Pedal Bone Osteitis

[HorseCrazy]

ok we took my horse to get radiographs because he got sore and tender footed with just dirt packed in his hoof or bedding ..so we wanted xrays to see how much sole thickness there was and how far the coffin bone was too the sole...

he is barefoot

the hoof tester results showed that he was slightly sensitive all over ( but then when she wrote it again down underneath it and crossed it out...so i don't know for sure but i think she said slightly sensitive all over)

he has no limp at walk or in stall

trot in hand on hard surface : they said he was "outchy" and went stiff

FLEXION TEST

Left Fore : Negative

Right Fore : Negative

Left Hind: Positive

Right Hind : Positive

RESULTS ON TURNS ON HARD SURFACE

Turn to the left : Slightly Off

Turn to the Right : Off RF ( we were told to park the trailer on unlevel ground and to walk him out front ways...and it was pretty high up and he jumped down on one foot onto hard ground don;t know if that could have caused something...because he was never off when he turned before i was angry they told us to unload there !)



before he got the xrays the vet trimmed the sole callous off the hoof was he suppose to do that? he only trimmed the sole callous off then someone told me he had to clean up the foot to get a good x ray

Results of X rays :

Severe Arthritis in the distal intertarsel joint in both the Left and right hock ( he says that are almost fused it surprised me i knew his hocks were stiff but he didn't show that much )

Left Hock also shows Arthritis in the Distal Metarsal joint

Thin Soles on both Right and Left Front Feet RF: 4mm-7mm LF 3mm-5mm

Separate Center of oseification of the lateral wing of P3 of both Left and Right Fronts ( they said it was nothing to eorry about and wasn't causing anything)

they also said he had some Pedal Osteitis on his front feet ( i am pretty sure they said both but she only marked it down on his LF medial and lateral focal Demineralazation even though it looks worse on the RF to me they said it was nothing to lose sleep over and it was from him not wearing shoes..and they don't think it was causing him pain and must have not thought it was that serious cause his ASSISTANT didn;t write it on the radiographic summary or or the overall impression based on examination he just wrote it on the radiograhic findings ..i hope they didn't just forget to write it :( )

The recommended putting Full Groove Shoes on with Leather Pads

before the xrays my farrier was rolling my horses toes so that the umpigmented wall and the tip of the sole/sole callous was even with echother and sharing the weightbaring is that a good idea with a horse with thin soles? and Pedal Bone Osteitis? do you think that could have caused it ?

what type of trimming and shoeing would you recommend?

I also heard that the bone can Remineralize is this true?

if i left out any info you need ask me and i will tell you i have xrays ( if i can find out how to get them off the cd) and pics if needed THANK YOU IN ADVANCE!

[Peggy Dolan]

That's quite a bit of info all at once. You must be upset and I wish you the best. As for shoeing advice, I would recommend that you have your farrier consult with the vet if there is a question about the protocol the vet called for. As much as one would like there to be a quick and right answer, sometimes it takes trial and error to get a horse to it's most comfortable and functional. I tell myself that it didn't get this way in a day and I can't fix it in a day.
Is there any way for you to post the radiographs and some good pictures of your horse's feet?

[HorseCrazy]

yes i was very upset but now i got over the initial shock and i am hopeful

he doesn't have any lameness really just tenderness on gravel and is stiff on hard ground

he said it is that he is just thin soled and he doesn't think the pedal bone osteitis is causing anythnig cause we caught it early...at least that is what he said i have never dealt with this before

i can postsome pictures and then i will have to get the x rays off the cd tommarrow

Left Front

http://images.snapfish.com/34676%3B398%7Ffp33%3B%3Enu%3D3254%3E3%3B7%3E942%3E WSNRCG%3D323363%3B%3A6299%3Bnu0mrj

http://images.snapfish.com/34676%3B398%7Ffp344%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3A6666%3Bnu0mrj

http://images.snapfish.com/34676%3B398%7Ffp339%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3A6666%3Cnu0mrj
sorry i have no idea why it is sideways

http://images.snapfish.com/34676%3B398%7Ffp344%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3A66778nu0mrj

[HorseCrazy]

