High/Low Syndrome

[60HorsesRunning]

I have a four year old Qh gelding whom I have been told has ''High/Low syndrome". That is, one of his radius bones is longer than the other. As a result his feet are uneven (along with everything else). He currently has a pad on one foot in an attempt to even him out. Right now he's doing excellent with his fix up and is riding very well. Before I got him he had been a bit of a 'reject'. I later found out the reason he was so cranky undersaddle. Since we've 'evened him out' he's done great. So my question is has anyone else come across this? Is it common? I've also been told that most of the time if they're uneven in the front, they're also uneven in the back. ANY information on this subject would be great!! Thanks.

[calshoer]

Basically you are seeing a club foot. (the high one).If you read the threads here about club feet you will be well informed. Patty

[Mackenzie J.]

Hi 60horsesrunning,

I've been researching and asking questions about this extensively because my horse also has the same thing. I posted a great article by Dr. Ridgeway, DVM, about this syndrome which explains potential problems and how to fix them. (under "High heel/low heel sydrome") I have posted some descriptions of what we've done...I'm pretty sure one of the topics is called "farrier help" in the general forum (I think...). The farriers here have been a wonderful help.

We did find that he was imbalanced in the hind as well. It's a bit of a chicken/egg question...what came first? Each imbalance was significant enough to make us think it caused the other.

The crankiness undersaddle was very typical of mine as well. He was downright dangerous for a while (rearing and trying to stick his legs in the fence to take us both down) and it took a couple years to figure out that he was doing it to tell us it hurt to do what we asked. For him, as imbalanced as he was, it was terribly hard for him to travel to the right because his right front is the high foot. He's a sensitive one, a wuss, really, so every imbalance no matter how small is an issue for him.

I imagine, depending on your horse's severity and sensitivity, that you'll find saddle fitting and girth tightening to be an issue, and that the closer you get to him being due for shoes the worse his crankiness gets. Also, if you can, get up on a ladder and look at the horse from behind to see how chiropractically straight he is--mine was out in a lot of places from being so uneven for 8 years. Is his muscular development even on both sides? How does he move with the front legs--any winging or tripping? Dr. Ridgeway addresses many of these problems. Do you have any pictures of his feet and a head on picture showing his chest box? I'd love to see them if you do.

We've done the same as you said, only by using a wedge shoe on the low foot. We've used a 3 degree as his unevenness has been up to 3/4 of an inch. He didn't tolerate a wedge pad very well as it seemed too much pressure on the frog, but that seems to be individual per horse. But as you said, as long as you keep them even, they're fabulous. It's a night and day difference.

Patty mentioned the club foot thing, which I believe (in my humble opinon as I'm not a farrier) is the case for many horses but not all horses. From what I've read, you'd really have to have xrays to determine that, though.

Anyway, I hope this answers some questions, and feel free to ask any questions as I'd be happy to share some experiences.

Mac :)

[60HorsesRunning]

Thank you so much for your reply.

My gelding is very sensitive, about everything. He is also sensitive about the girth! That being a trait is very interesting!

His muscualar developement is definitly uneven. This was one of the tip offs to the farrier. I believe that he does wing a little in the front. It's also worth mentioning that he rope walks terribly in the back. From the hock down his whole right hind leg appears to be angled in. He also tends to carry his head to the right. So I wonder if he's imbalanced in the back end or if this is a result of him being bent that direction. I'm sure he probably could benefit from seeing a chiropractor.
I will try and get a few pictures and post on here tomorrow.
I believe that when the farrier first saw him, he thought he had a clubfoot and then later confirmed that it was, instead, the high/low condition. The farrier said that his actual leg (Radius bone) was shorter than the other. After reading that article I'm beginning to think that it's actually just his heel. You can plainly see looking at him that one heel is higher than the other. We did have shoes on both the front, and then a pad on the low foot. Recently he came up with an abcess on the high foot and the vet pulled the shoe and he was left with the shoe and pad on the low foot. From this, I found out that he moved even BETTER with that much lift. So as of right now we are shoeing him with one shoe with a pad on the low foot, and nothing on the other. I was a little concerned that this would feel a bit odd to him, and that the traction would be different, but apparantly he's moving alright. He's riding well also, even cantering under saddle which was near impossible before we found out he was uneven.
I do have a question: How were you able to determine how 'off' your horse was? We have attempted to get x-rays but the vet said it would do no good. He told us to measure his legs from the point of the shoulder down but that seems a bit inaccurate, Although I have done it.
I have attempted to find some sort of information on this subject but there doesn't seem to be much.
As I said, I will try and get some pictures. Thanks again!

