Sensitive to pressure at heel bulbs

[JB]

@LamenessRus

is the secret to fixing NPA really just to keep the toe back? That’s all? Seems too simple, no?

It’s more than that, it’s about balancing the whole foot, toes and heels. But even then, many NPA feet, especially if they’ve been that way a while, may need the heels elevated for a period of time for several reasons:

• get more immediate, healthy hoof-pastern alignment
• move some of the forces from above, more forward on the foot and not so much on the back of the compromised heels
• provide appropriate pressure in the back of the foot to encourage health, without causing pressure that hurts

Sometimes it really is about just fixing the trim and giving it time, and often that can be done barefoot if the back of the foot isn’t too sore. Barefoot does allow for as frequent trimming as needed, shoes allow for more immediate correction of the alignment. One isn’t better than the other, it just depends on what’s needed in the moment.

[fivestrideline]

At the risk of hijacking, but in the interest of some visual material, I’ll post a few pics of my horse after he got done by a new farrier today. Keep in mind this horse was about two weeks overdue and this is the first time this farrier has worked on him.

Front right coming out of shoes this spring:

Front right today:

I feel as if I could go behind the farrier and rasp some more wall bevel at least, but if I were to take this hoof back like the one site posted above I’d have a VERY lame horse. As it stands, he’s not footsore and the farrier really cleaned up his bars and flaps off the frog. I’m hoping that I can get after the walls and work with this farrier to get this horse in a better spot hoof-wise. Versus going it 100% alone.

[Kyrabee]

Yeah…it is so disappointing that it seems that many farriers just don’t know what a functional foot looks like.
I, at age 68, am embarking on trimming my own. My trimmer of 15 years retired. Due to injuries earlier in the year, I had 2 different farriers trim her. The first one’s job was just meh. He didn’t really trim much and she was a bit out of balance but by 3 1/2 weeks, I couldn’t get her boots on. With old trimmer, she would make it 4 1/2-5 weeks before the boots got too snug. she trimmed every 5 weeks. Next up this guys ‘boss’. Holy cow…he got her uber short. She was a bit sore but she has rock hard feet and fared OK after the first week. Her boots were downright loose. 2 other horses in the barn that he trimmed the same day ended up with abscesses so I feel lucky and decided nope…not that one.

When Julie retired, I decided that I couldn’t do any worse? I set out to trim…at least start. At this point she had been 8 weeks…and her boots still fit albeit snuggly. I managed a few mm off one front when my back seized up. It hurt to bend over and once I did, I couldn’t stand up. Ouch. There happened to be another farrier at the barn and I asked him if he could do a quick trim. He did chunk out a whole bunch of retained sole and declared they were fine . he didn’t touch her with the rasp. Honest to Pete. Once all that old sole was gone, she had a lot of wall that needed to go…not to mention, I looked at her from behind a day later and noticed my feeble attempts from that day left her heels on the right front about 1/4” higher than the left. Yeah, they were fine.

I did get my trimmer to come give me a tutorial. I have always done a little toe work and some cosmetic stuff to get rid of chips but never tried much beyond that. I have watched Julie trim her all this time so I am giving it a go. So far, so good. She is moving well and I certainly am on the doing less side. She didn’t have any pathology to start with so I am lucky there.

I am doing them every 2 weeks. I do fronts one day and hinds a few days later. My back is holding up OK. I would like to use a grinder on her but have had trouble getting her to accept it. I decided to shelve that for awhile. I may try again before next summer. We are desert here and her feet are rock hard. A grinder would certainly shorten the process and help with the bars. I trimmed yesterday and was only able to do minimal work on the bars due to the hardness of her feet. We are going into fall and hopefully will get some rain…maybe.

I too would prefer to have someone else do her but I am not impressed with any of the farriers that come to the barn currently and it is hard to get someone to come to a barn for one horse. I am at least giving it the old college try.

Susan

[LamenessRus]

@JB

@LamenessRus

is the secret to fixing NPA really just to keep the toe back? That’s all? Seems too simple, no?

It’s more than that, it’s about balancing the whole foot, toes and heels.

