Posted by M. W. Myers, D.V.M. on September 30, 2001 at 10:54:57:
In Reply to: Re: seeking other opinions on treatment for hoof slough posted by Todd King on September 20, 2001 at 00:12:33:
: : : : : : Yesterday I did a trim on a 9 yo Arabian gelding that has not been trimmed since last May when it (supposedly) first foundered (approx 4 months ago). It had founderd to the point of sole penetration on all four. The horse has lost one hind hoof capsule and will lose the other hind capsule soon. The fronts appear to be slightly more stable but he will probably lose those too. I have sought-out some opinions on this horse regarding protection for the sloughed hoof but would appreciate other opinions. Also, how does one determine whether a hoof has gangrene? There is some blood supply to the sole corium on all four feet but the laminar corium seems to have no blood supply.
: : : : : : Denise
: : : : : :
: : : : : Denise, if you can stabilize the hoof, then new hoof growth should begin underneath the sloughing hoof and help to provide a better foundation for the foot. I have had best luck with shoes, but knowing you don't use them, I don't know how to best advise getting them stabilized. I would say that if the foot is trimmed so that it is balanced and there is good support to the entire sole- including frog, then it may stabilize enough to begin the rebuilding process. As for gangrene, I would think that a competent vet should be able to recognize this and possibly treat if it isn't too advanced. If there is advanced gangrene, then there isn't likely much hope. While there may not appear to be blood supply to the laminar corium, I can assure you that there is some amount, and with the stabilization, it should greatly increase.
: : : : : Todd
: : : : Forgive me for the silly question, but how does a shoe stabilize a loose hoof capsule? I can understand how it would limit expansion/contraction but what about when the horse lands and the hoof capsule is forced up because of the extremely weak laminar connection-(I can actually see the hoof capsule moving up and down when the horse shifts weight on and off the feet). Since the shoe limits expansion/contraction does it prevent the coffin bone from descending within the hoof capsule? Maybe, just maybe, this would be one of the few cases for shoes then. And since I don't shoe (yet), maybe I should just walk away from this case. I did recommend the owner tape on styrofoam on the three hooves that have a hoof capsule. Placing tape around the exposed coffin bone on the sloughed hoof (to secure styrofoam) would probably not be a good idea? I would hope a vet could recognize gangrene-I was just wondering what it looked like-or even smelled like-does it smell similar to dead feet? (These feet are worse than any cadaver feet I've ever seen or smelled and certainly worse than any abscessed feet I've dealt with). They are literally rotted.
: : : : Denise
: : : On the foot with the exposed P3, you could try to rebuild with Bond-n-Flex or another type epoxy. Walking away would certainly be an option if you think you are in over your head. With some of these types, if you know they're gonna be put down anyway, then they can be great for experimenting and educational purposes, but you have to rectify with yourself and the owner the additional suffering if you can't pull them through.
: : : Todd
: : All four feet have exposed coffin bones (sole penetration)- one hoof has sloughed. Are you saying rebuild the sloughed hoof with an epoxy? Won't that interfer with any blood flow or kill any viable tissue? (which is why I don't want to tape anything to the bone.)
: : Denise
: Well, welcome to the world of hoofcare- where everything doesn't fit into a neat, tidy little package! Some things sound great in theory, but just don't quite cut it in practice. While the epoxy will kill some live tissue, and may impede some blood flow, it will also help to stabilize and support P3 so that the horse will be able to walk. If you are going to save the animal, it may be necessary to do things that you wouldn't normally think should be employed. Bond-n-flex has enough flexion to it that it models pretty close actual hoofwall, so it may serve you well. Even if it isn't ideal, if you want to save the horse, it may become necessary. The horse must have something upon which to bear weight and without hoofwall, something artificial must be provided or the bone will breakdown and the horse will then have to be put down. I would say at this point, that this is probably your only hope.
: Todd
There is a rather exotic method I have successfully used on very painful horses sloughing their hooves. You cast the lower limb up to the carpus (knee) and attach a walking bar to the bottom of the cast. You can enclose the hoof or leave it open to treat whichever seems appropriate. This distributes the weight off the hoof and allows the horse to walk more comfortably while healing. It is a tediuos procedure and requires continual monitoring, but it can be very beneficial.
There is no concern about "hoof mechanics" at this juncture. There is no hoof.
M. W. Myers, D.V.M.