My Horses 2 yr injury

[MysticRealm]

Hi, I am new. I have a 10 yr old thoroughbred mare, that I have owned for 3 yrs. For the past 2 yrs she has had on again off again lameness in her front feet (especially the right one) She was generally lame in summer, sound in winter. Also when she gets it it's WHAM and it's there and she then ranges in lameness from terrible to barely there, to no lameness and such. You can't ever really see it in the walk but can be very bad in the trot (we don't canter her when she is lame like that) She has been seen by 3 of the top vets around (one was an olympic vet) X-rays show NOTHING. There was lameness when they did a flexion test one time but I think that b/c she had been moving on that leg funny it caused secondary injuries (i will explain why I think this further down) The last vet said she could have something that 1 in 50 horses will ever get but 9 times out of 10 some sort of cortisone shot will fix it for a yr or 2, then you just redo the shot. It had something to do with her digital flexor sheath not lubricating enough. But that shot only helped for 2 months. So the vet's other suggestions were turnout and nerving her. Now obviously nerving her is the absolute LAST option.
So we turned her out. She has been out since Dec 1. Well we took her into the vets today b/c she had some fat back legs from being beat up on in the pasture, and told the vet bout her problem. We trotted her for him and he could see her favour her right leg slightly. Then he did the flexion test, Markie (my horse) was no more lame than before the test (which is why I do not think her real injury shows up with the flexion test)
So he told me that abviously the turn out isn't helping so he wants me to pull her back inside start working with her see what happens, if she gets lame again (was abit somfused here b/c he said he saw some very slight favouring in the leg when we trotted her) then get a vet out to do nerve blocking to see where the pain is (we had this done before, but not sure what the result was, I wish I knew, dang) then he suggested trying balanced shoeing or whatever that's called.
Ok coincidentaly these injuries all started around the time we switched farriers so I already was gonna try different farriers before I talked with the vet but now I want to look it to the Natural Balance shoeing. The second last vet said he loved what the new farrier was doing with her feet but I dunno, Want to try all my options
So I was wondering if you guys could look at pics of my horse and her feet and read my story and tell me your thoughts. That would be greatly appreciated.
Go to this page (hopefully it will work, plz tell me if it doesn't)
Hoof Pics (http://www.picturetrail.com/gallery/view?p=999&gid=6635758&uid=2332034)

Pics 1-3 are of her feet after the first or second time with new farrier (don't have pics of her feet with old farrier)
Pics4-5 are of her feet after many months with new farrier
Pic 6 is when I first got her
Pic 7 is End of the yr before last
Pic 8 is recent pic (she generally doesn't stand so under herself but it's the best recent confo pic I got)

[Phil Armitage]

Picture 6 and 8 tell a lot. In picture 6 the horse is in good condition, good muscleing in the front and especially the hind, which indicates to me the previous owner had her working off her hind end properly which takes a lot of stress off the front end. Picture 8 shows a lot of muscle loss, especially in the hind. This horse and most horses need to use there hind end properly or they will beat up the front legs and feet. The hind feet show signes of bull noseing this might indicate sore back, hocks etc again this could be from poor rideing or poor saddle fit. Do you shoe her in the hind or is she barefoot. My opinion, is focus on the rideing, saddle fit, sore back and hind feet. I don't know how long the front shoes have been on when you took those pictures so I am not going to comment on the shoeing. I would contact the previous owner and get some tips on how they rode her and excercised her, how often etc... Have someone evaluate your saddle and your rideing.

[calshoer]

I see two things that stand out.
First the front feet. Although decently shod in the traditional sense, the ratios on the bottom are backward when mapped out from a more natural perspective. There is too much heel on the foot , and the toe (and anterior sole ) has run forward from where it should be in relation to the coffin bone. I would bet on a lateral X-ray that the breakover point is an inch or more ahead of the tip of the coffin bone, when it should be only about 1/4 inch. And because there is too much heel, the ends of the heels are too far forward, under the foot. Therefore when you draw a line across the widest part of the foot,(about an inch behind the tip of the frog) the lengh of the sole surface from the line rearward is shorter than the length of the front to the brekoer point. That means the weight bearing is not back under the limb where it belongs, the heels are getting stressed, and there is undue levrage on the toe in order for the foot to break over. All that needs to be reversed for the foot to function properly .The current sole surface imbalance will cause abnormal stresses within the foot in the coffin joint,navicular bone, and impar ligament and heels. And pain in any or all of those structures.
By removing more heel,and setting the breakover point more under the tip of the coffin bone (instead of the perimeter fit) the stresses inside the foot will be grealy reduced.