I think that’s what gets me - no one seems to be able to say exactly what is critical for fixing NPA, other than keeping the toes short and balancing the foot, which is pretty unsatisfying as “balancing the foot” is probably the answer to most hoof pathologies. Like you said - surely there is something to be done with the back of the foot to address this? If so, what? do you move the heels back (which can inadvertently lower the back of the foot even more, worsening the NPA)? Leave them be? Add wedges and hope the shortened toe stops pulling the heels forward, allowing them to stay towards the back of the foot? I can see the logic of rasping the heels back to where they “should” be (or as much as the horse can allow), then adding wedges to provide alignment to the bony column, while you wait for the horse’s heels to start growing down, not forward. But surely this can’t be it, otherwise someone would have said this was the answer, right?

Hypothetically, if a farrier had a horse with perfect feet except had NPA, what would they do? What would be the key parts of the foot to focus on, and key actions to take? Obviously the answer, to some degree, is a broad “balance the whole foot”, but what specifically impacts the NPA? Or perhaps I should ask the opposite question - how does one create NPA, beyond just letting the toes grow long?

I guess I’d really like specifics as, over the last two years of reading about this, and talking to multiple farriers, no one has been able to clarify what approach one would take to address NPA specifically (and farriers are the worst at explaining stuff!). If I knew the answer to this question, I think it would help me evaluate new farriers (based on their responses to my question of “how would you fix NPA”, or at least be able to explain what I would want them to do.

Apologies if I missed this answer somewhere

[JB]

@LamenessRus

no one seems to be able to say exactly what is critical for fixing NPA, other than keeping the toes short and balancing the foot, which is pretty unsatisfying as “balancing the foot” is probably the answer to most hoof pathologies.

that’s because it depends on why the foot is NPA to start, and how long it’s been that way, and the hoof/pastern conformation. It’s a lot harder to fix this in a leg that has a long sloped pastern and a foot that wants to always crush the heel and grow a long toe, then a normal healthy foot that simply wasn’t trimmed well for 9 months.

@LamenessRus

If so, what? do you move the heels back (which can inadvertently lower the back of the foot even more, worsening the NPA)? Leave them be?

Heels that are “low” because they’re crushed and run forward, don’t get lower when you remove the crushed, compacted heel material. But the weight-bearing surface moves back, which is what you’re after.

@LamenessRus

Add wedges and hope the shortened toe stops pulling the heels forward, allowing them to stay towards the back of the foot?

Maybe, maybe not, it depends on how much re-alignment can be done with the trim

@LamenessRus

I can see the logic of rasping the heels back to where they “should” be (or as much as the horse can allow), then adding wedges to provide alignment to the bony column, while you wait for the horse’s heels to start growing down, not forward. But surely this can’t be it, otherwise someone would have said this was the answer, right?

That IS the answer in some cases. Wedges make some of these horses sore. Some disagree with wedges for any situation, others are open to trying them for a few cycles to see how things go, and revamping from there

There is no one answer, which is why you’re not finding THE tactic. How NPA is it actually? How long has it been that way? How unhealthy is the back of the foot? Lots of NPA frogs prolapse (and make people mistakenly think they’re just “fat and healthy”) and are too sore to put much extra pressure on, so you can’t just do All The Things right at once.

[LamenessRus]

Ah, the dreaded “it depends”

Interestingly, a very long pdf (that I have not finished reading) from the ELPO website suggests these possible causes of NPA (on page 6 of the pdf, for those playing at home):

1. hereditary factors (no surprise there)
2. collapse of the support tissue in the back of the foot and/or weak digital cushion (no specific reasons given, presumably numerous potential causes). This is also cited as the most common reason (not surprisingly, as this seems more like a “catch all” phenomenon, versus a root cause).
3. in super dry areas, the foot retains a lot of sole, particularly towards the toe, which builds up and mechanically tips P3 back (and has potential downstream consequences on the hoof wall due to toe dragging, making the hoof even weaker and more likely for P3 to be negative).

We are not in a dry climate (mid-Atlantic USA), and while there may be subtle hereditary factors, I think we’re definitely looking at option 2 in our situation. As I mentioned before, about 9-12 months before this FEI horse started having issues, we had switched to my trainer’s farrier. Even in my ignorance back then, I could see that 1) the horse’s toes were super long, 2) she was losing multiple shoes, when this had never been an issue before, and 3) the heels looked - to my ignorant eye - underneath her foot. So while it feels too easy to blame the farrier, I kinda do blame that farrier. When I switched farriers, we took baseline rads, and sure enough, she was NPA in the back (not as bad up front, luckily).

