Physician, heal thyself

[hufbutcher]

OK, so I'm supposed to be the expert (and I generally let my clients make that assumption). But now I'm the one with the lame horse.

He started to show noticeable and fairly consistent lameness a little over a year ago. TB gelding, now 15, size 3 flat low-heeled feet, most of his work the last 5 years has been pulling a carriage at a fair clip over hard roads, some gravel, some asphalt pavement. Took him to nearby university vet hospital about 6 months ago and got Xrays which showed pretty profound changes in his navicluar bones and some pedal osteitis in the LF, the one where the lameness is pronounced. They injected his feet, I brought him home and put him in wedge egg bars which he promptly ripped off, then made some Tennessee navicular shoes but didn't think they were doing anything, so went to regular shoes with blunted toes and wedge pads. In the meantime, got a series of 3 injections of Legend from local vet.

After about a month we seemed to see consistent relief, although he would start to gimp near the end of a long (15 km) drive. Found that if I gave him Bute after working him, he would be pretty much sound the next day. Haven't been doing much with him lately because of weather, but notice that when he has a good day he rips and romps with his partner in the pasture and ends up pretty lame at the end of the day.

So, any advice? I'm open to anything reasonable.

Lyle

[Ronald Aalders]

If the horse and feet look like what I've got in my head right now (pics would have helped here) your want to bring back breakover a lot. If this is the typical TB kind of digital cushion, (thats what I'm visualizing here') Í'ld get some SX 8 steel shoes. Shape them with a blocked toe, and curve them banana wise (moderate belly) Í would add a 3 degree wedge here, maybe even a 4 degree. With the improved breakover the banana offers you'll find shoes are not ripped off anymore either.

Of course there are other ways to ease breakover like the NB/EDSS system Patty and others know much more about than I do. If you never worked with banana's before maybe go for that system first. If that's not enough give the banana's a try.

Without pictures I can not really say anything about the "pedal osteitis". I can see that ease of breakover and realigning P1, P2 and P3 could help out you horse here.

The fact the bute helps speed up recovery (after the hyaluronic acid injections) may have someting to do with the anti-inflammatory effect of bute, rather than it being a pain killer. This may prove that the inflammation in the foot is the real problem, rather than the navicular changes. But then again that's really a hunch.



Ronald Aalders

[mwmyersdvm]

I see a lot of these horses and as Ron has suggested, the navicular changes usually mean nothing. I do venograms on many of them and the solar corium literally "lights up" from the inflammation. I like the Grand Circuit the****utic shoe, the TC-O, which unloads the wall and moves the breakover back very well. Aligning the phalanges or slightly breaking the bony column forward needs to be done as well. You will need frog support with the TC-O shoe or you can use the heart bar version, but this is a lot of metal for some horses.

M. W. Myers, D.V.M.

[Phil Armitage]

Here is what I would do before you go to the shoeing suggestions, don't get me wrong there great suggestions and I highly respect Dr. Myres and Ron. I was doing some thinking and thought I would add my 2 cents. Since this is your horse and you can care for him. Give him some time off and start with the Foam Block treatment for 3 to 6 weeks and then go to the shoeing recommendations maybe try the EDSS method same idea as what Ron and Dr. Myres suggested. Track the pain in the feet with hoof testers and note how he lands toe first or heel first over the period of treatment. Keep us posted as to his progress. Also post pictures of the feet if you can. I like the foam block treatment a lot for accute laminitis, abcesses, pedal ostietis and navicular this way you can get the pain undercontrol and then shoe the horse and determine if wedgeing is needed after the feet are in better shape. You have to rocker the toe and it is great reliefe on the DDFT and you will be able to provide protection to P-3. If your not familiar with the foam blocks let me know and I can point you in the right direction. Just a thought.