Rudi report: Two days ago, Jess came to the barn for another trim. This trim was 5 weeks after the previous trim – a very long span in between trims for Rudi, considering that, at one point, Jess was modifying something almost daily.
This trim, just like the last one, was a huge breakthrough for Rudi’s feet, on a number of fronts, and I’ll try to go through them in a way that allows you to see the modifications and understand the growth process.
Its hard to remember how much progress we’ve made, but here are what his feet looked like when he arrived:
As you look at this picture, his left front is to the right of the photo, and it was (and is) the more problematic foot. You can clearly see how the foot is deformed, with a huge flare towards the other foot. Here in this photo, he is not walking on his foot normally at all, even though he was traveling fairly soundly. The hoof wall has grown out sideways, and he is essentially walking on the wall on a horizontal plane, as opposed to a vertical plane.
When this happens, a number of issues develop in the interior of the hoof. In Rudi’s case, the bar had also become overgrown and distorted and was creating intense pressure up into the interior of the hoof – so much pressure that he couldn’t land on his heels, was walking on his toes. The bones in the interior of the hoof capsule moved and became damaged because of being in the wrong position, relative to the weight-bearing they are required to do. The pastern joint was rotated partially out place because of how he was having to land on and use his foot.
Our goal with this therapy has been to get all of this tissue moved back into place. Once the right tissue is in the right place, our hope is that the bones will settle back in to a more proper alignment, and we can at least arrest the damage being done. In terms of outcome, our hopes have been that we could get him to a point where he is stabilized, and can be turned out without needing therapeutic boots or daily soaking. While I’m still doing both, I think both Jess and I can see that we won’t need to forever. This is great news because it means that he can (if nothing else) be a happy pasture horse and we don’t have to worry about daily treatments or watching that his boots haven’t twisted or come off or are causing rubbing. It is a huge milestone to have reached.
The next goal is to see if we can get him sound enough for light work, and as of the day before yesterday, both Jess and I are leaning towards the answer to that question being ‘yes’. The 5 week interval between his last trim and Saturday’s trim gave him time to grow some correct tissue, without creating too much incorrect tissue (although on the left front, there still was plenty), and Rudi was feeling just fine. In fact, he was a bit ticked off that he had to leave his buddy Copper and come in and stand for the trim. He was traveling almost completely soundly and clearly felt no pain, so Jess and I spent a disproportionate amount of time on handling, but it was a terrific learning day for both Rudi and me.
Here is what his feet looked like prior to this trim.
This is the right front, and there are so many reasons this photo is exciting – the wall is getting thicker and stronger, but the most important change is down in the toe area.
As you look at this photo, to the bottom right, you will see an area where healthy sole is peaking through the unhealthy mix of old sole and smeared bar and necrotic tissue. It is only about the size of a quarter, but its such visible evidence that a new, healthy sole is on the way!
All the other stuff you see at the toe area is old keratoma which have now been replaced with healthy tissue and are growing out.
Here is the same foot after the trim:
In this picture, you can actually see the damage the keratoma did to the sole tissue. See that pink line that follows the hoof wall and then zig-zags behind the remnants of the hole in the toe? That is damaged, bruised sole which (at one point) was way up inside his foot – deep inside, probably near the coffin bone, and was decidedly painful. While it isn’t pretty to look at, it’s helpful to see external evidence of what was going on internally a bunch of months ago.
Here is the left front prior to the trim:
This foot is the one which is most problematic. Rudi has had imbalances in this foot for most of his life, and without trimming, they wreaked havoc on the internal and external structures of the foot. The hole that you see in the to area to the left is an old keratoma growing out, similar to the one in the right foot. The hole to the right, and a bit back from the toe, to the side, is the remnants of an area Jess cleaned up at the last trim, when we found sole tubules all compressed and misshapen by the fact that Rudi is still walking incorrectly on this foot.
Our goal with this trim was to clean the toe area, but also dig out as much bar as possible in the fulcrum area of the foot (where there shouldn’t be any bar, but where Rudi still has bar in abundance) and then also relieve enough pressure on the inner wall that he can start to walk a bit more heel-to-toe. He has not been able to do that, ever since I’ve had him. Most of the reason is embedded bar, but some of it is also heel and wall shape.
Here is that foot after the trim:
You can see from this picture (even though it isn’t the best in terms of clarity) that most of what looked gross, was just trimmed right off – it was pretty much superficial ugliness. The bigger change is that there was enough wall and sole for Jess to be able to really modify the medial wall – it is almost squared by comparison to the lateral wall, but this will widen out to a rounded shape now that the pressure is decreased. You can see in this photo that he still has bar in the fulcrum area (the white-ish lines beyond the halfway point of the frog, in the direction of the toe).
Horse’s hooves are actually quite flexible, and if there is bar in the fulcrum region, they loose that flexibility. Think of it this way: the midpoint of the hoof is like the arch of your foot. There should be an air gap there similar to (but no where near as high as) the space between the floor and the bottom of your foot under your arch. The horse’s hoof flexes there, but if bar has been allowed to grow into that space, they lose that flexibility, and the foot hurts.
Think about having something rock-hard pressing up into your arch every time you took a step. What would you do? You’d probably walk on your toes, and that is exactly what most horses do: they change their gait, sometimes imperceptibly, and land with almost all of their weight on their toes, instead of the normal heel-to-toe movement. This results is huge changes to the interior of the hoof. Not only is the bar tissue (which is just as hard as the hoof wall, because it is the same thing) cramming up into the interior of the hoof, but the foot isn’t designed to have the weight landing on the toe. The net result, after years and years and many thousands of pounds being carried by the foot incorrectly, is bone and tissue damage to the interior of the hoof.
Rudi has massive sidebone as a result of this way of moving. He also has coffin bone rotation, and bone demineralization in the tips of both coffin bones. The sidebone won’t (or typically doesn’t) affect soundness, but coffin bone rotation sure can. The demineralization seems to be more of a question mark. I’ve had some people look at his x-rays and tell me he needs to be put down, I’ve had others tell me he will never be sound. My own vet felt that he’d be sound but with corrective shoes and pads, however, he agreed that given time and working with Jess, we could also potentially get him sound following her therapy. Horses can lose a fair amount of their coffin bone, and still travel soundly. They have keratomas cut out all the time, and return to work. I’m hopeful that once we get him landing and moving heel-to-toe, that the coffin bone angle will improve. His pastern joint was also adversely affected by his feet, and we will hope for that to settle back into a better alignment, as well.
Some of Rudi’s outcome will depend upon his ability to handle the changes, but he was in a lot of pain for a long time, prior to my having him, and even though the process of this therapy to bring his feet back to health has, in and of itself, created painful times, he has handled them well. He seems to be able to handle the changes and the process well. The one picture which I did not get was the huge hug Rudi gave Jess at the end of the trim session, after she was finally able to cut away the pressure area on the wall on his left front. He buried his head against her and just said “Thank you” as clearly as any horse ever has.
Here are the before (when he arrived) and afters (after this most recent trim) viewed from the front:
It has taken us about 6 months of corrective therapy to get to this point, and we still have a way to go, but clearly are headed in the right direction.