Hoof Resection

HISTORY

Ten year old Arab stallion, in Atlanta, Georgia, with history bilateral laminitis and subsequent founder five years ago. The horse had been shod most recently with the four point method and full impression material. The stud had been getting progessively worse on the bad left front foot. He was extremely painful in front of the apex of the frog and grew no toe. Radiographically the left front appeared to have minimal solar depth (~3mm) at the point of the coffin bone and a significant lamellar wedge at the toe. Initially there didn't appear to be any abscessing and seemed just to be sore from pressure on the apex of the coffin bone by the impression material.

TREATMENT - FIRST VISIT:

I usually don't do many aggressive resections anymore. Since there was no toe growth left front I decided to groove the foot and since there was a significant lamellar wedge I also decided to do a resection. As well, I had a gut feeling that he had an abscess somewhere. As I resected the toe area and went to the point of the insensitive lamina a pinpoint area began to leak some serum. I made a pea size hole approximately 1.5 inches from the ground surface. Suddenly very thick (creamy peanut butter consistency) began draining; this drained steadily for ten minutes. The horse was immediately more comfortable and was considerably less painful to finger pressure at the central sole area. A modified four point heart bar shoe was applied. Impression material was placed in the foot leaving the central sole open with no pressure at all. A very long caudal support was incorporated in the shoe. While the horse need caudal support as he had underslung heels (pretty unusual for a foundered horse) the excessive length was more to make the owner happy; since this wasn't harmful to the horse I didn't mind doing this. The right front foot was trimmed and the shoe he had on was reset. The hole at the anterior hoof wall was enlarged to provide access for flushing. The hole was packed with gauze and bandaged every other day with sugardine.

TREATMENT - SUBSEQUENT VISITS:

The left front was changed from a heart bar to a modified four point bar shoe. Also a rim pad from quarter to quarter was attached and the foot was packed with impression material except at the central sole. The heart bar was taken out because the frog became very bruised. The right front had a GE bar shoe nailed on with impression material packed everywhere but the central sole. The area on the toe of the left front grew out in about four months.

OUTCOME & COMMENTS:

This case is a very good example of how the foundered foot is very often undergoing change and may need different shoeing from one reset to the next. It is also a good example of the need to treat a horse as an individual and that no one shoeing technique works for every horse. Currently the horse is doing very well and is on limited turnout with no bute.

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