[Mackenzie J.]

In my experience, the high/low syndrome has a much more pronounced effect on the sensitive horses. There's a pony mare at my barn that has the same thing, and while she's very one handed, she's not nearly as sensitive and one doesn't seem the same extreme symptoms that both our geldings seem to exhibit.

Is the heel on the low foot underrun? With mine, it's the same as you suspect: heel height is the difference, not bone length. My personal opinion on the origin of this heel height difference for my gelding is the hind imbalances combined with a really bad shoulder injury he had as a 4 yr old (a t-post rammed into the point of his shoulder). This supports my theory that the differences in heel height are a result of non even weighting of the front feet and that causes the uneven growth patterns. Again, I'm not a farrier or a vet (farriers and vets, please correct me if I'm wrong in any of this) but this has just been my experiences and results of research.

Have your farrier really look at your horses hind feet. Make sure that they are medially/laterally balanced. With my horse, on his right hind, he had a high spot on the medial side. On his left hind, he had a high spot on the lateral side, so in effect both feet were pointing in the same direction. This has great effects on the locomotion of the hind end. If you look head on, make sure than his coronet band is even (ie. it's not higher on one side of the hoof than the other). I wonder, does one of your gelding's hips/pelvis appear more forward? (It's easiest to determine this by standing on a bucket or ladder). I would assume so with the angled-in right hind. By any chance is he rockered, rolled, or dubbed in the hind feet? Pics of his hinds would be great too.

Speaking of the angling of the right hind, does it angle in (with the hock out and toe pointing in) or does it angle out (with the hock in and toe out)?

My gelding carried it angled out because this places the pelvis on that side forward, which helped compensate for the low front hoof.

With Rambo, his [many] chiropractic issues were literally instantaneously fixed when his feet are right. I would recomend, though, while you're figuring out your gelding's optimum, to have one come in. The head going one way body going another is reminiscent of Rambo too.

If you stand your horse square, look at him head on. Squat down so that you're even with his knees. You'll have to eyeball it a bit, but you'll be able to clearly see the difference in the knees. For instance, Rambo's (my gelding) right knee was about 3/4in. higher than the left knee. The right point of his chest box was also higher, creating a slanted instead of straight chest box. I could also see a difference in the heights of the fetlock and coronet band. You'll have to do this when he's barefoot on both front feet.

Just about everyone thought that the high foot was a club. We disagreed, and proved it when we took the "club" foot down 6 degrees in one trim (not something I recommend with every horse...) and he had no problems with the DDFT. It was cold and tight the next day (no wraps or liniment) even after jumping. Xrays could confirm that it is or isn't a club by determining if there's any rotation of the P3, but it won't tell you how much he's off.

You'll want to have your farrier gradually trim the heel of the high foot. He should also be careful to take as little heel from the low heeled foot as possible, as your goal is to get as much has as you can. This means he may just run it with a rasp or something. You can have him set the shoe full on the high foot to encourage it to spread which is what we did for a while.

We thought about doing the one shoe on, one shoe off thing too, but he can't be barefoot on his high foot--very tenderfooted on rocks. He also didn't appreciate the differences in traction. Perhaps a farrier on here could recomend whether this is okay long term--I really don't know.

