WWYD? - Three trusted professionals with three different opinions

[PaulnasherryRocky]

I recently had the vet out as my horse was 2/10ths lame when put on a circle on hard ground. A week of boxrest and bute made no difference, so we did nerve blocks - pain is in left front foot.
We xrayed the area to find nothing bone related, other than him being quite flat footed.

I now need to have an MRI, vet is suspecting collateral ligament damage.

Until then, vet suggested box rest for approx.12 weeks, wedges at the back of his shoes to bring the angle back to 10 degrees and relieve any pressure. Also gave me danilon and suggested in hand walks (or ridden in walk, but I can't do that as I know he will jog)

I've contacted my farrier and sent him the xrays, he reckons he isn't flat footed enough to warrant wedges, and to just keep his usual shoes.

I have got a second opinion from another farrier, who also agrees that he isn't flat footed enough for wedges, but I should go for some lateral support if collateral ligament damage is suspected, and to turn away until next year rather than the 12 weeks box rest as suggested by vet.

Vet has said don't treat for collateral ligament damage until it's confirmed with MRI.
So, three different opinions from 3 trusted professionals -

I hate the idea of him being on box rest for that long, he isn't the type to run around and is usually on 24/7 turnout at this time of year - we have a small paddock he could be turned out in alone - but I will do whatever is best for him to recover!

So..what am I supposed to do?!

(Thank you for reading if you got to the end!)

 

[HeyMich]

Another vet opinion? I know it might bring up a 4th option, but also they might agree with one of the others. Explain to them all the 3 opinions so far, and ask for specific reasons why they are/not recommended.

 

[ester]

I presume you mean the pedal bone is reverse rotated/flat?

wedges are contra-indicated if the horse is lacking heel, they may make the horse more comfortable short term but crush the horn tubules encouraging them to under run.

My own had flat pedal bones and suspected (based on movement) collateral ligament damage. Even if not presumed soft tissue was the main issue we did two cycles of bar shoeing to improve his hoof balance and heel, outwardly they looked much better but weren't any more functional.

so his shoes came off and I spent 6 months rehabbing him. He lost the bullnosed appearance of his hooves which indicated the pedal bone rotation (I suspect due to soft tissue improvements in the palmar hoof) and has been sound on them for the last 7 years.

 

[eggs]

Get an MRI done asap then at least you will have a fighting chance of knowing what is going on. One of mine had an MRI done late last year at Newmarket Equine Clinic which showed some damage to his palmar carpal ligament. We were then able to agree on a rehab plan and now he is sound and back in work.

 

[ester]

Actually I should have said that, if you have cover for an MRI you would likely to find it useful to have one.

 

[Landcruiser]

I'm no professional but surely 12 weeks in a tiny space can never be good for a large nomadic herd animal, either mentally or physically. I'd be getting the shoes off as a first resort, no egg bars, no wedges, (both will adversely affect the natural function and balance of the foot IMO), and turning away to rest in a small paddock next to others. Definitely MRI if it's an option in the first instance though.

 

[Melody Grey]

Will your insurance cover MRI? If so, go for it as it might reveal something entirely different and then you might infact be on a different path.

I would be considering and researching a barefoot rehab in your situation.

If uninsured, i’d go barefoot anyway, give it 6 months and see what you have then.

 

[Wheels]

Get the MRI as soon as you can (ie this week or next) and then you will have more to go on

 

[PaulnasherryRocky]

Thanks for your replies, I am definitely going to get the MRI done, its just a case of waiting for the insurance to give the go ahead first - they have said this could take up to 20 days for the referral to go through, but once they have given the OK I would be able to get the MRI booked in within a couple of days.

I've spoken to both farriers again, both know the horse and have said barefoot isn't a good option for him in particular - they both have barefoot horses so I know they're not "anti" barefoot. Both have suggested his normal shoe with some leather cushioning between the shoe and the hoof, just until the MRI. Once the MRI has been done hopefully everyone will have a much better idea on the course of action.

