Chester's 6 week comparison

Chester will have been here 6 weeks on Friday so although I'm a little early, its time for an update.

When he arrived he had the usual long toes, under-run heels and weak palmar hoof. On MRI he had lots going on, including bilateral DDFT and impar ligament damage and damage to the navicular bone. He had come out of shoes and been trimmed a few times before he came down - you can still see the nail-holes from his last set of shoes which had come off about 6 weeks earlier. 

Five and a bit weeks further on and his toes is shorter and his heels are beginning to improve. Still under-run of course as he has only just started using the back of his foot properly and its still weak. He hasn't been trimmed to make these changes, they have happened naturally as his foot has strengthened. 

You can see how contracted his heels are and he also had a ridge of sole extending from his bars when he arrived. This is usually a sign of a compromised foot and its makes horses generally much less comfortable if its trimmed off. 

Once the foot is working more as it should, the sole ridge, bars and contraction can begin to sort themselves out. His sole and frog are healthier although still very weak. 

Same story on his LF with toe and heels improving and giving a better hoof pastern axis as well. 

Again, a contracted foot with a frog and bars that desperately need to get stronger. Trimming bits off them  - or indeed taking his heels down or his toe back - is not the best way to strengthen them!

In his footage you can see how his landing was compromised not just in front but behind too - he is sliding both hind feet rather than placing them correctly. 6 weeks on things are beginning to improve but he has a way to go. As his palmar hoof develops his landing will improve and as his landing improves his palmar hoof will develop. 

Surprise, surprise...not really a "degenerative" disease after all...

Most of us first came across the term "navicular" in a context of dreadful doom and gloom. Once a horse was lame and navicular was diagnosed, the outlook supposedly was pessimistic. 

The article below, from Dick Vet, is characteristic in describing navicular syndrome as a "chronic degenerative disease" - whose progress might be slowed but would inevitably worsen over time. 

Of course, as those of us who have barefoot horses know, the types of long term weakness and pathology which are found on x-ray and MRI in "navicular" horses can, in fact, be improved and healed in the majority of cases. 

However, although most horses are first diagnosed via x-ray or MRI, its rare for horses with a navicular diagnosis to undergo x-ray or MRI after they have come sound following barefoot rehab...but there are a few horses for whom its been done. 

This is one of a set of radiographs taken of my old horse, Ghost, aged 23. He'd been diagnosed with navicular syndrome on the basis of x-rays which showed navicular bone damage aged 16 or 17.

He'd been in bar shoes for 2-3 years and became progressively lamer until, aged 19, I tried barefoot as a last resort.

By the time this plate was taken, in 2008, he'd been barefoot and back in work for 4 years. There was no longer any discernible bone damage, according to the vet, even though the 2008 plates were digital, much higher quality than the original x-rays and should have shown up every last blip.

Ghost lived til he was 25 yrs old and was sound and in full work till the end. He was eventually put down due to extensive melanomas which were seriously affecting his gut. 

Dexter's story is similar. Having been diagnosed with navicular and given a 5% chance of returning to any sort of work in 2007 he came here early in 2008 and was successfully rehabbed barefoot, despite having dreadful TB feet.

Dexter had an MRI in 2008 during his last week of rehab here and it showed a healed DDFT lesion. Over 5 years later Dex is still going strong, hunting and jumping.

The same result occurred when another ex-rehab had an MRI, again a few months after rehab. 

The collateral ligament injury which was evident on his initial MRI had healed and - even more interestingly - there appeared to be new bone growth being laid down in the navicular bone, which had also shown damage. Again, this horse went back to full work, hunting and jumping.

Of course these are only a small number individual horses - but the findings following rehab are consistent.

I was reminded of this over the weekend when I had an update on another ex-rehab who unfortunately suffered a bout of laminitis at the start of the summer. That was bad luck but its under control and I am sure he will be back on track in no time.

The interesting thing was the vet's comment as she re-xrayed his feet. He'd had an MRI before his rehab which showed navicular bone damage, DDFT and impar ligament damage. Of course the tendons and ligaments couldn't be assessed on x-ray but she did say that: "the navicular bone was much improved and showing signs of new bone formation". Not bad as he only went home at the start of this year.

So why has navicular syndrome been labelled as a "degenerative disease"? The clue may lie further on in the same Dick Vet article.

"Unfortunately navicular syndrome is not curable due to its chronic and degenerative nature. Therapy is structured around corrective trimming and shoeing...A variety of shoes may be used, for example egg bar shoes or raised heel shoes, but the essential feature is the provision of adequate length of shoe underneath the heel to give good support."

This statement, I must say, rings true with me and with many other owners whose horses have been shod with bar shoes or wedges in an attempt to alleviate the symptoms of navicular syndrome. My experience with remedial shoes is that the horse improves for a short period but over the medium and long term the lameness recurs and worsens as the palmar hoof deteriorates.

By contrast, the 4 barefoot rehab horses who've had investigation post-rehab all show healed tendons, ligaments and even bones.

Perhaps its rational to conclude from the radiographs and MRIs of these 4 horses that degeneration isn't inevitable.

Perhaps the reality is quite the opposite: tendons, ligaments and even bone can repair provided you give the palmar hoof a chance to strengthen and heal - and that's best done out of shoes.

Surprised? Not really....

Hoof growth, foot balance and frogs - Itsy's final update

Itsy is off home this weekend and although I posted her footage a week or so ago, there are some last photos to update in today's blog.  

Comparing her stance from day one till today the biggest changes are that she is pointing her RF less (and of course is much, much sounder on it) and loading her feet more evenly. 

