5yo’s foot lameness - what would you do?

dapple_grey

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My rising 5yo came in lame yesterday, on the same foot she had a bruised sole a few months ago. The first time she went lame (around Jan this year) we couldn’t get to the bottom of it so she had all the usual investigations. In summary:

Nerve blocked to LH foot
Negative to hoof testers
Zero swelling/anything obvious
X-rays showed minor medial lateral imbalance, it was noted she wore down the outside

Initially she was only positive to flexions but otherwise sound. Then she got worse and was 3/10 lame by which point I sent her to Newmarket for an MRI. Rather embarrassingly it showed up nothing else other than a big old bruise. Vet recommended trimming to support medial lateral imbalance. A week later the bruise came out like this:

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We tried for a period to trim to support her foot imbalance but she was still lame and struggling on the stoney drive at my yard. Vet and farrier pushed to try shoes so I reluctantly agreed. He put an extension on the side she wears down. Much sounder and vet signed her off to increase work a month ago.

The last couple of weeks I’ve noticed her resting that leg a lot and standing with it underneath her. I brought her in last night and she could barely turn left, extremely sticky and doesn’t want to step under her with LH. Trotted her up and she looked ok but pretty awful on the turn. Also sounded like she had a loose shoe but couldn’t work out which one.

Called farrier out and he couldn’t find anything obvious, said all the shoes were tight. He also said it sounded like one was loose but couldn’t see why. She’s due next week anyway so is going to try leaving more foot as I did think she’s on the short side currently.

I have attached some photos of the foot in question. Do I take shoes off? But then she bruises so easily. I’ve tried Keratex etc and it didn’t help. Try another shoeing cycle? At a loss at what to do. She’s an Irish Draught and yet so sensitive. Thank you!


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If there is a mediolateral imbalance and corrective farriery to improve it made it worse, I'd try two things:
1. a new farrier, or a good deal of research to ensure that the farrier is doing what he's supposed to be doing and not just trying stuff
2. look higher up, if she needs that imbalance to offload somewhere else (hock, SI or something) then removing that crutch has made it worse.. however assuming you've elimated higher up the limb
 
That foot looks…wrong. Almost twisted in a way. I would want to analyse the movement and then look for the why behind that.
 
Yeah it’s a valid point about it potentially reflecting on something higher up. I have videos of her moving and on the turn if anyone could take a look?

ETA: will have to send link via PM
 
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Does your farrier hot or cold shoe? I am a long way away from knowledgeable about feet and shoes but when I look at your photos I saw the shoe sitting very close to the frog on the right side potentially causing pressure on the frog when weight bearing or “shock absorbing”? I too saw a bigger heel bulb on the right hand side and I asked about hot or cold shoeing as there seemed not to be a close contact between shoe and hoof wall in the side shot…mind you that could be the loose sounding shoe if at the end of a shoeing cycle.
 
I appreciate you have supplied a lot but can you provide some further info?

In Jan a 4yo ID went lame, vets after a fair few tests didn't find anything but a bruise,

do you have any idea how she got the extensive bruising, was she on frozen ground, ridden over stones, lived on stones, was led over stones. Did anything happen eg did she have a serious play session on a hard surface?

I guess she was being ridden in dec/Jan. Was she barefoot, has she always been BF, was she ridden booted (or even shod) if so which boots

was she sound on the surfaces she was ridden on eg did she try and go on the grass verge or fly along happily over the gravelly tarmac
what about leading to the field did she march over anything or was she more reluctant,

who trimmed her, not their name just your current farrier, a barefoot trimmer and how often.

prior to Jan was she ever even slightly footsore.

if you have written that lot on another thread then apologies that I have missed it. :)
 
Does your farrier hot or cold shoe? I am a long way away from knowledgeable about feet and shoes but when I look at your photos I saw the shoe sitting very close to the frog on the right side potentially causing pressure on the frog when weight bearing or “shock absorbing”? I too saw a bigger heel bulb on the right hand side and I asked about hot or cold shoeing as there seemed not to be a close contact between shoe and hoof wall in the side shot…mind you that could be the loose sounding shoe if at the end of a shoeing cycle.