RIGHT FRONT

http://images.snapfish.com/34676%3B398%7Ffp344%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3A66683nu0mrj

http://images.snapfish.com/34676%3B398%7Ffp342%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3A66686nu0mrj
sideways again sorry

http://images.snapfish.com/34676%3B398%7Ffp33%3B%3Enu%3D3254%3E3%3B7%3E942%3E WSNRCG%3D323363%3B%3A62997nu0mrj

http://images.snapfish.com/34676%3B398%7Ffp345%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3A66776nu0mrj
this foot toes out a little that might be why it is off center

also the cement he was on wasn't perfectly level it slighlty slopes but only slightly

THANKS IN ADVANCE!

[Mike Ferrara]

If I was shoeing this hore, I would be comfortable going with the vets recommendation of shoes and pads, although, I'm not sure I know what they meant by "full grooved".

[Rick Burten]

With a sole depth as shallow as your horse's(18mm is considered appropriate for most all horses) I would not only shoe with a full pad, but also with a rim pad. The rim pad is placed closest to the foot and provides clearance. I would paint the sole of the foot anterior to the apex of the frog with a 50/50 mixture of Venice Turpentine and Pine Tar and fill the back of the hoof with Impression Material. Depending on what I felt appropriate, I might also add a frog support prosthesis to the bottom of the full pad(or use a full pad with one built in).

[HorseCrazy]

ok i got the x rays off the cd...and for the most part they confuse me .... why are some of the xrays of the right and left feet pointing the same way?? example the RF lateral and the LF lateral are pointing the same way...

and the RF Farrier Views and LF farrier views look like they have been switched with eachother ...well to me

RIGHT FRONT X RAYS

RF Lateral

http://images.snapfish.com/346774849%7Ffp344%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3B327%3A4nu0mrj

RF DV

http://images.snapfish.com/346774849%7Ffp344%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3A%3C53%3A%3Cnu0mrj

RF farrier View

http://images.snapfish.com/346774849%7Ffp33%3B%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3A%3C53%3B3nu0mrj

Navicular Skyline RF

http://images.snapfish.com/346774849%7Ffp345%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3B36%3A%3B5nu0mrj

[HorseCrazy]

LEFT FRONT X RAYS

LF Farrier View

http://images.snapfish.com/346774849%7Ffp339%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3A%3C53%3A%3Bnu0mrj

LF DV

http://images.snapfish.com/346774849%7Ffp339%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3B327%3A5nu0mrj

Navicular Skyline LF

http://images.snapfish.com/346774849%7Ffp339%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3B36%3A%3B4nu0mrj

LF Lateral

http://images.snapfish.com/346774849%7Ffp33%3B%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3B327%3A6nu0mrj

If the Xrays are too dark...i can lighten them well atleast they gave me them on a cd so that i can manipulate them so i can see them better

as you can see....i don't know why some of the xrays of the right and left foot are facing the same way.... they wouldn't let me hold my horse in the xray room so i didn't see and also i don't know why some of the xrays when they says it is the right foot it is the other way than it should....unless they took the xray from the inside of the foot......do they do that? or maybe they turned him around so he was facing the other way for one foot???

also someone told me not to let my farrier do the 4 point trim on my horse...cause they get club footed...is there any truth to that?

i also heard the bone can REmineralize true or false?

and should my farrier still roll the toe on my horse so that the unpigmented wall and sole callous share the load/weightbearing? if not what should he Do and NOT do? sorry i realised i asked these questions in the original post but i am worried about that

[Jaye Perry]

LEFT FRONT X RAYS

LF Farrier View

http://images.snapfish.com/346774849%7Ffp339%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3A%3C53%3A%3Bnu0mrj

LF DV

http://images.snapfish.com/346774849%7Ffp339%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3B327%3A5nu0mrj

Navicular Skyline LF

http://images.snapfish.com/346774849%7Ffp339%3Enu%3D3254%3E3%3B7%3E942%3EWSNR CG%3D323363%3B%3B36%3A%3B4nu0mrj

LF Lateral

http://images.snapfish.com/346774849%7Ffp33%3B%3Enu%3D3254%3E3%3B7%3E942%3EWS NRCG%3D323363%3B%3B327%3A6nu0mrj

[QUOTE] ....???

also someone told me not to let my farrier do the 4 point trim on my horse...cause they get club footed...is there any truth to that?
no

i also heard the bone can REmineralize true or false?

false


and should my farrier still roll the toe on my horse so that the unpigmented wall and sole callous share the load/weightbearing? if not what should he Do and NOT do? sorry i realised i asked these questions in the original post but i am worried about thatif you keeping the horse barefooted it would be a good idea.

