Pedal osteitis & thin soles

[NurseHorsey]

I’ve done some searching on the forums and found a few applicable threads but didn’t know if anyone could offer some more recent advice/experience…

My boy is a big OTTB 12 yr old gelding. We’ve had a few health issues - most recent being managing chronic scratches that contributed to a few cellulitis episodes last year (all overseen and managed with my vet). I had been riding him up until about December, when work and school got busy and the weather got icky, so he got most of the winter off.

Around February, I began noticing that his right front hoof was “slipping” - he’d walk onto the concrete aisle and seemed very unsure that he had purchase and would slip the leg as he walked. Farrier came out for normal shoeing rotation (shod in the front only) and noticed 2 spots of sole bruising; we discussed his “slipping” and thought an abscess might be brewing.

I began soaking and poulticing. No improvement after about a week, so I had the vet out; she saw the sole bruising as well, agreed it could be an abscess, so we popped his shoe and I kept at the aggressive soaking and poulticing. He was still slipping a bit when walking in the aisle but sound in the pasture (and in the ring when jogged) - he was happy to run around.

After a week-ish, there wasn’t really any improvement and I was nervous about a subsolar abscess, so I called out a bigger vet practice in the area for X-rays and kind-of a second opinion. 2nd vet agreed abscess was the most logical assumption but he wasn’t presenting typically. X-rays showed no abscess but very thin sole and mild pedal osteitis, which 2nd vet said was likely caused by his thin sole and hoof anatomy (flat hoof-ed, long toes that needed to be brought in).

2nd vet recommended starting on a hoof supplement with high biotin content (above 15 mg since he’s a big boy) - he’s on SmartHoof, which has 25 mg of biotin and some other supporting ingredients - to try to grow stimulate hoof growth. He spoke with my farrier and we all jointly agreed to try injectable pads on both hoofs, then possibly add egg bar shoes if the pads themselves didn’t give a lot of help. He also said to try to stretch the trimming cycle as far as possible to give the sole a chance to grow. 2nd vet recommended buting until the day prior that farrier came out to do the pads.

So my farrier was out Saturday; my guy seemed fine, if not better, Sunday and Monday. Farrier did pads, trimmed extra toe off, and tried to remove minimal sole when trimming. Then I walked him out of his stall yesterday and the slipping is happening again 2nd vet and I figured out that the slipping happens because he is reluctant to put initial weight on his toe, due to being sore, and tries to walk more on his heel, when he is on the concrete; when he is in pasture or the ring, the surface is more forgiving to his feet and he feels more comfortable.

I think I put too much hope on the instant fix of the pads but I’m feeling very frustrated and a little distraught. It’s a little scary to have him slipping like he is since he’s so big and it’s also hard to see him limping like he is, even just on one surface. I did take a video of him last night that I’m planning to send to 2nd vet so that we can discuss what’s happening but…

Does anyone have any anecdotal experience with PO and thin soles? Unless vet says otherwise, I’ll probably put him back on the bute for a few days to help him feel a little more comfortable but that’s just a band-aid on the problem for now.

Sorry this ended up so long; it’s been a bit of a journey over the past month and a half with this issue.

[LadyJ526]

I also have an OTTB with pedal osteitis, diagnosed about 2 years ago. My vet didn’t think even think PO was a possibility because she was SOOOO lame. After sending her off to the vet hospital thinking it was a soft tissue injury, it was mild PO.
The first thing my farrier did was put a spider plate on the affected hoof (LF), and then filled it in with Equathane. He explained that the spider plate helps to stabilize the hoof, and allow as little movement as possible. My vet also prescribed something that increases blood flow (can’t remember the name) in order to help with hoof growth, which we used for 30 days, and she was hand walked every day in increasing amounts to help with circulation. I kept her in the spider plate for about a year until she was consistently sound, and now have her in Castle plastic pads, filled with dental impression material I believe. We’ve had days here and there where she might start hitchy on that LF, but overall there’s been a huge improvement over where we started.
You may also want to look at using Previcox over Bute when you need it for longer periods. You can’t give it off and on like Bute, but it’s easier on their stomachs, and seems to be pretty successful on horses with PO. Hope this helps! I know how frustrating this can be!

[NurseHorsey]

Definitely helpful to hear your experience, LadyJ526!

I haven’t heard of spider plates before you mentioned them and my farrier seemed slightly reluctant to put on bar shoes in general, so I may have to talk to the vet about what’s best. The spider plate looks very interesting! If I need to, I’ll change farriers; he’s been great and we have a good rapport but if he’s not comfortable with doing corrective shoeing, I need what’s best for my guy.

