Horrible case of WLD, please help!

[Capriole]

Hi!
I was directed here by someone on another forum and hope somebody here can help!
My horse has the worst case of WLD I've ever seen and I just looked at the other "worst case" thread!
He literally has no hoof left, a little bit on the sides and about an inch below the coronet band! The shoer filled it in with acrylic and nailed on a shoe.
Within 2 weeks the top of the acrylic started lifting and then came off completely and took the shoe with it! I was sceptical about the acrylic to begin with because I was afraid it would trap additional fungus and make it worse, but with such a large area being affected leaving it exposed didn't seem an option! Now I don't know what to do!
I talked to the shoer and he said this was the only way he knows to fix it!
Right now the horse is confined to a 12x16 stall with soft bedding and he is still barefoot! I'm worried he might damage his foot without more support!
What should I do?
By the way, I have lots of pictures but don't know how to post them!

[Forgewizard]

Here is a teeny tiny photo of a shoe I fashioned for a horse that I had to do a severe WLD resection on years ago. UNfortunately it is a scan of a polaroid so you may have to squint to make it out. Also the photo was taken after the shoe had been reset so there is quite a bit of hoof grown back in. I really like my digital camera now especially when I review these old polaroids!

When I resected that hoof, the WLD had completely undermined the wall from about a half inch or so down from the coronet all around the dorsal wall. The hoof was left with about an inch wide strip at each heel wall. Everything else wasnon supportive and got removed. It was amazing the amount of sand and debris that had become packed into the cavity even before debridement. This packed debris is what actually caused the filly to go lame and why they called me.

I wanted to offer the hoof some support and make it "think" it still had toe dorsal wall so it would grow straight and not distort as the healing began.

For lack of a better name I called it a "Gooseneck" shoe.

I shaped the shoe to her hoof, and punched new holes at the heels.
Then forge welded an extension at the toe with another forge welded short "T" at the end of the extension.
Drilled three holes in the "T", countersunk the holes.
Hammered the "T" to have a curve to follow the hoof wall. Nailed the shoe to the hoof, hammered the extension to lay against the hoof wall and then screwed the "T" into the hoof wall using 3/8 inch wood screws.

The filly wore this shoe for the duration of her healing (16 weeks) and the shoe was reset every 4 weeks. I encouraged the owner to put the horse on Nu-Foot Vet formula and all of us were absolutely astonished at how rapidly this filly's hoof regrew! Within 16 weeks she had an entirely new hoof!

Besides the Nu-Foot, I also got her to do daily applications of Hydrogen Peroxide followed by White Vinegar. This filly's other forehoof had a small WLD cavity that was managed by just a mild debridement and allowing it to grow out.

Do NOT cover a WLD cavity unless you can ensure the pocket is 100% completely and entirely ANTIseptic before applying a synthetic covering! The air will kill the WLD organisms.

Hope this helps!
Kim

[J.H. shoeing]

I think I need to see some photos before I could give any good advice.

I have resected several WLD cases that left a lot less that one inch at the coranary band and went around to or past the fourth nail hole on a regular "keg" shoe. The horse will most likely recover, but it will take time.

Can you give a detailed step by step of what y'all have done so far starting with finding the WLD.

My last case was a QH gelding 8yrs. old? chronic laminitis in the front feet. Horse is shod on a regular schedule, and nothing was noted in the previous shoeing. Shod the horse and noticed some fungus around the toe back into the quarters of the right hind foot. Horse had walked up sound and have been shoeing this horse for two years. Dug into the fungus and it seemed to end about an 8th of an inch up into the hoof wall.

My thoughts are no problem just a little fungus from lack of foot cleaning and lack of activity. I nail on a shoe and notice that the horse seemed off as he walked off. I have the owner pull the horse back out and pull the shoe. I check the foot again and dig into the quarters and find a much deeper pocket of fungus. I resect the foot and found dirt crammed into the wall seperation at the toe, the reason that my first probing did not find the large pocket of WLD.

I resected from the third nail hole up to about one half inch from the hair line around to the other third nail hole. Once resected it was soaked in "White Lighting" solution and treated with merisol. Built a shoe with clips(3) and drove one nail on each side, loaded the bottom of the foot with "equi-build" for support and left resected area open. I did wrap the foot to help keep the shoe on, and so there would not be shoe sticking out all the way around the foot for him to step on.

I went back in a week and debrided the resected area again with a dremmel tool and soaked with "white lighting" solution and treated with merisol. After drying I filled in resected area of the foot with "adhere".