Her frogs and heels started to improve almost immediately and 12 weeks on are looking much better. The damage you can see in the lower photo is an old injury which is growing out - it doesn't bother her now though she was lame on this foot some weeks ago. 

A much shorter toe and more substantial palmar hoof - and though its hard to be sure I'd say the hairline is less deviated now as well. You can also chart her hoof growth by looking at the horizontal crack which is about a third of the way down in the top photo. 

Here it is at about 6 weeks - the dark area below is where weak hoof wall below the crack has chipped away.

At 12 weeks the crack is at ground level, meaning that Itsy should have grown a complete new hoof capsule within about 6 months of her shoes coming off.  

Caudal shots show that this is still a contract foot though its improving. There is a fairly deep central sulcus split which she had in shoes and which still has to heal up fully. 

Heel bulbs and digital cushion though are much better and she is heading towards more even loading. 

Same story on her RF which was the lamest foot when she arrived.  Notice how its not just that her frog is healthier but her foot is straighter on the limb than it was on day one. Its most likely this which has made the biggest difference to her soundness.

A much more balanced foot now and again nice fast hoof growth - the nail holes which were fairly high are grown out and the hoof has lost that convex profile too. 

A palmar hoof which is beginning to become stronger - still a way to go but lots to like so far!

Happy Friday, everyone...

I love to film the horses when they are let onto the hayfields after the grass has been cut. They always have a whale of a time and show off dreadfully.

For me the footage is not just something to enjoy now but to come back to in the middle of winter when the days are short, dark and cold - a little taste of summer all year round.

This year the clip features Felix, Charlie, Bryher, Tegan and Bailey then Dexter, Thomas the Third, Chester and Fryday. Hope you enjoy it too!

RRRReminder...

A quick reminder that the Rockley Rehabs' Reunion is happening again this year from September 12th-15th at the Milton Keynes Eventing Centre.

All rehabs are welcome, of course, and you can book by going to the RRR website or via the RRR Facebook group and if you book by the end of July the price is discounted. 

There is more info here or on the website - last year we had an amazing time and this year should be even bigger and better so hope to see you all there!

Blood, sweat and tears

Another fabulous update, this time from Hannah and Candy, who went home last year.

As all rehab owners know, the hard work, stress, blood, sweat and tears (ok, maybe not quite that bad, but you get the picture) really starts when horses get home and when there are still several months of rehab ahead of you. 

This is the time when you find out how risky your grazing is, how supportive (or otherwise) your friends are and how many hours of exercise and work it takes to grow a new hoof capsule!

No-one can deny how committed Hannah has been. She and Candy have worked in rain, snow, sun and everything in between. More importantly, she (and her support team) have risen to the challenge of the steep learning curve which we have all experienced once our horses went barefoot and once the responsibility for the feet was mostly down to just horse and rider...

Its hard work and it can feel like a huge responsibility but, on the upside, no-one can take away the feeling of satisfaction and pride when it all comes together as it obviously has for these two!

Rehab owners all, I salute you :-)

New boy O'Neil

New boy O'Neil arrived on Sunday. He'd been scheduled to come here some weeks ago but had been - as the phrase goes - unavoidably delayed. Once here, he lost no time in settling in...

O'Neil's feet were much longer than usual when he got here. Normally he would only have gone 4-6 weeks between being shod but the interval was longer than that this time.

O'Neil has been intermittently lame for more than a year and although he hasn't had an MRI his toe first landing and unhappiness on camber or unlevel surfaces suggest a combination of DDFT and collateral ligament strain. 

More on O'Neil - with some much better hoof pics - soon I hope!

Nice one!

Great update from the weekend from Amanda - this is her and Lucy at their first affiliated British Novice show-jumping comp at the weekend :-)

What a great start to the week!

Freddie's final update

Freddie is going home and its time for his final photos. His RF was his weaker foot and was landing toe first as well as loading unevenly.

Freddie has made some good improvements but equally there is a way to go before he has a strong enough heel and frog. The foot is more symmetrical though and less contracted. 

What you can't see in the photos is that his soles are also a lot thicker. When he arrived they flexed on thumb pressure, which is never ideal(!).

Here is his caudal shot. As well as a contracted frog and heel you can see that he was very underrun. 

He still is today, but at least his heels are heading in the right direction - back underneath his limb to give him better support. 

You can see the new growth in the lower photo, about a third of the way down his hoof capsule. Once it reaches the ground and he has a completely well-connected hoof capsule he should have better concavity as well and it should improve his under-run heels. 

You can see from this angle that the palmar hoof is building up but hasn't yet reached quite far enough to provide the support he needs at the heels. It will come, but its one of the frustrations of rehab that changes can never happen fast enough!

The same story on his worse foot - a shorter toe and better connection in the top third of the hoof capsule but he needs it to grow down completely to give him better palmar support. 

Its finally Fryday...

New boy Fryday actually arrived several days ago but there has been so much going on this week that he has - appropriately enough - only made it onto the blog today. 

Fryday is only a young horse but has been diagnosed on MRI with bilateral navicular damage, DDFT and impar ligament damage, joint damage and a bone bruise.

He has had Tildren and has also been shod with bar shoes and pads but neither his owner nor his vet felt he was improving as much as he should have done. You can't see a lot, of course, but he was definitely well shod - they were the toughest set of front shoes I've taken off in ages, and of course it was a boiling hot day(!)...

The business end - this is where the majority of the improvement needs to take place...Over to you, Fryday...