Feet xrays - foot balance, long toes and low heels

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emfen1305

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As part of ongoing investigation into Toby's mild lameness behind and just not being quite right, he was diagnosed with PSD on both hands after a positive block and then a scan. I asked for xrays of the front and back feet to rule out any issues that might be contributing, I was more interested in the hinds as he as an long toes and low heels and know that this can put pressure on the ligaments but wanted the fronts doing just in case there was something sinister going on. He is currently barefoot and has solid feet but he can be footy on stones and uneven ground. We have only been properly barefoot since the end of summer and he hasn't done too much work so I don't know for sure whether he would have got better. I have just been sent the x-rays so thought I'd post them as lots of very experienced and knowledgeable HHOers on here and as much as I have managed to get my head around all of the other conditions, the feet still baffle me!

There was nothing too exciting really. For the fronts, the vet says he has thin soles and some foot balance issues which has caused side bone so has recommended a farrier to do some remedial work to help address this, whether this be shoeing or trimming (but has recommended shoes for the thin soles). She said the toes are also longer than she would like which you can see on the x-ray but they don't look long in person! I did notice he has uneven wearing on the fronts even though he has not done much work recently. For the hinds, again thin soles and has recommended that the toe can be shortened further if
the farrier leaves some length on the shoe at the back to support the heels - this was not surprising though I am annoyed that I didn't push for the x-rays earlier!

My next step is look for a farrier that will look at the x-rays and help address the balance issues and the long toes behind but he is now going to be on box rest for 4 weeks and small paddock turn out after that so in no rush to do anything yet. Does anyone else have experience of these issues? if anything needs clarifying, please say, I am going off memory of the conversation from last night!

Hopefully you can see the album, it includes the photos I took of his feet as well! https://imgur.com/a/7ccLl
 
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I am absolutely no expert but hopefully one will be along shortly. In the meantime fwiw I'll give you my thoughts as someone with a barefoot horse ;-)

First my favourite question, what are you feeding?

If he's only been bare for a few months then I think you've made a good start I would like the back of the hooves to bulk up some more and the sulcus is a bit deep for my liking. But for hooves that aren't working that hard I have seen worse. Getting a thick sole takes time and generally, when shod, the soles are pared away. This is a big no for a barefoot horse so you need a farrier or trimmer who will leave well alone to allow it to thicken.

I'm sure I read something (possibly on here) about the sole growing out from around the frog/bars, so sole thickness comes outwards over time. An expert will hopefully confirm or debunk this for both of us.

Keeping the sulcus clean and free from any thrush will also help as he'll be comfortable enough to land heel first and in turn this will help develop the back of the hoof.

The only other thing may be to consider why he's wearing the hooves unevenly, it may be discomfort higher up that's causing a change in his movement. So possibly the hoof shape is the symptom rather than the cause??

Not sure I've been much help but hopefully an expert will be along soon.
 
I wouldn't be expecting thick soles, especially in front at this point, all putting shoes on is doing is lifting them off the floor, it won't make them any thicker ;) In front even on the xrays you can see the new angle of growth which will eventually shorten the toe (and the HPA will look better then too). Personally I wouldn't be too worried about the side bone, well from the point of jumping in to try and do anything about them now especially as they are fairly even medially and laterally. I don't know if you remember posts about Vardie the spotty? They were much more impressive and he was much better bare than shod.

I do think his hinds are trickier, how long have they been off? They are lacking in heel still and somewhat bullnosed, there really doesn't seem to be any toe to come off, the apparent length is due to the angle of growth coming down being in the wrong direction still. I'm interested to see what ycbm thinks after our wedges discussion for the PSD previously.
 
Diddleydoo said:
I am absolutely no expert but hopefully one will be along shortly. In the meantime fwiw I'll give you my thoughts as someone with a barefoot horse ;-)

First my favourite question, what are you feeding?

If he's only been bare for a few months then I think you've made a good start I would like the back of the hooves to bulk up some more and the sulcus is a bit deep for my liking. But for hooves that aren't working that hard I have seen worse. Getting a thick sole takes time and generally, when shod, the soles are pared away. This is a big no for a barefoot horse so you need a farrier or trimmer who will leave well alone to allow it to thicken.

I'm sure I read something (possibly on here) about the sole growing out from around the frog/bars, so sole thickness comes outwards over time. An expert will hopefully confirm or debunk this for both of us.

Keeping the sulcus clean and free from any thrush will also help as he'll be comfortable enough to land heel first and in turn this will help develop the back of the hoof.

