Rapid lameness recovery

Equine Podiatrist: Sally Bell

Horse: 'Loki' 7 year old sports horse

Loki

‘Loki’ a 7 yo sports horse arrived at EP Sally Bell’s Bristol based yard for rehabilitation in February ’21. Loki had a two year history of variable level intermittent lameness in front. His right fore was lower and flatter than his left fore. Previously he also had intermittent hind limb lameness, and found it hard to stretch over his topline. He was in extremely light work on straight lines in walk with a tiny amount of trot as his soundness allowed, had previously had huge amounts of box rest or very limited turnout, and all conventional routes had been exhausted, but he ‘never quite came right’.

Pre-arrival - January 2020:

• X-rays to pinpoint soundness problems

• Back x-rays all clear

• Front feet showed negative palmer angles, right fore more marked than left, but this was not dealt with as a problem at the time.

• Bone chips were discovered in both hind fetlock points and successfully removed with no further problems.

• Hind feet also showed negative palmer angles

• Shod with lateral extensions to both hinds.

Pre-arrival - July 2020:

• More inestigations to front feet, x-rays and mri scan, showed up the same previous problem with negative palmar angle to right fore

• Both front feet also contracted, with collapsed, underun heels, and thin soles

• Inflammation to the coffin joint and it’s collateral ligaments showed up on MRI, but no structural damage yet

• Treated with steroid injections into both coffin joints, and heartbar shoes –which improved his hoof angles mechanically, but his owner hadn’t noticed any improvement in comfort or soundness

Steroid injections were repeated late December ‘20 but made no difference.

3 Month Rehabilitation Program:

• On arrival he was landing incorrectly toe first on all four feet

• In those 3 months he had only time to grow ‘half a hoof capsule’ – the rehabilitated hoof!

• When he left to return home, his hind feet were landing correctly when barefoot and his front feet were landing correctly when barefoot on a soft surface, or in boots and pads on a hard surface.

• He was also sound on a circle in walk and trot on the lunge and ready to start light ridden work again!

Approach:

• Took his shoes off, and fitted boots and pads on all four feet for protection and comfort when necessary –as its important to keep horses comfortable when transitioning to barefoot

• the true effect of these changes will be seen when the new hoof reaches the ground, and the old hoof has grown out, with still more improvements likely over a longer period of time

• Trimmed his feet to encourage correct function and balance – as he was on Sally’s yard she could trim ‘little and often’ meaning everything stayed optimal, helping to speed up the improvements

• The boots and pads also provided appropriate stimulation, and so returned correct function to all of the structures in his feet, meaning they were finally able to recover the previous degeneration and gain strength

• Turned him out 24/7 using a mixture of our surface track and large grazing areas – essential for his mind as well as his body and feet

• As he became more reliably sound in his boots and pads, he was hand walked him around the lanes to increase the stimulation and therefore the strength in his feet

• He was seen regularly by a chartered physiotherapist, and put on a rehab program of stretches and exercises to help his body – within 5 weeks he had lost all of the compensatory muscular issues he had been suffering from

• He was fed a balanced, sensible, barefoot friendly diet with free access to hay and appropriate grazing

• Gut support products helped his gut recover from the culmative impact of the previous dietary changes.

  
  

By removing the negative influences on hoof health, and by adding or facilitating positive influences, Sally was able to make a significant difference to Loki’s hoof health over a relatively short timeframe.

Left fore on arrival

Right fore on arrival

Hind feet on arrival

The sequence of lateral shots below show the new growth coming down from the coronary band at a much better angle , with no new event lines. By the time of the last photo this has reached half way, fitting with the 3 month timeframe since the shoes came off – you can also see this on the dorsal shots on the next page. The whole foot has stopped migrating forwards, and is coming back underneath the limb. The breakover at the toe is fairly close to optimal by the final photo and once the new growth reaches the ground this should be truly correct. Although the heels were never terribly underun on this foot, if you look at the hairline it has stopped ‘curling under’ at the heels and become straighter, meaning the digital cushion and lateral cartilages here are fuller and stronger – you can see this nicely on the palmar shots on the next page. This has corrected the collapsed internal arch. All of this has created a much better hoof pastern axis – you can see this by comparing the pastern /dorsal hoof wall angles to the ground – there is approximately 10 degrees difference in the first and last photos! This means less strain on joints, tendons, ligaments and muscles further up the limb too.

The right fore showed worse pathology than the left fore – negative palmar angles had been confirmed on x-ray, the heels were underunning, and the dorsal wall bullnosing, indicating an incorrect toe first landing.

Loki