As well. this horse has typical thoroughbred weak feet. They are hollow in between the heels and bull nose which indicates a lack of internal structural cartilage to support the coffin joint. The frog can better support and align the coffin joint if the heels are *reduced*. to get the frog in more active contact with the ground.
The hind feet are more bull nosed than the fronts. In my experience that bull nose has (so far) *always* indicated a negative palmer angle to the coffin bone due to very weak feet internally. The negative angle of the hind coffin bones creates a sore navicular area (impar ligament coffin joint,navicular bone ) which then leads to sore hocks and a sore back as the horse compensates. There is plenty of discussion here about negative palmer angles if you look around the site .
I know of horses in the US and UK that have been through similar experiences such as yours, looked at repeatedly by top veterinrians with no real results, and then fixed in one shoeing when the whole shoeing protocol was changed to address the hoof imbalances and weak internal support issues. Patty

[MysticRealm]

Thank you for the replies, especially calshoer. Phil>> The reason why she has way less muscle is no fault of mine. I ride her very well from back to front. I have a very good trainer who shows at international level sometimes. He is very big on riding up and forward with the hind end pushing. The reason she has no muscle is b/c she hasn't been riden b/c she has been lame. The most riding she probably got that summer is 5 minutes maybe like 3 times a week, and mostly just to evaluate how sore she was. WHen I first got her she had an ill fitting saddle but now for the past atleast over 2 yrs has had a proper fitting one (a saddle fitter came out and found us the correct saddle, that fits Markie then fits me) Everything else on her is 100% sound, no back pain, no hock pain, no nothing, just unsound in the front end.
What do you guys mean by bull nosed. I have never heard that term before. I am deffinately gonna try a natural balance shoer. Thanks for the replies again!

[calshoer]

"Bull nose" means the front of the hoofwall is convex, (bulged out )instead of a nice straight line top to bottom .Exactly the opposite of dished. In every single bul nose foot that I have seen so far where I had a chance to get an Xray, the front of the coffin bone was tipped up, so the bulge comes from the front of the bone pushing the wall outward in the middle. Once the rear of the bone get better supported, the bulge in the hoof wall disappears (and doesn't have to wait to grow in.... it just straightens). AS well, supporting the frog moves the lower (distal) end of the second pastern bone forward in the coffin joint and thereby aligns the coffin joint better too.
Many farrier texts define 'bull nose' as having the toe dubbed off in the lower section ..blaming toe dragging or the farriers rasp but usually that is not the case. it is almost always that the wall is pushed out there in the middle by the bone tip. And on your horse, even in those pictures not close up of the hind feet it is an obvious visible problem. If you need a NB farrier who has some hands on training, call the EDSS offices and talk to Cody Ovnicek, or if you are in the UK call David Nicholls at Total Foot Protection Ltd in West Sus***. Patty

[Phil Armitage]

Your welcome, I hope you caught the focus on the hind feet.

[MysticRealm]

Thank you guys so much for the replies. Thanks for the description. I will call the EDSS offices. Thank you.

[MysticRealm]

I added the best pics I have of her barefeet to the album on the first page. Don't mind her cut and fat leg, nor the circles on the other pic

[MysticRealm]

Bump. And here are some questions I got from another board and the answers I gave, in case it helps
The questions were:
MR, what diagnostics besides flexion tests and radiographs were done?
Were any other joints evaluated? Has the horse been seen by an equine chiropractor? To your knowledge, has this horse ever had EPM or been tested to see if he does have EPM?

How extensive were the radiographic studies of this horse's foot, pastern and fetlock? Is this horse lame only under saddleand rider, or when out on a lunge line, or at free exercise? At what point during the trimming/shoeing cycle does the lameness seem to occur? How long is the interval between farrier/hoofcare provider visits? Has anything else happened or changed just prior to each incident?

The answers (to the best of my ability):
She has had the hoof tester done on her hooves and at some points in time the whole hoof was sensitive. She has had nerve blocking done but I just cannot seem to remember the results, we are trying to get in touch with the vet to find that out. I do not know how many other joints were evaluated that is a good question, I will try to ask the vet(s). Since she has been seen by three (and now 4) vets I might have to check with all of them (though 2 are from one hospital and 2 are from another, so I could ask just one from each place unless they don't know the info) Markie has been seen by a chiropractor once (early during the second last summer while she was still sound) and we were gonna do it again but then we just didn't. As far as I know she has never had or been tested for EPM (and I think the vet would've mentioned it in the prepurchase since he told us about her cancer in her 3rd eyelid, which was removed)

I think they took pretty extensive x-rays but I do want to ask if they took as many as possible (from dif angle or w/e). She is lame on the lunge and while undersaddle, we dont free lunge her when lame so I don't know there. I do not quite understand your question about the trimming cycle, could you plz explain. She goes 4-6 weeks in between shoeing. One time she tripped and that seemed to start it, but that was not the first time it happened, other than that nothing that I know of has really changed. The last time she was good then got it it was really abrupt. I think she had been fine for the whole rest of the week before then one day I got on her, walked her, she was normal, then picked up the trot and it was as if someone had shot her in the leg, it was bad. but then it does the same thing, it gets better and worse and better and worse. I hope I answered you questions ok. And I thank you guys so much for tryin to help.