The only other thing may be to consider why he's wearing the hooves unevenly, it may be discomfort higher up that's causing a change in his movement. So possibly the hoof shape is the symptom rather than the cause??

Not sure I've been much help but hopefully an expert will be along soon.
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Thoughts always very welcome so thank you for replying :)

Currently on an ulcer friendly diet so a little sugar and starch as possible, the current combo is speedi beet, token bit of alfa a, balancer and a couple of supplements but none admittedly for hooves as we've always believed he's got strong feet so never bothered with anything bar a bit of kevin bacon!

I've never seen my farrier or my trimmer take anything away from the sole to be honest, they usually just trim the toe and rasp around the edge but then I can't say I would know what it would look like if they were.. is that where they get the slicy knife (technical term) and use it on the frog? Forgive my ignorance!

I think we are still in the chicken/egg stage of things, we know he's been riddled with various issues with his hind end for a while now as well as ulcers so could very well be that he is front loading (hence why i wanted to the front xrays) so I am hopeful that once we have his back end fixed he will feel more comfortable. The vet doesn't seem to think the slight issue with his fronts would be the reason for the issues in his hind end but likely that they are symptom and not the cause!

Do you have any recommendations for products to keep the foot clean and protected? I think he has smelly feet but have always been told not worry about it!
 
ester said:
I wouldn't be expecting thick soles, especially in front at this point, all putting shoes on is doing is lifting them off the floor, it won't make them any thicker ;) In front even on the xrays you can see the new angle of growth which will eventually shorten the toe (and the HPA will look better then too). Personally I wouldn't be too worried about the side bone, well from the point of jumping in to try and do anything about them now especially as they are fairly even medially and laterally. I don't know if you remember posts about Vardie the spotty? They were much more impressive and he was much better bare than shod.

I do think his hinds are trickier, how long have they been off? They are lacking in heel still and somewhat bullnosed, there really doesn't seem to be any toe to come off, the apparent length is due to the angle of growth coming down being in the wrong direction still. I'm interested to see what ycbm thinks after our wedges discussion for the PSD previously.
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So you don't think I should be too quick to whack shoes on the fronts then? I am not fussy whether he is shod or unshod, he is always kept barefoot in the winter as he throws shoes due to being an idiot in our sucky mud field and then this year he threw one at the end of the summer randomly so I just decided to try him with them off permanently, he doesn't like the uneven ground though, he does go quite pottery even when walking to the field so not sure if it would just be kinder to shoe him (booting for turn out isn't an option as I don't put him out and not sure they would survive all day in the field in our mud!) I think I actually saw those posts yesterday when I was looking up sidebone! The vet told me not to get worked up about it!

He has always been barefoot behind since I got him (2 1/2 years) and we have been constantly battling with this long toe low heel issue. The vet thinks a bit more can come off if he had support behind and I do think the heel is the problem. I'm hoping ycbm will be along shortly to have a look at them and let me know what she thinks. I am still inclined to want to put wedges or some sort of support on the heels and I am going to see if I can get recommendations for a farrier that is used to dealing with these sorts of issues and will look at the xrays and make recommendations. I fully admit I am too novice and ignorant to know what to do for the best for him but seemed to have picked a right bunch of "experts" over the last year who have fobbed me off so need to make sure I get the right farrier to help us!
 
I think the fronts would probably come on fine out of shoes. I agree with your vet re. not getting worked up about the sidebone as it stands. I think realistically what you do with the fronts depends on your plans for the backs as they are I think more complicated and more important, and less well behaved. I don't know how much of it may be a chicken/egg situation with the suspensories but I think you'd have very little to lose trying him in shoes/wedges to see if it makes him more comfortable.
He has very fat frogs behind but I actually wonder if they are so big because of the lack of heel, something has to try come in a sort/support it.
 
I have an eventer with a similar issue and he has pads on his fronts to raise his heels up. He has had three sets now and farrier thinks he might need four more and can then come out of using them. barefoot isn't an option for me, but he is 100% more comfortable and happy since the pads went in.
 