Firts get the hocks done, this will help the horse get off his front end. Then get his coffin joints done it will help with the navicular changes and lack of sole depth.

Here are your X-rays back with some marks that were not in the descriptive analysis.
Both naviculars on the Dorso/Ventral pic have changes on the flexural medulla surfaces, in the RF there seems to be some type of adhesion in the lateral pic of the DFFT in the posterior portion of the coffin joint. JMO

[Phil Armitage]

Jaye the area I enclosed in the black rectangle, is that calsification (is that the right term to use) below the distal end of P3? Mike Weldenstien mentioned something about this especially when it extends past the wings and how it can cause corns. The recomendation was not to use bar shoes or wedges, but a wider web in the toe with a rolled toe and narrow web in the branches to the heel. I am assumeing any white or grey showing up on a radiograph is dense like calsification, ostiets. If it is, I can see the problem with a barshoe and pads. Rim pads and seating out the shoe and frog support might be a good solution. I am also currious if anyone has found equipack to be too much pressure in this type of situation? Myron Mclaine heart bar pad and equipack might be a good thing to try.

[Jaye Perry]

enclosed in the black rectangle, is that calsification (is that the right term to use) below the distal end of P3?
Not a True lateral, tilted a bit.



Mike Weldenstien mentioned something about this especially when it extends past the wings and how it can cause corns.
There is a little fussiness in the wings, but not as detrimental as it looks. Sole depth is the primary problem with pain, secondary is navicular changes on the the medulla ridge.
Corns in poperly shod feet arise from flexural problems; within and above the hoof.



The recomendation was not to use bar shoes or wedges, but a wider web in the toe with a rolled toe and narrow web in the branches to the heel.
Narow or somewhat "Penciled" heels will concentrate GFR in the heels. That's why I dispize ST.Criox Eventer steel shoes.

I am assumeing any white or grey showing up on a radiograph is dense like calsification, ostiets
Good pedal bones will have distinct lines of demarcation, fuzzy, feathering fingers and gaps will be signs of bony change. Bony change is "One" source of pain.

Lack of sole depth and bad hocks have this horse in a lot of un-due pain. Shoes and pads up front and injections of the hocks and coffin joints will help this horse.




http://www.horseshoes.com/forums/attachment.php?attachmentid=2432&stc=1

[Phil Armitage]

Thanks Jaye, I also agree with you about starting with getting the hind end comfortable to help get this horse off his front feet. Thanks again, this helps a lot.

[Jaye Perry]

.....they also said he had some Pedal Osteitis on his front feet ( i am pretty sure they said both but she only marked it down on his LF medial and lateral focal Demineralazation even though it looks worse on the RF to me they said it was nothing to lose sleep over ....


One can loose sleep over this case of pedal osteitis!

[HorseCrazy]

ok so even if he rolled the toe so the unpigmented hoofwall and sole callous shared the weightbaring it wouldn't cause any sole pressure or inflame the lamina ? worsen the pedal Oseitis?

also what do you think about the Pedal Osteitis ? are you able to tell when it happened? and how severe it is? my vet said it was mild but i don;t know how to tell is he looking at the channels or the part at the tip of the toe ?


i don't know if he put it on the page of the findings but he also said that he had 4 *short* cone lesions on one foot of the hoof and 5 *short* cone lesions on the other hoof but he said that horses have navicular changes in there navicular bone and show no sign of lameness and he said that he doesn't think the changes he seen in my horses foot are causing lameness.... he extends and reaches out and lands heel first wonderfully ...but is just ouchy and stiff loking on hard surfaces and tender on gravel....so i don;t think he has heel pain..although they did say he was off on turns but i never saw him off in a turn before ( on any surface) he might have been sore after the lady made him jump off the trailer on to hard ground from high up . unless he just shows the pain on circles ( which he never showed before) because he doesn't short stride or land toe first...

