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Laminitis and Other Orthopedic Diseases

November 2017 - AAEP is on Stall Rest

AAEP is taking the month of November off from "Ask the Vet", but will be back in December to answer your equine health questions concerning winter weather care for your horse with expert, Dr. Christine Tuma.



Click here to read this month's questions and answers.
  1. I have a Rocky Mountain filly with a club foot. She was fitted with the Redden Shoes at age 12 months for almost 6 weeks and developed a thick sole. It has been a year of patience to see how her foot is coming along. Now at age 25 months, the foot is dishing, but has no unsoundness. I hand walk her 3 miles a day with boots on all four feet. I do not see any shortening of the stride on her club foot. She is trimmed every 6 weeks, but the toe keeps breaking off. I hand graze her to prevent her doing the club foot grazing habit and her hay is in nibblenets to minimze her grazing on the ground. This is my first horse and I bought her when she was only 30 hours old. The breeder did not take precaution with her growth and my filly started this in about 8 months of age. I had been hoping her foot would improve to the first level of Dr. Redden's grading scale, but it is between 2 and 3, closer to a 2. It looks great after a trim every time and it looks like a level one, but the toe quickly breaks and I have to rasp the broken off pieces of hoof wall on her toe. I need to find people who have club footed horses to get their experience. I plan on using her for trail. I would like to do long trail rides and to condition her for the trails. However, I have no one to ask or to gather information on what to expect with this filly for the long term. I don't know if I can get anyone to tell me what her foot will do. I know if I sell her, she will never get the care I give to her and she could deteriorate, so selling her is not an option. I need to find out if she can gait between 6 to 7 miles per hour. I need to find out what to expect. I ride her two days a week for 10-20 minutes for training for her manners. She will be taught to gait at 30 months. I hope to condition her when she turns 48 months by long slow distance. She will be ridden very lightly until then. She is doing beautifully, but I am always having this fear of hurting her when I don't know better. I need to hear from other people who have ridden horses with a club foot and what to expect. I contacted Dr Jay Mero of AERC and he said the odds are stacked against her and to take it slow, and I can do that. I just don't know what to do and what not to do. I have tried the Internet, but there is really very limited information. I need her to gait and to do the slow soft canter as I have a bad back and cannot go fast myself. Do you know of people who take care of club footed horses and what did they learn to expect from such horses? The only horse I know of is Assault, the Thoroughbred that won the Triple Crown, but I know of no other athletic horses with a club foot. After researching for a year, I am stumped for there are no owners talking about taking care of a club foot long term. My veterinarian said if I had taken her to him earlier, her foot would be better. I live out in a rural area in KY, and it is hard to get a good farrier. He comes every six weeks and he is very good. He does not seem concerned like I am. I am thinking of asking him to teach me to rasp her heel one stroke per week. Would this help her? She is doing better not doing that grazing stance as I move her every time she does that. She'll try to move the club foot forward, but it is akward with the high heel, so she switches and keeps her front feet closer to together. She knows I don't like her spreading her front legs. I also watch her standing when she is crosstied. She keeps her feet pretty close together, with the club foot slightly behind her normal foot. I don't know if I should insist she keep her front feet level with each other. I don't know what else I can do to give her the best possible "foot" forward. Do you know what other owners have done for their horses? Does massage help to stretch the DDT? Any suggestions what I can do? She did not have the check tendon surgery as that compromises the DDT on the long term, as I understand it.

    (View Answer)

    This is quite the history and it sounds very frustrating for you. I am of the belief that these club feet are actually genetic, so I don't recommend too much time be spent on reducing the 'grazing' stance which is a belief that is commonly held by farriers and other horse people, but clearly the hay net has helped this behavior so that cannot be detrimental to your cause.

    The part of your story that makes me concerned is when you say that after trimming, the filly's club foot reduces in grade. This is likely because the heel is being reduced and making the outside of the hoof look more normal. 

    Unfortunately, it does not change the inside of the foot (usually club foot horses have a bigger angle to the coffin bone when viewed from the side) and you are making it look 'better' to you, but it doesn't feel better for the horse as it really only increases tension on the deep floor tendon. The increased tension causes increased stress on the front part of the coffin bone and the toe of the hoof capsule, which causes the toe to break off like you are observing in your horse. 