I agree, information about this is scarce! Almost everyone I talked to was convinced that it was a club foot thing. I'm actually convinced that the problem is more his low foot as his angles on his high foot correspond fairly well with his shoulder angles--his shoulders are pretty upright--around 58* which seems to be his optimum hoove angle. In the past year or so, his feet have gotten so much better. We never focused on getting his feet to match, rather, to make him even. If the knees are even, the spine will be straight, and they'll physically be able to preform their tasks.

Does your gelding have any vices? Rambo cribs, but it's dramatically decreased in severity, especially after he gets shod. That's one way we can tell that he's getting uneven is when the cribbing increases in regularity.

Do you have a wedge pad or just a flat pad on him? One thing I learned is that a wedge pad is useful for getting the angles to be align in the low foot, as it usually has a broken back axis (and maybe a negative palmar angle). If you get the angle right with the wedge pad and still need more lift, then you can use a regular pad on top of that to make the knees even. When we used pads with him, he had a three degree wedge and then another extra pad, and this was perfect (though he didn't like the feeling of the pressure of the packing, so we've gone to aluminum wedge shoes).

Another tip: have an easyboot around just in case he pulls the shoe on the low foot. While you can't have it on in turnout (I made that mistake and it wasn't pretty...) it can make them more comfortable by providing extra lift when riding or even for just a few hours when you're grooming them or something.

Anyway, it's great discussing this with you! I haven't talked to anyone else whose horse exhibits this. I hope this helps, and I look forward to your response and pictures! If I can, I'll borrow my sisters digital camera and take some pictures of Rambo's feet.

Mac :)

[Phil Armitage]

Club feet are a result of feet that are pulled up by the Deep Flexor, horses can grow and develop this from over feeding and genetics. Some horses develop a higher foot (long heels0) from compensateing for issues like sore suspensorys, pain in the foot, sore joints like pasturn, knees shoulders, anything that will cause them to take the weight off the foot will cause the foot to become longer in the heels and contracted, the frog also atrophys and thrush becomes a problem due to the deep sulci and commisurse, contraction and lack of circulation. After reading this thread I am trying to figure out what you guys mean by high foot and low foot. It am assumeing when you say low foot you mean the foot with low heels and high you mean the foot with high heels. If you suspect the high heel leg to be shorter then you do not want to add length by shoes and pads to the longer limb you would want to add length to the shorter leg. Assumeing this is the real problem, adding length to the shorter leg would make sense, however I don't believe this is the case. I think what your finding is the horse is very one sided and for some reason favors one leg. Could be club foot, sore tendons, sore joints, back problem or just very one sided, like us humans can be very right handed. If on leg were longer than the other it would not make sense to add length to the longer leg, this would add more pressure to the already crushed heels and exasperate the problem in the shorter leg, but is sounds like your finding the opposite, that adding a shoe and pad is helping. From your description is sounds like you are adding pads to the foot with lower heels and what your finding is it provides comfort, probably protecting a sore spot in the bottom of the foot, which adds to the theory that he places more weight on that foot and is starting to cause problems in it. I think the leg with the more upright foot is the original source of the problem or the diagnol limb in the hind and this is causing him to beat up his lower heeled foot or what you consider to be his longer leg. This would explain why adding pads to the low foot seems to help, I think what your actually doing is protecting a sore foot, probably in the heels and navicular region, caused by so much weight and cuncussion from favoring the other leg or compensateing for some other problem. For now this is a bandaid and the source of the problem still needs to be found. When you see a foot that appears to be bigger and not as upright and the heels appear to be lower, this is a result of the horse putting more weight on that foot. Most horses are sided, more talented going one way than the other, stands on one leg more to eat and sleep and paws more on one let than the other. This affects the balance of the horse and the shape of there feet. Some horses are more sided than others and there are very few ambitextrous horses out there. This is what I got out of the thread so far. What needs to be done is find out why he favors one leg and try to fix that problem then he might use it more and get the weight off the goot leg before it becomes a problem in both front legs. I highly recommend a chiropractor looks at your horse and goes over every inch of him. I have seen horses like this really benifit from good chiropractor work. The shape of the foot will take care of itself over time if the problem is solved.