Vet did mention that we could give him a “circulation stimulating” supplement/treatment but that he would hold off on that for a bit to see what changing the trim cycle and adding the hoof supplement would do.

I was thinking on the drive into work today and Previcox crossed my mind but of course was off of it by the time I got to my desk - I’m going to look into that.

I think I’m just frustrated because he is fine (nearly great!) in pasture and in the ring (just in hand, I have not started riding again) but ask him to walk across concrete and his slipping looks neurological until you realize he’s trying to walk on his RF heel, so no wonder he’s slipping. It’s good to hear about successful management of PO from someone else. I’ve already decided no more jumping; if I can get him back in work and in shape, we might do some low-level dressage stuff. If not, he’ll just be a pleasure horse to hack around. So I’m not even trying to get him back to a super high level. :sigh:

[OTTB2]

Do tildren ASAP that helps a lot. My horse had early stages of it and after tildren it has helped a lot. But my guy is also 6 and he was a lot more resilient. PO is a slippery slope if not caught early. I would also pull his shoes for more in depth x-rays. Shoes with support like a bar shoe is also very beneficial. Personally I wouldn’t keep him on bute just because it tears up their stomach.

[NurseHorsey]

[QUOTE=OTTB_;8609429]
Do tildren ASAP that helps a lot. My horse had early stages of it and after tildren it has helped a lot. But my guy is also 6 and he was a lot more resilient. PO is a slippery slope if not caught early. I would also pull his shoes for more in depth x-rays. Shoes with support like a bar shoe is also very beneficial. Personally I wouldn’t keep him on bute just because it tears up their stomach.[/QUOTE]

I’ll have to talk to my vet about Tildren; I sent him a video clip last night that shows the slipping issue that’s re-emerged, so I’m interested to see what his thoughts are. I don’t know if the “circulation-promoting” drug he mentioned could be Tildren.

We did pull his shoe, on his RF hoof, to do the X-rays. Didn’t X-ray the other hoof, unfortunately, but that’s next up on the list.

I put him back on the bute last night but, again emailed the vet, so he might come back with other suggestions. I’m not sure if he will prescribe Previcoxx, since it is an off-label use in horses, but I definitely want to ask him about it.

[Trails]

My mare had PO and thin soles. When first diagnosed she wore ordinary shoes with plastic pads (packed). She was also on "the “circulation-promoting” drug " but I know it wasn’t Tildren. If I remember or can find out I’ll let you know. After stall rest and hand walking she was allowed turnout in a small paddock. Then on to light riding and built from there. For years she wore pads but has never jumped since the PO was diagnosed. She was back into full riding.
A couple of years ago I wanted her front foot x-rayed and the results showed that calcium had filled in the part of the bone that had disintegrated. New bone had formed. No more PO, no more pads. I started painting her soles religiously to toughen them up and all has been well.
At this point in her life she is on Previcox but it is for her arthritis - absolutely nothing to do with her foot.

[NurseHorsey]

[QUOTE=Trails;8610244]
My mare had PO and thin soles. When first diagnosed she wore ordinary shoes with plastic pads (packed). She was also on "the “circulation-promoting” drug " but I know it wasn’t Tildren. If I remember or can find out I’ll let you know. After stall rest and hand walking she was allowed turnout in a small paddock. Then on to light riding and built from there. For years she wore pads but has never jumped since the PO was diagnosed. She was back into full riding.
A couple of years ago I wanted her front foot x-rayed and the results showed that calcium had filled in the part of the bone that had disintegrated. New bone had formed. No more PO, no more pads. I started painting her soles religiously to toughen them up and all has been well.
At this point in her life she is on Previcox but it is for her arthritis - absolutely nothing to do with her foot.[/QUOTE]

This is really nice to hear the vet told me his PO was “mild,” so I’m hopeful that I can bring him back so that we could do some local competing in low-level dressage.

Vet’s secretary confirmed receipt of my email and video, so I’m anxious to hear what he has to say. My guy seems to do much better when he’s turned out (stone dust paddock currently, grass field come summer) as much as possible but with the rain and the weird weather recently, it just hasn’t happened as much as I’d like, so I’m wondering if giving him something for circulation could help a little.

[Alex2]

My gelding was diagnosed with mild PO a couple years ago. My farrier puts his shoes on backwards so he has heel support but nothing under his toes. This offers him support while keeping the toe short. He events at the P/I level without issue so there are success stories out there!

