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TOPIC: AGAIN, negative palmar/plantar angles?

RE:AGAIN, negative palmar/plantar angles? 16 Aug 2009 13:57 #46

  • tbloomer
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DeniseMc wrote:
But since I respect your opinion I'd still like to know what your educated guess is of those hooves-NPA?
No, with what little I can see of the hoof forms in your pictures they don't jump out at me and scream NPA. They look like feet on horses that are neglected and haven't been used very hard - like over 3' and higher fences on a daily basis.
My experiences with some of the vets around here are probably different than your experiences. Some of the vets around here are not always correct in their diagnosis; they don't walk on water. Some of them have made their share of mistakes too and some of them have cost horses and ponies their lives; and they have been humbled by it.
So? That's why the field of medicine is always open to second, third, fourth . . . opinions. OTOH, you don't get to diagnose unless you are a medical professional.

My point had nothing to do with vets making mistakes. Had to do with you "playing vet" . . . making a diagnosis and acting on it instead of insisting that you need a diagnosis from a medical professional when you suspect pathology.
I think when mistakes are made they need to be acknowledged but the only thing that should come from tragedy or an incorrect diagnosis is learning from one's mistakes. I have forgiven many vets around here for mistakes they've made over the years --they are only human and they really tried the best they could.
If I think a vet didn't get a diagnosis correct I ask for a second opinion. Usually an incorrect diagnosis happens when the vet doesn't have all the information or isn't following standard diagnostic protocols. However, when I suspect a medical problem, I call in a medical practitioner instead of allowing horse owners to talk me into expanding my practice into medical practice just to save them a few hundred dollars. OTOH, most of the pictures you posted (except the really severe stuff) I probably wouldn't have asked for a vet. Like I said at the top of this post, they look like neglected feet on horses not used very hard. Nothing that couldn't be turned around in a few months of basic hoof care to establish a new baseline.

-Deletia of stuff about vets making mistakes -
I don't have the attitude I can fix anything and everything or that I know it all-at least I hope I don't come across that way, (but according to Brian, I do).
You come across as an inexperienced rookie that thinks she can and has diagnosed and cured. Your pictures posted without radiographic correlation reinforced the impression. Your enumeration of multiple cases "cured" without "diagnosis" amount to hubris claims of derring "do of feets." So from the getgo I had the same impression as Brian, et. al. I just went about addressing the situation in a different way. You could say I was experimenting with a different way of dealing with rookies.

- more deletia of suff about how "comfortable" things are -
If you aren't a rookie, I apologise. I was just responding to the impression you made. :cool:
Tom Bloomer
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RE:AGAIN, negative palmar/plantar angles? 16 Aug 2009 16:27 #47

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Jaye Perry wrote:


I like this, I know there were some 2nd and 3rd and so on, but apparently there was room to hang them:rolleyes:HAH:cool:
Jason Gilliland
"whether you think you can or think you caint your usually right" Henry Ford

"Im not as good as I once was, but Im just as good once as I ever was" My Grandad

"a wink is as good as a nod, to a blind mule" Barney Fyffe
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RE:AGAIN, negative palmar/plantar angles? 16 Aug 2009 20:48 #48

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I'll jump in on one point..... the radiographic evidence...in my own work SO FAR every foot which was first presented to me with a convex shape (even slight)to the middle of the dorsal wall has had a negative palmer/plantar angle ,when I have had a chance to get radiographs. Without exeption.

SO FAR.
Now of course I haven't had the chance to get radiographs on ever ysingle one of them, and perhaps someday I will find one that is not NPA , but not so far.

Don't bother to ask for exact numbers of cases or the radiograhs because in my daily work (which these have been) I never thought to keep a formal record for study and therefore never got copies of the rads of most cases. I'll say its many dozens of horses over the last 14 years or so. . :)
Patty Stiller CNBF,CLS
www.hoofcareonline.com
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RE:AGAIN, negative palmar/plantar angles? 16 Aug 2009 20:53 #49

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Tom B, as per my above post, there are consistent "red flags" to a probable NPA, without radiographs. So when a foot presents to me as a probable NPA, then I treat it as a NPA with consistently good results.
Most vets I have worked with just tell me that is is a probable NPA, even without taking radiographs and just say 'fix it'. Why? Because they also understand and see the external "red flags" of a NPA. It ain't rocket science.
Patty Stiller CNBF,CLS
www.hoofcareonline.com
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RE:AGAIN, negative palmar/plantar angles? 16 Aug 2009 21:05 #50

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DeniseMc wrote:
I know you may find this hard to believe, but all of those cases were receiving regular hoof care, even the chestnut in the first post. So, establishing a "new baseline"-could you explain in simple terms what you mean by that so I can understand?
Baseline has to do with the "history" of what is normal locomotion for a given horse under its current husbandry and work load. If you change the hoof care regiment the performance baseline can change. Thus you begin to develop a new history. NPA horses will have a history of gradual loss of performance. Over time the horse begins to compensate for the additional leverage. Muscles develop in the wrong places. Joints begin to break down. Fix the feet and the NPA still comes back because the other problems/movement and weight bearing compensation have not been corrected. So a NPA horse might require chiropractic adjustments or hock injections or both before you can get the feet back under control. In horses that don't work very hard the compensation doesn't happen because they aren't being asked to do that much.
And so now I understand why vets don't like to work with you. It proably has nothing to do with your horseshoeing skills or lack of horseshoeing skills.
I work with vets very well. The situation I described to you is what can happen when you let horse owners "prevent" you from working with vets. It can also happen when the vet examines the horse without the benefit of knowing the hoof care history and baseline. Often the owner has no idea what the farrier is seeing. If the vet and farrier do not examine the horse together, then it ain't likely that the owner is going to be able to give the vet all the details. The more information the practitioner has, the better chance of getting a good diagnosis.