Shod the horse again in five weeks from second visit and he showed no other signs of WLD. In this shoeing I again used "equi-build" and "adhere" and the three clipped shoe. Six weeks later shod the horse with clipped shoe and left resected area open as it was getting smaller the more the foot grew out.

Two more shoeings and almost all of resected area has grown out. horses has been sound enough to ride since second shoeing.

This is the only case that I have ever had that was this bad and onset this quickly and the only case I have ever had in a single hind foot. Most of my cases have been in front feet and if they affected the hinds they had it bad all the way around.

I have had some cases that were resected so much that there was no way to apply a shoe. On those we bedded in deep shavings and had very limited turnout in sand. They were also sore, alot. There are some ways to get support in the foot with or without a shoe. But sand will act as a natural support as it fills in the foot when the stand on it.

Sorry for the long post but your post sounded like you were in a slight panic and I thought this might help calm some fears. If you are worried about support of the boney column talk to your Farrier and both of you consult a DVM.

Jeff, CF

[Capriole]

Thanks for the answers! I'm feeling a little bit less paniky! :)
Kim, that shoe you made sounds really ingeneous! I wish I had an experienced, inovative shoer like that! Unfortunately the resected area is much bigger on my horse, so not sure that would work even if I had someone that could do it! :(
Jeff, can you tell me how to post the pics? I don't have a website that I could link to!
When I found the WLD I called the vet, he took X-rays and cut back some of the hoofwall, but the X-rays showed a very large area and he didn't have the tools or know-how to deal with it. So next I had both the vet and the shoer out and the shoer cut and dremled back all the bad area and then applied acrylic and shoes!
After the acrylic part came off the hoof looked really bad, smelly and gooey, so I'm sure moisture had gotten in for a while! I took the horse to the vet again and had more X-rays taken. They showed some fuzziness of the outer edges of the coffin bone (pedal ostitis?), but he couldn't tell if this is old or new. By the way, the first (field) X-rays also showed this, but since they weren't a great quality it was ignored until we could take more X-rays.
The horse is an OTTB, so that injury could have happened while on the track.
This was about 2 weeks ago and the horse has been barefoot since. The first week or so I wrapped the foot, but the duct taping caused thrush in his frog, so eventually I just left it off. I feel it might be better to leave it like this, but I'm really worried about causing damage to the bony column. What other support is there without putting on shoes?

[J.H. shoeing]

I have to get my spouse to post pics for me. There is a thread here someplace on how to post pics. I think it is in the FAQ's too at the top of the page.

You can tape support to the foot, use dental impression material, equi-pak and equi-build can be put in without shoes but it stays better with shoes, lilly pads, I have used rolls of gauze and vet wrap in a pinch.

Duct tape wont cause thrush but the stuff that it traps will. Change wraps very regularly and clean the foot let it dry out. Stall the horse and bed him in deep shavings that should help with the moisture in the foot.

On cases where the foot is diseased and there is no hoof wall to work with you will have to think outside the box.

The horse is barefoot now how is he getting around? If he is alright, stall him in deep shavings and give him limited turnout until he has enough foot grown out to work with.

Jeff, CF

[hoofnhound]

Capriole,If you go to www.tinypic.com and have them host the pictures (it's very easy) you can then post the links to the pics here.

[Forgewizard]

Capriole,

Definitely allowing the air to get to the debried areas will improve the outcome for your horse. as far as support for the bony colum while new hoof is growing in. Well, just remeber that the extensive undermining of the wall by the WLD organisms has already caused her to move around with unsupported bony column- you aer just able to SEE it now that the walll has been removed and the cavities are exposed.

Without the acess to an experienced farrier and with monitoring of the bony column by your vet you may be able to handle the wall repair by that tried and true method of "Time to cure all wounds".

Your main concern right now is probably protection of the sole and prevention of bruising and possible abscesses from extensive bruising. I am assuming your horse is on R&R and is NOT being expected to perform until the hoof regrows.

The styrofoam is a gereat temporary product but can be difficult to keep attached to the hoof if the horse has access to free roaming. there is an interesting new product on the mrket I saw for the first time at the Laminitis Conference in W. Palm Beach check out: www.soft-ride.com (http://www.soft-ride.com) these nifty boots have a phenomenal padded insert of variuos density cushions complete with frog support shaped into the pad! The pad is durable, washable and offers great protection.

Another option would be the hoof boots offered by: www.castleplastics.com (http://www.castleplastics.com)

both of these boots allow air to circulate around the hoof.