It's great to hear some success stories, keeo them coming!
Thanks again,

 

[Leandy]

mmm, the vet is a vet and a farrier is a farrier, both have different areas of expertise and significantly differing levels of training. I'd want a trusted vet and a trusted farrier to work together to come to suitable treatment. I wouldn't be taking the advice of a farrier over that of a good vet at all. What does the vet say about the farrier's views? Do you know what farrier the vet rates for remedial work?

 

[Leandy]

Why do you need to wait so long for the MRI?

 

[ester]

what are their reasons for it not being a good option?

 

[Meowy Catkin]

I've spoken to both farriers again, both know the horse and have said barefoot isn't a good option for him in particular - they both have barefoot horses so I know they're not "anti" barefoot.

I've been there, the horse 'couldn't possibly go BF' but she wasn't sound in shoes any more and her hoof capsules were distorted and full of holes from abscesses. Shoes off and she was immediately sound.

Make of it what you will but she's not been shod for years now and her hooves are much, much healthier.

 

[PaulnasherryRocky]

mmm, the vet is a vet and a farrier is a farrier, both have different areas of expertise and significantly differing levels of training. I'd want a trusted vet and a trusted farrier to work together to come to suitable treatment. I wouldn't be taking the advice of a farrier over that of a good vet at all. What does the vet say about the farrier's views? Do you know what farrier the vet rates for remedial work?

Why do you need to wait so long for the MRI?

I'm hoping to get my farrier booked in ASAP and while he is there I'd like him to call my vet - I know that he is one of the farriers used by the vet college (this is one of my main reasons for using him)
I would rather they decide the best course of action between them than me!

MRI taking so long to book in just because they have to await my vets write up and agree the referral first - 20 days to agree is the worst case scenario, so I am hoping for much sooner and will be one of those nagging clients to make sure everything has been sent off asap.

what are their reasons for it not being a good option?

You're right to question this and I know I will question it further when I next see my farrier - I'm useless at remembering details, but I know previously he has mentioned my horses (back) feet being in a state of disrepair after I took had back shoes off for half a year (long story as to why) - they don't tend to grow well, they kind of went square?
I know 6 months isn't enough time for a horse to grow a new hoof and be all of a sudden great barefoot, but I wouldn't even say he was field sound without his backs on - he usually has a nice fast walk when out but he became very slow and not wanting to move much - so I understand why it was recommended to do a good trim and put his back shoes back on. We don't have a great field in terms of being good for barefoot - it's just a big field with long lush grass. When he is fully retired (and barefoot) I'd like him to be on a proper track system, but for now if shoes keep him comfortable and that's what the farrier thinks is best, I will go with that.

 

[Meowy Catkin]

Here you go, the day the shoes came off.

ETA - earlier that day with the shoe.

 

[Goldenstar]

I would start the box rest at once with the shoes removed.
I would get the MRI done pronto .
I would return the horse to work without shoes
I have successfully got a horse back to work with this problem so there is hope.

 

[PaulnasherryRocky]

Here you go, the day the shoes came off.

Wow - I don't suppose there would even be a way to keep shoes on those!

How old was your horse?
My boy is 14, I've had 5 amazing years of riding out of him but I just don't feel like we are ready to give up yet - I know he will take such a long time to come even field sound barefoot, I think I'm worried it will then be too late to get started again?

Food wise he is fed agrobs futura, a lite balancer and chaff with a joint supplement too - am I doing something wrong for his hoof growth in terms of diet? (he is on a mixture of soaked hay and horse hage while in his stable, with a bucket of emerald green "readigrass")

 

[PaulnasherryRocky]

Thank you Goldenstar - I am such a worrier, I'm just scared to go so against the vet/farrier opinons - I guess I need as many success stories like yours to bite the bullet and go with it

I would start the box rest at once with the shoes removed.
I would get the MRI done pronto .
I would return the horse to work without shoes
I have successfully got a horse back to work with this problem so there is hope.

