Title (Diagnosis): 11.2.1.  Injured collateral lilgaments due to poor hoof balance

              1. Author of texts and photographs: Ing. Jindrich Vincalek, CE-F

                 

            2. Literary review: Horseshoeing, 42.2.3. Disease of collateral ligaments of limb joints,

                ISBN: 978-80-7490-052-5, Tisk Pálka 2015

 

            3. Patient data No. 11.2.1.

                Breed: Lusitanian horse

                Sex: Stallion

                Age: Born 16.5.2009

                Color: Dark bay

                Work use: Dressage grade "T"

 

  • Problems complained of by the owner: loss of movement (space), alternating limping on both forelegs, especially in the turns

  • Duration of the problem: about 3 months

  • Stabling: In the box

  • Feed : Common for a sport horse

  • Litter : Straw with shawings

  • The surface on which the horse most often moves: riding arena with sand and non-woven fabric, grassy paddock

  • Frequency of hoof treatment : In the Czech Republic, shod regularly at 6-8 week intervals. The last two shoeings were performed in Germany, where the horse had been in training for a long time.

  • Shoeing type: Keg shoes 22x8 by Kerckhaert

  • Lameness, possible diagnosis: The horse is lame on both front limbs, especially inside the turn. The horse first underwent an examination in Germany and both hoof joints were treated with corticoids. The lameness did not improve much and that is why it was imported back to the Czech Republic. Here he was re-examined sonographically, radiologically and by local anesthesia. Hoof imbalance and affected internal collateral ligaments of hoof joints were diagnosed.

4. Anamnesis:
5. Case description:
  • Characterization of the changes:

The horse shows 2-3 degree lameness on both front limbs in the final phase of loading, breakover and pushoff. Shortens steps and rejects active forward movement.

 

  • Conformation:

In the frontal plane, the limbs are slightly wide based and in the horizontal plane they show the inward rotation of the phalanges. Both of these defects overload the inner half of the hooves and cause them to deform.

 

  • Hoof shape and pathological changes - Shape of the hoof and pathologic changes:

The shape of the hooves of the forelegs, when viewed from the front, diverges with the concavely curved outer hoof wall. The inner hoof wall is almost vertical. A look at the soles reveals a large imbalance in the individual halves and quarters. The largest surface has  lateral front quarter of the sole. The result is an aggravated sinking of the lateral front part of the hoof into the soft surface and subsequent tilting of the hoof.

 

 

 

 

 

 

 

 

 

 

 

       

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ultrasonography showed no damage to the soft tissues of the distal limbs. X-ray examination revealed large differences between the shape of the hoof capsule and the coffin bone on anteroposterior projection and oxpring. In both front limbs, the center of gravity of the hoof capsule was shifted forward and out of the center of gravity of the coffin bone. Positive local anesthesia on the hooves confirmed the pain of the palmar parts of the hooves .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  • Evaluation of the hoof care and the type of shoening:

The horse's movement problems were clearly caused by poor hoof trim during the last two shoeings. Failure to follow the principles of the balance of hooves and limbs led to imbalance and subsequent lameness. The method of shoeing could not be evaluated because the shoes were removed during the X-ray examination the day before.

Fig. No. 1 and 2 .: From the left - Left and right front hoof before trim -  viewed from the front.

9.jpg
10.jpg
11.jpg
13.jpg
14.jpg

Fig. No. 5 and 6 .: Left - Left and right front hoof before trim - viewed from behind.

 

The rear view of the position of the hooves relative to the distal part of the limbs confirms the inward rotation of the toe and the need for the hoof to break over its outer front part.

1. LP před úpr..jpg

X-rays before hoof trim. The evaluation of the images revealed a large asymmetry in the placement of the coffin bone in the hoof capsule, depending on the center of gravity of the hoof. The principle of parallelism of the lower surface of the coffin bone and the bearing edge of the hoof was not met. The lateral front parts of the hooves were taller and longer, which was reflected in the anteroposterior images by the oblique placement of the coffin bones in inward direction. As a result, the crevices of the digital joints on the inside of the limbs were opened excessively and the internal collateral ligaments were bruised and sore.

