Yesterday!

...we had a meet here because it was my birthday - I was trying to keep quiet about age but someone had other ideas!! We had a really fantastic day - thanks to everyone who came, everyone who helped, and especially to my brother Jon and nephew Samuel who slaved over sandwiches, cake and sausages all morning :-)

Changing hoof loading

More rehab photos, another new arrival who is growing a new hoof capsule at an impressive rate. As you can see from the (sorry, slightly blurry) upper photo, he has poor medio-lateral balance, confirmed by X-rays.

In shoes, his hoof was shunting laterally and collapsing medially, but if you look at the new hoof angle, and project where the hoof capsule should be when it has grown down, he will have much more medial support, which over the longer term should improve his soundness.

The top band of new growth really is growing in at that angle, its not just a camera angle - in fact in real life the difference is even more dramatic - and this hoof growth has developed in less than 4 weeks, and despite the fact that he is not able yet to do much work. He has a very weak and under-run caudal hoof but this is also slowly starting to strengthen, although that process will be a long time.

Frog development

Thought these shots might be interesting, keeping the theme for the week(!). This is a horse who is here for rehab at the moment, the lower photo LF the day he arrived, the top photo same foot after less than 3 weeks.

He has weak frogs, of course, and no digital cushion to speak of, particularly on this foot, but frog stimulus is key to getting a healthier caudal hoof, and he is making a good effort to improve himself :-)

Hoof loading - shod and barefoot comparison

One good thing about having snow is that there are lots of hoof prints to look at - an endless source of fascination for a hoof-anorak like me! Often, the snow means that shod horses can't venture out, because its just too dangerous, but the snowfall last Friday was so light that for once you could see the barefoot and shod horses' hoofprints side by side.

The close-up shots make the difference in how hooves load crystal clear, and also highlights the factors I blogged about earlier in the week.

The weight of the shod horse has been taken peripherally, by the rim of the hoof; the frog has taken almost no weight and has barely touched the ground.

By contrast, the weight of the barefoot horse has been taken caudally, by the heel and frog, with the hoof wall sharing the load as the limb moves towards breakover.

If you think about the weight of the horse's body, held up by the bony column of the leg, its easy to imagine which loading option gives greater stability, support and shock absorption. Its also very clear how much smaller the loading area is for the shod foot, putting a much greater strain on the edge of the hoof. The barefoot horse, by contrast, has a huge surface area over which to spread the load.

These photos really illustrate the effect shoes/barefoot may have on bone stimulus, I think - as I posted on the 2 blogs earlier this week - http://rockleyfarm.blogspot.com/2010/02/stress-shielding-more-about-bones-and.html and http://rockleyfarm.blogspot.com/2010/02/reversing-navicular-bone-damage.html

FWIW, I am not taking bets as to which horse has the healthier bones, even though the barefoot print is from a horse is who is 25 years old!

Stress shielding - more about bones, and shoes

While I was following up research on bone regeneration that I blogged about on Monday (http://rockleyfarm.blogspot.com/2010/02/reversing-navicular-bone-damage.html), I came across an even more interesting fact from research into human biomechanics.

As with bone regeneration, its something that you could discuss with a medical doctor and they would simply say - "Duh, of course - thats nothing new"...BUT I don't think its crossed over into equine veterinary research yet. Maybe I am wrong, so if anyone can point me at any studies, PLEASE do so!

Its common ground that bone forms in response to mechanical load, so the stresses and strains which the bone receives from movement and its environment are critical to its strength.

What is mind-blowing (but when you think about it, not surprising) is that if you replace or support a bone with a stiffer material, like metal, then the stiffer material becomes the primary load-bearing structure. This reduces load to the bone and it degenerates in response.

This process is called "stress shielding" and it has received a lot of attention from researchers into human medicine, because bone degeneration is a consequent problem in patients with hip or knee replacements, and its also a factor when fractures are repaired with metal plates.

I had a lightbulb moment when I read about this, because stress shielding may well be the one of the factors affecting shod hooves.

Bob Bowker is already starting to look at pedal bone density in cadaver hooves, and is postulating a link between peripheral loading and osteoporotic bones - his article is here.

The question is whether shoes are also causing stress shielding; if so, this would be another way in which bone density could be adversely affected. Changing both the loading of the hoof and removing the stress shielding should therefore lead to bone restoration over time.

What we need, of course, is research into how seriously bone density in horses (particularly navicular and pedal bone density) is affected by shoes, and whether its possible (and how long it takes) to restore density in a correctly loaded, unshod hoof.

