6.6.1. Long toe hoof with underrun heels and palmar pain
Title of the article (Diagnosis): Long toe hoof with uderrun heels and palmar pain
Authors: J. Vinčálek
Place of work: Stud Farm Měník
Literature overview: Podkovářství, ISBN: 978-80-7490-052-5, Tisk Pálka 2015
Breed: Czech warmblood
Age: 17 y/o
Working discipline: Intermidiate eventing
2. Data of the patient
Reason why the owner complains: Constantly lame on front left limb.
Length of the problems: 6 – 8 months
Stabling conditions: Box with posibility of paddock
Surface on which the horse moves most often: Sand and grassy paddock
Frequency of the hoof care: Regular shoeing in 6-8 weeks intervals
Type of shoeing: Front shoes Equilibrium, hind regular shoes Mustad Libero 25x8 size 3.
Characterisation of the problems:
Lame on left front limb, lately persistently. More significant in circles and on hard surface. Worsening woth longer shoeing interval.
Limbs with slight outward rotation and toed in digits. Long pasterns ephasized by camped out stance. Borken back hoof axis. Limb conformation in sagital plane strongly overweights palmar parts of the hooves.
Shape of the hoof and pathologic changes:
Both front hooves have very low angle with underrun heels and extensive horn growth in dorsal parts.
Evaluation of the hoof care:
Last trim probably didn’t achieve the optimal shortening of the dorsal parts of the hooves. Hooves were very long before shoeing and with collapsed heels.
Fig. 1.: Rigth front limb from side view before shoeing
Fig. 2.: Left front limb from side view before shoeing.
Evaluation of the type of shoeing:
With respect to mare’s long stride and her sport career, the shoes could be very long. But their lenght was not sufficient due to extensive horn growth in dorsal parts of the hooves and the shoes vere too short at the end of shoeing interval. Dorso-palmar balance was correct considering the sole surface, but the shoes were set too dorsally, and thus impeded the breakover and increased load of flexors. Long hooves with breakover point too dorsally potentiated the lenght of the digits with long pasterns. This situations contributes to even further underruning of the heels.
Fig. 3.: Bottom view of right front hoof before shoeing
Fig. 4.: Bottom view of left front hoof before shoeing
Presentation of the mare showed a slight first impact on outer halves of the hooves, caused by outward rotation of the limbs. From front and side view was obvious heel first impact due to zero or negative palmar angle of the coffin bones.
Digital extension device examination confirmed higher sensitivity to extension of front left limb.
The mare was examined before shoeing by the Lameness locator in circles on firm ground with positive result on the left front limb on both sides.
Video No. 1. and 2.: Examination before shoeing on straight lines and in circles in trot
Fig. 5.: Lameness locator examination report on circle in trot on lounge before shoeing
4. Problem description
5. Choisen solutions
By trimming the outer halves of the hooves we achieved more regular impact in latero-medial direction. Underrun heels were also trimed to the base of the frog with positive impact on double impact and shifting of the center of the gravity in palmar direction. DOrsal part of the hooves was trimmed as much as possible from the sole edge and also from wall and the edges of the hoves were rounded up to the white line. Distal part of the bearing edge was trimmed to create a slight rocker.
For shoeing were used the same Equilibrium shoes in size 2, with stud holes. Dorsal part of the shoe was widened between caps, in order to set them behind the dorsal edge of the bearing edge. Rocker was created between caps.
Shoes were shaped to shift the breakover almost under the tip of the coffin bone and the hoof was shortened as mucha s possible with respect to the lenght of the digit and vertical axis of the limb. Dorso-palmar balance was improved to 70% with favor of the palmar parts of the hooves. Also the lenght of the underrun heels was shortened for more than half.
Fig. 6.: Right front hoof after shoeing
Fig. 7.: Right fron hoof after shoeing
Fig. 7.: Rigth left hoof after shoeing
Fig. 8.: Left front hoof after trimming
Unless the lameness improves until next shoeing, it will be necessary to treat the pedal joints.
Rules of the further care:
Regular shoeing in shorter interval.
The mare was presented and examined by the Lameness locator again after shoeing. The movement was more active with slight lameness registered by the Locator.
Changes in shoe choice and shoeing:
No changes were necessary yet.
Farriery treatment effect:
The lameness of the mare on left front limb was reduced by 57 %.
Result of the care:
After second shoeing with gradual loading a reasonable management, the mare was able to commence preparation for eventing season.
Videos No.3. and 4.:
Examination after shoeing on straight lines and circles in trot.
Fig. 9.: Lameness locator examination report on circle in trot on lounge after shoeing
6. Follow up – Development of changes
6. Conclusion (take home message):