Re: PS

Subject:

Comments:
: : : : : : : : : : : : : I have a client who is doing everything to help me with her 15 year old horse who has been diagnosed with navicular. We have been working to get the horse sound for a year and 2 months ago for no apparent reason he came up totally lame and could barely walk out at all. She took him to the vet and the radios show some abmornalities but nothing that any of us thinks should cause him to be in pain daily. The isoxoprine was (key word here) helping- at day 21 at twice a day he seemed much more comfortable. She has been giving him the meds once a day for the last 2 weeks- per the vets instructions- and now the horse is back to almost not walking at all according to her. ????? We put egg bars on him 5 weeks ago. He has a long toe but can't pull much off just yet because the growth is so poor in this horse. We have him on a strong vet vitamin to help get things growing, but he is really falling apart all over again and it seems directly linked to the isoxoprine. : : : : : : : : : : : : : Any ideas???? suggestions? Thanks. : : : : : : : : : : : : : Sophie : : : : : : : : : : : : In some case you can not get a navicular horse sound. : : : : : : : : : : : : I would suggest a new set of radiographs and shoeing with the GE-N shoe at this point. You might also want to try the EDDS system. : : : : : : : : : : : : You need to get the toe off and the heels up. You can build the heels with with a product called Level It, or use of a wedge pad or shoe. But do pull the toe back. : : : : : : : : : : : : What type of Meds? : : : : : : : : : : : : Just my thinking. : : : : : : : : : : : : Ray Miller : : : : : : : : : : : You will neeed to change your thinking to the mechanics of equine locomotion and not to "cut off toe, elevate heel" dogma. : : : : : : : : : : : You must enhance breakover according to what radiographically needs to be done. This will involve a proper shoe set and correctly constructed shoeing package that will not only optimize the mechanics, but will also remove the stressors that are preventing proper hoof growth. : : : : : : : : : : : This is not for the faint of heart and will require an advanced desire to up the learning curve. If you want to venture into these waters, I can be reached on the consulting area of this site. : : : : : : : : : : : M. W. Myers, D.V.M. : : : : : : : : : : : : : : : : : : : : Dr. Myers, what I had pictured in my mind was a horse with very low to no heels and long toes. I see a lot of this type of sore heeled horse in our area, that are called navicular. But when I bring the heels up and reduce the toe from the bottom, then shoeing with an N shoe or wedge of some type. The heal pain leaves and the horse goes sound. : : : : : : : : : : I just about put in the above post this kind of information, guess I should have. : : : : : : : : : : Ray Miller : : : : : : : : : PS: I met to add also that I change the manufactured breakover on the N shoe to what the horses natural break over is. : : : : : : : : : Ray Miller : : : : : : : : Most of the long toe-underrun heel horses I see cannot have their toes reduced from the bottom as the coffin bone is nearly on the ground at the toe. The breakover enhancement must come from correctly setting the breakover via radiographs with a correct shoeing package. : : : : : : : : The standard manufactured GEN shoe does not have adequate breakover to accomplish this. This was my initial concern over the advice to apply this shoe. : : : : : : : : M. W. Myers, D.V.M. : : : : : : : : : : : : : That is what a hammer and forge is for. : : : : : : : Allen : : : : : : Absolutely, and it will be wonderful when these items are more commonly in use in my area. : : : : : : Again my concern is in the use of the terminology to "elevate heel and cut off toe". We all need to get accustomed to using more correct terminology because there are numerous farriers out there that do not understand breakover and limb loading. They will cut off the toe until the horse cannot bear weight on the nearly exposed coffin bone tip and jack the heel up to apply more pressure to this area and then blame us for suggesting a method that made the horse sore. This is my concern. : : : : : : M. W. Myers, D.V.M. : : : : : Understand about the terminology. : : : : : Yes I see a lot of this. Matter of fact just had a horse like this presented to me eight weeks ago. We went to the correct method. The horse is walking 100% better and the p-1,p-2, p-3 are now in alinement. The p-3 where it should be. Horse had been shod the other way for two years. : : : : : Ray Miller : : : : Something I have been made aware of by some good researchers is when you trim the tall heels down and thereby offer ground support to the frog , the digital cushion is supported upward, which moves the distal end of P2 forward, the proximal end of P2 down a little (lowering the angle of the pastern) so you end up get better coffin joint alignment. I have seen this happen radiographicaly many times. : : : : Getting the breakover rearward is also imporatant because if the toe is long, the intersection of the impar ligament and deep flexor tendon can be inflamed and painful, which causes the horse lands toe first. Landing toe first causes a momentary 'jamming' of P2 backward and down into the coffin joint and navicular bone .(ouch) Getting the breakover back relieves the tension in the DDFT and impar ligament at he moment before heel lift, which reduces the pain there, which then allows the horse to willingly land more heel first, which lifts the digital cushion and aligns the coffin joint correectly before it loads. : : : : That is why trimming heel back and moving breakover instead of leaving them tall works better. : : : : If, after the heels are trimmed back the horse needs some wedge for a while until the hoof starts to heal, then I use as much as it takes.along with frog support (as much as the horse will tolerate) , to help the horse find a heel first landing, and lowering the wedge as time goes on. : : : : Dr Barbara Page from Littleton Colorado presented a paper including a study which clearly showed radiographically how this joint alignment happens with improved breakover and frog support. (I think it was at AAEP in 2001) : : : : Leaving them tall in the heels may temporarily ease pain as it unloads the tendon attatchment for a while, but as the structures inside the hoof lack ground support and try to move to where they were under load, the pain (and often some diffeent types of pathology ) most often comes back later. : : : : Hope this makes as much sense to others as it has to me. : : : : Patty : : : Yes, it makes sense. But what if you are starting with a horse tha already has no heel, that is long in the toe. Would you not want to back up the toe and build heel? : : : Ray Miller : : I have found that if you just get the breakover point of toe backed up,and the frog s=functioning, the heels build themselves, and quite rapidly in most cases. IThere is no need to build them artificially.besides, if you build the heels up you would still have to add some type of frog support. Frog function is a key element. : : If however (as I mentioned) the horse is not landing heel first after they are trimmed and/or shod flat with the frog on the ground, then a full stiff wedge pad, or a frog support wedge pad, or a bar wedge pad will get them more comfortable and using the heels so they land on and stimulate the heels and then they repair quicker. : : I have not had to build a heel up in years since I began understanding these mechanics better. : : Patty : Have always added the frog support. I will give the next one a shot this way, with out the build up and see where it goes. Never to old to learn something a bit different. : Ray Miller