"The impossible we do at once, miracles take a little longer"

Do you remember this saying, which used to be posted up in many different workplaces? It seems an appropriate motto for rehab especially when you are a "last chance saloon" for many horses but we have to at the same time be very, very realistic and we certainly can't promise miracles.

Take Dali for example. This was his typical stance when he arrived. He had extensive DDFT and impar and collateral ligament damage along with navicular and P3 bone changes diagnosed on MRI in early 2011 but he had been lame for many months before that.

His problems were bilateral (in both feet) although the RF was worse. The prognosis was that he would gradually worsen as his condition degenerated and sure enough by the time he arrived here - in June 2012 - he was extremely lame RF and pointing continually.

His vet had said Dali would not cope barefoot because of his flat feet but equally remedial farriery had not improved him. This is his stance today - better, and happier to load his RF.

For comparison, here are his lateral shots from June (above) and today (below). Big changes in toe length and quite a significant amount of hoof growth (compare the level of the event line) but this isn't the whole story.

From the front its easier to see how his medio-lateral balance is changing. Again, the time difference is 3 months, from June to September.

Its subtle, but look at the hairline in both photos and assess which is more even, which is the better loading hoof, which appears more stable?

The sole shots give, as usual, a good indication of whether the heels are less under-run and whether the palmar hoof is stronger. This is also the place to look for symmetry (NOT from the top!) because symmetry here confirms that the hoof is loading evenly and that the medio-lateral balance is correct. 

A much healthier foot, I am sure you will agree, although the heels still need to improve a lot. Concavity will come once the whole hoof capsule has grown in at the new angle. Incidentally, this is a good example of why frogs shouldn't be trimmed(!) - many well meaning farriers and trimmers would take a knife to this and make it a nice neat triangle...

But while Dali is growing a healthier hoof capsule in a relatively short time this is only part of the picture. He has been lame for a long, long time. On MRI and on ultrasound he has extensive bone damage and bone - while capable of remodelling - takes many months to repair.

Dali is becoming sounder - he is capable of work and is improving but his rehab is not something that can be completed in a few weeks. We have started the process here but it needs to carry on for months and months after he has gone home. Rehab is done in many small, gradual steps over a long period, not in a quick wave of the magic wand and if a horse has suffered severe long term damage then the legacy of that may always impair his performance to some extent.

It can sometimes seem incredible how well horses can recover from long term lameness - but at the same time it is essential to be understand that the worse the damage, and the longer the horse has been lame the longer and more difficult the rehab process will be. Its important to realise that miracles don't always happen - and when they do, it takes a lot longer than 12 weeks for them to be complete.