1. LP před úpr.-.jpg
3. PP před upr..jpg
3. PP před upr.-.jpg
5. LP před úpravou.jpg
5. LP před úpravou..jpg
7. PP před úpravou.jpg
7. PP před úpravou-.jpg

Fig. No. 7.a, b .: From the left - Anteroposterior image of the left front hoof before trim. b): with geometric marking

Fig. No. 8.a, b .: From the left - Anteroposterior image of the right anterior hoof before trim. b): with geometric marking

Fig. No. 9.a, b .: From the left -  Oxspring image of the left front hoof before trim. b): with geometric marking

Fig. No. 10.a, b .: From the left -  Oxpring image of the right front hoof before trim. b): with geometric marking

12.jpg

Fig. No. 3 and 4 .: Left - Left and right front hoof before trim -

viewed from below

7. Chosen measures
  • Selected hoof treatment - Trimming:

The trim must  follow the hoof mapping principles to unify the center of gravity of the coffin bone and the hoof capsule. The ideal situation is that after trimming the hoof, all opposite points of the bearing edge are equidistant from the center of gravity of the coffin bone. For the given hooves, the longer part of the hoof wall was trimmed and the concave curvature of the diverging hoof wall was rasped around the circumference. At the heels, the same height was maintained on both hooves. When adjusting the soles, we paid attention to the same height of the arch on both halves of the hoof.

15.jpg
16.jpg
17.jpg
18.jpg

Fig. No. 11 and 12 .: Left - Left and right hoof after trim when viewed from the front

Fig. No. 13 and 14: From left - Left and right hoof after trim when viewed from below

After trimming the hooves, control X-rays were taken, which confirmed that the correct trim of the hooves achieved almost ideal balance.

1. LP před úpr.-.jpg
2. LP po úpr.-.jpg
3. PP před upr.-.jpg
4. PP po úpr-.jpg

Fig. No.15 and 16: From the left - Anteroposterior image of the left front hoof with geometric markings before and after trim

Fig. No.17 and 18 .: From the left - Anteroposterior image of the right front hoof with geometric markings before and after trim

5. LP před úpravou..jpg
6. LP po úpravě-.jpg
7. PP před úpravou-.jpg
8. PP po úpravě-.jpg

Fig. No.15 and 16: From the left - Oxpring image  of the left front hoof with geometric marking before and after trim

Fig. No.17 and 18 .: From left - Oxpring image of the right front hoof with geometric marking before and after trim

  • Shoe preparation:

It is not necessary to invent any special shoes for shoeing hooves adjusted to a good balance. We chose Libero size 2 single-clip horseshoes and hot-fitted them with adequate overlaps on both hooves so that they maximally support the balance of the hooves with respect to the center of gravity. To relieve the internal collateral ligaments, we forged a slight rocker between the first inner and the second outer nail hole . In the end, we safed the horseshoes.

 

  • Shoeing:

We used Derby 4 nails, size 51 mm. They were nailed into the first three holes to minimize restriction of the hoof mechanism. Horseshoes must respect and in some cases support the natural axes of the limbs and the balance of the hooves. Fig .: 19,20,21,22,23,24.

19.jpg
21.jpg
23.jpg

Fig. No.19 - 21: Left - Left front hoof after shoeing when viewed from the front, bottom and back

20.jpg
22.jpg
24.jpg

Fig. No.22 - 24: Left - Right front hoof after shoeing seen from the front, bottom and back

  • Veterinary measures and rules of further care:

Follow up in the case if oersisting lamenss.  During next shoeing pay attention to the correct balance of the hooves and limbs.

  • Effect of the trim:

The effect of the trim was visible on the shape of the hooves and the position of the limbs. Control X-rays also confirmed an improvement in balance.

 

  • Changes in the choice of shoes and shoeing:

Changes in the choice of shoes could not be evaluated because the shoes were removed during the examination of the horse.

 

  • Effect of farrier measures - treatment effect

No special farrier measures were applied during shoeing. The biggest effect was brought by the correct trim of the hooves.

 

  • Result of the care

Immediately after shoeing, the horse's movement during the lead out improved by about 30%. In the next five to seven days of rest, the horse stopped limping even on a hard surface and two weeks after shoeing he was already in full training.

8. Follow up – Development of changes
9. Conclusion for practice

Proper adjustment of the hoof capsule with respect to the coffin bone, natural axes of the limbs and the center of gravity of the hoof should be part of the basic knowledge and practical skills of every farrier. The absence of sufficient practice and theoretical knowledge in the study of farriery is ultimately reflected in many similar cases.