[Gary Hill]

I don't know if circulation is a problem in a club type foot or even a contracted heel type foot. Blood flow is apparent, due to the extra amount of heel grown on these type feet. I do agree that the problem orginates up high in the shoulder where the muscle attached to the deep flexor may be constricted or atroped that keeps the DDFT taunt. Deep muscle massage might just be more of what they need than anything else? Does anyone agree or have a comment about this thought? Thanks good thread! Gary

[caballus]

Many club feet originate from foal years. ... Foals born in stabling conditions are most often fed OFF the ground at chest height. Hay racks, buckets hung on the walls, water in buckets off the wall -- the foals never get a chance to stretch out those muscles and tendons as they're growing. ... the natural horse is SUPPOSED to eat ON the ground ... head way down, stretch those muscles and tendons and ligaments as they grow, allow the sinuses to drain, etc. etc. I bet there'd be ALOT less "club feet" if we saw more of the natural feeding methods ...

--Gwen

[hksuermann]

I think Mackenzie is dead on. You men, go put on one of your wife's or girlfriend's high-heeled shoes (OK, you ladies can do this too, but it won't be nearly so funny) and see what happens to your pelvis and how you distribute your weight over your feet. Let's say you put the high heel on your right foot, and remain barefoot left...you now stand with your pelvis (lets say this is the equivalent of the horse's shoulder girdle) twisted to the left (right side higher and more forward, left side lower and to the rear), your left knee is hyperextended and bearing far more weight than it should...the right knee is slightly flexed, and less weight bearing (except during movement, as the horse will swing his head and weight over the right front limb to unload the left and lift it up out of its "pit", as you will find out when you try to walk with one high heel on). The hyperextension in the left knee (stressing the DDFT) will cause the horse to wear his left heel out, and the opposite dynamic (unloading of the DDFT) will occur in the right foot, with a resulting excess of heel growth. Technically not a club, but certainly able to fool a lot of farriers if the problem has been present for years.

Regardless of whether the high-heeled foot is a true club or not, one must address its lower heeled partner, as it will be the one to bear the brunt of the burden, taking the toll especially in the knee joint. In this case, the left front being the low-heeled foot, its diagonal pair the right hind will tend to be torqued as well (with many of the mediolateral imbalances Mackenzie mentioned) as it is also used to unload the left fore, the "functionally shorter" limb. The diagonal hind tends to be carried more forward and closer to the body in order to create the leverage it needs, and you notice this especially as a twist in the pelvis.

Yes, great thread! More discussion!

[Gary Hill]

Very true that the very early stage of a foals life affect and or actually cause the problem. Growth spurts that foals experiance mostly due to a high protein diet and lack of exercise ,do cause the problem lots of the time. Problem in our area is the grass, coastal bermuda can really take off in the spring when we have lots of rain such as this year. I see it in more that a few pasture raised foals, where the grass is rich and the owners feed mommie like she's still carrying. Even with foals grazing they seem, and this is just my humble observation, that they stretch out say the front left and head goes down to eat with the fight foot on it's medial toe. When I trim them for the first time ,the left front medial heel is run under with the toe of that foot long. The right front due to the wear is short on the medial toe, and the heels tall. I've kinda kept up with a group that 8 out of 10 wore their feet the same way. We go from black gumbo on one side of the Trinity River to sandy loam that further east turns to sugar sand. The harder black ground really wears the toes of both but that one foot will have all heel. I try to trim all foals at 4 months so I can get a good start on them. Some respond of course better that others but most do so much better when their diet is controlled. Any thoughts anyone? Lunch is over so I better get back to work, we finally actually see the Sun today, flys are out and I so the grass ain't far behind! Gary

[Mackenzie J.]