..i am not sure if that is what you are talking about...but i forgot to add that in there

Also the vet said his hocks were almost Fused...but he didn't put that on the paper... he doesn't seem that stiff or sore when being ridden or free lunged...so i don't know

I can post the hock xrays if you want

He prescribed Isoxuprine and Bute

Bute is to be given 1 gram tablet 2 times a day

Isoxuprine is to be given 10 tablets 2 times a day he did not tell me what Isoxuprine is for...

i heard it is for opening/dilating the blood vessels and letting more lood through...but if there is inflammation of the coffin bone..then do you want more blood to go there when it is already inflamed?

ok here is the full finding they found on the xrays :

Limb: LEFT FRONT DV VIEW

Interpretations :
P3 shows medial & lateral Focal Dimineralization,

Navicular Bone shows 4 cones ( short) ,

LEFT FRONT SKYLINE VIEW

Skyline navicular shows Slight new Bone Deposition ( otherwise NSL/No significant Lesions

FRONT LEFT LATERAL VIEW

P1 shows NSL/No Significant Lesions

P2 shows NSL/No significan Lesions

P3 shows HDPD = 26.7

3-5mm sole thickness CSF/ Clinically Significant Finding

Seperate center of Oscification Lateral Wing of P3 IF/Incidental Finding

Navicular Bone : Good Loose Marrow & Good marrow to cortex ration



RIGHT HIND LO VIEW OF HOCK

Severe Arthritis of Distal Intertarsel Joint


RIGHT HIND MO VIEW OF HOCK

No visable Joint Space

Advanced Arthritis of DIT Joint


RIGHT FRONT DV VIEW

P3 - NSL/No significant Lesions

Navicular Bone - 5 cones (short)


RIGHT FRONT SKYLINE VIEW


P3- Separate Center of Oscification Lateral Wing P3,

New Bone Deposition Along Medial lamina Surface


RIGHT FRONT LATERAL VIEW

HDPD 25.3

sole thickness 7mm-4mm

Navicular Bone - Good Marrow to Cortex Ratio


LEFT HIND LO VIEW of HOCK

Severe Arthritis of DIT Joint

LEFT HIND MO VIEW

Arthritis in the DMT Joint

[HorseCrazy]

One can loose sleep over this case of pedal osteitis!


oh trust me i am DEFINITLY losing sleep over this.... even though they said not to...i want to make sure

[THamilton]

Phil,

In response to: "I am also currious if anyone has found equipack to be too much pressure in this type of situation?"

I chose not to use Equipak because I cannot control it enough to keep it from pressurring the sole. I like to use a NB shoe that is attatched with two or three rivets in the toe to a Castle Performance Pad. This sucks the pad to the shoe and guarantees me no contact with the thin sole when I apply the package correctly. I use IM (which I can control) from just behind the tip of the live frog to help distribute the weight and to keep debris from getting under the pad.

I have used this setup many times with great success. Future appointments have shown more sole depth and better soundness. I eventually try to get the horse to just a natural balance shoe.

Tony

[Phil Armitage]

oh trust me i am DEFINITLY losing sleep over this.... even though they said not to...i want to make sure

HorseCrazy, Jay did not mean for you to loose sleep over your situation. He posted an X-Ray of a worse case, where there is significant loss of bone. Your situation is pretty manageable. I agree with your vet on the shoeing protocal for the front feet, also Tony's idea is a good method. I also recommend you follow Jay's adivise about starting with the hocks. Horses carry most of there weight on the front end to start with any discomfort in the hind end causes them to shift even more to the front feet. Because of the lack of sole depth on your horses feet this is causeing a significant amount of cuncussion into the bottom of the coffin bone which can eventually lead to remodleing and bone loss like the x-ray Jaye posted. The proper shoeing can support the foot and protect the coffin bone. Your farrier needs to be carefull not to add pressure to the toe and any other area on the foot that will cause pressure into a sore and weak area of the foot.

Best wishes.

