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TOPIC: your thoughts on these x rays

RE:your thoughts on these x rays 22 May 2010 20:56 #76

  • Jaye Perry
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scruggs1 wrote:
Well, if you just want a specific answer, it is the reestablishment of tissue inhibitors of metalloproteinases in the check and balance system of TIMMP's vs. MMP's which allow the hoof wall to grown down and maintain their attachment to the distal phalanx.

Until this process occurs (usually within 24-72 hours) anything that attempts to mechanically prevent distal migration compromises the prognosis...especially something that localizes those pressures to a specific area like the frog. Foam, sand, impression material, etc. do not stop the process either, they distribute the ground pressures more evenly across the entire solar surface. Nailing a heart bar to an actively rotating foot is the mechanical equivalent of trying to strangle someone in the process of having a stroke to keep the clot from going further.

(sorry Rick, Patrick, and Jaye...you only need to give so much rope)

You "POINTY HEADED" B^^^H!:eek::p:D
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RE:your thoughts on these x rays 22 May 2010 21:41 #77

  • reillyshoe
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I am not sure I agree John. Any mechanical treatment which reduces the tension of the dorsal lammellar interface would be potentially useful during an acute episode, don't you think?
I know one study found a cast/wedge combination to be more effective at reducing strain on the dorsal hoofwall than a heart bar shoe.
P
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RE:your thoughts on these x rays 22 May 2010 21:51 #78

  • Jaye Perry
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"Scruggie" is talking MMP( MMP attachment of coded enzymes), histology for those who are chemically impaired, that has found to be both productive and wasteful.

Mechanics are what we are, thus your divergant from "Scruggie's" histology lesson. Pat pleaze pay attention in class!:rolleyes::p
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RE:your thoughts on these x rays 22 May 2010 22:38 #79

  • scruggs1
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reillyshoe wrote:
I am not sure I agree John. Any mechanical treatment which reduces the tension of the dorsal lammellar interface would be potentially useful during an acute episode, don't you think?

Yes, hence the reference to the foam, sand, and impression material. But these things do not prevent the distal migration, they redistribute pressure points of normal force coming from the ground. This redistribution unloads the lamellar interface (the dorsal mechanical aid I believe you are referencing) to varying degrees, but unlike nailing a heartbar, they do not compromise by constriction, localized areas of the plexus and subsequent nourished tissues. My contention is that the only thing that will stop the distal migration in the acute phase is the return of the TIMMP's to their role in the negative feedback cycle. If the germinal cells of the epidermal lamella have no way to reattach themselves to the basement membrane, it doesn't matter what we do to the foot. Further compressing the tissues between the distal surface of P3 and the horny frog by nailing a heartbar during the acute phase is counter productive.

The heartbar certainly has a utility in the chronic phase, but it actually increases pressure on the ddft. ;)
Scruggs Farrier Service
John Scruggs, CJF
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RE:your thoughts on these x rays 22 May 2010 23:18 #80

  • reillyshoe
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So if a horse is non weightbearing during the period of lammellar compromise? Would displacement be prevented?
P
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RE:your thoughts on these x rays 22 May 2010 23:34 #81

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reillyshoe wrote:
So if a horse is non weightbearing during the period of lammellar compromise? Would displacement be prevented?

Ha! You are on to something here. We can put them in space or just keep them lying down. Wouldn't prevent detachment, but gravitational induced displacement would be negated...unless you count displacement as the void of a few microns distance across created when the hemidesmosomes are absolved. I guess it just 'depends' on you level of 'sticklerness'. :D
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RE:your thoughts on these x rays 22 May 2010 23:47 #82

  • reillyshoe
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John,
If a horse experiences a systemically induced episode of acute laminitis, why are the front feet usually affected more than the hind feet? Is the answer purely weight, or are the mechanics related to displacement of P3/hoof capsule?
P
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RE:your thoughts on these x rays 23 May 2010 00:24 #83

  • scruggs1
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Pat,
You are getting me in trouble..I am at the sister-in-laws and having to hide in the house so I can whip out the crackberry and respond. But, since I am already 'in the bathroom' I think I have been given enough rope here. I'll stick my neck out further and take one more stab anyway.