 

[wills_91]

Who are you insured with? When my mare needed an MRI I called and they agreed to it over the phone that day and she had it done the day after.

 

[AmyMay]

If you can arrange it, it would be useful for your farrier and vet to discuss the proposals together, with the x rays and horse in front of them.

 

[ester]

6 months really is enough time for them to grow a new hoof and be 'pretty good', not necessarily rock crunching (we never truely managed that) but I would expect them to be good in a field/on a surface/on flat tarmac. As such I can totally understand their current reasoning.

It does make me wonder whether there was something missing nutrition wise.

Lots of us are worriers, why do you think I put bar shoes on to start the vet made it sound like a very simple fix. But I knew that in my head that I had mental time line that I was giving for it to make an improvement- 12 weeks was plenty for me to consider changing direction.
fwiw he was 19 at the time, hunted until 24 over varied terrain as well as his schooling being pretty unrecognisable than pre lameness. He retired at 25 due to issues entirely unrelated to his hooves.

It absolutely doesn't work for all but I think likely makes the best improvement possible for many.

 

[Orangehorse]

You could start work with hoof boots with pads in. This will be supporting the hoof, be comfortable for him to walk correctly which will strengthen the hoof.

But get MRI first.

 

[Ambers Echo]

When I had a farrier disagreeing with a plan from a vet I contacted the vet to let him know the farrier's views and asked them to talk to each other and agree a plan. When they spoke, the vet listened carefully to the farrier and also explained his rationale more clearly to the farrier. We followed the vet's plan. Which led to a really positive outcome pretty much exactly in line with the prognosis and course predicted by the vet.

 

[PoppyAnderson]

Yes I always say the same thing on here.......but vets and farriers do not always know best. Bute/boxrest/remedial shoeing is literally the worse possible way of addressing this issue. Barefoot transition, with movement and the right nutrition is the best chance you have of getting a sound horse back. Read everything on the Rockley farm blog and step away from the world of 'expert' vets and farriers.

 

[PaulnasherryRocky]

Who are you insured with? When my mare needed an MRI I called and they agreed to it over the phone that day and she had it done the day after.

I'm insured with NFU, which are usually one of the better ones - I will give them a call tomorrow as I would much prefer to get the MRI ASAP if that is at all possible?

If you can arrange it, it would be useful for your farrier and vet to discuss the proposals together, with the x rays and horse in front of them.

My farrier can be quite tricky to get hold of, so I've written an email ccing the farrier and the vet basically asking them to discuss what the best option is - I like to have everything in writing too!

6 months really is enough time for them to grow a new hoof and be 'pretty good', not necessarily rock crunching (we never truely managed that) but I would expect them to be good in a field/on a surface/on flat tarmac. As such I can totally understand their current reasoning.

It does make me wonder whether there was something missing nutrition wise.

Lots of us are worriers, why do you think I put bar shoes on to start the vet made it sound like a very simple fix. But I knew that in my head that I had mental time line that I was giving for it to make an improvement- 12 weeks was plenty for me to consider changing direction.
fwiw he was 19 at the time, hunted until 24 over varied terrain as well as his schooling being pretty unrecognisable than pre lameness. He retired at 25 due to issues entirely unrelated to his hooves.

It absolutely doesn't work for all but I think likely makes the best improvement possible for many.

For nutrition, we (used to) regularly attend camps and clinics where they often had a nutritionist or someone from topsepc/spillers/baileys with a weigh bridge and they would discuss your feeding regime - other than each brand telling me I should use theirs instead of the others, none of them recommended I add anything extra to his diet - I assume our lack of varied hedges & other plants around coupled with very rich grass is the reasoning for his rubbish feet - but I hope the balancer would be balancing that!