He actually cold shod this time as it was her first set of shoes, so didn’t want to worry her with the smoke. But I believe we’ll be hot shoeing next time, he’s coming back on Tuesday. She’s on a 5 week cycle. Would a large heel be swelling from taking too much weight?
 
I appreciate you have supplied a lot but can you provide some further info?

In Jan a 4yo ID went lame, vets after a fair few tests didn't find anything but a bruise,

do you have any idea how she got the extensive bruising, was she on frozen ground, ridden over stones, lived on stones, was led over stones. Did anything happen eg did she have a serious play session on a hard surface?

I guess she was being ridden in dec/Jan. Was she barefoot, has she always been BF, was she ridden booted (or even shod) if so which boots

was she sound on the surfaces she was ridden on eg did she try and go on the grass verge or fly along happily over the gravelly tarmac
what about leading to the field did she march over anything or was she more reluctant,

who trimmed her, not their name just your current farrier, a barefoot trimmer and how often.

prior to Jan was she ever even slightly footsore.

if you have written that lot on another thread then apologies that I have missed it. :)
Of course, hoping I have covered what you’ve asked below..

No idea how she got the bruise. We do have a very stoney driveway so put it down to stepping on a stone. When I first bought her last summer (unbroken at the time) she marched across the stones fine barefoot. Gradually I noticed her trying to walk on the grass verge and when she had shoes put on she was much more confident across stones. However given the choice would still favour the grass verge.

Always been BF until this current first set of shoes. My farrier trimmed her every 6 weeks up until this point and Newmarket vet advised 5 week cycle with the shoes.

Hope that’s everything. Visited her this evening and it’s quite noticeable how she keeps her LH camped under 😞 My vet has been kept up to date with all of this.
 
my guess would be that last dec/jan the work either riding or even leading on a stoney driveway just got too much for her feet and she became lame from the bruising. I would also guess from her foot pic this may have been coming on for a while. Easy to be wise in hindsight but personally I would have ridden her for quite a long while booted after backing her, before trying to transition her to riding barefoot. (tihat is in no way criticism)

We tried for a period to trim to support her foot imbalance but she was still lame and struggling on the stoney drive at my yard. Vet and farrier pushed to try shoes so I reluctantly agreed. He put an extension on the side she wears down. Much sounder and vet signed her off to increase work a month ago.

I would have thought it very unlikely she would have become sound by that stage very much at all as her sole is flat and so close to the ground. Then put shoes on and like magic the foot is raised off the ground. Any pain from bruising is much relieved.
Vet said to increase work a month ago which I imagine you did and 2 weeks later sore. I would guess that she again stepped on stones or ATM due to the lack of rain possible simply hard rutted grass as you were riding along and it re bruised the sole which hadn't totally healed.

I had one like this with very similar flat feet, the bruise lasted forever and despite the vets, farrier and x rays ended in an abscess before finally coming sound. That may not happen to yours of course but possibly she is still simply sore.

With vet investigations behind you that is the scenario I would work on. Of course sore feet have a knock on effect to the rest of the body so she may be carrying herself badly due to that.

your question was what would you do. For me it would be remove the shoes. Get some boots and thick pads. Those boots would be for healing her and starting to rehab when sound. I would leave them on most of the time but try to stable/put on rubber mats or even nice springy grass or somewhere soft for a time each day so you can remove the boots but she is on a kind surface.

Boots I would choose would be cavallo, trails, epics or any others with a thick sole and that can take a 12mm pad. I would be experimenting with the pads to see what she found most comfy.
I would leave at least 5 weeks before any trimming to let her feet grow and also to see where she wants her feet to go. Any trimming may be very minimal just to correct rather than remove a lot of hoof.

I would carry on with all of this until she was charging around in boots, playing, being an idiot and obviously very happy then consider some riding boots for her. If she was mine and I suspect stones may well be an issue in the future I would plan on her being a booted riding horse rather than a barefoot one.