In humans, it used to be thought that bone loss due to stress shielding peaked 2 years after an implant, but now its thought to continue indefinitely. Its also a common cause of pain for human patients and there is no reason why this shouldn't also be true for horses.

Meanwhile, I am posting photos tomorrow which illustrate things quite nicely :-)

Reversing navicular bone damage

There is a common belief among horseowners and vets that once a horse has navicular bone damage, that damage is degenerative - it will get worse over time and cause the horse increasing lameness.

Perhaps this is partly due to the traditional view that navicular bony changes were the cause of the lameness; in fact we now know that they are a symptom, and usually only occur once the horse has been lame for a while, but you can still find lots of textbooks and websites which describe navicular as a degenerative bone condition.

Our own horse, Ghost, was diagnosed with navicular in 2000, on the basis of nerve-blocks and X-rays which showed mild bone damage. He has been sound and in work barefoot for many years now, and in 2007 we had him X-rayed again, only to find (as we expected) that his navicular bone no longer showed any evidence of damage.

If you think about it logically, you would expect that, as poor biomechanics can stress soft tissue and lead to inflammation and eventually bone damage, correct movement and loading will over time allow the bone to strengthen and remodel. Its a process which is well understood in human orthopaedic medicine, after all:

"in a deformed bone the internal structure was radically altered as a response to the static forces working on it. A normal bone will alter to meet a change in its function. If such change in mechanical environment is rectified, the bone will resume its former shape and structure."

JSR Golding

Its no coincidence that these types of horses show caudal hoof pain and are landing toe first - as well as the soft tissue damage which they will show on MRI, the reduced loading of the caudal hoof is bound to affect bone as well:

" when the loads are increased over normal levels, bone mass is increased, and when the loads are decreased, bone mass is lost"

MCH van der Meulen, P J Prendergast

This is a fascinating area, and I've got lots more about this tomorrow and Wednesday :-)

Caught out!

Andy made the tactical error yesterday of setting out from home in a 2 wheel drive car...

...this meant that last night he had to abandon it 3 miles from Rockley and walk up the hill by the light of the silvery moon...

This morning, of course, there is no chance of retrieving the car, and there is MORE snow forecast later today. Horses are quite happy about this, apart from the lack of hunting, but its is becoming a little inconvenient, even with 4WD...

...spoke too soon...

...because the snow today has stuck...think it might have been sent down from the Peak district...!

For the rehab horses, its an improvement on the freeze we had last week, as they are still all at the stage when they find hard, uneven ground uncomfortable. Snow means they can move comfortably round a much bigger area, so for them its ideal.

The other horses enjoy it too - most of the snow fell this morning and there was a concerted rush out of the barn (where they had mostly spent the night) to go and roll in the deepest snow - although as we've only had about half an inch, "deep" is really the wrong description :-)

Its not forecast to stay for long - must admit I am hoping that this is the last bout of snow for this winter. As C said yesterday, its been a long one already...

This morning...

...its still snowing, although its wet and slushy and not lying for long. We had such a lovely sunny day last Sunday that I hoped it was a turning point, but obviously not :-(

I know its still only mid -Feb, but since we've had snow off and on since before Christmas, I would have thought we were due a bit of better weather...

On a more positive note, Angel had a good day yesterday, when I finally managed to get him out hunting again - he has had a very difficult introduction to hunting as I've been too busy to get him out consistently, and then on the days when I had planned to try, the weather was so bad that there was no hunting. As you can see from his mileage, he has only been out a few times, but yesterday was the day when I really felt for the first time that he understood what his job was, and was really starting to build in confidence.

He was only out for 3 hours yesterday but the ground was difficult - wet and deep, snowy in places and often steep and slippery. It did him no end of good to have to deal with this type of terrain!

I've found the continental horses generally need much more time than the English or Irish horses to learn about how to go up and down hills and cross the country effectively. I suppose its because the warmbloods that we've had here have worked predominantly in the school before they arrived. All credit to them that, after a few trips out, they seem to get the hang of it and love the wide open spaces :-)

Parachutes and project Dexter

We had a friend staying last week who is a consultant surgeon, and we were discussing evidence-based treatments for humans and in animals, and how our reactions towards new developments aren't always governed by logic(!).

There is a quote at the back of "Feet First" from a fantastic book called "Bad Medicine" by David Wootton, which I've mentioned on the blog before: http://rockleyfarm.blogspot.com/2009/06/what-progress-means.html

The many examples in "Bad Medicine" demonstrate how much our traditions, egos, hopes and fears can slow down progress, even when logically there seems no reason for the delay. Equally, we can often cling to ineffective remedies, purely through habit.