ester said:
I think the fronts would probably come on fine out of shoes. I agree with your vet re. not getting worked up about the sidebone as it stands. I think realistically what you do with the fronts depends on your plans for the backs as they are I think more complicated and more important, and less well behaved. I don't know how much of it may be a chicken/egg situation with the suspensories but I think you'd have very little to lose trying him in shoes/wedges to see if it makes him more comfortable.
He has very fat frogs behind but I actually wonder if they are so big because of the lack of heel, something has to try come in a sort/support it.
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I think you are right, the hinds are more important to sort, my hope is that if I can sort those and make him comfortable, I will be able to bring him back into a decent level of work and then the fronts will come right, in terms of the balance - this is what the vet also thinks. We moved forward with the op for the PSD today actually as regardless of whether it is primary or secondary to other issues or just poor confirmation, the alternative treatments were not viable for him and our cirucumstances and unfortunately I am bound by insurance time frames so the op was the most sensible thing to do. This will at least get him more comfortable and then we can continue to scrutinise his movement to see what further issues there may be - Sacroiliac is next on my list, the vet has told me that we have to take it one step at a time so I am trying not to get too excited about having my horse back!!
 
paddi22 said:
I have an eventer with a similar issue and he has pads on his fronts to raise his heels up. He has had three sets now and farrier thinks he might need four more and can then come out of using them. barefoot isn't an option for me, but he is 100% more comfortable and happy since the pads went in.
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That's interesting to hear - what will you do once the pads come out, normal shoes? My worry is that I will fix the issue, come out of the remedial shoes and then it will start to deteriorate again and I won't be able to tell - I guess that is what a good farrier is for but I feel like I have lost faith in all "experts" at the moment!
 
emfen1305 said:
That's interesting to hear - what will you do once the pads come out, normal shoes? My worry is that I will fix the issue, come out of the remedial shoes and then it will start to deteriorate again and I won't be able to tell - I guess that is what a good farrier is for but I feel like I have lost faith in all "experts" at the moment!
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yeah the aim is for normal shoes, but you never know with horses! The difference the pads made to his way of going was amazing, he was instantly more comfortable and his whole way of going improved.
 
paddi22 said:
yeah the aim is for normal shoes, but you never know with horses! The difference the pads made to his way of going was amazing, he was instantly more comfortable and his whole way of going improved.
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I hope he continues to improve! Sounds like I need to be hunting down a good farrier!
 
ester said:
does your vet not have a good one they use?
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They do, however he will only shoe by referral at the clinic on Wednesdays which would be OK for the first couple of times but I don't want to transport him every 6 weeks to have his feet done if I can get someone to come to me!
 
My cob was shod with lateral extensions behind after his bilateral hind PSD diagnosis. It meant that his fronts had to be shod too, though they weren't a problem. The vet was most insistent that he neeed the support of the extensions. The PSD did come good with box rest followed by gradually increasing peroids of walking in hand.
 
emfen1305 said:
They do, however he will only shoe by referral at the clinic on Wednesdays which would be OK for the first couple of times but I don't want to transport him every 6 weeks to have his feet done if I can get someone to come to me!
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maybe not but if you do and it seems to be working at least that farrier will have information to pass on to whoever you do end up using/may have a suggestion of someone he trusts to carry it on.
 
ester said:
maybe not but if you do and it seems to be working at least that farrier will have information to pass on to whoever you do end up using/may have a suggestion of someone he trusts to carry it on.
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I didn't think about it that way - definitely worth mentioning to the vets when we get closer to the time, I am hoping that my vet might also have recommendations!
 
Tiddlypom said:
My cob was shod with lateral extensions behind after his bilateral hind PSD diagnosis. It meant that his fronts had to be shod too, though they weren't a problem. The vet was most insistent that he neeed the support of the extensions. The PSD did come good with box rest followed by gradually increasing peroids of walking in hand.
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That's good to know, thank you :) I am just itching to get him all fixed but I know it is going to be a long process and everything needs to be done a step at a time!
 
emfen1305 said:
Thoughts always very welcome so thank you for replying :)

Currently on an ulcer friendly diet so a little sugar and starch as possible, the current combo is speedi beet, token bit of alfa a, balancer and a couple of supplements but none admittedly for hooves as we've always believed he's got strong feet so never bothered with anything bar a bit of kevin bacon!
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Since you've already sorted the sugar and starch my only suggestions would be to try one of the 'well known barefoot balancers' and see if it helps. I've certainly seen an improvement using Forage Plus but I'm aware some of the others are equally effective. The other thing is the Alfa A, my mare was footy while I was feeding an alfalfa based chop. I do understand this is a difficult one as alfalfa is highly recommended for ulcer issues. Maybe something to consider further down the line as you've clearly got a lot going on with him at the moment

emfen1305 said:
I've never seen my farrier or my trimmer take anything away from the sole to be honest, they usually just trim the toe and rasp around the edge but then I can't say I would know what it would look like if they were.. is that where they get the slicy knife (technical term) and use it on the frog? Forgive my ignorance!
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That's it exactly, they'll sometimes remove sole too. If you've never seen it happen then hopefully that's not part of the issue. That's not ignorance, that's a perfectly accurate description ;-) I've no idea what the slicey knife is really called either.

