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Palmar and plantar angles - anybody up for a foot discussion? X-rays added

Anybody care for a hoof thread?

Seven year old presents as sore in the lumbar and gluteal areas, has progressed to the point he doesn’t want to canter. Appears sound at the trot.

Had his shoes pulled in December and gave him the winter off. He’s been back in light work for a month and he looks and feels better than he did in the fall but he still is sore and says no to cantering.

I’m having his feet radiographed on Thursday to check angles, will probably X-ray the hocks as well. Multiple therapies have been tried in the past to keep him comfortable, including injections in the SI and stifles, and meso therapy across the back.

Photos are one week after his last trim. Horse has a history since two-three year old of standing camped under by choice. He also overloads the hind feet as evidenced by previous shoe wear and also what his feet show since he’s been barefoot.

Recent trot video:

https://www.facebook.com/1494030110/posts/10228657990423377/?d=n

I’m sure people who know far more than me will chime in here - following cause I’m interested. I will say my understanding is camped under + sore SI/lumbar/hamstrings can indicate angles are off.

Also, my amateur assessment looks like his toes are pretty long (especially in front), and I see jamming of the quarters and run forward heels. Again I’m just learning about all this myself! I’d be curious of pics of his soles, and please post the rads if you can!

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The fronts show evidence of long-term long toes.

The RH especially suggests NPA, not so much the LH but there’s still a coronet curve there that could be about bars never being properly cleaned

Make SURE the vet marks the coronet band and the TRUE tip of the frog - not simply where the point of the frog is, but pare it back if necessary to find where it joins the sole.

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Thanks @JB

The RH has always been where I’ve detected the most soreness.

Assuming the rads concur, now what? Can it be fixed by trimming alone or is corrective shoeing required.

I am not a vet - first order of business would be seeing what the rads show about that sole depth. If the sole depth is precariously thin, sometimes the only answer is elevating the feet off the ground to build sole depth. This can be done by shoes, glue ons, or boots.

I would imagine your horse is bilaterally lame with those feet, which can disguise a limp and would contribute to the horse not wanting to canter. The hinds concern me more than the fronts - the fronts are long and show chronic long toe, but that toe can be corrected over a few short cycle trims. It will take longer for the heel to start growing correctly instead of under.

The hinds show more pathologically unhealthy signs to my (amateur) eye that look like they will take more than a few cycles to straighten out. The curving of the coronet band/jamming will impact future growth, and the fever rings are more pronounced behind which is consistent with long-term sole discomfort AKA laminitic inflammation. That may be because of NPA, or it may be because of the total lack of support behind, but the grooves you’re seeing from the heel that undulate out are symptoms of a chronically unhealthy hoof.

When the coronet curve – or “hairline” – undulates like that, it is usually because of mechanical imbalances in the hoof. In this case, I think it is because the heel has run too far forward, leaving no heel purchase or support for the hoof. When people say “jammed up quarters” or “jammed hairline” they are referring to the visual line the coronet band (and new hoof growth) makes.

With these cases it is often darkest before dawn. These angles don’t transpire overnight. They are chronic, and the horse has adapted postural changes to alleviate the pain associated with these imbalances. Be aware on your journey to correction that your horse may have good days and bad. It takes a long time to untangle the musculoskeletal complaints seen with these cases - it is not just about fixing the feet. It is about unlearning the postural adaptations, and that takes time and pain.

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So much depends on lots of things. If trimming alone caused this, then trimming can fix it, even if you need some shoeing adjustments to help.

If it’s caused by how the horse is moving, then you have to figure that out, meaning it would be some back and forth with trimming/shoeing and PT work for the horse.

I agree with what Beowulf says about the fronts being in better shape, even though they need work too. 1 good trim will do a lot of good for them, and in 2-3 cycles, assuming short enough, with proper trims, they’ll look pretty great.