Of course, nowadays we expect that new medical or veterinary developments can prove that they are effective before we adopt them - its the key reason behind Project Dexter, after all - but our friend last week (who is himself involved in research as well as clinical practice) reminded me that research statistics, while important, aren't necessarily the be-all and end-all.

As he said, there will never be a double-blind clinical trial for a parachute.

I'd never thought of barefoot rehab as a parachute, but of course for a lot of horses (including most of the ones here) thats exactly what it is.

Comparisons - Paul before and after

I've only just got round to sorting out the last photos I took of Paul's hooves before he went home.

By way of quick comparison, here are his shots from his first and last days.

I've got the inital photos for the current rehab horses as well, but those will have to go up in a different post, and of course they have very little to show in the way of hoof improvements as yet.

When are hooves "too short"?

Someone on the UKNHCP forum was asking whether their (newly out of shoes) horse was sore because he was "wearing his feet too short". Its a common question, and there is a common preconception that barefoot horses will "wear their feet away" doing road work. None of us with barefoot horses have ever seen this happen, but its still a pervasive myth :-)

But back to the horse who was sore...It turned out that he had been working well without shoes and had been fine doing roadwork right up to the point when he was trimmed. In fact, it was the trimming of his sole and frog which had made him sore, not working without shoes. And before anyone asks, it was a registered farrier not a UKNHCP practitioner who performed the trim.

These photos aren't of that horse, but they do show a foot that is way too short - not because its got little hoof wall, as people sometimes think, but because its internally too short - there is too little depth of sole protecting the internal structures of the hoof and its a sure way of making a horse sore.

Quote of the week!

From Paul's owner:

"Everyone is amazed that Paul is sound and has been hunting...but on the bizarre side, they all keep asking me when I can put his shoes back on! Now why would I do that?!"

:-)

Peripheral neuropathy - why hooves hurt?

Horses coming out of shoes can show pain or sensitivity in their feet, and it can be for all sorts of reasons.

Traditionally, if you saw a horse struggling over stony ground you would assume it "needed" shoes. Its something we see often with rehab horses - initially, straight out of shoes they often find hard concrete or rough stony ground uncomfortable and yet the same horses, after a few weeks of a good diet, non-invasive trimming and correct movement, can go over that ground without shoes.

A poor diet, high in sugar and low in minerals, will give many horses sole sensitivity. Another common cause is aggressive thinning or cutting of the sole and frog - this is normally a "man-made" problem, particularly in horses who pull their shoes and are reshod at frequent intervals.

There is one other factor to consider, which I've been wondering about for a while. Its well documented in humans that nerve damage can be caused by poor circulation and as a side effect of repetitive strain injuries which have led to compression and soft tissue damage.

We know that shod horses frequently have reduced proprioception and poor vascular circulation, by comparison with a healthy barefoot horse; of course many of the rehab horses which come here have the equine equivalent of RSI, a toe first landing which has led to tendon and ligament damage.

It would not be surprising therefore if they also suffered from nerve damage and related hoof pain - or peripheral neuropathy, as it would be called in a human. If this is the case, then with an improving hoof there should also be nerve regeneration (provided there are still some healthy neural cells), but this not only takes time, but can also cause pain. Its yet another reason not to force horses to work on surfaces unless and until they are comfortable on them.

Out in a blaze of glory!

...and of course its Paul we are talking about...He went home yesterday but we and his owner had planned for some time that it would be a lovely grand finale for him to go hunting on his last day.

As far as she knew, he had hunted in Ireland, but the last thing that she had expected when she brought him down at the end of November was that he would be hunting at the beginning of February!

It was a very cold but beautiful day, and so we loaded up Paul, plus Felix and Charlie to be his hunting buddies, and off we went.

It was clear at the meet that Paul had seen it all before, and although there were one or two other horses misbehaving, he behaved like a complete pro with hounds and other horses. He went at the back, went in the middle, had people passing him and went over streams and wet places without turning a hair - you couldn't have asked for better manners.

We kept it to a short day, for his first time, and he capped it off with a long hack back to the trailers up the road, good as gold. What a little star he is :-)

Updated to add: Had a text to say that Paul is fine this morning, but C aches "all over"... Ooops! :-0

New rehab horses...

...haven't had time to post for the last day or so as we have been really busy with rehab horses coming, and going...

I'll post details of them when over the next day or so, but its always both exciting and worrying having new horses arrive - exciting because of the hope that they will improve and recover, and worry because its always a huge responsibility tkaing care of other people's beloved horses.

The new boys are all sweethearts, and have settled in well so far, so there will be more about them soon!

Spring is here...