    There are a couple of ways to deal with this situation. At this age, there is still a possibility to cut the check ligament (sometimes with severe club feet we even cut the deep digital flexor tendon) and with appropriate healing time, the horse may reduce a grade. Your horse is older than we usually do this. It can still work but usually leaves a scar/blemish at the surgery site. The other option is shoeing-wise you can a.) leave the heel as much as is possible - there may still be dishing and an abnormal shape to the foot, but it will keep her more sound in the long run or b.) put some rocker shoes on her to relieve some of the tension on the deep digital flexor tendon. Karen Blake, DVM, DACVS, Park City, UT

  2. My show hunter has an old capped hock. Is there anything I can do to reduce it? He is perfectly sound.

    (View Answer)

    Unfortunately, these are usually permanent blemishes on the horse. Sometimes your veterinarian can ultrasound to see if there is fluid in the bursa, which they can inject with steroids and sometimes get a decrease in swelling, but most of the time the swelling is actually scar tissue. Karen Blake, DVM, DACVS, Park City, UT

  3. Do you think that a natural hoof care (barefoot) program can help a horse heal and recover from laminitis? 

    (View Answer)

    Barefoot trimming can be fine for mild laminitic cases. However, for the high scale laminitis cases, they really need extra mechanics, which they can only get from a shoe. Typically, I will temporarily tape on a Nanric ultimate shoe. This will decrease tension on the deep digital flexor tendon and allow less stress to be put on the lamina. Karen Blake, DVM, DACVS, Park City, UT

  4. My 10-year-old gelding was diagnosed with high ringbone last year. I rested him, gave him supplements and special shoeing. He was sound to ride lightly last fall. Unfortunatley, this spring he limped after running around the pasture when a horse pal left our farm. Is there any long term hope for this horse to recover?

    (View Answer)

    High ringbone can be very frustrating to deal with over the years. Depending on how the joint looks on radiographs, there are a few options. If your horse is in the early stages of ringbone (arthritis), you can try doing joint injections to relieve the pain and inflammation - IRAP would be the best way to slow the progression of arthritis, but you could also try a triamcinolone/Hyaluronic acid combination.

    Unfortunately the only way to permanently decrease pain/lameness is to have a pastern arthrodesis performed, which is when the joint is fused surgically with a plate and screws. Karen Blake, DVM, DACVS, Park City, UT

  5. What are the pink splotches just below the coronet band on my paint horse\'s rear hooves. Yes both hoof walls have them. One is streaked horizontally , and the othe hoof is more of a splot.

    (View Answer)

    Most likely, the pink splotches that you notice are bruising within the hoof wall. These frequently appear on horses who have thinner hoof walls, horses with selenium deficiency or simply, horses with white feet. Karen Blake, DVM, DACVS, Park City, UT

  6. A couple of years ago, my now 19-year-old Quarter Horse mare developed IAD and was treated with Prednisone, which caused her to develop laminitis. With quick action we were able to keep the damage to a minimum based on her x-rays. She appears sound now and I am able to ride her. I have noticed that every once in a while she will be cautious on how she walks on hard surfaces such as concrete. Is this caused by scaring from the laminitis or should I be looking for some other problem? She has never had foot or lameness issues prior to this and I was also wondering, given her history, if I could let her go barefoot.

    (View Answer)

    It is possible, depending on your horse's condition, that she is having small flare ups of her laminitis. Anything that causes inflammation in her body, such as an illness or equine metabolic syndrome or Cushings, could cause your horse to have these intermittent flare-ups. I would ask your veterinarian to see if any other causes for mild laminitis flare-ups, such as the ones mentioned above, could be a cause for mild laminitis in your horse.

    Additionally, if your horse has a low heel angle, this can compromise the blood supply slightly and cause slow sole growth. In that case, your horse is feeling the concussion of the concrete on her feet, which can be painful. Karen Blake, DVM, DACVS, Park City, UT

  7. I have a 14-year-old Standardbred that had surgery on his knees when he was younger. Is it possible that he will get arthritis in his knees when he gets older? If so, what are some simple ways to try and prevent it or keep it at a minimum? Would paddock boots work at all?

    (View Answer)

    It is possible for him to get arthritis from having surgery on his knees if it was from 'chips' being removed or osteochondral fragments from OCD lesions (formed developmentally), however we usually remove the fragments to prevent ongoing arthritis. If they were removed because of damage during racing, it depends on how much damage occurred at the time of injury and how long the horse waited to have surgery as to whether they will develop arthritis. 

    There are many preventative techniques out there such as intravenous Legend or it's new generic, intramuscular Adequan or Pentosan, and oral joint supplements, which are more for supportive care of daily wear and tear. The most effective form of prevention is a therapy called IRAP, which is a protein produced from the horse when processed overnight, incubated and the serum collected. The IRAP is then injected into the joint over 3-4 doses every 1-2 weeks (depending on your vet's preference). IRAP blocks the main inflammatory mediator IL-1, so it slows or stops the inflammatory cycle within the joint. Karen Blake, DVM, DACVS, Park City, UT