None the less, thank you all for the feedback, comments, and suggestions. I’ve joined a few more facebook groups, have ~ 20 more tabs open from the various websites mentioned, and have a lot of reading to do. I got a little braver yesterday and took my rasp to create at least more of a bevel around the toes. Coincidentally, she is already feeling less sore at the heel bulbs, so while she still has a lot of progress to make, she is much more comfortable.

[JB]

I’d agree with those 3 (mostly, more in a sec), but IME, the MOST common is just craptastic trimming.

As for #3, that’s a farrier/trimmer fault. If you’re doing the right work every time you trim, then while you might allow some of that excess sole to remain to help the foot, you STILL trim the breakover relative to the true apex of the frog, and you STILL trim vertical wall height appropriately

@LamenessRus

I got a little braver yesterday and took my rasp to create at least more of a bevel around the toes.

awesome! You can always go back and take a little more, nothing wrong with being conservative

@LamenessRus

Coincidentally, she is already feeling less sore at the heel bulbs, so while she still has a lot of progress to make, she is much more comfortable.

That’s the best news!

[Libby2563]

Since you mentioned the mid-Atlantic and NBC, maybe look into Daisy Bicking (https://daisyhavenfarm.com)? She’s in PA and does barefoot and glue-on rehab work, including consults if you’re not in that part of the state (Coatesville area). She also teaches 4-5 day hands-on hoof care courses. I have no personal experience but her website used to have some really informative blog-type posts with lots of pictures that I found useful. That part of the website seems to be behind a paywall now but here’s the list of courses: https://www.integrativehoofschool.com/courses. (I’m tempted to go to one myself and would be interested if anyone has feedback on her.)

[LamenessRus]

Thanks Libby! Looks like she has a course coming up in November. I’ll have a look at her materials.

In case anyone has a farrier recommendation in the Montgomery County, Maryland area, I’m all ears!

[alfonsina]

I’ve had three different trimmers trained by Daisy Bicking and each did dreadful work, two of them trimming so aggressively that my horse was lame for extended periods, even necessitating a vet call!

[Scribbler]

@alfonsina

I’ve had three different trimmers trained by Daisy Bicking and each did dreadful work, two of them trimming so aggressively that my horse was lame for extended periods, even necessitating a vet call!

Is that related to Daisy herself and how she works, or is it because the trimmers were taking short courses that didn’t really give them the skills to work on other people’s horses? I know nothing about DB other than seeing her name on barefoot discussion groups, she’s nowhere near me. Her advice always seemed in line with what my trimmer says and does, trimmer did a good 2 year community college farrier program years ago. But I never looked further at DB, when I wonder about things my main resource is Pete Ramey’s materials.

I do try to avoid self taught or short-course trained trimmers. I think if you have the physical aptitude you can learn to trim your own horses with some trimmer oversight, especially as you can do a little bit constantly and not cause problems. But it’s a big jump to analyzing the issues in an unfamiliar horse and correcting them in one session.

So it’s possible DB has some questionable tactics, but also possible that her courses aren’t long or rigorous enough to turn out really competent professional trimmers.

One of my barn friends drifted away from the very competent trimmer I use and went with a self trained dude with a good YouTube presence. After 4 or 5 years she is back with the competent trimmer getting the run forward heels under control.

There are lots of half trained or self trained trimmers out there who proclaim that “this or that isn’t taught in farrier school.” With DB, she said that about “slippering” heels which is just what my very competent trimmer calls “opening up the bars.” I sent my trimmer a link to double check and she agreed. Anyhow, whenever a self styled alt practitioner someone says “I have this secret skill that I developed that professionally trained people in my field never learn,” and it turns out to be something that competent professional people all learn and do, I lose a little bit of confidence. Either they are just really ignorant of the parameters of their chosen profession, or they are deliberately scamming and lying. So after that I lost interest in DB on SM because I figured I wasn’t going to learn anything both new and true.

That might be unfair, but I can’t follow everyone online and just get the same old same old questions back and forth.

DB may be a great trimmer in her own right and may well offer courses that help owners work on their own horses in a useful way.

I’ve found that my hand strength and arthritic fingers means I can rasp only a bit each day and I can’t make any impact with a hoof knife on the wall or bars, and hoof clippers are a bit random, though I can take off obvious chunks that need to be gone. So I have given up on any idea of really learning to trim, though I know a fair bit about how it should look.