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Topic: Farriers

Expert: Christine Sizemore
Date: 3/11/2008
Subject: Barefoot Rehab

Question
QUESTION: My 13-year-old Appendix Quarter Horse named Bugsy was diagnosed with
navicular syndrome last year and I took him barefoot Feb. 1 (using a trimmer
in Pete Ramey's group) hoping to cure his lameness. I was initially worried
about his becoming overly sore without shoes but he seems to have
weathered that without much incident. But when I brought him back to the
trimmer last Friday (March 7) for a second trim, all of a sudden he appeared
to be off at a trot on his front LEFT leg instead of his RIGHT (as he had been
previously--and the right foot was the primary one diagnosed as navicular).
Is this something I should be concerned about? What's going on?!? I'm
attaching a JPEG showing his front feet at various stages over the past 5 or so
weeks in case that's of any help. Bugsy's front right foot is somewhat upright
and to the best of my understanding is in worse shape as the frog and digital
cushion were thus always left far off the ground. Both front heels were
contracted. And the most outstanding feature I can think of regarding his
front left leg is that it paddles when he trots. I don't get the feeling Bugsy's
doing any worse than last week and if I had to say one way or the other I'd
guess he may be even doing a little bit better. But, if so, why would he all of a
sudden be off on his other leg?!? Can you help me understand what's going
on?!? Thanks for whatever insights you can offer!
IMAGE: Bugsy.jpg

ANSWER: Thanks Evan!
There are a few things that may be going on with Bugsy....thanks for the pics! Can you please send me pics of him standing on level ground (cement, or pavement or something like that where you can see his feet) - Pics that show the whole horse from the side the way he NATURALLY wants to stand, i.e. don't make him square up if he does not want to and just move him back and forth a few steps until he has settled into the most comfortable stance - and also a pic front on with his head in it as well, and on straight from the back, and then a closer view (camera on the ground) of his hinds and fronts from the front and the side, and if it is safe, from the back of the feet as well? For a horse with his issues, the side to side, and more importantly, the front to back balance is critical to assess the appropriate approach for any corrections.
Also, please be aware that it will take time before any adjustments that are done through barefoot trims will set in...it takes 9-12 months for a new hoof to grow and it will be a few months before you can see a definite change in his feet. However, I can definitely help you assess what may be going on with him suddenly not feeling well with the other leg, if this may be related to trims. What part of the country are you located in and what footing/moisture is Bugsy kept and ridden on?

With the new pics, I will do my very best to try to explain to you what may be going on.
Also, when you say he was diagnosed with Navicular syndrome, can you tell me what test the vet did to arrive at this diagnosis and do you happen to have pics of Bugsy in shoes from before that time? Also best view would be from the side on level hard ground.

Thanks again!
Christine

---------- FOLLOW-UP ----------

QUESTION: Thanks for your quick reply! Yes, I understand if we're lucky enough to get
Bugsy sound again it may take a number of months. And, no, just to be sure
I'm communicating what's going on properly, I'm NOT saying he's now lame
on BOTH legs (but rather at a trot on the left--instead of the right). In fact,
he almost seems to trot a little better than before. It's really hard to say
because of all the variables involved, including how hard/much he's been
playing with his mates in turnout before I arrive. And this past weekend it
was especially tough because of all the rain (and there's no indoor ring where
I board him). What I'm hoping you may be able to tell me, though, is if such
variation may be normal during rehab. I'm attaching an image showing his
two front feet from the side on Feb. 23 in the event that's hopeful. Most of
the other shots you've requested I don't have on hand and won't be able to
take most likely until at least next weekend. I do have a shot or two of him in
his navicular shoes (I'm not sure about pre-navicular diagnosis shoes) but I
believe I can only attach one image here. Also, in answer to your question, he
was diagnosed with navicular syndrome at Cornell University after first a
nerve block test, and then they took x-rays of his feet. Also, we're in northern
New Jersey and the footing since he's been barefoot has been mostly either
snowy/frozen or wet/muddy/melting. Finally, where he's boarded now he's
usually turned out during the day with 5 or 6 other horses on I'm guessing no
more than 3 or 4 acres, and my understanding is it would be better for his
rehab if I moved him to more turnout--acreage-wise and time-wise. Is that
correct? Problem right now is, however, I know of a place where he could be
turned out on 12 acres but his only two companions would be older horses--
one mostly blind and one somewhat lame--and I'm thinking (but don't know)
that might not be as advantageous. What do you think? Thanks again!
IMAGE: Bugsy223.jpg

ANSWER: ugh..I just realized that another loooong response I wrote to you never got sent...let me see whether I can put it back together.

First of all - turnout...I think that 12 acres with a few older horses is much better than small acreage with young ones. Horses move around a lot when they have a large pasture to eat.
It is possible for horses that are fresh out of shoes to develop abscesses since the dynamics on the hoof have changed. If he is not lame from running around in the pasture and being happy with his shoes off :-), he might have an abscess brewing which may explain sudden and unexpected discomfort on one or the other leg. Also, I am assuming that his diagnosis of navicular disease based on nerve blocks and X-rays means more caudal foot pain which can have several contributors. Assuming that the pain indeed originates in the navicular area, you have to imagine that the deep digital flexor tendon (DDF), which inserts at the bottom of the coffin bone and gets routed over the navicular bone is at greatest tension during the breakover phase of the stride. So, a horse with elongated hooves and long toes with respect to the center of rotation of the P3/P2 joint puts naturally more stress on the DDF in each stride. So, on a hoof that already had low heels (this is in reference to sole plane) further lowering of the heels may throw off the dorso-palmar balance even more and create a few more issues for this leg. So working on getting his breakover back and create better dorso-palmar balance would be THE one thing I would focus on for him.
Ok...what else was in the E-mail that was not sent....could you post pics on one of these public internet sites, like photobucket, where I can access them via password, or send them to me to my personal E-mail? I would like to look at them more closely and having them one by one rather than a composite would be best. My e-mail is jnksize@comcast.net.

I think that was it...I will add later if I can think of other info I forgot.

Christine

---------- FOLLOW-UP ----------

QUESTION: Regarding turnout, as you say, more acres mean not only more room to run
around but more grass to eat (and I know he loves to graze). But horses are
also social creatures (I know Bugsy is!) and besides having others to help keep
him moving being with 5-6 other somewhat playful horses (as opposed to 2
older, somewhat handicapped horses) I'm assuming also provides good
companionship. So I look at it as a tradeoff. And can I assume you think he
gains more having greater turnout than he loses by having fewer less active
friends?!? Thanks again!

Answer
Hi Evan, yes I do! My view of large herds on small acreage is that there are always herd dynamics going on with pecking orders kept in line and I actually think that while being in a larger herd may provide some security for horses it also produces quite a bit of stress and food competition. So my view is that if the turnout is great, a horse has other horse friends to hang out with and "trade lookout for predators" with, its actually less stressful for them with fewer herdmates....you may know of situations where a horse was shown to be lame ridden or in the barn and then miraculously, the lameness was gone as soon as the horse joined the herd...this seems to be because horses with a certain herd status on in cramped quarter can't afford to show "weakness" since they will likely be challenged by their herdmates...so in my opinion it not quite as it is with humans where you hang out with your friends and share friendly stories and a beer, but rather a quite competitive situation where rank and status need to be maintained. I would always opt for more turnout and larger pastures over larger herds.

Christine

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