An absolute bare bones minimum to offer some protection as well as allow air to the cavities is to wrap the hoof in a baby diaper( paper type- not cloth) two diapers if the ground is wet. Then duct around the hoof. The diapers will wick any moisture away from the hoof and allow air to circulat e next to the hoof. Change this wrap EVERY single day! Spraying the cavity with Hydrogen Peroxide then again with white vinegar. LEt the hoof dry a bit before diapering and taping. The diaper should extend well up the pastern so that when taping, you do NOT get any of the tape adhesive on the coronet. Avoid taping the coronet and DON'T tape above the pastern. Vetwrap may be easier than duct tape- and can be wrapped up the pastern, but may prove quite ex[pensive if you change this wrap daily.

Hope this helps!
Regards,
Kim

You might also want to look into "fungidye" at: www.farrierscience.com (http://www.farrierscience.com) this is a great topical antibacterial/antifungal.

[JMPalmer]

Unfortunately, most hoof boots should not be kept on 24-7 or overhydration and resulting hoof infections can occur. I have found the Dallmer clog, a strap on rocker toed plastic shoe, to be very helpful in situations where a nail on shoe is undesireable or there just isn't enough wall to apply one.

Like a regular shoe, they are open at the bottom (but barred) and do not totally seal the outer hoof from the air. They can be fitted with studs for winter traction. I would strongly advise padding the clogs to engage the whole hoof for support and not just the wall. I’ve used a couple of purple podiatry closed cell foam pads (from EDSS) with them to allow decent frog contact with the ground. Pads such as the Hooftrax bubble gel pads with impression material applied into the frog commisures may also work. An application of Thrushbuster (purple dye) before adding the IM and pads will keep the stinkies away. Really.

The clogs CAN be kept on indefinitely. Dallmers are also very easy to apply and remove.


http://www.huf24.com/Hufschutz/Hufschuhe/Dallmer_Clog/hauptteil_dallmer_clog.html

http://www.hufshop-online.de/info/en/dallmer_clog_en.htm

http://www.impactgel.com/equine/horseshoePads.asp


Good luck.

[caballus]

Can the horse be ridden in the Dallmars as well as in Epics or Old Macs? What is the cost comparison of the 3?

Thanks.

[Capriole]

Here are finally some of the pictures I took when this was first done!
The foot looks quite a bit different now that it's been exposed to the air for a couple of weeks and I will go out and also take some new pictures!
What do you think? By they way, the horse is confined to his stall with some handwalking. Absolutely no riding, he is very sore on that foot which you will understand once you see the pictures!
http://www.decowatches.com/Horse/Hoof1.JPG
http://www.decowatches.com/Horse/Hoof3.JPG
http://www.decowatches.com/Horse/Hoof6.JPG
http://www.decowatches.com/Horse/Hoof7.JPG
http://www.decowatches.com/Horse/Hoof9.JPG

[SlowShoe]

Is there no shoe in the last picture, or was the side of the shoe covered with the adhere?

Did he soak the hoof in any type of anti-fungle solutions before covering it?

A case like this needs to be tended to at least every other week by the farrier if you hope to keep a shoe on, and checked or treated daily by the owner.

[Red Amor]

The has been a great deal of good work done here
I just wonder how the horse got on , it all seemed to happen to quicklly was there any abscesses after the rebuild

Not slinging any trype at all just wondering is all
great job big effort good on you mate

[SlowShoe]

great job big effort good on you mate

Agreed!!!!

[Rick Burten]

IMNTBCHO and experience, covering a hoof that has been debrided because of white line disease with acrylic is one of if not, the worst things one can do.

I would have used an aluminum heart bar shoe, pulled up some side clips and glued the shoe to the hoof. Even if a bit of the glue got up onto the bottom edge of the resected area, it would not have caused a problem because that area is generally pathogen free. This happens because the pathogens involved literally eat their way up the hoof wall. Since there appears to be enough hoof wall remaining to get at least one or two nails into, the combination of a couple of stabilizing nails and glue should be more than enough to keep the shoe in place. The heart bar is necessary because since so much wall is gone, the bone can be quite unstable in the remaining hoof capsule. By leaving the affected area open, it can be treated and also benefits from the exposure to light and air.

[Capriole]

The shoe is under there in the last picture, the acrylic covered it!
No, he did not soak the foot in antifungal solution, just cleaned it real well!
As far as the abscess goes, I think it is very likely that one is brewing! After the acrylic and shoe came off and I took the horse to the vet he reacted to hoof-testers, but I guess that could have other reasons as well? The vet prescribed antibiotics for the possible bone involvement and maybe that took care of the abscess too? Like I said the horse is very sore and will put almost no pressure on that foot, that could be due to the fact that half the foot is gone or maybe there is still an abscess in there?
By the way, I mentioned glue-on shoes to the farrier, but he didn't think they would work. In his opinion the hoof wall needed to be replaced in order to give the foot stability. I'm not familiar with heart-bar shoes, how do they help stabilize the bone? That is my biggest fear right now!
Thanks again for all the great answers!

