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The Evolution of "Navicular" Feet

Here are some updated photos of GG, the "navicular" horse I adopted in November, 2011 and have been rehabbing since. First, a body shot to show that he's been on a diet! GG had very flared, flat hooves with prominent growth rings, signs of laminitis. GG started his rehab with simple grass hay and low-sugar timothy hay pellets, and is now eating free choice hay and grass, Triple Crown Lite, Animed Remission (a mineral/magnesium/chromium supplement for horses prone to laminitis) and MSM (for inflammation and to help his heaves). The lack of weight also helps him because his small hooves don't need that extra pressure.

And now, photos of GG's left front hoof, which he has shown intermittent lameness on for about 3 years:

The heels and toe have come back, and the wall has smoothed out showing less stress rings. I also like how the hoof went from look "dead" to looking "alive but stressed" to looking "alive but relaxed" in the photo progression. The significant arch in the 3/3/12 photo is from aggressively dressing back GG's severe quarter flare, as seen in the below "front view" photos. The flare is now grown out, so GG's "arch" is much more natural.

Also, I did change my trimming style after viewing the 3/3/12 photo, and started taking flare off higher up the wall. This can be a controversial practice, but in GG's case it has seemed to work very well and the stress rings have not returned. He just was not growing the flare out using the method of just beveling the bottom. Of course, there is no way to know if this would have occurred using the more conservative method eventually, but I really like the results and believe that being more aggressive with the flare higher up the wall did help.

Here is the back of GG's foot:

GG's foot still isn't pretty, but it is functional. What I like the most about the 10/7/12 photo is that GG's heels are expanding, a sign that he is using them more. After these photos were taken, GG free lunged around the pasture barefoot and for the first time EVER I watched him land flat at the trot and canter. Ideally, we want a horse to land heel-first at these gaits, but the combination of GG's upright pasterns and long history of heel pain means that he may never be able to achieve a truly heel-first landing. However, he was landing heel-first at the walk, and we are moving in the right direction, so you never know!

Here are the front views of GG's hoof. He started out with a very large flare. I believe he was actually slightly "sunk" on the lateral (outside/right) side. Look at how crooked the short pastern joint looks, much lower on the side with the flare. In the subsequent photos, it looks much more even:

Again, notice the lack of stress rings, and how perfectly balanced the coronary band is now, even though the foot itself is skewed due to GG's rotational deformity (his pasterns rotate in below the fetlock joint, making him pigeon toed).

Finally, here are the sole shots. Again, the progression of "diseased/dead" to "stressed but alive" to "alive and relaxed" is apparent. In the 3/3/12 shot, GG is exhibiting what farrier Esco Buff refers to as "retracted soles" where you will have a marked "scooped out" solar concavity that is common in thin soled horses in wet muddy conditions. His sole is probably around 1/4 inch in this photo, but someone unfamiliar with this condition might think he has full thickness and concavity to his sole! In the 10/7/12 photo, the "retracted sole" is gone and the hoof is much rounder. I also like how the heels and bars look more even. Finally, the toe has been brought back, and the heels have opened up:

That's all for now! All in all, not bad! :)

Lacey's Two Left Feet

Here are some before and after shots of Lacey's feet. Lacey came out of shoes the day the before photos were taken, June 28th, 2012. The after shots were taken about 3 months later, and two trims later, on September 23rd, 2012.

First, Lacey's left front foot. Notice how much shorter the toe has gotten, and how much the heels have opened up. The hoof is much less contracted.

Here are comparisons with the shoe to show how much her heels have opened up, and how far her toe has come back:

Now, Lacey's left hind foot. This is Lacey's problem leg. The hoof was very out of balance, with an extremely long/high toe. The pictures speak for themselves as far as how much her heels have opened up, are no longer run under, and how the imbalance has righted itself:

And here is Lacey enjoying her new, better balanced, healthier feet!

Does Your Horse Have Long Hind Toes?

Long hind toes in hind hooves seem to be an epidemic with horses today, and coincidentally, so is hind limb arthritis/stiffness/lameness. Long hind toes can also cause back stiffness because the horse literally has to brace their entire hind musculature to keep from falling backwards. 

The fix for long toes is easy; it is really a simple trim, and not rocket science at all. You will want to pay special attention if your horse tends to stand "camped under" behind; that is, with the cannon bones forward under the body. If this is the case, run your fingers firmly down either side of your horse's hindquarter just below the backbone. Often, these horses will flinch and "duck away" from pain in these muscles.

Below is a blog post on a new client of mine, who has been having hind-limb lameness off and on for several months now, including "gluteal pain;" that is, she flinched strongly when these muscles were palpated. An hour after her shoes were pulled and her feet trimmed, Lacey no longer had any pain in her gluteal muscles.

