Severe Lameness Insight

[snaffle1987]

I have an elderly (just shy of 30) horse who is currently exhibiting extreme lameness. Full story below

Horse has IR and has been maintained for the past 3+ years. When the IR was discovered; horse had foundered rather severely and recovered to be 100% sound. Only bouts with foot soreness was encountered in winter months with very hard frozen ground but was easily maintained
Horse has been wearing front shoes since original IR episode with no issue or further unsoundness outside of random bouts during frozen ground

Fast forward to today:

-2 weeks ago horse had regular trim and re-shoeing.
-Horse was fine after trim for 2 or 3 days
-Saw horse jogging across paddock with a noticeable limp at the trot on one front foot. Sound at walk. Still putting weight on entire foot.
-Horse is a bit flighty and will randomly run around pasture like a loon: possible step on stone or kicked himself
-Brought in for stall rest on deep bedding, cold hosing, did several days of magic cushion, daily poultice
-Horse has gotten progressively worse as the next few days went on and has stabilized to where he is at now: Horse will not bear weight on heel and spends extended amounts of time resting hoof on toe.
-There is NO heat in the hoof or elevated pulse

Vet was called after day 2 of no improvement.
-Vet determined this did not appear to be a new founder episode; no elevated pulse in hoof, no heat, and horse was not standing or exhibiting founder-like behavior
-An Abscess or source of a possible one could not be located
-Shoe was pulled for full hoof evaluation but no apparent injury or glaring issue could be found
-Vet specializes in farrier care
-Gelding was very sensitive to hoof testers around typical areas of founder victims but not very sensitive to heel area with hoof testers; despite behavior being exhibited
-Vet placed Shoe on backwards to see if it would take pressure off the toe and support heel. Nailing the shoe back on was very ugly. Gelding walked out well. But still reluctant to place weight on heel
-Gelding wore shoe in this manner on stall rest for 1 week with no improvement; just par for the course.

Vet called again after 1 week of no improvement after shoe adaption
-Pulled shoe. Still sensitive to hoof testers. Good foot slightly sensitive (as usual) but not nearly as bad as this foot
-no heat or elevated pulse
-Other foot holding up well and no issue

• taped on Founder Clogs with horrible results. Gelding was reluctant to walk at all. Scrapped that plan immediately
  -Taped on leather pads with extra strong adhesive to see if lack of shoe/nails will encourage more comfort --> Horse walked out well in the rubber padded aisle but not anywhere near 100% sound
  Decided to leave with the pads and see how he felt after a few days of no shoe/nails. The idea the vet had was the shoe was putting pressure on areas that were suddenly sore for unknown reason. Since this was his first time not wearing a shoe; he wanted to give him a few days to get used to it and see if it changed how he felt on it
  -Horse’s Extensor tendons on the front of the leg were noted to be sore from constantly being pulled to alleviate weight on heel
  -I have continued to poultice and wrap every other day with no change in result

-Xrays have not been taken yet. The vet said that regarding Founder they wouldn’t reveal much other than he foundered.

Where we are at:

Quickly approaching third week since issue first noticed. Little to no improvement
Horse was on a Banamine/Bute daily dosage with no positive results. Stopped giving it to avoid any prolonged dosing issues.
We do not know if the trim job escalated this or if he stepped on a stone or kicked himself or what the answer may be
Horse is still in pads/no shoe on bad foot.
There is still no heat or elevated pulse and the foot looks healthy and very good.
Horse is still on deep-bedded stall rest with a hand walk up and down the rubber padded aisle every night
Horse is extremely, extremely sensitive if walked outside on hard ground.
This is still only isolated to one fore foot

I am beginning to lose my mind because no plan or amount of maintenance appears to improve anything and there is no glaring answers to point any of us in a direction.

I think next step is an Xray to see if there is a fracture or if there is something embedded in the hoof (during the first review there was nothing found that would believe something to be in the hoof). At this point I am in agreement that I don’t think we are looking at founder again. Horse is not acting like his typical signs of founder

The horse will stand on cross ties and stand with the leg straight as of today but will not bear full weight on the leg 90% of the time. Better than we were a week ago, yes. but I constitute this to about 1% improvement.

