White Line Disease

HISTORY:

This is an eight year old retired Standardbred pacer with a history of chronic left front poor hoof quality and weakness, The original Farrier had exacerbated this condition by never removing the separated hoof wall and letting a severe dish form at the toe. Eventually the hoof started to fall apart and the horse could not keep a shoe on more than a week at a time . The owner became frustrated with the lack of care and interest by the first farrier, and brought the horse to another farrier. The second farrier performed an incomplete resection on the affected hoof wall. The second farrier then applied hoof repair material to the foot and applied a bar shoe to the foot. Within four days the horse was non-weight bearing on the left front foot, an abscess subsequently vented out on the inside of the hoof wall above the repair material. The horse lost the shoe and the repair material fell apart. At this point both farriers basically gave up, I was then asked to try to salvage the horse.

DIAGNOSIS:

Chronic extensive white line disease, as well as a slight amount of coffin bone rotation. There was also very minimal solar thickness to protect the bottom of the foot based on the appearance of the radiographs. The inside hoof wall was separated due to the abscess, and the toe wall and outside quarter had significant separation due to the white line disease. Since the toe had been allowed to dish out the heels were severely underrun and the hoof axis was badly broken back.

TREATMENT/S:

Initially I debrided all of the separated diseased hoof wall. I then rebuilt the hoof with hoof repair material as well as building up the bottom of the hoof to get the sole off of the ground. Despite the fact that I applied acetone to the hoof for at least ten minutes, and the first layer of repair material was impregnated with potassium penicillin, rebuilding the hoof immediately after debridement proved to be a major mistake on my part. After the hoof was repaired I applied a heart bar shoe with three degree wedge pad. Within two weeks the horse was once again non-weight bear lame, the delay in the horse becoming lame was probably due to the antibiotic impregnated repair material slowing bacterial growth. After removing the shoe the soreness was localized to the outside heel. I removed the repair material on the outside of the hoof and debrided until I established adequate drainage for the abcess. Unfortunately the abscess involved a significant portion of sensitive laminae on the outside heel. The horse was stall rested for thirty days and the affected area of the hoof was bandaged until it keratinzed and started growing down. After thirty days I removed the rest of the repair material and had to make a decision as to what kind of shoe to apply. There was not enough hoof wall to nail a shoe without having to use hoof repair material.

Since we had had such bad luck with the application of repair material, I elected to glue a shoe on. I used an IBEX wedge glue-on to the left front. This shoe seems to stay on much better than the other brand of glue-on that uses tabs and cyanoacrylate. I believe that since the tabs are all attached to each other at the base of the shoe, this results in a significantly more stable shoe.

OUTCOME:

Currently the hoof is growing out very well, but the hoof still needs a glue on for another six weeks or so; as there is significant hoof wall missing. The horse is sound again and being ridden daily. This case points out the real importance of completely debriding all affected hoof material as well as allowing adequate time to disinfect the hoof. Even though the hoof was meticulously prepared there was still a flora of bacteria that resulted in a failure of the repair. Had I waited five to seven days after debriding the foot and treated with a disinfectant there would probably not have been any problems with the hoof repair.

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