DDFT, coffin joint. Barefoot or shoes?

Hi everyone,

So after a battle with a subtle lameness and choppy stride in front, my horse was discovered to have “abnormal findings” on his DDFT above and going down to the navicular bone (very mild, no tears, in stages of healing), some bone bruising with fluid around the navicular bone, thin soles, and some abnormalities with his coffin joint on his LF. RF showed similar bruising with fluid, thin soles, but no injury to the DDFT or issue with the coffin joint. No a nornalities with the navicular bone itself. He has no lameness at all on the RF. This was all diagnosed via xray (vet said angles were all normal) , ultrasound, and finally a MRI. Our vet said this could be a result of a traumatic event, as he has a huge popped splint on the right, or something chronic along with a trauma. He also said something about his digital cushion not being adequate to support whatever is going on, but I’m not sure what that means, to be honest.
Important to note is while in training my horse had been barefoot, but we noticed a big issue with long toes, tripping, and forging, so decided to try shoes. It didn’t make much difference, so we removed them when I had a baby, after about 6 months. Horse was sound for a year after that, and we more recently used a new trimmer who took off sole, and that’s when these issues manifested.

My vet wants to do eggbar shoes and rest for the DDFT, and says there are no true research based treatments for this issue that have been proven to work. (He is one of the top lamness specialists in the surrounding states.) He also said we can inject the coffin joint, provided there is bone pain, but many clinical findings such as this do not necessarily correlate with discomfort, so we should block before blindly injecting. My horse never exhibited heel pain or frog pain, but did have sole pain on the LF with hoof testers.

That being said, my horse is already barefoot, but the trimmer thinks I should do a Rockley style barefoot rehab instead of the shoes and rest recommended by the vet. I am really torn, as my horse is also already on a forage only diet with a ration balancer, so not an inflammatory diet by any means, and 24/7 turnout. I’m skeptical about the entire thing say the least, but am certainly open to learning more. I just want to do the right thing y my horse and not cause any more degeneration by messing about with various treatments.

After reading my novel, does anybody have some insight? I apologize if my rendition the findings are not detailed but they were relayed to me in very vague terms. Thanks so much, in advance!

I would go along with the lameness specialty vets recommendation on the egg bars for now. I dont know about injecting at this point. It might resolve with rest and the shoes without the invasive procedure plus he’s not in great discomfort.

Give him a few months of this and see where you are. DDFTs take a loooong time ( my horse was 18months) plus the other things like thin soles can dealt with. Reevaluate every few months/ shoeing cycles.

You say he was working barefoot in the past but had problems with long toes and forging? Say what? Thats a bad trim, not simply no shoes. Was it the same farrier you have now??

Anyway, go with the vet recommendation for shoes for now.

While I am generally inclined to go with the vet’s recommendation, I am really skeptical of shoeing for these type of issues unless you have a top farrier.

Every farrier under the sun thinks they can do this type of corrective/palliative work. About 90% end up making the problem worse. You end up in this cycle where you need complex shoeing forever because “aw shucks he just has bad feet,” or “the problem was worse than we thought.”

Sometimes even the vets refer you to subpar farriers.

I would be more comfortable employing a proper, balanced barefoot trim and rest. Although seeing as how your current trimmer was attending the horse’s hooves when the issues began, I would seek alternative opinions.

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I went down the rabbit hole of fancier and fancier shoeing and vet intervention and have now turned the horse out and pulled his shoes.

My horse had a bone bruise, collateral ligament damage, and possible abnormality in his DDFT that all lined up with the divot on the bottom of his sole. We are are nearly 100% sure it was from stepping on a rock. That was May 2019. Threw everything at it, horse became sound quickly after, returned to work slowly, and all seemed OK. At that point the presumption was that it wasn’t the DDFT since that would have taken longer.

Horse apparently reinjured it, or maybe the DDFT never healed, but he went lame again in April 2020. This time nothing worked, at least for more than two weeks. Went to fancy farrier. Tack walked horse for a total of six months. I have an MRI report from May that says everything is minor and should heal quickly. Which reminds me that Alamo Pintado never returned my call when I asked for a review/reinterpretation back around Thanksgiving.

Even without shoes, horse is sounder than he was six weeks ago when we turned him out. He’s living out 24/7.

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I’d get a farrier who can fix the long toes issue. And put on shoes and Equipak. I have had great success with Equipak helping build sole. But you need a good trim regardless of what you do. With the tripping and forging, if trimming back the toes doesn’t fix it you can rocker the shoe some to improve the breakover. Could be that extra leverage he’s got built into the foot is contributing to the soft tissue problem. Because he has thin soles, I would be hesitant to rehab this barefoot. But I think an eggbar probably isn’t necessary based on your description of the issue and how he moves.

