hoof dorsal resection

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EAST KENT

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As above really..your experiences?:confused:This seems to be the next step for my mare,and reading up I can see the logic of it.The "gas pocket" shows clearly on x ray,she is in heart bars with gel padding,but logically the cause of the pressure "under her nail" so to speak must be released.Can she go out in a tiny bare paddock in hoof boots afterwards?She is very calm about all this,box rest since the beginning of Feb but quite content .Just be a shame for no sun to warm her back all summer.
So far there is minimal rotation,but obviously I want her out of pain ASAP.Off to buy huge sacks of unmolassed oat straw to mix in with a tad of taster tomorrow!
 
As someone who has done over 200 resections I would now advise any owner not to have it done.
In its day it seemed the answer to any form of separation in the dorsal area, along with the fitting of Hart bars (usually plastic) but now I certainly know different.
We get obsessed with trying to get everything back to being as normal as possible as quickly as we can without taking note of the in-built repair system that the horse has.
By all means relieve the toe of any pressure, but that can be done from the palmer surface, plus the caudal 1/3 (rear) of the foot should be encouraged to take all the support it can.
By performing a resection you loose the integrity of the horn structure around the toe, leading to flares Med and lat that will only increase the long term horn separation in the white line.
I now find that I get better results by treating laminitic referrals with barefoot trimming than I did with resections and shoes, not only that but when they are better the horn quality is far better.
 
Heelfirst said:
As someone who has done over 200 resections I would now advise any owner not to have it done.
In its day it seemed the answer to any form of separation in the dorsal area, along with the fitting of Hart bars (usually plastic) but now I certainly know different.
We get obsessed with trying to get everything back to being as normal as possible as quickly as we can without taking note of the in-built repair system that the horse has.
By all means relieve the toe of any pressure, but that can be done from the palmer surface, plus the caudal 1/3 (rear) of the foot should be encouraged to take all the support it can.
By performing a resection you loose the integrity of the horn structure around the toe, leading to flares Med and lat that will only increase the long term horn separation in the white line.
I now find that I get better results by treating laminitic referrals with barefoot trimming than I did with resections and shoes, not only that but when they are better the horn quality is far better.
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Wow! Who are you? I want to shake your hand!!!

A REAL expert who says that dorsal wall resection does no good, and barefoot laminitis rehab does.

Fantastic, and welcome :)
 
Can anyone explain the rationale for resecting laminitic hooves please?
Has the vet explained their reasons East Kent?
 
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EAST KENT said:
The "gas pocket" shows clearly on x ray,she is in heart bars with gel padding,but logically the cause of the pressure "under her nail" so to speak must be released.
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Is this the reason your vet is giving for the resection?

Don't mean to labour the point but what pressure is 'under the nail' so to speak? I am unable to understand where this pressure is coming from. Call me a numpty but it makes no sense to me whatsoever. The gas pocket is just an air space.
In my understanding the pain in laminitis comes from the inflammation... that is what has to be got under control for pain relief.
 
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What I have seen happen when we got to the laminitic early enough, we would start to perform the resection and the laminae would literally swell outwards as you were rasping due to the inflammation.
Now I realise that if we relieve the pressure on the dorsal section by letting the foot back on to it’s heel and putting a 45% break-over in the toe we could create the same pain lose without having the long period of dorsal repair.
Mechanically laminitis is like hitting your nail with a hammer, you get bruised disconnected tissue, swelling, pressure and pain. It is possible to puncture the nail with a hot pin (not to gory for you I hope) and release the pressure which does help the pain but not the disconnected tissue which can often fill the cavity, leading to more discomfort.
It is far better not to put pressure on the area and wait for the new nail (horn) to grow and protect the inner structure
By the time you see gas in the cavity the pressure has gone and really you are just looking at a void plus necrotic laminae
 
Thanks for that Heelfirst. I can see that with inflammation comes swelling which causes pain in the hoof but this should subside when the inflammation subsides surely? I know my pony gets comfortable quickly (days) when I address her diet even before any trim. Obviously, some horses are different and an appropriate trim you describe is needed for pain relief for them.

Heelfirst said:
By the time you see gas in the cavity the pressure has gone and really you are just looking at a void plus necrotic laminae
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This is what I thought but a lot of vets seem to think that this void needs pressure releasing. I read of drilling, resections etc. to relieve pressure so often.
 
All I know is my mare has pain,no I do not want to have a re-section done,nor does my farrier,but the vet is adament,I shall ring Boss Vet,he has years and years of experience to back any discision. Difficult problem,I can remember vaguely the farm pony having vertical grooves cut in her front hooves..was that for the same thing?Anyway,I shall hold fire for now
 
EK I don't know if you could find it if you search for it, it's probably buried way back last year. But someone described how a mare had this done to relieve her painful laminitic feet and on coming home from the hospital she lay down in her stable groaning until someone was compassionate enough to have her put down.

As far as I am aware there is no clinical evidence worth the paper it's written on to support a hoof resection for laminitis. I believe that what studies have been done failed to have either significant numbers or a control group where the minimalist approach recommended by Heelfirst was used.

If the space is gas, and the operation is to be done for pressure release, can you ask your vet why that gas would not be released through one 5mm hole rather than complete removal of the front of the foot? Or even through the bottom, where the dead laminae will no longer be providing a seal?

I'd go with your farrier long before I would trust a vet on this. What they are taught about feet at college is minimal, precisely because they rely on the farriers who specialise in feet.

Are your vets being advised by Robert Eustace or his crew? My own vet does not hold the Laminitis Trust is very high regard, to put it mildly.
 
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By the time you see gas in the cavity the pressure has gone and really you are just looking at a void plus necrotic laminae
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....and then abscesses which at that point many vets give up and recommend PTS, unnecessarily really.

Eustace is a fan of dorsal wall resection, I remember being at a vet presentation locally when he was expounding it and showing his pictures. Thought then that it was a hiding to nothing

Many Laminitics can be recovered, but not many vets know how to do it.
 
Discussing it with my farrier..who has discussed it with said vet,basically we lost in translation.What she wants done is the toe in a small half moon shape rasped away,and both myself and farrier are much relieved and will go along with that.CPT ,obviously it was researched by me on the internet,for such a radical step I needed to know the exact facts.Maybe you can find it,but incredibly it films this procedure being done with no sedation ,nothing,the horse did not react in any way you would expect .It had necrotic holes in three places,and in fact it had to have even more digging out done at vet hospital later.Amazingly it recovered!Got it straight now,but really,the conflicting views on laminitus are diverse to say the least,boss vet ,for instance is on about starving and "keeping them moving".Everyone else stresses box rest. It is extraordinary how such an old and common problem seems not to have a set regime as a remedy.
The emergency diet is her basic ration,fairly rough meadow hay,oat straw chaff ,unmolassed,and beet pulp as a taster,plus formula for feet and charcoal.She was never a typical laminitus horse,never getting fat or cresty,just one bad reel of silage did for her,and we were very lucky my Highland was not affected as well,munching this very same reel,but she is almost indistructable..thank goodness.
 
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Everything about laminitis is a judgement - when to trim, when to rest, when to gently move, when to deep bed and it's different for each case

But the basics are the same - proper diet, proper supplementation, conformable surface, quiet environment, if required heels down toes back, boots with pads, no shoes, frog supports if needed
 
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