For me knowing there was a bruising issue already diagnosed I would work along those lines until I had solved that known problem before considering anything else but obviously that is down to your vet.

From what I have read about ID's I suspect there could well be the potential for laminitis so I would be very careful with the grass so that I didn't confuse this current problem with low grade laminitis as well.

that is simply my opinion based on my barefoot horses, I could be completely wrong and someone else may have far better ideas :D:D
 
my guess would be that last dec/jan the work either riding or even leading on a stoney driveway just got too much for her feet and she became lame from the bruising. I would also guess from her foot pic this may have been coming on for a while. Easy to be wise in hindsight but personally I would have ridden her for quite a long while booted after backing her, before trying to transition her to riding barefoot. (tihat is in no way criticism)

We tried for a period to trim to support her foot imbalance but she was still lame and struggling on the stoney drive at my yard. Vet and farrier pushed to try shoes so I reluctantly agreed. He put an extension on the side she wears down. Much sounder and vet signed her off to increase work a month ago.

I would have thought it very unlikely she would have become sound by that stage very much at all as her sole is flat and so close to the ground. Then put shoes on and like magic the foot is raised off the ground. Any pain from bruising is much relieved.
Vet said to increase work a month ago which I imagine you did and 2 weeks later sore. I would guess that she again stepped on stones or ATM due to the lack of rain possible simply hard rutted grass as you were riding along and it re bruised the sole which hadn't totally healed.

I had one like this with very similar flat feet, the bruise lasted forever and despite the vets, farrier and x rays ended in an abscess before finally coming sound. That may not happen to yours of course but possibly she is still simply sore.

With vet investigations behind you that is the scenario I would work on. Of course sore feet have a knock on effect to the rest of the body so she may be carrying herself badly due to that.

your question was what would you do. For me it would be remove the shoes. Get some boots and thick pads. Those boots would be for healing her and starting to rehab when sound. I would leave them on most of the time but try to stable/put on rubber mats or even nice springy grass or somewhere soft for a time each day so you can remove the boots but she is on a kind surface.

Boots I would choose would be cavallo, trails, epics or any others with a thick sole and that can take a 12mm pad. I would be experimenting with the pads to see what she found most comfy.
I would leave at least 5 weeks before any trimming to let her feet grow and also to see where she wants her feet to go. Any trimming may be very minimal just to correct rather than remove a lot of hoof.

I would carry on with all of this until she was charging around in boots, playing, being an idiot and obviously very happy then consider some riding boots for her. If she was mine and I suspect stones may well be an issue in the future I would plan on her being a booted riding horse rather than a barefoot one.

For me knowing there was a bruising issue already diagnosed I would work along those lines until I had solved that known problem before considering anything else but obviously that is down to your vet.

From what I have read about ID's I suspect there could well be the potential for laminitis so I would be very careful with the grass so that I didn't confuse this current problem with low grade laminitis as well.

that is simply my opinion based on my barefoot horses, I could be completely wrong and someone else may have far better ideas :D:D

Thank you so much for such a detailed and thought-out reply. I had wanted to try boots initially but both vet and farrier said due to the way she moves (she comes down heavy on the outside) she’d need them on all the time. I don’t think you can turn out in boots or are there some that can be left on?
 
my guess would be that last dec/jan the work either riding or even leading on a stoney driveway just got too much for her feet and she became lame from the bruising. I would also guess from her foot pic this may have been coming on for a while. Easy to be wise in hindsight but personally I would have ridden her for quite a long while booted after backing her, before trying to transition her to riding barefoot. (tihat is in no way criticism)

We tried for a period to trim to support her foot imbalance but she was still lame and struggling on the stoney drive at my yard. Vet and farrier pushed to try shoes so I reluctantly agreed. He put an extension on the side she wears down. Much sounder and vet signed her off to increase work a month ago.

I would have thought it very unlikely she would have become sound by that stage very much at all as her sole is flat and so close to the ground. Then put shoes on and like magic the foot is raised off the ground. Any pain from bruising is much relieved.
Vet said to increase work a month ago which I imagine you did and 2 weeks later sore. I would guess that she again stepped on stones or ATM due to the lack of rain possible simply hard rutted grass as you were riding along and it re bruised the sole which hadn't totally healed.