Thank you, hksuermann, for saying exactly what I was attempting so inadequately to describe!!

For those of you who haven't read Dr. Ridgeway's article, here's the link:

http://www.schleese.com/editorial/articles/highlow.html

Gary, Rambo's shoulder muscles were really tight...deep muscle massage might benefit many, but it would send him into full body spasms (due to something else...a whole 'nother problem). I think it should definitely be explored, if for no other reasons these horses are usually pretty muscle sore and a massage could aleviate some pent up tension.

Great discussion, let's keep it going! :)

Mac

[Phil Armitage]

I don't know if circulation is a problem in a club type foot or even a contracted heel type foot. Blood flow is apparent, due to the extra amount of heel grown on these type feet. I do agree that the problem orginates up high in the shoulder where the muscle attached to the deep flexor may be constricted or atroped that keeps the DDFT taunt. Deep muscle massage might just be more of what they need than anything else? Does anyone agree or have a comment about this thought? Thanks good thread! Gary

In my post I was talking about lame horses, where the foot on the lame limb contracts, frog atrophys and developes a high heel becuase the horse is favoring it. These problems can get very complex and cause all kinds of secondary problems from compensateing. I have seen people get thrown off track and change approach even after the source of the problem is proven becuase the horse gets sore from thrush.

[old heller]

you're right it was more difficult with only one high heel on. :rolleyes:

[Phil Armitage]

Thank you, hksuermann, for saying exactly what I was attempting so inadequately to describe!!

For those of you who haven't read Dr. Ridgeway's article, here's the link:

http://www.schleese.com/editorial/articles/highlow.html

Gary, Rambo's shoulder muscles were really tight...deep muscle massage might benefit many, but it would send him into full body spasms (due to something else...a whole 'nother problem). I think it should definitely be explored, if for no other reasons these horses are usually pretty muscle sore and a massage could aleviate some pent up tension.

Great discussion, let's keep it going! :)

Mac

Hi Mac, I read the Article on High/Low Syndrome. It made a lot of sense and very informative. Interesting how he views the low foot especially the lack of internal fiborus tissue in the caudle aspect of the foot. I think what he is talking about; is a prolapsed frog and normaly the dorsal wall will bullnose as a result becuase the coffin bone rotateing backwards, will see a fat frog with this condition. I quess this could be a problem in one foot and if it is, I can see why the horse compensates for it. This can become very painfull, it also sounds like he has found this sets off a string of problems due to the horse compentsateing. He sees this as the root cause of the problem and I like the way he addresses it with shoeing. I have corrected this problem in hind feet and it does cause back problems from compensateing. I will be takeing a closer look at these high/low syndromes from now on. Thanks for shareing the information.

[Mackenzie J.]

Interesting how he views the low foot especially the lack of internal fiborus tissue in the caudle aspect of the foot. I think what he is talking about; is a prolapsed frog and normaly the dorsal wall will bullnose as a result becuase the coffin bone rotateing backwards, will see a fat frog with this condition.

Is this what a negative palmar angle is? I've heard that term before and I think this is what it is referencing too, but I wasn't sure. Without the wedge, mine does have a broken back pastern angle. Would the prolapsed frog cause a compromised digital cushion? My horse does have a fatter frog on his low foot.

Hi Mac, I read the Article on High/Low Syndrome. It made a lot of sense and very informative. This can become very painfull, it also sounds like he has found this sets off a string of problems due to the horse compentsateing. He sees this as the root cause of the problem and I like the way he addresses it with shoeing. I have corrected this problem in hind feet and it does cause back problems from compensateing. I will be takeing a closer look at these high/low syndromes from now on. Thanks for shareing the information.