Thank you, everyone! I suspect the issue is going to be the same for finding a farrier or a barefoot trimmer: how will I know who is capable of fixing the issue and not making it worse? Who is actually “good?” Most accomplished farriers won’t come out for 1 horse anyway, so I already have that against us.

I have limited hoof knowledge, so I am afraid I won’t know what to look for anyway. My vet isn’t local, so cannot give recommendations. I have used recommendations from friends in the past with mostly poor results.

I find a lot of people are like me in the sense that they trust their farrier and think they are doing a good job, when they are actually causing a lot of harm. They know no differently. They find out the hard way that it’s not the case when lameness issues or injury crops up down the road, or when a vet takes issue with the trim/shoeing job.

I feel lost and confused, but most of all, afraid to hurt my horse by my own ignorance.

P.s. I am not using the long toes farrier or the one that cut off all the sole currently. We did find someone else, who is into the whole Rockley method.

Honestly, it’s frustrating. If you are near a vet hospital, private or school-affiliated, call them. Most will have a really good farrier on staff, or on-call, for horses that need therapeutics, as well as horses that are spending time there for other things and just need trims/shoes. You will likely have to haul the horse to the clinic, or to a barn that the farrier has a relationship with. However, after the first time, that person should be able to refer you to someone closer, and also give that person instructions/supervision so things stay on the right track.

My horse was similar in that he had DDFT issues (but not torn) and the inflammation upon MRI. He was actually moving soundly by the time he had the MRI. He had been barefoot his entire life and everyone agreed his angles were good. (Balance was good too until he started having issues, then his heels started shearing) They thought it was early Navicular Syndrome.

Clinic and farrier consulted and he is now in 2 degree frog support pads up front. This relieves some of the pull on the DDFT. He has been sound for nearly 2 years this way. We have discussed whether he needs the degree pads, but his feet have held up well and if it ain’t broke…

It is key to have a farrier and vet that can work together. Ask your vet and hope that you can get someone to come out for one horse.

I’ve had some similar experiences with a mare the past two years. She actually had a fracture on the medial wing of her RH coffin bone, and some abnormality in the DDFT on the same leg. However, the vet said the DDFT was OK, and we treated the coffin bone by stabilizing it with a custom made clip shoe. I keep my horses barefoot and trim them myself, so I didn’t have a relationship with a shoer. I used the best farrier in the area, recommended to me by someone who runs a rehab facility. The farrier who does the most work at the equine hospital. He made a beautiful shoe, reset it for me once, then fell off the face of the earth. However, by the reset, I noticed the toe getting long. We had to locate another vet-recommended farrier to get the shoe reset a second time, and by then, the toe was getting uncomfortably long, in my opinion, but not really, if compared to most of the other shod horses at my barn. Well, the vet cleared my mare to be moved to a slightly larger pen, which happened to be muddy that week, and she injured the DDFT. I am convinced this wouldn’t have happened if her toe hadn’t been allowed to run out, even though it was within the realm of what I see on 90% of shod horses. Luckily the coffin bone was healed at that point, I had the shoe pulled and I brought the breakover back by at least an inch and was able to successfully rehab the DDFT (going on 10 months in normal work).

Now in the case of the coffin bone, a shoe was kind of the only choice, but I wish I’d been a more vocal client about getting the toe backed up. I just tell this story because I see so many long toes and owners totally oblivious because all the horses have it and it looks normal. Some of them stay sound, but some can’t compensate for the added leverage on the tendons.

To speak to the coffin joint, it’s probably not too relevant to your situation, but my then 3 yo had an OCD removed from a front coffin joint last summer and she was mildly lame for a few months after surgery. We eventually did one round of PRP injection and she went sound within a week. Of course, that is a young horse with a fairly fresh insult to the joint; results might not be as good on an older horse and older injury, but I thought I’d throw that out there.

As far as the digital cushion, you might want to watch this webinar: https://www.youtube.com/watch?v=o4FWggy4c7g
There are other good videos about toe length, glue-on shoes to bring breakover back, and other hoof/leg topics on this channel that might help you as well.

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@outerbanks77 I had a very similar experience, injury-wise.

Fractured coffin bone, ruptured her coffin joint, damaged her DDFT.

I was using a very good barefoot trimmer when the injury happened (it was a pasture accident). Despite me being a crazy barefooter, of course I followed veterinary advice for treating this type of injury and used his farrier for shoeing. That fracture needed support.