I had one like this with very similar flat feet, the bruise lasted forever and despite the vets, farrier and x rays ended in an abscess before finally coming sound. That may not happen to yours of course but possibly she is still simply sore.

With vet investigations behind you that is the scenario I would work on. Of course sore feet have a knock on effect to the rest of the body so she may be carrying herself badly due to that.

your question was what would you do. For me it would be remove the shoes. Get some boots and thick pads. Those boots would be for healing her and starting to rehab when sound. I would leave them on most of the time but try to stable/put on rubber mats or even nice springy grass or somewhere soft for a time each day so you can remove the boots but she is on a kind surface.

Boots I would choose would be cavallo, trails, epics or any others with a thick sole and that can take a 12mm pad. I would be experimenting with the pads to see what she found most comfy.
I would leave at least 5 weeks before any trimming to let her feet grow and also to see where she wants her feet to go. Any trimming may be very minimal just to correct rather than remove a lot of hoof.

I would carry on with all of this until she was charging around in boots, playing, being an idiot and obviously very happy then consider some riding boots for her. If she was mine and I suspect stones may well be an issue in the future I would plan on her being a booted riding horse rather than a barefoot one.

For me knowing there was a bruising issue already diagnosed I would work along those lines until I had solved that known problem before considering anything else but obviously that is down to your vet.

From what I have read about ID's I suspect there could well be the potential for laminitis so I would be very careful with the grass so that I didn't confuse this current problem with low grade laminitis as well.

that is simply my opinion based on my barefoot horses, I could be completely wrong and someone else may have far better ideas :D:D
This sounds a far more likely and realistic assessment than from either the farrier or the vet.
Do watch the grass, it’s locked up, stressed sugar just waiting to explode with the first drop of rain.
 
Thank you so much for such a detailed and thought-out reply. I had wanted to try boots initially but both vet and farrier said due to the way she moves (she comes down heavy on the outside) she’d need them on all the time. I don’t think you can turn out in boots or are there some that can be left on?
you can turn out in boots (and pads) they just need to be the right ones, people use cavallos quite a lot for turnout. There are other options for sole protection too (hoof armour or rubber crumb protections) that's why it would be useful to know if she bruised because her sole depth isn't/wasn't great and if so whether than could be improved alongside other measures. Something changed from her being rock crunching when you first got her to not, more work? abrasive arena? autumn grass flush?
 
you can turn out in boots (and pads) they just need to be the right ones, people use cavallos quite a lot for turnout. There are other options for sole protection too (hoof armour or rubber crumb protections) that's why it would be useful to know if she bruised because her sole depth isn't/wasn't great and if so whether than could be improved alongside other measures. Something changed from her being rock crunching when you first got her to not, more work? abrasive arena? autumn grass flush?

Here are the X rays and also MRI. I can’t remember any comment made about sole depth

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If nothing else you are spoiling us with hoof pics! That doesn't look like a lot to me (and I thought it was poss a bit flat in your first pic as did paddy) but others might like to way in more on that.

Also with the pic where I said the heel bulbs are wonky, now on laptop it looks like that might be because the lateral side is closer to the camera, I'd have a good look at that in real life and see what you think. The good news is she's kept a good frog.

Paddy where do you get the 12lb pads for, I was going to like EPS for the OP so she knows what you meant but they only go up to 9lb

 
OP Tiddlypom is the first person I think of that has posted quite a bit on having her horse turned out in boots all round, you can search her previous posts- this one happens to have a pic.
 
OP Tiddlypom is the first person I think of that has posted quite a bit on having her horse turned out in boots all round, you can search her previous posts- this one happens to have a pic.
Thank you, that’s really helpful.

Would she need booting all round, or could you just put them on the back feet?
 
Thank you so much for such a detailed and thought-out reply. I had wanted to try boots initially but both vet and farrier said due to the way she moves (she comes down heavy on the outside) she’d need them on all the time. I don’t think you can turn out in boots or are there some that can be left on?
You can turn out full time in boots, especially at this time of year when the ground is dry 🙂.

