I’m so very curious what they are measuring as rotation. Xrays aren’t my thing, I can see glaring issues, but more subtle things get by me. To me, P3 is a little lower in angle than most want to see, which is 3-5*. If the cannon bone was vertical for this, the HPA is a bit broken back
Boots really are so much easier to work with sometimes, so hopefully that will get him more comfy!
I haven’t the foggiest idea how they are measuring tbh
He is doing good comfort wise, medicated obvs, but that’s better than in pain despite medication.
Farrier is gonna try to come Friday am. Hopefully the boots will be here by then. I do have some renegade boots I can use as a stop gag temporarily I guess if needed. Or strap foam to feet. 
I’m thinking have vet come again next week, x ray again to measure for toes and if toes aren’t back enough then get on horn to get another farrier.
Go to Walmart and get a camping mat. Cut out foam inserts to put in the bottom of his renegades. Or you can buy the gel inserts to put in hoof boots from TSC.
I can certainly see why he is lame. I think pads and adjusting the angles over time will help a lot. I think cloud boots could make a big difference and also agree with Susan, I think inserts could help as well.
If it were me, I’d take pictures of the hooves on a solid surface from the sides and front/back and then take another set after his next trim. I’d be really interested in seeing how his feet are progressing with this farrier.
I had rads very similar to this years and years ago.
Start taking photos every trim cycle. It will develop your eye and put you on the fast track to seeing whether you are improving or sliding backwards. Are the fever rings receding? Are they continually coming in? Is his toe gradually correcting, or no? Etc.
An unbalanced hoof doesn’t happen overnight. I don’t know how much you like your farrier but in your shoes I would be truly unhappy with the farrier for their hand in this.
We all assume our hoof care professionals know what they are doing but unfortunately, barring something obvious like a hoof falling off, most people cannot identify pathologically unhealthy hooves.
I ended up firing the farrier because when I tried to approach him with my concerns he became borderline ballistic. It was hard, but I don’t regret it. Even though we used him for years, he couldn’t fix the issue he was causing or didn’t care to see how he was contributing to it by letting the hoof get so unbalanced. Your photos reminded me of my horse’s back then and other posters are right, visually the hoof is glaringly unbalanced in a way one would expect a hoof professional to have comments on it.
We had to put my guy in steel shoes, with a rim pad. He’s still in rim pads to this day even though it’s been 8 years. The rim pads really helped lift his sole off of the ground and keep it from being sheared by substrate. Full pads did not work for him because his sole was so thin that any sort of contact with it caused him to go from ‘minorly bilaterally sore’ to ‘oh my god did he founder’?
Just remember with boots, they often act the way full pads do in that they interact with the sole. In your guy’s case his soles are so thin on x-ray you may see some discomfort initially. I agree it might be worth cutting camping mats or even yoga mats to get a little cushion between the boot and the sole.
It’s not just the toe that needs to be corrected, I hope your farrier knows that. If I were you and you did not have a dire need to use this farrier, I might casually be looking at other horses by other farriers and seeing how their feet look. So many of these issues are farrier caused. Your horse also needs much more heel and sole depth, neither of which will happen until the toe is significantly brought back. These cases take a long, long time and sometimes their comfort gets worse before they get better, but you should always be seeing improvement every trim cycle.
It does look like he’s got some rotation, but to me it doesn’t look new based on the dished wall and toe shape. Those are definitely some very thin soles! Perhaps this acute lameness was largely from changing his setup and removing the wedge pad, but there are for sure chronic problems going on.
Can you tell me what you see?
I have been taking some hoof pictures and observing his hoof. I’m not an expert, but I’m not completely unfamiliar with general hoof shape. This horse’s feet were looking better none of that toe dishing and heels were growing more down than running under, he went broke leg looking lame in back, and then things started deteriorating again up front.
In the x ray where the nail doesn’t obscure the tip of coffin bone, the way the tip of that bone looks made vet question if this isn’t a chronic issue for this horse. I’ve only had him for 1 year and 3 months. I only have minimal info on his history. I know he was lame when I met him. I know he had been retired for a few years before I got him. At any rate it’s possible, maybe even probable he has foundered before.