Horse is in excellent spirits, bright, happy, eating

After reading all of this has anyone encountered similar issues? Something we are not looking at but should be? Too much taken off at regular trimming? Stone bruise? Tissue injury (not thinking this is likely since horse is so sore on hard ground)? I am at a loss

[candyappy]

I would definitely get x- rays asap. Foot and leg, because you never know! I hope you find something.

[walkinthewalk]

The poor horse probably has arthritis on the coffin bone, in the coronary band, or both.

that’s my educated guess based on my 26 yr old IR/Cushings horse who displayed the same initial signs.

I didn’t mess around. I called the mobile sports lameness vet as my regular vet does not have a portable x-ray.

Whaddayaknow. My horse has arthritis at the top of the P3 and in the coronary band of the same hoof.

He is now in composite shoes - a model of Versas by EasyCare to be exact. He also wears a full plastic/pliable pad with a 3/8” rise at the back, and medium hard DIM by ShuFil for packing between the lad and the frog.

His shoes get nailed on and he rarely flinches. I give him Previcox for the reset anyway.

Get your horse xrayed “Yesterday” and get a decent pair of composite shoes and packing on him.

[No1]

Start with blocking the foot. Other than being a little better with the leather pad on, nothing you’ve said actually points to it being in the foot. Be 100% sure where the lameness is, then decide what imaging in needed.

Also, get a second opinion.

The comment about x-rays telling you nothing helpful is nonsensical. Even if the horse has, somehow, managed to founder in one foot only, degree of rotation will help determine the likely hood of successfully making the horse sound again. It could also show a gas pocket where a deep abscess is brewing. It could also show coffin bone fracture, it could show low ring bone, it could show…any number of useful things.

[SusanO]

And if nothing else- x-rays may tell you how much sole depth you are dealing with. Maybe he got trimmed too short and in the subsequent days bruised his foot and is now sore.

I would get him to somebody that can block him and get a good set of x-rays on that foot. It could be anything and just throwing the kitchen sink at it can be very frustrating, not to mention costly.

[Xanthoria]

I’m low key shocked your vet didn’t X-ray this horse a long time ago.

[Weezer]

Sometimes lameness can be an indication of neurological problems. Around here, we test for Lymes disease when we have lameness that we can’t pinpoint. Not sure if that’s a factor in your area.

[snaffle1987]

Xrays taken within the past year indicate no arthritis anywhere or issues with the foot other than the rotation caused by the founder. The horse has been Xrayed many times over the past few years to monitor his situation; however Xrays have not yet been recommended at this time for this episode. I am asking for them at this point and i think they should’ve been taken on the second revisit but I am not a vet. Blood has not been pulled but I think if we were dealing with Lyme or an infection; this would be more of a mild case of lameness; not absolutely crippling.

It was a very dry spring this year and the hooves of the horses got very hard. I am definitely considering that the hoof was hard at time of shoeing and too much sole was removed and then potentially got stone bruised etc. But this is just theory and an Xray would be needed to determine how much Sole we are dealing with.

We are also finding, in this current situation, that certain levels of padding is putting excess pressure on the sole of the hoof and making whatever the issue is 10x worse. This is not typical of what has occurred in the past. This horse has had specialty shoeing after the original episode in which he wore composite shoes and pads and actually had silicone injection done which worked wonders on the original founder episode and helped him recover quickly.

Unfortunately the vet that has helped this horse recover from the original episode and through any bouts of soreness is not longer with the practice and has moved out of state.

[IPEsq]

I also think you should xray, possibly block first (blocking if successful could help him bear weight to get a good image). Could be a P3 fracture or something unrelated to the trim; timing could be coincidence.

[snaffle1987]

thank you. We have an appointment for an Xray, will talk more when the vet arrives and he can see current status of him and so forth. No improvement. Still very sensitive on ground outside of stall. Trying to remain optimistic but it is hard

[4horses]

I’m guessing an abscess. That would be my hope. Exceedingly painful and they often don’t want weight on the heel or sole.