Although in my head I feel like I know what I want to do, like you I think I will use the insurance and do the vets way - but only for 12 weeks. If that isn't showing improvement or has made anything worse, I've enquired about a rehabilitation track system in the South West, which will be the plan b option.

Thank you again for the success story, especially considering the age as that is what's stressing me out as well!

When I had a farrier disagreeing with a plan from a vet I contacted the vet to let him know the farrier's views and asked them to talk to each other and agree a plan. When they spoke, the vet listened carefully to the farrier and also explained his rationale more clearly to the farrier. We followed the vet's plan. Which led to a really positive outcome pretty much exactly in line with the prognosis and course predicted by the vet.

Yes, you're right and for this reason I don't like to be the middle man, especially when things are discussed in person or over the phone because I usually forget pretty important details - I think they will both communicate, i'm just impatient and want everything done now!

Yes I always say the same thing on here.......but vets and farriers do not always know best. Bute/boxrest/remedial shoeing is literally the worse possible way of addressing this issue. Barefoot transition, with movement and the right nutrition is the best chance you have of getting a sound horse back. Read everything on the Rockley farm blog and step away from the world of 'expert' vets and farriers.

Strangely enough, as above I wrote i've enquired about a track system in the south west - it was Rockley Farm! At the start of this year I started saving for a new trailer with living, so instead of that I could spend the money on rehab there as it seems like rehab heaven. First I will do the vets way, otherwise I know I will always be thinking "but what if..."


Thanks all for your help so far, I really appreciate it. Getting a lot clearer in my head for future plans now, just need to get the MRI out of the way to see what we are actually dealing with!

 

[Meowy Catkin]

Wow - I don't suppose there would even be a way to keep shoes on those!

How old was your horse?
My boy is 14, I've had 5 amazing years of riding out of him but I just don't feel like we are ready to give up yet - I know he will take such a long time to come even field sound barefoot, I think I'm worried it will then be too late to get started again?

I moved area in 2010 and therefore had to change farrier. New farrier let her toes get too long and the heels under-ran, when I questioned how he shod her I was told that it was due to her being half TB ('typical TB feet' and she'll never be sound without shoes). That Farrier was sacked and the new farrier and vet worked together. There was a lot of worry about soft tissue damage, but the shoes came off, her toes were trimmed and all the rubbish from the old abscesses around the nail holes was removed. She walked away sound on concrete, tarmac and grass as soon as the shoes were off. I would have got boots if she had needed them.

ETA - she's 22 now and still unshod.

 

[ester]

I wouldn't touch feed advice from any of the brands and most of their balancers are not ideal. That's a good thing at this point though as it is likely you would be able to make some improvements.

There are quite a lot more people about with track systems now, I see a couple come up on the wiltshire fb pages recently. (I was somerset, then wilts before I moved to cambs, horse still in somerset enjoying retirement).

 

[Pearlsasinger]

I bought an 18 yr old. Previous owner told me that her farrier said she would never manage without shoes. My farrier said' I'm not putting back shoes on, she leans too much'. She was absolutely fine without back shoes, so we took off the front shoes and got her some boots. She got to be able to walk down our very stoney lane without the boots. Age doesn't really matter, it's the condition of the hooves - she had a hoof friendly diet with me, which is what made the difference, imo..

 

[scats]

I would box rest the horse until the MRI is done, and the sooner for that the better. Then you will have a better idea of what you are dealing with. The shoes will have to come off for the MRI so I’d then keep them off, personally.
I dealt with a major collateral ligament injury about 14 years ago.

Vets will generally recommend box rest with controlled walking. It’s up to you whether you go down this route or try something different but obviously if you are relying on insurance money, your treatment options may well be largely governed by this.

 

[paddy555]

I haven't read all the replies however as far as the slow foot growth is concerned I had this with one horse. It took forever to grow a hoof. I put him on an equimins supplement, we got quick results and he achieved a normal rate of hoof growth. There are of course other good supplements eg Forage plus that a lot of people use but it does need to be a "good" supplement.