Barefoot rehab Q - Subtle foot lameness

[rara007]

Hi there!

I have a horse I’m considering taking this route. He is usually unshod over the winter and copes well, he’s was only shod to hold studs and as a bit footy in the spring on type1 hardcore yard. He’s currently walking out well with his shoes off (post MRI). He’s 1/10 lame left fore on a right circle on hard lunge so pretty subtle. Sounder than most horses you see. I think it’s probably chronic his lameness that just wax and wanes. He’s definitely taken the odd funny stride trotting on cambers in 2023.

MRI summary below:

In both front feet, there is an insertional lesion/desmitis of the lateral collateral ligament of the distal interphalangeal joint, a mild desmitis of the lateral collateral sesamoidean ligament and the lateral chondrochoronal ligament (L>R).
The small periarticular osteophytes and mild synovitis of the distal interphalangeal joint could be a normal variation or indicate mild osteoarthritis (RF>LF).
There is a long toe conformation in both forefeet.

I do have rads too and I can get hoof pictures if needed. His horn quality is very good and he lays down a lot of sole. His frogs quickly get deep once he’s shod.

Conventional vet advice is a wide web (laterally) shoe, and poss medicate the coffin joint. Anything from 6m box rest to 4m turnout with walk exercise.

If I was to barefoot him would there be any rest period? He’d happily go out at walk and trot for a ‘full’ length hack tomorrow. He’s not going to run out of foot he’s got loads! How about schooling work and the turning forces that applies? He finds left canter transition hard, but he’s a capable little horse who works well and you can’t see the lameness when he’s working on the bit. How many days a week is enough? I’m not very time rich and my patience for walk hacks is almost 0.

I have access to roads with the odd track if going over 5km, a rubber arena and a flat grass field.

Is out 24/7 (not a track, but naturally active in field) or in during the day (to limit grass) better?

Thoughts appreciated

Thanks!

 

[SusieT]

I think you need to be cautious that barefoot as such is not going to solve those inflammatory changes. Inflammation needs rest, time and sometimes medication. They need rest and probably gentle movement to settle them. A steroid inject may or may not help. I think Barefoot may be helpful even if for no other reason than to remind you to slow down until his foot hardens up, which is likely to be about the timeframe to allow soft tissue injuries to settle..
He doesn't need rest from a barefoot point of view unless he is sore while his foot hardens up.
I would probably take shoes off, turn away in small flat, non rough paddock for 6-8 weeks then build up slowly and go from there. I would also consider that schooling is likely to have a high risk of flaring this up if you don't let it settle completely. Horses are frustrating aren't they- but MRI is amazing! All in all that report doesn't sound like the end of the world?

 

[ycbm]

Rara probably the most important thing at the moment is whether he is landing heel first, toe first, or flat.

Can you video him in slow motion from the side with the camera held really low down?

If he lands toe first then a conventional barefoot rehab would be an increasing program of work in hand until such time as he begins to land flat, then walk work ridden on straight lines until he is heel first landing when you can gradually introduce trot, then canter. And of all that goes OK then you can start with some circling in arenas again. No box rest at all, the movement is key to getting the foot to reshape itself.

Have you got a farrier who will be fully on board with this? It's really key. So is assertive thrush control.

Personally I'd want him out full time but only if he's a horse where the grass doesn't weaken his feet or make him fat.

I hope that helps.
.

 

[rara007]

We’re already landing heel first- I got one flat landing with several walks up and down. Top pic the flat one.

The fact there’s changes bilaterally and there was no known acute lameness is what’s making me blame the feet rather than a true injury. He doesn’t go lamer with work or the day after.

 

[ycbm]

He's got an interesting tighter band half way down one foot, Rara, did that coincide with his shoes being off last winter?

His heels are underrun, though not drastically. I'd be hopeful of getting those back under his legs and resolving the issues. You're starting from a pretty good place.

With that landing, if he was mine and as little lame as you report, I'd be getting him up to one hour walk hacking mostly on roads, 2 days then rest, 2 days then rest (the rest is important for repair) as soon as I could depending on how fit he is now.

Does he land on both heels at the same time?
.

 

[millitiger]

Sounds very very similar to my boy!
Left fore lameness, only when turning right.
We MRI'd and saw some inflammation of the coffin joint but no ligament or tendon damage at all.

Vet wanted to go full pads, bar shoes and steroids into both coffin joints. They couldn't tell me what the long term plan was or how we'd get him out of the bar shoes, bearing in mind he had been in graduated pads for 8 months and still had no heels.

I have taken shoes off, he had a trim and field rest for 8 weeks.
2 weeks of bute initially to help settle the inflammation.
Boots worn in the field with pads for support.

We are now 11 weeks in-
Boots worn for work and he is hacking up to 30 mins, walk only. Or riding in the field in long straight lines, walk only. No arena work so I'm not tempted to do too much!
Not wearing the boots for turnout any more.

He is moving so well now, we'll continue to up the time hacking and start to introduce some trot in the field and some lateral work etc. and hopefully continue to up it until back in full work (eventing 90-100 and dressage Med/Ad. Med)

 

[rara007]

I think probably- he was shod in April I believe, and had been unshod since approx September at that point. The hoof with the line is the lame one.

Yes landing pretty flat laterally, one time medial first in my walk up.

He’s probably my soundest horse, I don’t enjoy hard lunging the other…! but once you know you know.

 

[ycbm]

I'm glad to see those photos Rara, because the underrun heels didn't look to me to be bad enough to cause his issues. But his lateral landing is nowhere near equal enough for me to be happy if he were mine, and if he's been landing like that a long time it would give a good explanation for your MRI results. Unless the photos are misleading the right hand side of the foot is definitely making ground contact after the left.

I don't know if I would trim him to try and correct that, those decisions can only really be made in the flesh, but if road work on straight line doesn't bring that landing dead flat laterally quite soon, he might need some help.

I actually think this is good news because it does give some confidence that there is a foot balance issue that he can change which will resolve things.
.