Sure, the ddft in the front plays a greater role because it is directly attached to the muscle head. In the front gravity and ddf contraction both contribute to detachment. Applications that reduce ddft tension, static and dynamic, are useful in decreasing detachment...particularly in the acute phase. Unless the abaxial ddft preesure somehow reduces axial tension, I can not see how a heartbar is beneficial in the acute stage..unless it has swelled heels and the bar is not touching the frog.
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John Scruggs, CJF
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RE:your thoughts on these x rays 23 May 2010 00:30 #84

  • reillyshoe
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Then you would presumably be in favor of wedging the front feet in an extreme manner during an acute laminitis episode? This would reduce DDFT tension and (following your logic) limit displacement?
P
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RE:your thoughts on these x rays 23 May 2010 00:56 #85

  • Rick Burten
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scruggs1 wrote:
........ when the hemidesmosomes are absolved........
is this done by a member of the clergy or can a lay person perform the ceremony?:p If its a member of the clergy, what denomination is preferred?;)
Rick Burten PF

In the immortal words of Ron White: "But let me tell you something, folks: You can't fix S-tupid. There's not a pill you can take; there's not a class you can go to. S-tupid is forever."
."


Je pense donc je suis
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RE:your thoughts on these x rays 23 May 2010 02:26 #86

  • scruggs1
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Rick Burten wrote:
is this done by a member of the clergy or can a lay person perform the ceremony?:p If its a member of the clergy, what denomination is preferred?;)

Mr. Rick,
I believe the mmp's that perform the service are non-denominational. Once the union is broken between the basal cell and the membrane, the real question I have is who gets custody of the molecules. :p


Mr. Reilly,
I am going to refrain from being led further down into the inductive reasoning labrynth until I am home and in the company of my library...besides, my mother-in-law is really wearing me out at the cards because you are getting more of my limited cerebral power than 'hand and foot' is right now. I will try to either have myself painted into a corner or give you some of your rope back by mid morning. :D
Scruggs Farrier Service
John Scruggs, CJF
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RE:your thoughts on these x rays 23 May 2010 05:59 #87

  • scruggs1
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reillyshoe wrote:
Then you would presumably be in favor of wedging the front feet in an extreme manner during an acute laminitis episode? This would reduce DDFT tension and (following your logic) limit displacement?

Home now. Before narcolepsy grabs hold, I will retract and/or clarify. In the acute phase I am not for localizing weight distribution to the frog by itself. I am all for supporting the caudal aspect of the foot with something that will distribute pressures, as evenly as possible, across all the ground surface structures of caudal aspect of the foot. To what degree this supportive redistribution acts as mechanical inhibition of rotation, I would have to say either it depends or I don't know. Does it mechanically prevent rotation? I don't think so. Does it dampen the degree thereof? It's quite possible, but to what degree, I am not sure. I do think, if nothing else, it makes the horse more comfortable as it attempts to stand on the caudal half of the foot while waiting on the feedback loop to reestablish itself. In my limited experience, nailing a heart bar to an acute laminitic not only causes more pain because of the process, it is not as effective as sticking foam, impression material, or other deformable 'support' under the back of the foot. If one wants to use the heart bar in combination with impression material, it can be taped/vet wrapped on...but at this point, the shoe itself may just be redundant. I am not sure what you would consider "extreme", but I do think elevation can reduce the tension in the ddft, which in turn can reduce laminar tension as can unloading the wall at the toe. I do like the heart bar and think it has beneficial and multiple applications. I don't like it in the acute phase.

My statement of "...anything that attempts to mechanically prevent distal migration compromises the prognosis" would be better and a more correct conveyance of my thought process here as "...anything that attempts to mechanically prevent distal migration, by localizing the support instead of dispersing it, compromises the prognosis."

Since you are our resident expert and probably deal with more of these in one year than most of us will see in our career, what is your protocol and thought process for the acute phase?
Scruggs Farrier Service
John Scruggs, CJF
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RE:your thoughts on these x rays 23 May 2010 11:46 #88

  • reillyshoe
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I tape domed impression material onto the bottom of the foot without removing the existing shoe (usually).



P
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RE:your thoughts on these x rays 23 May 2010 13:18 #89

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P
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RE:your thoughts on these x rays 24 May 2010 16:40 #90

  • SlowShoe
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Pat,
Have you done this test with a heartbar? Can you perform it with nailed on shoes or does it destroy the sensor? How about with a clog and IM? Either way you can clearly see that the use of the IM in this fashion spreads out the load, and helps keep the dorsal aspect (and rest of the perimeter hoofwall) from being loaded so heavily. I;ve got to make one of those fancy plates. How long before the IM tears apart?

-josh
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