However, some horse owners don't want to pay the cost of having both professionals collaborating. The vet doesn't know what the farrier sees and the farrier isn't there when the vet looks at the horse. Then the owner begins passing messages back and forth. Vet and farrier never get on the same page because the owner is in the middle.
Tom Bloomer
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Here's the deal. I'm trying to keep it simple.
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RE:AGAIN, negative palmar/plantar angles? 16 Aug 2009 21:20 #51

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DeniseMc wrote:
Seems to me you are making your own "diagnosis" when you don't agree with one the first vet has made; you call in second, third, etc, till you get the answer you want to hear. And not only do you not agree with the first, second, third one, you don't think they're doing their job properly. Again, it's no wonder vets don't like to work with you.
It seems that you don't understand the dynamics of working relationships with multiple professionals.

When the diagnosis and treatment does not work it is SOP to get another opinion or at a minimum review the case with another practitioner. I bring in other farriers when I'm not making progress. Some vets will refer cases to more experienced vets or specialists. It is not uncommon for me to work on horses and have multiple vets involved just because there are multiple vets working in the same practice. It doesn't have anything to do with me not liking vets or vets not likeing me. It has to do with professionals working together to solve problems. Often two heads are better than one or a second set of eyes will see something the other missed.

It also has to do with professionals following up on treatment and catching and correcting mistakes. If the protocol chosen isn't working then everybody involved should know about it.
Tom Bloomer
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Here's the deal. I'm trying to keep it simple.
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RE:AGAIN, negative palmar/plantar angles? 17 Aug 2009 03:14 #52

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So a NPA horse might require chiropractic adjustments or hock injections or both before you can get the feet back under control. In horses that don't work very hard the compensation doesn't happen because they aren't being asked to do that much.
IME once the P3 angles and DIP joint alignment are corrected, the hocks, get better quite soon and do not need the injections, and any chiropractic is used after is to get rid of the lingering effects of the horse compensating for the previous NPA.
In other words the NPA is the primary culprit causing everything else, and there is no reason it cannot or should not be corrected and got under control first using whatever shoeing needed to do that.
Fix the feet and the NPA still comes back because the other problems/movement and weight bearing compensation have not been corrected.
if the NPA comes back then it was not "fixed". It was managed fora while but the management protocol was either changed or removed . I Find that many NPA horses require frog support and maybe some wedging for their whole performance life to maintain the correct DIP joint alignment. It is most likely because NPA horses usually lack enough digital cushion and axial projections of the ungual cartilages to hold up their own coffin bones. If the horse never developed that cartilage, he may never develop it.
Patty Stiller CNBF,CLS
www.hoofcareonline.com
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RE:AGAIN, negative palmar/plantar angles? 17 Aug 2009 11:39 #53

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calshoer wrote:
IME once the P3 angles and DIP joint alignment are corrected, the hocks, get better quite soon and do not need the injections, and any chiropractic is used after is to get rid of the lingering effects of the horse compensating for the previous NPA.
Yes. You fix the feet but you haven't fixed the muscular development/atrophy and weight bearing compensation. The longer it is that the horse was working hard with NPA, the longer it is going to take to redevelop the frame that is working over your "relocated foundation." While it may be best for the horse to rest for a few months, we don't always have control of the work regiment.
In other words the NPA is the primary culprit causing everything else, and there is no reason it cannot or should not be corrected and got under control first using whatever shoeing needed to do that.if the NPA comes back then it was not "fixed". It was managed fora while but the management protocol was either changed or removed.
Fixing the horse is dependent on how bad things got and how long things were bad. NPA might be the chicken or the egg. But until the framework of the horse is returned to normal function the foundation is not going to have a stable baseline.
I Find that many NPA horses require frog support and maybe some wedging for their whole performance life to maintain the correct DIP joint alignment. It is most likely because NPA horses usually lack enough digital cushion and axial projections of the ungual cartilages to hold up their own coffin bones. If the horse never developed that cartilage, he may never develop it.
So in some horses you can't fix it, just manage it with appliances. Maybe you should refer those to Denise. :confused:

OTOH, if the horse's "performance life" involved mostly grazing, how many of those have you had that needed a "package" to hold their DIPJ together? How many NPA pasture potatos do you have in "management packages?" YMMV, But I've not encountered pasture potatos with NPA unless NPA was the "undiscovered cause" for the end of their "performace life."
Tom Bloomer
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RE:AGAIN, negative palmar/plantar angles? 22 Aug 2009 21:42 #54

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calshoer-170004]IME once the P3 angles and DIP joint alignment are corrected, the hocks, get better quite soon and do not need the injections, and any chiropractic is used after is to get rid of the lingering effects of the horse compensating for the previous NPA.

