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TOPIC: Flexor problems

Flexor problems 13 Apr 2012 23:26 #1

  • Mark_Gough
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Client sent me this photo today and asked if I could help. Foal was born Easter day. Client transported the filly to the Hagyard Equine Medical Institute. Apparently the podiatry center tried various extensions but the foal kept pulling/tearing them off.

I've dealt with this type of problem in the hinds but have not had a case where it occurred in the forelimbs. I'm thinking plastic glue-on extensions, then a heavy wrap over thick cotton padding from the fetlock down to the end of the extension, creating a sloping surface. Maybe a flexible plastic guard on the back of that sloped surface?

Any ideas/help would be appreciated.

Cheers,
Mark

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Re: Flexor problems 14 Apr 2012 00:00 #2

Mark, I'm totally pulling this right out of my ***, but I don't think any amount of extension alone would help this, it's so severe. It would at best make the hoof/ pastern axis broken forward, like a horse that has "broken down" in the suspensory apparatus. I'm guessing some type of prosthetic should be applied to the fetlock joint. I saw one once, constructed of PVC, padding, bar stock, and velcro strapping - steel bars from it to the shoe. You could cast on the shoe, given the age of the horse. YMMV. Good luck.

Edit to add: The PVC was 4 inch diameter, ripped lengthwise, in four pieces, two above the fetlock, and two below, riveted together with bar stock to achieve the desired cannon bone/pastern angle. It encapsulated the leg, with padding between the PVC and leg. Best description I can come up with.

Regards
Rick Shepherd

Although we know what we believe, we may only believe what we know. Dr William Moyers
Last Edit: 14 Apr 2012 00:17 by Western Hill Forge.
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Re: Flexor problems 14 Apr 2012 00:23 #3

  • Mark_Gough
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Thanks for the thoughts Rick. I've had some luck with extensions on the hinds. It does help the horse to straighten but I've never been able to offer fact-based reasons as to why.

Some presume the issue is under-developed (lax) flexoral musculature and that movement will strengthen/tighten that muscle group, ultimately exerting more static force on the connective tendon. Others think it's a matter of waiting for bone to lengthen, tightening the muscle/tendon connective tissues.

I don't know which is right or even if either is correct but do know that the extensions bring the base of support back under the limb, increasing fetlock height as the limb straightens under the horse. A lot of these young horses straighten up fairly well on their own but not sure that will happen in this case.

Wouldn't any kind of prosthetic have to be kept well distal the fetlock joint to avoid interference with joint movement?

Cheers,
Mark
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Re: Flexor problems 14 Apr 2012 09:54 #4

  • Christos Axis
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Mark_Gough wrote:
Some presume the issue is under-developed (lax) flexoral musculature and that movement will strengthen/tighten that muscle group, ultimately exerting more static force on the connective tendon. Others think it's a matter of waiting for bone to lengthen, tightening the muscle/tendon connective tissues.

I know of no studies or other data to support this, but the idea of the bones being short for that length of tendon may be valid. I've had good luck with increasing the diet of the foal to increase bone growth. In three foals I've managed with lax fetlocks, two of them orphan, icreasing the diet gave positive results within a week and corrected the problem within a month.

But it could be just luck.
Christos Axis
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Re: Flexor problems 14 Apr 2012 12:35 #5

  • horsman_ship
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Hi Mark,

I would think that it is too early to start any extention with this foal. I have seen worse that came right on their own. as a rule of thumb I will leave them for a couple of weeks in small paddocks, the worst think you could do to this foal is box rest. after two weeks I will assess it again.
Zouhair Benjabbour
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Re: Flexor problems 14 Apr 2012 12:50 #6

  • Mark_Gough
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I appreciate the thoughts and comments. Scheduled to see this foal next week and I agree; many of these foals straighten up to a great extent on their own in the first month.

The concern is that the foal is not weight bearing on the hoof except at the very rear of the heels, driving the soft capsule forward under load. I think it's important to do whatever I can to get the solar surface of the capsule in contact with the ground. Also agree that movement in the first weeks is important to assist in flexoral muscle development.

I'll evaluate the foal in person next Friday and make a determination as to what, if anything, should be done beyond letting nature take its course.

The plan for now, should I intervene at all, would be a prosthetic comprised of a glued-on dalric cuff with the heel extension attached via bungie cord to a collar just above the carpus. That bungie would act as a ddft supplement to get the foot under the limb. The thought is that this will provide better skeletal alignment during early bone growth and allow improved movement while the flexor muscles develop.

Cheers,
Mark
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Re: Flexor problems 15 Apr 2012 12:20 #7

Mark, in the case I saw, joint movement was all but eliminated. It wasn't a long term deal.