emfen1305 said:
I think we are still in the chicken/egg stage of things, we know he's been riddled with various issues with his hind end for a while now as well as ulcers so could very well be that he is front loading (hence why i wanted to the front xrays) so I am hopeful that once we have his back end fixed he will feel more comfortable. The vet doesn't seem to think the slight issue with his fronts would be the reason for the issues in his hind end but likely that they are symptom and not the cause!
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I do sympathise I'm juggling issues too so I know how hard, and frustrating, it can be. Hopefully as you start to resolve the causes it will help those that are symptoms to resolve too.

emfen1305 said:
Do you have any recommendations for products to keep the foot clean and protected? I think he has smelly feet but have always been told not worry about it!
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The Cleantrax and Red Horse products seem well thought of but she's never had trouble with thrush so I can't personally vouch for any of them, sorry.
 
Diddleydoo said:
Since you've already sorted the sugar and starch my only suggestions would be to try one of the 'well known barefoot balancers' and see if it helps. I've certainly seen an improvement using Forage Plus but I'm aware some of the others are equally effective. The other thing is the Alfa A, my mare was footy while I was feeding an alfalfa based chop. I do understand this is a difficult one as alfalfa is highly recommended for ulcer issues. Maybe something to consider further down the line as you've clearly got a lot going on with him at the moment

That's it exactly, they'll sometimes remove sole too. If you've never seen it happen then hopefully that's not part of the issue. That's not ignorance, that's a perfectly accurate description ;-) I've no idea what the slicey knife is really called either.

I do sympathise I'm juggling issues too so I know how hard, and frustrating, it can be. Hopefully as you start to resolve the causes it will help those that are symptoms to resolve too.

The Cleantrax and Red Horse products seem well thought of but she's never had trouble with thrush so I can't personally vouch for any of them, sorry.
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Thanks :) My plan is to take him off the Alfa A once this bag is used up, I think his ulcers are splash ulcers related to stress which is now more than likely from the low grade pain he has been in so hoping once the pain is gone, the ulcers will stay away! He is an internal worrier which doesn't help! I just used the chaff to bulk up the mash and slow him down a bit but I can use something else for that. I did look at barefoot balancers but wasn't sure what more they would give than more normal balancer but maybe I need to look into it more - current balancer is a spillers one which I know has fillers *shudder* but I had to strip all extra iron out and it was the only one I could get hold of at the time, I've heard good things about FP though!
 
I'm interested to see how you get on Emfen l. I have a beast with similar issues despite having been bf and fed all the right minerals, kept on the right grazing, etc etc since a foal. He's now 6 and has mild djd in his hocks. I've also just sent off hairs for pssm testing. Vet is sure his soles are congenitally thin and everything we've trued has failed, from hours walking on tarmac to boots. He's now shod in front, with heel extensions for extra support and we can see the new growth is wider at the heel so we are hopefully moving in the right direction. Slow and frustrating progress at times though!
 
Nudibranch said:
I'm interested to see how you get on Emfen l. I have a beast with similar issues despite having been bf and fed all the right minerals, kept on the right grazing, etc etc since a foal. He's now 6 and has mild djd in his hocks. I've also just sent off hairs for pssm testing. Vet is sure his soles are congenitally thin and everything we've trued has failed, from hours walking on tarmac to boots. He's now shod in front, with heel extensions for extra support and we can see the new growth is wider at the heel so we are hopefully moving in the right direction. Slow and frustrating progress at times though!
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I will update with any new info :) Toby came to me shod on all fours with "normal" shoes but agreement of him going in the field I wanted him to go in was the back shoes needed to come off (we didn't know if he was a kicker, he's not I am pleased to report!). When I first started wondering if there were issues I messaged the old owners to ask if there was a reason why he was shod on all fours and they just said it's just what all of their horses had on so not helpful. Toby also has mildly arthritic hocks (vet says not unusual for a 10 year old) and I had him tested for PSSM1 but came back negative and he didn't respond to the diet anyway. Vet thinks that conformation is playing a part (he is straight hocked) and he has potentially been compensating for a long time. I am hoping to speak with a farrier about all of these and see their recommendations but seems that shoes on the backs with extensions would be the way forward!
 
where in the country are you based? My farrier (master farrier) does remedial shoeing for a big equine hospital and loves a challenge. He has completely transformed my horses's feet and I would recommend him without hesitation.
 
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