Have you found any other way to treat this in the front feet (ie. without wedges/pads)? I'm just curious, as this is the only way Dr. Ridgeway recommends and the only way my farrier and I have been able to figure out. I noticed you posted the link to the article in another thread regarding barefooters...This would be a case (I hope I don't stir up too big of a debate, here :p ) where I'm positive that Rambo could never be barefoot. It seems that he'd just get more and more uneven and more uncomfortable, because the only way to even them up is to make the knees even with a wedge. Anyway, just curious as to your opinion.

What have you found to be the best approach in the hind feet? I've only seen it in the front feet before, but I imagine it would have similar effects of making the hips/pelvis uneven and out of wack.

Thanks for your time, Phil,
Mac

[Phil Armitage]

Yes this is a negative palmer angle or also refered to as reverse rotation. If the problem is due to lack of internal supportive structure like the Plantar cushion and/or lateral cartilidge I would assume the problem is perminant. I think there is research being done to determine if these tissues can develop. It is my understanding that most of this developes after birth by cuncussion when the new born gets up and starts moveing walking and running. The prolapsed frog is a result of the bone coloumb wanting to go to the ground and the frog is over grown makeing up for what is lacking internaly, mother natures way of dealing with it. I have seen some frogs go way past the heels and the heels almost nonexisting when a horse is shod in an open shoe or wedged without frog support. This is where barefooters could make the argument that shoes would exasperate the problem because the foot will sink through the shoe and wedge and will break the pasturn angle stressing joints even more and they are correct. I feel pretty confident that correcting the angle and adding frog support is the best way to handlle this problem and is a must if your horse is competeing. I have seen reverse rotation on the hind so bad, that it causes a bullnoseing appearance in the dorsal wall, the tip of the coffing bone is pushing into the hoof wall as it rotates and it is painfull. The frogs are fat and past the heels. Somtimes I start off pulling the shoes and letting the horse stand on the frog if they are not being worked (this can be painfull, but it works and the horse becomes comfortable within a few days or less), this will start pushing the coffin bone back up. Then I maintain it with frog support, I like to use Myron Mclain heart bar pads and Equipak. It can be difficult at times, useing pads in my area because of excess moisture and mudd seasons we have, so alternateing between an open shoe and pad or going barefoot when you can is a good idea to maintain healthy feet. I put your article on the barefoot discussion, so that it would open some eyes that there are situations where horses lack structure intenaly and there perfectly good horses, mentaly and physicaly however there handicapped by bad feet and we as Farriers can provide a way for them to be productive. I really like what I am learning on this site and the information that is shared. I wish I could go back to the horses I did with this Hi/Low syndrome in the past, I always looked at it as the high foot being the source of the problem, sometimes it is, but I will now be takeing a closer look at the low foot. Never considered the other as being the source of the problem. Wedgeing a foot up can be harmfull and can exasperate a problem, but having more information on what to look for helps make better decision. Excellen information thank you for shareing it. Very good thread.

[Mackenzie J.]

. I feel pretty confident that correcting the angle and adding frog support is the best way to handle this problem and is a must if your horse is competeing...Then I maintain it with frog support, I like to use Myron Mclain heart bar pads and Equipak. It can be difficult at times, useing pads in my area because of excess moisture and mudd seasons we have, so alternateing between an open shoe and pad or going barefoot when you can is a good idea to maintain healthy feet.

Thanks for the great information about the negative palmar angle and the prolapsed frog. My horse's broken back axis seems to be a result of underrun heels and long toes. Could this be caused by a prolapsed frog? He does have a wider frog on this foot than on the other (but I always attributed that to the smaller frog being on the contracted, upright hoof). It's not terribly bigger as some of the extremes you described, just fatter. Is there a degree of variency with prolapsed frogs (ie. very prolapsed or only a little prolapsed)?

Here's a question: If the prolapsed frog can compromise the digital cushion in the caudle portion of the hoof, would this damage blood supply to the heel area thus causing a reason for lack of heel growth? Thus, when the correct angle can be restored, blood flow would be better to the caudle aspect of the hoof, creating better heel growth. Is this a viable theory?