This is my thin soled (and thin skinned) homebred, sadly now lost to something completely unrelated. The vet had said she would be crippled without shoes, but she did grand turned out 22 hours a day for a few weeks during her rehab in her Cavallo treks all round. They didn’t rub or twist.

It’s worth a try. Good luck.


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After this period she could be turned out without her boots, but they helped her through a rough patch. Initially she would look sounder when shoes were put on, then she would go much lamer.

ETA I used the Cavallo gel pads in the Treks. These.

 
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If nothing else you are spoiling us with hoof pics! That doesn't look like a lot to me (and I thought it was poss a bit flat in your first pic as did paddy) but others might like to way in more on that.

Also with the pic where I said the heel bulbs are wonky, now on laptop it looks like that might be because the lateral side is closer to the camera, I'd have a good look at that in real life and see what you think. The good news is she's kept a good frog.

Paddy where do you get the 12lb pads for, I was going to like EPS for the OP so she knows what you meant but they only go up to 9lb

12 mm not 12 lbs.

Thank you, that’s really helpful.

Would she need booting all round, or could you just put them on the back feet?
for some reason you have a bruise on one foot. We don't know why it could have been a genuine accident affecting 1 foot or it could indicate the sole is thin, mare cannot cope with stones at this stage of her BF journey, possibly autumn lami or anything else so I would work on the basis the other 3 feet may not be brilliant and boot the whole lot. Better to be cautious.

I would measure your feet (all of them) and then email urban horse, send them some foot pics, explain the problem and specifically point out the boots are for rehab and they MUST have a thick sole. You will probably end up, once she has the info, of discussing it with Carolyn on the phone.

first thing is to find out what choices you have in your sizes.
Boots obviously have to fit and hopefully your feet will grow so it will be a case probably of ordering one or two and seeing if that size and make fit and returning those that don't. (you can try them on over a plastic bag but not walk in them)

I don't think vets and farriers have much experience of 24/7 long term booting to rehab.

I am sure that boots are going to see like a total minefield to you now :D:D

best thing is to measure all your feet and then go onto urbanhorse.com (or TheSaddleryshop.com or hoofboutique ) and read up a bit about boots.

If you then decide to go ahead come back and ask your questions. There is a lot of experience on here about boots. Many of us have rehabbed horses in this way.

It will be interesting to see how your feet grow and how your mare wants them (which may be different to how the trimmer/farrier decides)
 
Ah I misread!

Having lots of boot options these days is both helpful and a bit overwhelming but the right people def know what fits best, especially hind foot wise ie not so round
 
Need some HHO words of encouragement…

I had a moment of weakness and vet and farrier persuaded me to try another shoeing cycle. I really wish I hadn’t. That foot just looks worse now. I called my vet back out as wasn’t happy that she was constantly resting that LH, and just looking a bit unhappy.

Vet watched her trot up and still had a mild LH lameness but it improved with time and by the end she was actually sound on flexion test. Interestingly she was very resistant on the right rein on a circle both hard and soft, fine on left rein. We used the equinosis equipment (for those who don’t know it’s very clever gait analysis technology) which showed lameness in the LH and even her front left now 😩

I’m going to take the shoes off and get boots with pads as people suggested. Think I’m just looking for reassurance as it’s so hard go going against the advice of professionals.

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Ok deep breath.

What you really need to do is with shoes off take photos with tape measure in situ for length and width.

Send the photos to one/all of the great boot companies who are good with advice. Tell them that you are going to need room to pad for now too.
Urban horse/the saddlery shop/equine podiatry supplies.

if you think you’re definitely going to need boots the first moment out of shoes they can prob come up with something that will be a bit forgiving on fit to get you through that bit (even if you didn’t then end up keeping them, they keep their 2nd hand value quite well)

Unfortunately my own experience was all in Somerset/wilts before I moved here so I don’t know anyone trimmer wise out here I could recommend.
 
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