our vet is suggesting Coffin bone injections to help with the Pedal Osteitis. His prognosis is guarded as there are so many different issues going on with the hoofs. Not to mention that as a result of this, his tendons have stiffened up and caused him to become over in the knee.

Here is what I would focus on:

1) Inflammation: From what you describe is most likely caused by the heavy work. The repeated concussion (bruising of the sole) causes the inflammation -> The chronic inflammation causes the Pedal Osteitis and navicular syndrome -> The N.S. causes toe first landing -> Toe first landing aggravates all the prior problems -> Vicious circle...

2) Laminitis: This most commonly is related to diet, and/or long toes, and/or toe first landing.
Again, if you feed him like an IR horse, then it's most likely a mechanical problem, caused either by his trim or just a reaction to the inflammation problem and the toe first landing.

I would also be very open to hearing any other suggestions. We really love this horse and want him to be comfortable. If he's a pasture pet, so be it, but we don't want him in pain. Nerving is not an option.

I would focus on reducing the inflamation. Use non-steroid anti-inflamatory and be very carefull with "therapeutic shoeing" because it may give temporary relief, but cause long term harm (see MissyClare's comment). In my opinion boots are the best option, until he's not sore anymore.

Make sure that he has a good trim - Remember that the root cause seems to be the repetitive brusing, so thining the sole in any fashion will only do more harm. And dont' allow long toes.

Keep in mind that you may have a great farrier, and he may do a great job on your other horses, but it may not be the best trim for this horse. (We would love to see pictures of his feet)

Don't work him once he's better - Give him time to recover and consider semi-retiring him, but certainly slow him down.

Well, I hope this helps.