The hinds do indicate a lot more long-term damage, and will just likely take longer to resolve, Poor hind feet easily set off body issues which exacerbate hoof issues, so you’ll be “peeling the onion” for a while to resolve them both.

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There’s a good amount distortion at the toe (front feet) which should be addressed, either through the trim or shoe positioning. Playing around with the toe lever often gets the front legs standing with the cannon bone perpendicular to the ground.

The hinds are quite a bit different, it’s doubtful you’ll be able to straighten them up through just the trim. Playing around with shoe position and toe lever may work some. If not you can make a shoe such as a rockerbar or navicular relief type shoe to force the hind legs out from under himself.

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Just did X-rays. All angles within normal positive range.

All four feet showed longer outside walls than inside walls causing imbalance like this

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The vet felt this was more critical than potentially longish toes, although not likely to be causing his reluctance to canter and prevalent soreness over the lumbar and SI.

She referred me to her boss, a nationally known lameness vet, to do another exam and ultrasound of the hind suspensories.

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Not discounting your vet at all, but wondering what “normal positive” means? I had two good vets (and a few farriers) think 0 degrees was normal so I am asking just to see if I had bad luck with vets or if it’s more common

+2 - +4 all the way around. In viewing the rads it was visually obvious to me there was no negative distortion as well. I’m pretty bummed because I wanted an easier answer than it appears I’m going to get.

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I had the same Q as fivestride, so that’s good you actually saw at least 2* That said, I want higher than 2*, I want to see 3* or even a bit higher depending on the foot.

Can you post the rads?

Longer lateral walls - how long since the last trim? Some farriers struggle with either medial or lateral trimming based on how they situate their body under the horse, OR struggle with, say, all the left (as looking at the foot) sides due to being weaker in their left hand/arm (or vice versa if they’re left-handed).

But also, how a horse moves can cause excess wear on medial or lateral walls, so if he’s moving such that the inside/medial wall of all feet are getting more wear, that leads to the longer lateral wall. You need to find out whether the lateral walls are being left too long, or if the horse is wearing his medial walls more than the laterals

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I’m going to throw out here to check your hoof-pastern axis, please! Having a positive plantar angle is not enough.
You would be surprised how many horses with a ‘positive’ angle are still broken back in the HPA.

Had a somewhat similar discussion with my farrier and bodyworker yesterday about how the horses’ stance (camped under) contributes to back pain/soreness, yet it’s a chicken/egg kind of thing. The back is sore, so they camp under trying to alleviate. Which puts too much pressure on the heels causing more crushing/running under. Which then exacerbates the back pain. So we fix the NPA in whatever fashion, but… I know in the case of my own horse, it’s an ongoing battle to keep her ‘positive enough’ so that her feet aren’t contributing to her back pain, yet manage the back pain itself so she isn’t standing on her heels.
Hope all that makes sense.

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You can get a pretty good idea of the HPA if the feet in the pics. It’s not a totally accurate view of the fronts, as the lens was a bit too far forward. But the HPA on all 4 looks pretty ok, even the fronts with some longer toes, due to the heels standing up pretty well instead of crushing.

Yes, this horse looks okay in the HPA. I’m just throwing out that not all horses are, esp with NPA, and it needs to be acknowledged as something to look at.

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Oh absolutely! WAY too many horses have a broken back HPA as a result of long toes, independent of NPA. Having one, doesn’t mean the other exists, any more than not having one doesn’t mean the other doesn’t exist.

Even having an aligned HP doesn’t mean the foot is balanced. Long toes and tall heels may mean there’s still an aligned HPA, but also, if that goes on long enough, it means a contracted foot

I’ll post the rads as soon as I get them emailed to me. Thanks!

image image

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Radiographs of said horse.

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But thé p3 of thé front feet are not a bit sinking?

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No, that is dishing of the hoof capsule. When the hoof capsule dishes or flares, the corresponding coffin bone gets closer to the ground.

And Can you correct that with trimming?