Monday 9 July 2012

Eva and the frog

Eva will be going home at the end of this week and its about time for a recap on her feet and their progress. When she arrived her veterinary report stated she was 3/10 lame RF and this was supported by MRI which showed a severe DDFT tear running from mid-pastern to insertion.

The MRI report gave her a poor prognosis and had recommended extended box rest as the best means of improving her lameness but her owners and vet felt that this would not be suitable for her - and having had her living here for the last 3 months I think they were quite right! 
Eva had been shod with remedial shoes and pads but they had not been successful in improving her soundness. From this angle its interesting to notice that the shoes are distorting the loading of her foot, particularly the medial side, which looks as if it is collapsing.  

By comparison, her foot today (at the top) is loading much more evenly and this is reflected in her improved soundness. It also looks a whole lot healthier today. 
This is the same foot part way through her rehab. With the shoes off you can see the split in the central sulcus which is often a by product of long term shoeing and heel contraction. Its harder to spot when a horse is in shoes but its always a cause for concern. 
Lots of time on good surfaces which are supportive but stimulating has enabled Eva's hoof health to improve dramatically. The photo at the top and this one - from today - are 14 weeks apart. With injuries like hers its absolutely essential that the horse is on comfortable surfaces and has support. Equally without stimulus the palmar hoof will be slow to develop, which is where our tracks are critical.
These shots are interesting because they show how long her toe was in shoes. The wedged heel and pad were intended to "support" the heel but in fact a more effective way to provide that support was to take the shoes off and allow her to build a stronger palmar hoof using the tracks and surfaces here. 
Compare the profile of her foot today. The toe is shorter, the heel less underrun and the hairline is no longer distorted. Instead of teetering toe first on her wedged shoes she is planting her foot solidly heel first. 
And here we go with the sole one...
...part way through...
...and today. The frog has massively improved, as you can see, but equally important is the better medio-lateral balance. I tend to think that this is the best angle for assessing hoof balance, as looking at it from the sole gives you the clearest idea of how the foot is loading on the ground.

Here are her sole shots from a few days after shoes (on the left) and today. The red line is the mid point of the frog and the green line middle of the heels - together showing where the hoof is loading. 

I hope you can see that the load in the recent photo (on the right) is more balanced and that the heels are much further back and more supportive. Of course its not perfect yet as she still has several weeks of hoof capsule growth to go before all the old hoof is grown out but its heading in the right direction.

These shots illustrate that good hoof balance looks very different from the sole, as compared to from the top of the hoof (where we are more used to judging feet). On the right, her foot is loading better and is more supportive of her limb instead of being twisted and overloading medially.


Amy Hughes said...

What clever feet! i am looking forwards to road testing them myself! :-)

jenj said...

No matter how many times you post before-and-after shots, it never ceases to amaze me just how much the hoof and horse change in such a short period of time. Eva looks truly fantastic!

Best of luck to Eva and her mum for wonderful, SOUND work ahead!

Val said...

Awesome comparison photos.

I do not understand how the professional(s) who shod the horse previously could think that the pads and long toe were helping the horse. I realize that they gave the horse a poor prognosis, but that just makes it seem even more like they really did not know what to do. Thank goodness the horse was sent to you for rehab. I hope she continues to improve.

Amy Hughes said...

To be fair to the farrier and vet who advised this shoeing set-up (and both displayed a real concern and commitment to try and help Eva, for which I am grateful, if nothing else because I had to 'go down that path' before I recognised the need to try something else..) ... they did not know that we were dealing with a DDFT tear at the time it was decided to put bar shoes, wedges and gel pads on.

Before MRI the vet's best guess was that the lameness was caused by a negative pedal bone angle putting pressure on the coffin joint - and the thinking behind the shoeing was to raise and support the heel (hence bars and wedges) and reduce pressure on the coffin joint. The pads were apparently to try and reduce contraction of the frog in bar shoes. The long toe I guess is the inevitable result of artificially raising the heel. I wouldnt go down that route again, but a friend's horse who had a similar diagnosis (coffin joints, not the DDFT) has been sound and competing medium dressage for 18 months (so far....) since the same farrier (advised by the same vet) put bar shoes on. So they have had some success (depending on what you want for and from your horse... and 12 months ago I would have said that all I wanted was for her to be sound in shoes, which we tried and failed to achieve)

Rockley Farm blog readers all (by now) know that both DDFT and and negative pedal bone angle/navicular type problems don't need remedial shoeing ... but its taking a little while for the rest of the world to catch up ;-)

M's mum said...

Way to go Eva! Fab changes!

Jassy Mackenzie said...

Amy, you are a really good person to be able to offer such a balanced opinion over such an emotive issue! I hope Eva goes from strength to strength...!

Nic Barker said...

Great comment, Amy. Its important to remember that everyone involved is always trying to do the best for the horse. Most importantly, in Eva's case, when the remedial shoes weren't working her vet was very supportive of trying something else, which was fantastic.

After all, we've all tried things which didn't work - the trick is then to change your approach, which is the mark of a thoughtful professional.