[khall]

No PO but have dealt with thin soles before with laminitic mare. She is shod in frog support pads with dental impression material under them. This has significantly increased the sole depth she has.

Question for OP: How is the palmer angle of the horse? With long toe and low heel often they will have a neg palmer angle which can cause all sorts of issues on top of the thin soles. Boarder in the barn came with this issue, she went into heart bar shoes, but she did not have thin soles. I personally like the frog support pads and dental impression material for these horses, has helped my mare tremendously.

[NurseHorsey]

[QUOTE=khall;8611002]
No PO but have dealt with thin soles before with laminitic mare. She is shod in frog support pads with dental impression material under them. This has significantly increased the sole depth she has.

Question for OP: How is the palmer angle of the horse? With long toe and low heel often they will have a neg palmer angle which can cause all sorts of issues on top of the thin soles. Boarder in the barn came with this issue, she went into heart bar shoes, but she did not have thin soles. I personally like the frog support pads and dental impression material for these horses, has helped my mare tremendously.[/QUOTE]

This is one thing that hasn’t been discussed between me, the vet, and farrier; I have woefully limited knowledge when it comes to hoof-related things (which I’m improving whether I like it or not in dealing with this issue! :)).

The vet really focused on discussing the degree of degeneration in the pedal bone that he saw, his thin sole depth, and how to address those two issues. Based on my limited knowledge and his hoof anatomy, I would be surprised if he didn’t have a negative palmar angle. I’ll have to address the frog support pads and different impression material with vet and farrier. If the vet and farrier hadn’t been adamant about pacing our “treatments” in terms of shoeing, I probably would’ve put him in egg bars right away last weekend, so now I’m kind of regretting not pushing a little harder to jump right in and do the pour-ins and egg bars all together.

[khall]

My farrier does not like pour in pads, he says they set up to hard for these thin soled horses which is why he uses dental impression material, usually the softest one. The mare in heart bars only went with the bar shoes, no pads etc under them, you get the support from the heart bar. My mare is in plastic pads with frog support made into the pads (this mare’s angles were fine, just very thin soled), they are a full pad that the farrier then puts dental impression material under the pads. She is also in a half round steel shoe now because of some other issues. She has low ringbone that usually is not a problem, but required the half rounds for stabilization compared to the aluminum which she was in for years.

[CC1]

Yep, thin, soft soles, flat feet and pedal osteitis in my gelding. He was diagnosed almost 2 years ago. I have a feeling it had been bothering him for some time but he also has PSSM so it was a bit difficult to sort it all out.

He was affected in both fronts so he was never lame but very sensitive on gravel and did not want to go forward; sensitive to hoof testers and even I could see the degeneration on the xrays!

We have tried a myriad of shoeing options (regular wide web eventers with leather pads, Sigafoos glue-ons, Equipak pour in pads with the eventer shoes and the Sigafoos, regular eventer shoes with a soft latex pad and onion shoes. We finally switched to a bar shoe and thick leather pads and for the last 2 shoeings he has shown no bruising and no sensitivity to nailing. Yay! because of the PSSM, I am bringing him very slowly back into work so the jury is still out about his comfort level when ridden.

Oh, and he is also on a circulation stimulating med. My vet uses pentoxifylline.

[someday]

Osphos?

I have a horse with the same issues. Hasn’t been totally sound in a few years. Pour-in pads tripled his sole depth within just a few shoeing cycles per x-rays. I’m going to go ahead and try Osphos to see if it helps with the bone issues. Appointment is next week. Not expecting a miracle, but hopefully some improvement.

[Gatt_Eno]

@someday

Osphos?

I have a horse with the same issues. Hasn’t been totally sound in a few years. Pour-in pads tripled his sole depth within just a few shoeing cycles per x-rays. I’m going to go ahead and try Osphos to see if it helps with the bone issues. Appointment is next week. Not expecting a miracle, but hopefully some improvement.

thin sole, under-run heels, PO, contracted frogs, right? How did you go with the Osphos? Am still debating trying it.

[Hilary]

What helped my horse was to use rim pads rather than full. He needs wedges and my farrier cuts them so his sole is exposed. At the same time he was injured so he wasn’t working and the combination of time off and the rim pads allowed his sole to harden, if not thicken. With full pads either they kept the sole too soft, or the packing moved and created pressure, but the rims gave him space between the ground and sole, and the time off, one good thing about that injury, let his sole harden. Before this he would be uncomfortable standing barefoot during shoeing. Now he can even be ok if he loses a shoe and has to be barefoot for a day.