Same for one of mine, plus a reluctance to go forward.
The other one we found 0 PA behind had crazy tight hamstrings, some generalized hind end soreness, vague issues in the stifle (slipping), a camped under posture, and a head twist + chomping + general unwillingness to allow any contact with his mouth. I did a combo of stifle injections and a shoeing change, and am seeing massive improvement.
Is it weird I’m hoping this is the final peel of the onion on my horse? Bc these are very similar symptoms to what I’m still seeing after a TON of vet work.
Not at all. In the grand scheme of issues, NPA is a relatively easy fix. The problems arise when it’s been a chronic issue and now you have pathology higher up that needs treatment as well.
FWIW, I have a horse with kissing spines that we think were aggravated by chronic NPA. Essentially, I think I might’ve been able to manage him in a riding career if I’d known then what I know now - but hoof angle issues exacerbate and create issues in the suspensories/hocks/stifles/SI/back. Catching and fixing it early is key!
Live and learn. That horse has been extremely educational for me in all things EXCEPT riding. I’m both grateful and saddened by it 
Is it usually better to be barefoot behind to fix NPA? Or shoes behind? Or shoes with frog support pads?
I’m very sure different people will have different opinions on this, but for both of my ottbs who went on the NPA correction journey, we did it barefoot. My trimmer is of the belief that the most effective way to correct angles is to do small trims to take the toe back really often (like every two weeks), and that’s just most efficiently done barefoot. Nailing in new shoes every two weeks is going to wreak havoc on hoof walls. Even if you’re taking a lot of toe off each trim, a six-week cycle can still be enough time for things to want to run forward.
Frog support/stimulation is also extremely important for encouraging heel growth, and of course, a barefoot horse is necessarily going to get good frog contact with the ground. Of course you can use pads to create frog contact with shoes as well, just one more thing to think about.
On the flip side, both of mine needed boots for the transition and boots are a PITA 
Many roads to Rome. It depends on the horse and other pathology - for example if the horse is thin soled and ouchy barefoot, it’s more productive to offer them some sort of protection (boots, or shoes and pads). For severe cases like the -5 degrees horse, a wedge appliance allows instant relief to the tendons and other structures while the foot is rehabbed. Some horses might need a temporary wedge to change their movement pattern and stop crushing their heels, others must have them on for longer.
A more mild case, such as a 0 degree or so with plenty of sole depth, can often be corrected more easily barefoot than one that is more severe.
Boots can be SO frustrating - and impossible for some boarding situations! Which leaves the horse needing to go barefoot or the shoe route.
I have the exact same hope for my guy - I am sick of peeling onions and it certainly makes me cry lol. If this isn’t the final peel I may just take his shoes off and give him time to be a horse.
Seconding this. I know many people insist that all horses can go barefoot, but it was not and continues to not be a plausible option for my horse even though his hoof quality has improved drastically in the last year or so. Even if he did have the hoof quality for it, at four degrees negative, we needed the wedge to prevent him from reaggravating his suspensories and help correct his biomechanics. I wish he could be one of those fun barefoot TBs (my wallet wishes that, lol) but it wasn’t a fair ask of him and I’m not going to make him miserable and sore for months to a year+ to try to make that happen.
To anyone dealing with NPA, work with your vet and your farrier in conjunction to figure out what’s going to be best for your horse to address the situation. If it’s barefoot with really frequent trims, great. If it’s shoes plus wedge pads, great. If it’s a wedged shoe (different from a pad), great. Don’t let the internet tell you how you “should” fix it if it runs counter to what you and your support team know about your horse.
On another note, as I’ve said on other threads, it doesn’t always work out like my situation did where we found the NPA which unpeeled the whole onion and even the previous chronic suspensory strains don’t appear to have created any real limitations for my horse, but this really can mess with their entire body and be the thing that unravels everything else. I wish I’d known about it a couple of years sooner because I could have saved myself several thousand dollars in diagnostics and failed treatments over that time period.
Reading all of these replies makes me so frustrated (actually angry) about the lack of farrier quality in general. I’ve been fortunate enough to get an education on feet over the years, but not every owner has that, and the fact that there are farriers out there taking people’s money and trimming their horses so incorrectly is infuriating.
Even with that, mine refuses to grow that heel down instead of running forward. This is where I ponder conformation all the way up the leg. Her heel angle is in line with her pastern angle which is in line with her croup angle… is that her normal? Is it okay? How much can you change all the angles without causing yet another problem?
I try not to live in this rabbit hole but good grief already…
I feel you, one of mine simply won’t put height on the heel either. We just do our best to keep him on a trim schedule that’s short enough to make sure both toes and heels are staying back, so that even if he’s not growing a heel up, his angles are correct and he’s comfy. That being said I’d like to get him back into front shoes in the near future and I do worry about how we’ll maintain angles with the lack of heel!