Rick
Rick Shepherd

Although we know what we believe, we may only believe what we know. Dr William Moyers
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Re: Flexor problems 15 Apr 2012 13:56 #8

  • brian robertson
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Do what you can; be as humane as possible but remember Darwin had a theory or 2 about this kind of thing. Castration or neutering is in order for this little one and it's parents should probably never get together again. We have to quit breeding high maintaince animals if our industry is to survive..
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Re: Flexor problems 06 May 2012 13:29 #9

  • DeniseMc
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Mark,
What did you end up doing?


Denise
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Re: Flexor problems 06 May 2012 14:27 #10

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DeniseMc wrote:
Mark,
What did you end up doing?

Denise

Thanks for reminding me Denise. I shared the follow-up information on facebook and another farrier's site but forget to update this one. I'll do that now.

Much thanks to Patrick Reilly for his thoughts and assistance on this case.

Step one was to fabricate some kind of supportive shoe. I used a plastic breadboard and cut out two shoes with heel extensions. I cut matching leather pads to act as the "sole" of the package.



Temporarily fitted the shoe/pad and pre-drilled for screws. Fitted screws to compress the leather then ground off any protruding screw tips.



Here's what it looked like when pre-fitted together.





Next step was to attach the plastic shoes using a few drops of vettec adhere at the edges of the hoof wall then wrap the foot/shoe with elasticon tape.



Only have one photo of the last few steps.

I needed a way to prevent the foal from "stepping off" the shoes. I packed the back of the pastern/heel area with surgical cotton batting then wrapped the whole thing with vetrap tape. This covered and protected the extended heels of the shoes.

Last step was to attach the leather "soles". The screws went through the leather, the tape and the plastic shoe. This prevents the foal from prematurely wearing through the exposed tape. The screw heads provided traction.



So... here's where we started.



And here's what the foal looked like with the package installed.



I left the package on for two weeks. The foal was let out in a small paddock for twice a day exercise, one hour each session. The package allowed her to move better and develop the flexor muscles that will hopefully make the orthotics unnecessary.

I just reset her package on Friday. The package was still intact with only some small wear at the tape around the toe. The leather soles did their job and protected the bottom of the package. The cotton batting and vetrap prevented the foal from pulling the package off.

When I removed the first package, the bottom of her hoof was clean and healthy. There were no abrasions or problems with the heel bulbs or pastern area.

The feet had grown slightly so I cut new shoes/pads to fit and added 3/8" of length to the heel extensions.

After removing the initial package, the fetlocks dropped some but I measured a 25% improvement in fetlock height as compared to day one. She's loading the bare foot better (flat on the ground) but there's still a small gap under the toe when she stands. Much less than observed on day one before any treatment.

After installing the latest package, fetlock height increased 60% over day one measurements.

To quantify improvement, I use two measurements.

I first measure from the center of the fetlock joint to the ground. This value should increase over time if the protocol is working.

The second measurement is the distance from the heel of the package to a line dropped vertically from the fetlock. This value should get smaller over time if the protocol is working.

In addition to the measurements, I look for the foot to load flat on the ground with no gap between the toe and the ground. We're not 100% there yet, but I'm hopeful we will be.

This latest reset will stay in place for 3 weeks then I'll re-evaluate.

Thanks again to everyone who offered advice and ideas on how I might assist this horse.

Cheers,
Mark
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Re: Flexor problems 06 May 2012 14:46 #11

  • Mark_Gough
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Here's a video the owner posted on facebook. The link is public so you should be able to see it even without a facebook account.

www.facebook.com/video/video.php?v=979688334827

Cheers,
Mark
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Re: Flexor problems 06 May 2012 17:16 #12

  • Rick Burten
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Good job, Mark! What does the vet say about the length of time it is taking for the flexor muscles to fully compensate/adjust?
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."
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Je pense donc je suis
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Re: Flexor problems 06 May 2012 17:48 #13

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Rick Burten wrote:
Good job, Mark! What does the vet say about the length of time it is taking for the flexor muscles to fully compensate/adjust?

Thanks Rick. The attending veterinarians were at Hagyard's Medical about 2 hours south of here. They have not, to my knowledge, been following the case since I took over. The local vet hasn't been involved.

One of the things I noticed when I first visited with this foal was a complete visual/palpable lack of flexor muscle. Friday, I could both see and feel significant muscle development. You can see it in the photo too, particularly just above the elbow.

Here's a couple of the work I did Friday afternoon. I figure that if I can keep the horse standing straighter than the lady in the background, I'm winning. :whistle:





Cheers,
Mark
Last Edit: 06 May 2012 17:50 by Mark_Gough.
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Re: Flexor problems 06 May 2012 21:33 #14

  • DeniseMc
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Nice job Mark!
I figure that if I can keep the horse standing straighter than the lady in the background, I'm winning.

LOL.

Just curious,what does the mare's conformation look like?
Denise
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Re: Flexor problems 07 May 2012 00:32 #15

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DeniseMc wrote:
Nice job Mark!

Thanks!
Just curious,what does the mare's conformation look like?
Denise

A lot like what you see in the photos and video. :)

Cheers,
Mark
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