Hmmmmm.....





In other words the NPA is the primary culprit causing everything else, and there is no reason it cannot or should not be corrected and got under control first using whatever shoeing needed to do that.if the NPA comes back then it was not "fixed". It was managed fora while but the management protocol was either changed or removed . I Find that many NPA horses require frog support and maybe some wedging for their whole performance life to maintain the correct DIP joint alignment.

IME, invovle a vet and get a definite diagnosis of the lameness isssue. "The feet are reactive to pressures placed upon them."
Thus, an combined effort with the farrier, vet and owner to solve the issue(s).



It is most likely because NPA horses usually lack enough digital cushion and axial projections of the ungual cartilages to hold up their own coffin bones. If the horse never developed that cartilage, he may never develop it.


Really? See above about "reactive".

Here is an example of your flawed opine. A Lateral rad of a hind foot:





Here is the diagnosed issue for the hind foot rad above; it's nowhere near the hock. That is why i like and IME get a definite diagnosis:


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RE:AGAIN, negative palmar/plantar angles? 23 Aug 2009 02:06 #55

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IME, invovle a vet and get a definite diagnosis of the lameness isssue. "The feet are reactive to pressures placed upon them."
Most often the vet IS involved , and most often there is no other "definitive diagnosis" besides NPA .
And most often, once the NPA is corrected, the horses go sound.
As well how do you know the severe NPA in your case did not cause the strain the suspensory and sesamoids?
To quote you...."Hmmmm". :D
Patty Stiller CNBF,CLS
www.hoofcareonline.com
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RE:AGAIN, negative palmar/plantar angles? 23 Aug 2009 02:14 #56

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I started this thread with three horses in mind, now four. All are worked in the same discipline at the same barn by the same trainer. The four show well (two of them very well), have very possible NPA (Plantar), and one of the four is showing signs of lameness, but only when he is asked to do something other than what he shows. All four crush the heels of the hinds and the two I saw this week are camped out behind. Now what would the cause be?
RJ Little
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"I ain't askin' nobody for nuthin', if I can't get it on my own." - Charlie Daniels
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RE:AGAIN, negative palmar/plantar angles? 23 Aug 2009 10:52 #57

  • Jaye Perry
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calshoer-Most often the vet IS involved , and most often there is no other "definitive diagnosis" besides NPA .
That is not what you said or either implied:
IME once the P3 angles and DIP joint alignment are corrected, the hocks, get better quite soon and do not need the injections, and any chiropractic is used after is to get rid of the lingering effects of the horse compensating for the previous NPA.
And most often, once the NPA is corrected, the horses go sound.
Your definition of "Sound" has been shown to be questionable at best.




As well how do you know the severe NPA in your case did not cause the strain the suspensory and sesamoids?
"Sesamoiditis is a recurring problem occurring at regular intervals, due to continual strenuous exercise. Muscle fatigue is the most important factor because more weight is supported by the suspensory and over-dorsiflexion of the fetlock increases."
Shoeing and trimming is way down on the list of causation. But when shoeing this type of lesion the "Evil Eggbars" are used in most cases.:rolleyes::p

BTW, the horse was a Jumper and a fence walker~~
" recurring at regular intervals of strenuous exercise".



To quote you...."Hmmmm".
Thus if you did work with a vet on/with lameness issues the definite diagnosis would involve rads. The definite diagnosis for this particular horse was nailed down with this oblique rad; to confirm the diagnosis:

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RE:AGAIN, negative palmar/plantar angles? 23 Aug 2009 11:03 #58

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Short answer =



+
http://www.sciencemuseum.org.uk/onlinestuff/snot/~/media/818B16FC66D44386927D789A9280BA5D.ashx?db=master
Tom Bloomer
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Here's the deal. I'm trying to keep it simple.
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RE:AGAIN, negative palmar/plantar angles? 23 Aug 2009 11:54 #59

westtxshoer wrote:
I started this thread with three horses in mind, now four. All are worked in the same discipline at the same barn by the same trainer. The four show well (two of them very well), have very possible NPA (Plantar), and one of the four is showing signs of lameness, but only when he is asked to do something other than what he shows. All four crush the heels of the hinds and the two I saw this week are camped out behind. Now what would the cause be?

RJ,

What discipline are the two that are camped out behind?

Regards,
Brian R. Purrington
This email address is being protected from spambots. You need JavaScript enabled to view it.
www.wellshodhorses.com
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RE:AGAIN, negative palmar/plantar angles? 23 Aug 2009 15:03 #60

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Jaye,
to get back your implication that the sesamoid issues are the cause of the NPA in your posted case rather than the other way around, can you document whether that same horse was NOT NPA prior to the development of the sesamoid issues?.
Patty Stiller CNBF,CLS
www.hoofcareonline.com
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