[Forgewizard]

Capriole,

Something I would have done besides NOT covering the hoof with acrylic or urethane- would be to punch or drill some nail holes furhther back on the heel of the shoe and nail two nails there instead of to the essentially non-existant hoof forward of the quarters.

While nailing into the heel area is NOT generally condoned, there are insatnaces when it is necesary for a couple intervals to allow the hoof to repair itself and still retain a shoe.

That hoof would have been a perfect candidate for a "gooseneck " shoe too!

I sure hope the infection does NOT continue under that acrylic! While applying the acrylic certainly appeases the eye- it will NOT aid in healing the hoof.

Fungidye is an antiseptic/antifungal that can be applied and used under acrylic or urethane applications if it is absolutely necessary to apply synthetic coverings to the hoof.

Regards, Kim

[J.H. shoeing]

I agree with Rick.

That is a large resection and the fungus/WLD needed to be treated with something (white lighting, thimerisol) along with the resection. In my opinion the composite material should have been left off until the fungus/WLD was under control/or dried up. If one small piece of the fungus/WLD was still present and the composite covered it cutting off the oxygen the fungus will grow.

I think a heart bar shoe is in order. The heart bar shoe will privide rigid support as the bar will be assisting in supporting the boney collum. It is rigid support as it has no "give" and continues with support whether or not the foot is loaded (bearing weight) or not. I am struggling to explain this without being able to show you with a shoe and horses foot or a diagram.

Jeff, CF

[JMPalmer]

Gwen wrote: Can the horse be ridden in the Dallmars as well as in Epics or Old Macs? What is the cost comparison of the 3?<<

Gwen, yes the horse can be ridden in the Dallmers. They were developed for that purpose. They just happen to be very useful as an aid for certain pathologies, more than any other hoof "boot" currently available, IMO.

Personally, I've tried the Swiss Boots (custom; not much support), Old Macs (too hard and too clunky), Sabre Sneakers (too slippery for turnnout) and Easy boots (waste of money, IMO). I've considered Boas boots and the SoftRides Kim mentioned. But both of these, like the Macs and the others, completely encase the hoof which I don't think is a good thing for more than a few hours at a time.

I'm sure you can do the math as easily as I can. The Dallmers are a bit more than the other two you listed, around $180 dollars US. They are very sturdy and a pair can last for many months or even years, depending on the amount of use. Many of the parts are replaceable too.

Here's another link that lets you turn the thing around, along with pricing:

http://www.hoofshop.com/pi355116985.htm?categoryId=7

[SpiritHorse]

I know how you feel!

A specialist recently found out what was wrong with our BLM mare, the other vet would not get off the founder routine and this horse was on grass hay and a handful of oats and basically dry lotted.

My mare sounds like she has less than that of your poor horse, I pray she gets better too!

In our case the WLD had shoved her hoof capsule over 2 degrees in the left foot and 7 in the right making the coffin bone look like it had rotated 10 degrees. His Xrays showed different no rotation of the bone period.

His shoe prescription was to trim out the nasty, 7% iodine in the cracks, 3 degree wedge pad and square toed shoes. He had our blacksmith trim her feet so many inches and cut her toe back as far as possible for breakover. No acrylic or anything was applied to her case.

She walks better now, once in awhile she will paddle her feet I still think the cold bothers it. But she is moving better and seems less pained now. It is a long road back.
Weither she will be ridden again is uncertain as it is too early but they think she will once her hooves grow back out.

HUGS!!! And there is some great people here believe me, I have battled with our vet over this as it has gone on since December and I finally had enough of his explanations and it didn't seem right in my gut so I went and called the specialist and I got alot of great information from alot of folks including Kim *Forgewizard*

[Capriole]

Hi Spirithorse!
Hope your mare recovers fully! I don't want to think about my horse not recovering fully from this. I show him in Dressage and Jumping and had (have) big dreams for us!
I too am so glad to have found this board as it gave me enough confidence to do what I thought was right (not covering the resection again). I'm still worried about damage to the bone, but the horse is being monitored very closely and I'm keeping my fingers crossed!

[rbloom11]

Hello!

Does your horse wear any shoes? If not why don't you try some of the WHITE LIGHTNING. I think that it could help you tremedously. It even helps other fungal infections such as rain rot and thrush. ;) Hope everything goes well for your poor horse.

Lots of luck!
Rachael