[Phil Armitage]

Phil,

In response to: "I am also currious if anyone has found equipack to be too much pressure in this type of situation?"

I chose not to use Equipak because I cannot control it enough to keep it from pressurring the sole. I like to use a NB shoe that is attatched with two or three rivets in the toe to a Castle Performance Pad. This sucks the pad to the shoe and guarantees me no contact with the thin sole when I apply the package correctly. I use IM (which I can control) from just behind the tip of the live frog to help distribute the weight and to keep debris from getting under the pad.

I have used this setup many times with great success. Future appointments have shown more sole depth and better soundness. I eventually try to get the horse to just a natural balance shoe.

Tony

Thanks Tony, definately times when useing equipack can be a problem. Useing the Myron Mclain pad and filling the equipack to the pad level seems to work pretty good and provide frog support. I have also gained sole thickness useing the method.

[HorseCrazy]

OK thank you all! yeah all the vets assistants kept telling me ohh your horse has pedal osteitis tell your farrier not to roll the toe like that because if the sole callous is weighbaring it will make it worse because it will inflame the lamina and coffin bone and add to the problem ...

but then Jaye Perry said it would be a good idea to roll the toe if going barefoot...

and then phil armitage said : make sure there is no sole pressure especially in the toe region or the weak area ( which is the whole sole) at all

i thought this would mean the sole callous too ?

so i am CONFUSED! :D



:confused: ~~~if the sole callous remains weightbearing it won't cause Inflammation of the Lamina/coffin bone, sole pressure and won't make it worse??? ~~~

~~~or should he stop rolling the toe and leave the hoofwall as the main weightbaring structure???~~`

~~~if the toe is already rolled so that the sole callous is bearing weight and you put a shoe over it will that cause problems ? if so...what do you do? trim the sole callous off so it is not bearing any weight? or just leave it ?~~~



I am sorry i seem so REDUNDANT but that it my main concern...i just want to make it clear to my farrier and make sure i understand CORRECTLY

ALSO my farrier said he is worried about the pads and bacteria causing problems .

but i definitly want pads on rather than having him causing worse damage to his hoof will what Rick Burten said: 50/50 mixture of Venice Turpentine and Pine Tar and fill the back of the hoof with Impression Material. be a pretty good protection of bacteria?

ALSO he still has slight hoofwall seperation will putting a shoe over that cause any problems? ?


again sorry for all the questions :o

[mwmyersdvm]

Gentlemen,
Since this is a farrier forum, it would be prudent to radiograph the hind hooves and correct the imbalances before injecting the hocks, don't you agree?

This horse has multiple issues and the way to sort them out is one by one.
Radiograph and balance the hind end. This is the easiest thing to do first. Choose a workable method to increase sole depth in front. I prefer roller motion shoes, but you do need to know how to apply these to good effect. Telling someone's farrier to do this without a detailed explanation as to how to do it will result in a disaster. For additonal assistance in "pedal osteitis" I add the Hof Trax shock absorptive pads. I get really good results with this package. I use Equilox pink (soft) pack under this and watch for toe pressure.

I would stop here and allow these steps to take effect before proceeding further. Put the horse on some serious ground work for six weeks while the trim and shoeing is taking effect. My preference is to get the Clinton Anderson DVD's on "Ground Handling for Respect" and do the program. You will have a better balanced and better behaved horse at the end of the rest period and then you proceed from there. No matter how well behaved he is now, you will see a positive difference if you do this.

[Jaye Perry]

Gentlemen,
Since this is a farrier forum, it would be prudent to radiograph the hind hooves and correct the imbalances before injecting the hocks, don't you agree?
.......
.

No Good Doctor, the rads already show degenerative changes with positive flexions per posted analysis.



The horse is barefoot. A set of shoes, with pads on the front will only ,at this point, let the foot obtain growth of wall and sole for manipulation at the next shoeing cycle. Usually the horn memory, relaxation of tubules, will continue until the next or even sometimes into the 3rd cycle. Proper balance cannot be achieved until horn memory has been curtailed.
IMO doing the hocks will afford some comfort and stability in the horse's way of going. Also redistributions on weight bearing off the fore limbs/hooves, which show significant changes in and around the coffin joints.