Lacey is a new client of mine. We pulled her shoes on June 28th, 2012. Lacey has been having issues with hind end stiffness/lameness. She also showed pain when her "gluteal" muscles, on either side of her tail, were palpated. Here is Lacey's typical stance with shoes:

This stance is typical of horses with long toes on their hind feet. A 2011 study showed a correlation between gluteal pain and long hind toes. The abstract is available here.

Here is how Lacey immediately stood when the shoes were removed:

Do you see the sigh of relief and relaxation? I believe that Lacey was accustomed to going right into this stretch when her shoes were removed. The change in her stance was literally immediate.

Here is a photo of her left hind hoof. This has been the leg she has been "off" on. The vet diagnosed hock arthritis based on a positive lameness exam after a flexion test of the hock. The photo has been marked to show the broken line made by the front of her hoof and the front of her pastern, and the approximate the position of the coffin bone inside the hoof capsule. Notice the "negative palmar angle;" that is, the bone is tipped back (the bottom is supposed to be "ground parallel" on the hind feet):

Here is Lacey's left hind hoof after the trim. Notice the improved palmar angle. To note how much height was taken off the toe region, notice how much closer the nail holes are to the ground. Lacey's hindquarter muscles had to pull all her weight over this 1/2 inch (minimum) of extra height in her toes, overworking them with every stride. Also notice that the hoof and pastern are now more or less in line with each other:

Now check out Lacey's left to right ("medial" to "lateral") balance on this foot. Can you see how much higher the inside wall is than the outside?

The horse's "live sole" (the waxy stuff under the chalky stuff) grows to the same thickness throughout the hoof, so is a good indication of where the actual inner structures sit in relation to the ground. I therefore balance the wall to the "live sole plane," e.g. the sole plane after the chalky soft stuff is scraped away. Here is what we came up with after trimming:

The balance is still "off" as you can see, but it is much closer. Because Lacey had such an extremely imbalanced hoof and was just coming out of shoes, I was a bit conservative with this first trim. Once she begins wearing her feet the way she wants without a shoe in the way, it will be easier to gauge exactly how much more medial (inside) wall can come off.

Now here are the sole shots. These were marked with a marker. To measure how much toe needs to come off the front, I find the widest part of the sole, then the very back of the frog material, and measure this distance forward on the toe and mark it. I learned this method at a very informative clinic put on by the folks at Daisy Haven Farm and it has proved invaluable when assessing deformed hooves to determine exactly how much toe to take off. The front line marks where Lacey's sole should end. Often on the hind feet, the sole can stretch past this spot and if you don't know better, you would think it is "live" but it is really extra material that should be removed:

And here is her left hind hoof after the trim:

Lacey's right hind had similar issues, and was also longer on the inside. You can see how crooked her right hind leg is when viewed from behind. Her left hoof has been trimmed, and her right has not. Part of the reason that her left hind is so crooked is because of all the height that was taken off. When one hoof has lots more height than the other, the horse stands with that hoof further under the body to compensate for the additional height:

You can see how much straighter and more open she is standing after the trim. Although I unfortunately didn't take before shots from behind before the trim, she was much more "base-narrow" due to her imbalanced hooves:

Here are the before and after shots of Lacey's right hind hoof for comparison. The after shot, the coffin bone didn't change position as much as I drew it to, but you can compare the different angle by noticing the position of the nail holes (it is now probably ground-parallel or close to it):

After her trim, this was Lacey's stance:

Our goal with trimming the hind feet is to get the cannon bones as close to perpendicular as possible, and we have almost done so. This is the only way the hind muscles can get a break. Lacey has been standing "under" with her hind feet for so long, that I have a feeling she will take a few trims to fully change the way she stands, and may always have a tendency to "camp under" from time to time.

The first few steps that Lacey took with her shorter toes were very strange. She placed no weight on her heels and walked on her "tippy toes." Initially I thought she was sore in her heels due to the shoe removal, but this seemed odd since I took almost no height off of her heels and she had decent frogs and heel structures. I now think that her muscles were so tight from battling those long toes that she took a few strides to realize that she could relax. She started walking normally after a few steps.

Another amazing thing about this first trim was that when her gluteal muscles were palpated after the trim (along the sides of her croup), she showed absolutely no pain. I really didn't expect these muscles to improve so quickly.

Finally, what we couldn't catch on camera (because it was dark) was Lacey tearing around the outdoor arena, showing no hoof tenderness, and very little hind-end lameness, 20 minutes after her shoe removal/first trim. Lacey's owner said she couldn't remember the last time Lacey was so animated and "like her old self" running around free in the arena.

Lacey's owner is giving her horse a break to get used to no shoes, after wearing them nonstop for about 10 years. When she begins ring and trail work again, she will purchase boots to help Lacey over the rocky trails near her home.