...or at least that is what Ghost thinks...

Ever since I have known him (more than 15 years now!), a nice, bright, warm, sunny day any time from Feb onwards is the cue for him to completely lose his normally shaky hold on good manners.

You might think that, at the age of 25, he is old enough to know better; you might think that the fact that he is only in light work and has a coat like a woolly mammoth would make him think twice about galloping flat out up the road. You would be wrong.

The problem is that he is just as competitive now as he was when we first got him - its the reason you can't take him hunting, unless there is no-one else out (!), because he doesn't tolerate other horses in front of him for any reason. It makes him a great horse to take on a trip like Ride Bare, because he never runs out of curiosity about what's round the next corner, and he doesn't in the least mind going hundreds of miles in unfamiliar country on his own.

Usually he is fine to lead other horses from, but the other day he tried to get into a race with Paul and today he tried it with Angel...Luckily both of them have better manners than Ghost...

Left, left, left...

I should caveat this post by saying that most of the horses who come here have displayed a bilateral front limb lameness before they arrived. This has normally been confirmed by nerve blocks - a typical pattern is that the owner asks for a lameness assessment because the horse hasn't been quite right for a while, but the lameness is often intermittent.

At the assessment, the lameness is identified to one limb (usually the left!), but when that limb is blocked out, often the horse shows lameness on the right limb. In other words, both are causing problems, but one is worse than the other, and the worse limb is therefore the one that shows up the problem first.

The interesting thing is that most horses have the left front limb as the worse limb, and if they have a hind limb problem as well (as many do), then the right hind limb is worse.

Of course, there are always exceptions, but all except one of the horses in Project Dexter (and as far as I can remember, all the horses who pre-dated the research), had a worse left than right limb, both in terms of assessed lameness and conformation.

Medio-lateral balance

This is a clip of a newly arrived rehab horse, taken when he had his shoes on. Its interesting because you can clearly see how badly he has been affected by the poor medio-lateral balance of his hooves.

In slow motion, you can see that his landing has a pronounced imbalance to the lateral side. He has had the imbalance for a long time, we assume; when the farrier most recently tried to correct it and shod the horse using X-rays, the change was more than the horse could cope with and he became even more lame. We are hoping that allowing his feet to rebalance out of shoes will help make him more comfortable - time will tell.

Its thanks to the owners

We are making good progress with Project Dexter, which should be our first step towards providing credible evidence of navicular/DDFT rehab, but the progress hasn't been due to vets, its been due to owners.

There is one honourable exception: Jeremy Hyde, from Eqwest, who had the original idea for the project and helped to kick-start it, as well as referring Dexter, Erik and Blue here. Without him, we wouldn't even have got the research project off the ground!

Most other horses, though, have come because their owners have refused to give up on them, and because they refused to believe their vet when they were told that they'd tried everything, and that their horse had no future.

The purpose of this post is to say a big thank you to all the horse owners who have done their research, asked difficult questions, and been prepared to go out on a limb for their horses. Thanks also to all the vets who, despite being deeply sceptical, agreed to speak to me and gave their (in some cases reluctant!) consent to the horses coming here!

Too good to be true?

There is of course a well-known phrase - "If something sounds too good to be true it probably is" - and given that most of the horses who come to Rockley do so as a last resort, I know that people think it might apply to the rehab we do here.

I was asked yesterday whether the horses listed on the website are all the horses who've been through Project Dexter, or whether they've been cherry-picked as success stories. In fact, every horse is listed - there are other success stories (like Ghost) who aren't on there because they pre-dated the research project, but there aren't any failures that we've kept hidden.

If it still sounds too good to be true, think of it this way: the 3 most important things you can do to keep yourself healthy are to eat a good diet, exercise regularly and not smoke. The 3 most important things for hoof health in a horse are a good diet, regular (and biomechanically correct) exercise and non-invasive trimming. I was going to equate shoeing with smoking, but maybe thats unfair ;-)

Praise from an unlikely source

One of the members of the UKNHCP forum receives the BHS newsletter for North Wales, and kindly posted to tell us about a very glowing review of "Feet First" which has appeared there - here's her post:

"Just a few quotes from it: 'If you keep a horse, you should read this book. If you are a farrier, trimmer, physio or vet you should be made to read it'. (strong stuff, I thought ) ' well thought out, well written', ' A book with such good advice is a Godsend to every barefoot horseowner', 'You'll read it over and over and your friends should get their own!'. I don't know who the author of the review is, it doesn't say, but 'hats off' to the BHS I say"

Praise indeed, so thank you BHS, and thanks Helen for putting up the comment :-)