You mentioned a very succesful shoeing package of frog support and Equipack. Originally we put my horse in a full wedge pad because my farrier didn't have the correct size aluminum shoes on hand. He used pink and white putty-like packing material (I don't know what it was, that's just a description). Rambo seemed very uncomfortable with this shoeing package. I assumed that he was reacting to the amount of pressure that the packing and pad placed on his frog (thinking that he had a prolapsed frog and/or compromised digital cushion). He will be in competition this season (we're getting a late start...we will be doing the 3'6 Medal, Maclay, and USET, as well as the level 3-5 jumpers), and has had no soundness problems whatsoever...he just seemed very uncomfortable with the package. He is much better in an aluminum wedge without any pad or frog support at all.

I can definitely understand the reasoning of the frog support; do you have an idea of why he wouldn't like it? Have you had horses do this before, and do you keep them in the frog support and the become more comfortable eventually?

We have had a really rainy/wet season here in St. Louis, so he did get a little thrushy in one foot.

I would love to get some pictures of his feet...my sister just got a digital camera, so I'll see if I can get some soon.

.I put your article on the barefoot discussion, so that it would open some eyes that there are situations where horses lack structure intenaly and there perfectly good horses, mentaly and physicaly however there handicapped by bad feet and we as Farriers can provide a way for them to be productive.

I fully agree and support this statement.

.I really like what I am learning on this site and the information that is shared. I wish I could go back to the horses I did with this Hi/Low syndrome in the past, I always looked at it as the high foot being the source of the problem, sometimes it is, but I will now be takeing a closer look at the low foot. Never considered the other as being the source of the problem. Wedgeing a foot up can be harmfull and can exasperate a problem, but having more information on what to look for helps make better decision. Excellen information thank you for shareing it. Very good thread.

This site is an incredible resource. I am so thankful for it. My knowledge about the equine hoof and farriery has skyrocketed, and there's such a vast amount of things that I still don't know. ;) It's great that people can come and learn and share with each other. I get on here every day and read every new post...my huge thanks to farriers like you who spend time educating yourself and others. It is to be commended.

Thank you so much for your help.
Mac :)

[Phil Armitage]

Sorry I took so long to respond, kind of lost track of this thread. Anyways here is my thoughts. I included your comments and questions.

Thanks for the great information about the negative palmar angle and the prolapsed frog. My horse's broken back axis seems to be a result of underrun heels and long toes. Could this be caused by a prolapsed frog? Yes it can. Just for clarification, the prolapesed frog is not a cause but a result of a negative palmer angle (P3 reverse rotateing) and the cause is a lack of fiborous tissue (Digital Cushion to support the coffin bone) usually there is also a distortion in the front of the hoof "Bull Nosing" from the tip of P3 pushing into the wall from the inside out. The reverse rotation of P3 gives a low heel / long toe look. He does have a wider frog on this foot than on the other (but I always attributed that to the smaller frog being on the contracted, upright hoof). It's not terribly bigger as some of the extremes you described, just fatter. Is there a degree of variency with prolapsed frogs (ie. very prolapsed or only a little prolapsed)? I think so, the reverse rotation can change depending on the length of the heels, type of shoes and pads, footing and amount of work.

Here's a question: If the prolapsed frog can compromise the digital cushion in the caudle portion of the hoof, would this damage blood supply to the heel area thus causing a reason for lack of heel growth? Thus, when the correct angle can be restored, blood flow would be better to the caudle aspect of the hoof, creating better heel growth. Is this a viable theory? The way I understand it the prolapsed frog is caused by a reverse rotation of P3 the compromise or weakness is the digital cushion and probably lack of lateral cartilage. This internal weakness is what causes P3 to tip back and a prolapse or push and flatten the frog. The frog pressure can push P3 back into alignment and restore a proper angle and normal size frog. I think proper angles does help circulation, but I think the restored heel is due to proper repositioning of P3.