Corrective shoeing for Upward Patellar Fixation?

[Obsidian_Fire]

Long story short, this seems to be what ails my mare.

It is intermittent, fairly mild, but maybe not to her!

In researching best options for helping, physical therapy of course: hills, backing, straight lines, caveletti, etc., but very little info to be found on shoeing options. I wanted her shod behind so I could trail ride her. But my vet/chiro tells me to get them off as it’s putting additional stress on the situation (and indeed, the issue has become worse since being shod behind).

So, what do I do? Is there therapeutic shoeing for this issue? Do I just use boots to ride outdoors? (trails around here are generally rocky and not appropriate for unshod/unbooted horses). And if boots, what kind?..since I want something that won’t cause additional stress on the limbs.

Yes, I’ve read other threads & googled all over for information but there just isn’t much re: shoeing protocol.

TIA!

[JB]

More likely than not, the shoes added length to the breakover, which is the real cause of the worsening. That’s the first thing I’d look at.

Pictures would help

Did she become worse immediately on putting shoes on, or did it take a few weeks? If the former, then see above. If the latter, then I would guess that she was not able to wear her toes like she needed, so the extra length was exacerbating her issue.

How often do you trail ride?

I’ve been hearing excellent things about the newer Scoot Boots, but in general, boots are also going to add length to the BO. There are some which have more appropriate BO built in, others you can actually rasp one on, but there may be one that has a much better hoofprint right off the bat.

[Obsidian_Fire]

@JB thanks, I was hoping you’d respond.

If she can’t wear shoes and can’t wear boots then how the heck do I get her out on the hills she so desperately needs? She can go barefoot behind but…Okay I feel like I’m at cross-purposes here. On one hand, we teach our horses to use their butts. Which they won’t do if they hurt. So I remove the shoes to help the stifles, then her feet hurt so she still doesn’t want to bear weight behind… and maybe I’m worrying for nothing? She was barefoot behind when I got her and had been for quite awhile. But, she was totally green and unfit and skinny. Plus it was end of summer so doing anything beyond arena work was not happening. For now, I ride her all around the farm, and that means gravel. Every place I would go to trail ride means gravel. Old logging roads, river rock, gravel on muddy areas at state parks. Things like that. Next summer, hopefully horse camping out in the wilderness. Which means more rock.

What about setting the toe of the shoe back kind of like you’d do for navicular? Quicker breakover. I wonder about the tighter fitting boots such as Scoot Boots - they aren’t that thick and might not feel any worse than average toe growth, especially if I fit them snug and then keep her toes rasped every 3 weeks or so. ???

She got worse right after shoeing. I thought it was because she was such a jerk to the farrier that she ended up tweaking something. But, here we are again just re-set and right back to it.

Chiro (also a DMV) told me I’d better get religion about those PT exercises.

[JB]

My point about the shoes compounding an issue wasn’t intended to say don’t use shoes I was trying to say - perhaps the shoes are not set where they belong, to put the breakover where they belong, which is why pictures can help. Occasionally, a horse benefits from having a shoe backed up just behind where the technically correct BO is. It’s something to play with (which I know can be hard when it comes to nailing on shoes!).

Also, if the heels are not back where they belong, having a shoe create a BO even slightly too far forward, can create enough of an A/P imbalance to cause a worsening.

I agree with the chiro/dvm - find religion :winkgrin: This can be about including cavaletti work that forces quadriceps engagement without pounding the feet/body, and that can be done on the most comfortable surface you have.

What else is around the farm? Pasture?

[MissAriel]

Another thought on the boots - if you are only using them during trails, they will have less impact that the shoes that are on the horse 24/7

[beowulf]

@JB

More likely than not, the shoes added length to the breakover, which is the real cause of the worsening. That’s the first thing I’d look at.

Pictures would help

Did she become worse immediately on putting shoes on, or did it take a few weeks? If the former, then see above. If the latter, then I would guess that she was not able to wear her toes like she needed, so the extra length was exacerbating her issue.

How often do you trail ride?

I’ve been hearing excellent things about the newer Scoot Boots, but in general, boots are also going to add length to the BO. There are some which have more appropriate BO built in, others you can actually rasp one on, but there may be one that has a much better hoofprint right off the bat.

Generally, the first thing my vet recommends for a horse with UFP is being shod behind… so… it sounds like your culprit is the horse is incorrectly shod behind, and the breakover is exacerbating the issue.

My vet thinks most UFP is the direct cause of too much stress to the joint either by too much repetitive circles, or really bad angles behind.

UFP in my experience is rarely the originator of the issue. Usually something else has come along to tip over the apple-cart, so to keep that in mind while you’re juggling how to go forward with the issue.

That she was bad for the farrier, I wonder if there is something bothering her in the stifle to cause the UFP. Not uncommon, at least here, for me to hear that a horse with UFP is later diagnosed with stifle lesions or tears.