Once the fracture was healed, we were still having some shoeing/soundness problems. Several vets told me I’d need to go down the wormhole with all sorts of therapeutic shoeing options forever. The local farrier referred by the local vet was just… bad. The big wig farrier who flew in every 5 weeks wasn’t much better, but 3x as expensive.

My barefoot guy was really quietly persistent through the whole thing, insisting that once the fracture was healed, that he would be able to get her sound barefoot. After things with the big wig farrier were getting increasingly complicated and expensive without improving, I let my barefoot guy take a crack at her.

Don’t you know, the horse that was “never going to be pasture sound without shoes” was sound within months. :woman_shrugging:

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Thank you to all who replied. I think I am going to start with shoes and see where that takes us, as I can always try barefoot if it doesn’t work out. At least I can say I followed veterinary recommendations, which will allow a better working relationship between me and my vet. Working in the field (small animal) I know it’s frustrating for owners to go off on their own path and want the vets to fix it afterwards.

That being said, I’m still scared about how to find a reputable farrier. For every one mentioned I heard equal amounts of good and bad. I even called 2 veterinary hospitals, and was shocked to hear one recommend a farrier that I feel has a poor reputation. Who can you even trust?!

It’s tough. I don’t want to insult the farriers or vets reading this, but it is the unfortunate truth that farrier education in this country is just bad. We have entire generations of “well educated” and experienced farriers and vets who don’t even understand hoof pathologies.

I think the best thing to do is call the major equine vet schools and podiatry programs. If you are not close enough to utilize the farrier at one, ask them if they can refer you to someone who can travel to your area.

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I struggled with the farrier issue with a previous “bad foot” horse. First, the vet and farrier have to be able to work together. It is no good if the vet says do X and the farrier does Y and says X isn’t possible but the vet does not believe him and still wants X! Yet farrier insists he knows how to address the problem…

I went through a couple of mismatches in trying to sort this out. What ultimately worked for me was finding a farrier referral from someone who had a horse with similar issues. Before calling him, I called my vet and asked if he had worked with him. Vet was familiar with him and thought he could work with him. I asked him to be very specific about what he wanted and why and share the radiographs. Then had to get farrier to agree to trim/shoe my horse to the agreed specifications. Vet and farrier communicated well, and we finally had a smoother path forward! My other option would have been to pay for a vet and a farrier call at the same time so they could discuss options while actually working on the horse.

I had trust in my vet’s diagnosis and treatment plan. With current horse, it took a visit to the Big Clinic and MRI to diagnose and Clinic worked well with local vet on treatment plan. Also fortunate that vet and current farrier work well together. I did hate to put orthopedic shoes on those feet, but (knock wood) it has worked.

I read that in 80%+ horses with navicular changes have soft tissue (DDFT) damage before you see bony changes. Getting the back of the foot healthy is really important so the horse feels comfortable to land heel first. If you have contracted heels, thrush in the central sulcus, thin soles, underrun heels, etc these will all contribute to toe first landings and contribute to the problem. Bar shoes, wedges, composite shoes seem to help for a while but then the lameness returns.

I would take a different approach and address diet and treat any thrush/white line present, pull the shoes and put the horse in some boots with pads to start.

Some references for you:

https://www.paulickreport.com/horse-care-category/incorrect-trimming-and-shoeing-cause-navicular-issues-in-horses/

https://www.hoofrehab.com/NavicularSyndrome.html

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Going down a similar road, and found rest, backing up the breakover and using half rounds and pads combined with previcox/equioxx and a good equine body worker or chiropractor (as always, everything affects everything!) helped get my guy moving nicely again. Good luck with your horse; such a frustrating adventure! As a side note, my horse has a mild but visible high/ low hoof conformation issue which makes boots impossible to fit and any fix less likely to be 100% given his conformation. As with all high/low front hoof combos, the higher is narrower and lower is wider and the resulting challenges go all up through the shoulder affecting balance, movement, and saddle fit.

IMO giving the hoof a chance to heal naturally is always the best strategy. I understand not everyone agrees. As an anecdotal example, realizing it proves nothing, my neighbor down the street has a cushings pony who foundered a year ago and he was just put down after doing everything her vet told her to do for his feet including shoes and whatever else. My kid’s pony was diagnosed around the same time, has chronic laminitis (she is 28+ years old) and is still getting around mostly pain free thanks to my barefoot trimmer. When my neighbor originally called to ask my advice I said I would not give her any but shared how I was going to handle my mare’s situation. She chose another path. My pony is still here.

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