So my horse has flat angles behind that we are working on (nothing drastic at the moment though.) When I talked to my farrier about it, he said “Some people believe it’s a conformational thing due to the rest of the leg/stifle/hip angle.”
Personally I feel like it’s a chicken or the egg type scenario… Hard to say what came first.
This is very long, but it was a really good exploration of that exact question.
Update…Had radiographs done today. Horse was right at 4 weeks from last shoeing. Negative on both hinds, worse on the right hind which corresponds with his lumbar soreness.
This isn’t helpful, but as a result of this thread, I had hind rads done a week and a half ago (already going to the vet for a sore hind end that didn’t fully resolve with stifle injections).
Horse was muscle tight all through the lumbar and hind but didn’t flex off anywhere (in most recent visit- was sore in stifles previous visit). The very good lameness vet noted the tightness in the pelvis and injected SI, muscles over whorl bones, and a muscle knot between his hip and SI on the left side. Upon my request, we took hind rads and he was -2 on the right and -3 on the left. I originally started this lameness work up journey because he was angry and kicking out in left lead canter.
I sent my farrier the instructions from the vet and the marked up rads. The instructions were to bring back and square off the toe, and that the vet thought my horse had enough sole to fix the angles without needing shoes/wedges.
Farrier said my horse doesn’t have extra toe to take off and that horse might need to wear hind shoes indefinitely because we don’t know WHY the angles became bad (whether he’s sore because of the angles or the angles are due to him using himself badly because he was sore–vet more or less said the same). Farrier comes a week from Friday and I’m supposed to continue working the horse in the meantime to see if the SI injection worked.
This is just the most fun. /s
Fun indeed :(.
Mine was 1.75 and 2.3 degrees negative. My vet recommended frog support pads with a wedge.
Honestly, it sounds like your farrier caused the issues, IMO. Rads are rads and I hesitate if a farrier is arguing with them - did your vet measure the sole thickness? Perhaps there’s a difference in opinion on the sole thickness shown on radiograph?
If you’re daring, you could always post them here 
.
Anyway, I’m sorry for EVERYONE dealing with this. It’s incredible that the last thing people (vets/farriers/etc) check are the hind angles, and often just to humor the owner. How much time and effort could we save if we checked those first?
I have a horse that wrecks his angles due to diagnosed issues higher up, but if we’d found the NPA years earlier I think he’d still be rideable…now I just try to maintain the vicious cycle he’s in.
I don’t even want to add up the amount of money I’ve spent chasing all sorts of things higher up…that I am pretty convinced now were all a result of his feet.
A vet school and very big name clinic did extensive work ups, no one mentioned his hind feet even once.
My regular vet radiographed at my request and I had previously brought it up to farrier and got the brush off.
Well the rads don’t lie indeed.
I might have to get brave enough to post them here because I honestly don’t know who to believe.
Three vets told me they didn’t think it was worth the bother to radiograph his hind feet over the last year because my farrier is well known for being good and visually, they looked ok.
Lameness vet has an excellent reputation and people trailer in from all over the midwest to see him. He agreed in response to my request for rads that horse’s angles looked a bit low. I specifically asked if my specific farrier (who he knows) was capable of fixing this and vet felt sure he was. He couldn’t say whether the NPAs were the chicken or the egg re: other hind end soreness. He did not measure sole depth and said that part would be up to farrier. Vet was not overly concerned about the timeline of bringing horse back into work after injections compared to timeline of getting feet fixed.
Farrier has been really good historically and has been doing this 11 yr old horse’s feet since he was 3. We only started having particular soreness in the last year. Other of this farrier’s clients have also started having foot based problems in the last year. There is exactly one other local farrier my small barn is comfortable working with and he’s getting close to retirement age. My other option involves trailering for every appointment and I don’t own a trailer (but this isn’t impossible. Just wildly inconvenient).
I hate it.
ETA: This is made more difficult because my knowledge of everything “hoof” is pretty superficial and I know the depth of eyeroll I will get from “the internet said…”
Do the feet look different? Hard to tell if you aren’t already a bit psychotic about hooves (cough, me, cough), but that may be a clue.
FWIW, I moved to a barn and the BO has been using the same farrier forever. Based on some conversations, I’m gathering that the hooves have changed drastically over the years. The farrier used to do dressage horses and a mustang roll type thing on the barefoot trims, but now does mainly ASBs. My shod horse got INSANELY tall/long feet with him and there’s almost no rolling of the walls. I don’t know what changed, but something major did. This farrier brushed off the NPA FWIW.
ETA: I will say the weather and ground conditions have been very different this year alone, so that’s something to consider as a factor. Weather and ground conditions don’t make toes long, though…
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