I’ve got no qualms about getting another farrier. Current farrier is planning to come tomorrow and remove these shoes and do what he can to back the toe up. I need the shoes off and this is the most expedient way to do so. If the vet isn’t 100% satisfied either by pictures I text her or revisit with x ray. We’ll find another farrier.
I’m watching YouTube videos on trimming / shoeing laminitic horses like mad. Lots of variability in approaches. Seems like a lot a videos they don’t touch the outer wall and that dish in toe stays…for years. Some videos they rasp the outer wall hard to get that dish out. I think I understand from vet she’s looking for the latter. But I’m not 100 sure. At any rate I’m getting a crash course in laminitis/founder.
I am not a vet or IPEsq but I saw the same thing in bot images. The most obvious to my eye was the dorsal wall pulling away from the dorsal surface of P3 and the feathering of the distal phalanx as well as remodeling around the toe, hard to tell with that nail in the way. Both images to my eye show the beginning of a laminal wedge. I agree that this has been ongoing and doesn’t look like an event that just happened - that impression comes from how severely remodeled (the dished wall / bulging toe) the hoof is. I’d wonder about sinking with this horse considering how much distance is between the coronet hairline and the distal phalanx.
There’s definitely a wedge there, and there’s definitely an increasing distance between P3 and the wall, as you go down the foot. Laminitis for sure. I just don’t see rotation, and to me, there’s not enough angle (ie the heel of P3 is too low)
If the wall were straight, and that distance increased, then yes, rotation for sure.
There’s definitely sinking, there’s too much distance between the top of P3 and the coronet
I wonder if she saw rotation because of the feathering at the tip?
If so, that’s not the definition of rotation LOL It IS a way to see pedal osteitis starting, likely due to those thin soles
I’m thinking that’s why we were using the heel lift shoes before.
Do you, or anyone else, have a good resource for educational hood pictures? I can see heels. I can see flares. But estimating is the toe long / short I can’t see.
Definitely not the definition of rotation in of itself, but its evidence of past rotation with other markers present.
(Disclaimer: Not a vet, just conveying what I’ve learned from being present for laminitic cases.)
I think if it’s turning up that’s a marker for chronic laminitis but that’s just me and my current Google frenzy talking
Vet says boots should be here tomorrow around lunch bar FedEx delay.
Horse thinks this safe starch forage is yummy.
How long has your current farrier been shoeing him? Is your current farrier the podiatrist specialist? Do you have any pictures of the feet before this last shoeing?
The heels are low (in relation to the whole foot, not saying they need to grow taller, yet), because the long toe is creating a lower overall angle. Simple raising the heels just adds more pressure on long toes
www.barefoothorse.com has some really good pictures and drawings, with the anatomy labeled, and some good before/after trims. For those reasons, I like that site. Ignore the anti-shoe sentiment in it 
Top to bottom, the hoof wall should be a straight line, no matter what angle you’re looking from. The difference is that when viewed from the front, the foot should be a cone shape - still straight line top to bottom, but wider at the bottom.
ELPO hoof mapping is something I love, and find makes it very, very simple for newbies to learn where landmarks are and what they mean
Here’s a guide to learning deformities
And all the study material here is free
The Protocol Guides in that 2nd link show you how to find and map the foot, which you do with markers, which means you can map every single foot (that isn’t shod) over and over and over without actually doing anything (other than maybe removing overgrown frog tips)
For sure, it can be evidence of past rotation. I just can’t figure out what they’re seeing as current rotation
Maybe 9/10 months. Farrier is preferred by the podiatrist vet specialist in the area. But it’s my understanding that those are scenarios where the farrier is trimming to that vet’s directives from his x rays. I don’t use that vet though so … I’ve got no issues getting another farrier. It won’t be the first or last time I change farriers. I’ll see if I have recent pics of front feet again. Pretty sure my camera has been pointing at his back legs recently.
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