Most of the time I’ve seen estrone & hind shoes as part of the ‘rehab plan’, alongside a strict 5 week conditioning schedule that sees almost no cantering at all, and no circles, with a preference for all work being done on straight lines and terrain to condition the stifle appropriately.

[Obsidian_Fire]

@JB, Yes, the “farm” where I board is just pasture, turnouts. I ride down the aisles in between paddocks, out in the “trail course area” and up in a large paddock where she is turned out - which is where I’d like to spend the summer schooling! And the arena, which is junky sand footing that desperately needs replacing. Where I’m at is the flattest place I think I’ve ever been.

Given how crappy she is for the farrier, I dunno… maybe ace her ahead of time… last time I twitched her with my hand and that worked but I can’t stand there twitching her for an hour!

@MissAriel, your comment makes sense.

[Obsidian_Fire]

@beowulf I had her stifles filmed yesterday and they are perfect. So the joints are okay. He did stress it doesn’t mean there isn’t a soft tissue problem.
I appreciate your comments, it gives me many things to mention to my vets as we figure this out.

I get bored in the arena pretty fast so we don’t do a ton of “circles” per se. We do a lot of changes of direction, we ride 80% at the walk/trot because canter…OTTB… need I say more? LOL. She needed a ton of reschooling before canter entered her repertoire! And when I say “let’s go outside” she marches herself to the gate and waits while I lean over and open it! LOL. Then around the farm we go.

I think I’m making this sound a little like I have no plans or structure to my rides, that’s not true. Schooling is schooling and we work on it diligently. Playtime is playtime. I try to mix it up to keep her fresh.

[JB]

Can you post a conformation picture of her, as well as some good hoof pics (all 4)?
http://www.all-natural-horse-care.com/good-hoof-photos.html

IME, and via my vet and several other resources I have found, most UFP originates with a straighter than ideal stifle joint. That’s why it’s not uncommon in growing youngsters who are going through a butt-high stage, and why it’s more common in breeds who, in general, tend to have straighter stifle confo (such as the TWH).

There are things which can straighten a healthy stifle angle - negative palmar angle, for example. A horse who has been confined to a stall for a significant length of time (whether injury or not) is more likely to have weaker quadriceps and tensor fascae muscles, which are muscles which aid in getting that ligament off its hook. That’s why exercise is important - strengthen those muscles.

The ligament could be truly too short, in which case the splitting procedure tends to work well to effectively lengthen it a bit, or too “short” due to compensation issues (such as flat/negative palmar angle). That tends to result in locking.

It can also be too long, which tends to result in the “banana peel” slipping/catching

No ace for farrier work. Ever You don’t want the horse “blowing out” of it, which is dangerous. I don’t know any farrier or trimmer who will get under an ace’d horse. If you think this is discomfort-related, talk to your vet about some bute for the day before and of. If this is behavior, that’s firstly on you to fix, but also something to discuss with your farrier so the 2 of you can be prepared to deal with issues.

I would work in-hand, or ridden at the walk, in that sand ring. Rarely is sand footing too bad to even walk in, even if it’s just for a few minutes a day to increase muscle strength. You can set raised cavaletti in there and work over them at the walk, ridden or not.

[mroades]

Ask your vet about Estrone injections

[tulachard]

We used wedges with frog support on the hinds when my horse was at his worst with UFP…I think he wore them for a maybe 3-4 months? Then, he had the ligament splitting surgery and we transitioned him to hind shoes with trailers for a few months to wean him off wedges. Now we are back in regular hind shoes.

[clarity]

I have an OTTB with what sounds like the same issue… Religiously worked on the rehab program of hills, poles, and transitions, gradually increasing duration/intensity. What I think helped the most was trot work, particularly over slightly raised cavaletti. We would do trot work in the ring, with lots of transitions - anything to get the hind end engaged - and then follow up with a walk up and down the hills on the property. She’s 100% now, no issues at all, about 6 months later.

Not sure about how shoes would play a role but I’m currently researching boots for a different issue (forced to go barefoot in front) and from what I can tell, the Scoot Boots specifically require correct breakover and don’t add height like the Cavallos or similar seem to. Haven’t ordered mine yet, but looking forward to trying them.

[Heinz_57]

Question: how is she “bad” for the farrier? Refusing to stand, yanking her foot back when he tries to pull it rearward? Leaning? Kicking?

I would agree with taking a closer look at the trim (and shoe job) on those hind feet, especially. If he’s setting the shoe full to an already long toe, that could be half your battle. If she’s off balance laterally, that could exacerbate things too.

Scoot boots has a low-profile boot that might suit your purpose…the sole is much thinner than most of the boots on the market.

[Marla_100]

Can you post pics of hinds from all angles and sole shots also. Could be your trimmer/farrier is leaving toes too long

and heels may be high also or run forward. IME, correcting a bad trim can sometimes correct this problem.