Bit of a bind

I first met this charming big black beastie (BBB) on 13^th May last year.  His owner had contacted me for help as she didn’t want to lose him.

Prior to our meeting BBB had been referred to a leading referral centre (LRC) with 4/10 lameness in the left fore.

Using MRI scanning the diagnosis was remodelling of the Navicular bone and some damage to the DDFT in both front feet, but primarily the left fore.  But when the owner discussed the diagnosis the waters got muddied somewhat, but ultimately the LRC recommended a year in a field and maybe he would be suitable for the odd hack if he was shod with wedge shoes.  The vets said enjoy that for as long as you can but his prognosis isn't a good one and ultimately will result in Euthanasia. 

And so our journey as Team BBB began.



Recently deshod. Outer hoof wall previously
rasped out. Signs of nail bind present



Roughly two weeks later



Now, notice flared quarters. Not perfect, but
 funcional and sound



Hind post deshoeing

 



Hind now

To be honest there was nothing exceptional in the outward appearance of the recently deshod hooves.  Thinning of hoof walls and nail bind are surprisingly common in the UK.  What was more unusual was the condition of the hind feet, but these weren’t the focus of the lameness issues.

Today all the hooves are still a work in progress, and I can’t comment on the condition of either the Navicular bones or DDFTs - but what is form without function?  And I am happy to report that BBB is sound and moving beautifully.

How has the owner achieved this remarkable outcome?  Well lots of hard work it’s true, a successful barefoot horse needs a lot of exercise, but diet change was important and allowing the hooves to function naturally without the impediment of a rigid shoe.

What BBB’s owner has to say

"Prior to having a horse with 'caudal foot pain' exacerbated by shoeing I would not have even considered barefoot. I am embarrassed to admit that the one person who kept her horse barefoot at one of the competition yards I was at was someone I avoided as I thought she was slightly strange and a 'parelli type' hacking with horse trainers and never wanting traditional shoes. I didn't for a second think that by keeping her horse barefoot she was looking out for the wellbeing of her horse’s soundness and longevity.

I started my barefoot journey truthfully and honestly because I felt I had little other choice or at least not a very hopeful other choice! I am amazed at how Lucy has guided me, sometimes through gritted teeth (especially with reference to the dietary changes!) with patience and honesty. I was told from the start that it is not always an easy journey and that he may well be sore initially and have peaks and troughs in his transition phase. I was very lucky in that it went very smoothly with an overall improvement that was seen very quickly.

BBB is now one year barefoot and has grown his first new hoof capsule (apparently the second will be even better!) He is completely sound and competing successfully at BD level dressage. I owe this phenomenon to nature which is truly a rather wonderful thing, BBB for 'talking' to me and guiding Lucy's expert DEET principle and to Lucy for being there every step of the way (it helps that you do not go to bed until late!). I look forward to seeing BBB's feet this time next year :)"

Navicular and metabolic - the next instalment

It's amazing what you find when you have a tidy up.......

We looked at this case earlier this year but having reorganised my files I have found an old photo which you might find interesting, especially when you compare it with the end of October shot.

This case particularly highlights how shoes mask deep seated problems.  The horse was diagnosed with navicular, but no one mentioned the multiple event lines, stretched white line, collapsed sole and forward running foot and what these might mean.  Except that the horse was "genetically flat footed" ...........

Thought you might like a few quotes from this horse's carer (with their permission so thank you to them :-) )

"Someone watching me pick xxxx's feet out today said 'You are lucky with her, she has great feet' I actually stood up in shock and said are you talking to me??!! "

"She really is stomping along on her feet. I actually forget no shoes at times :) "

 "When I started this process I did not think her feet would get smaller, that I would be able to rug her up without being bitten and kicked, I could hack without shoes, that her flat feet weren't genetic :) So much learned!"

22 06 11 recently deshod

31 10 11 post 'hiccup' - see end



22 06 11 recently deshod



08 11 11



























































Hiccup - this horse is so sensitive that a few handfuls of the 'wrong sort' of hay can make her lame and grumpy and it shows in the structure of her feet too.

Time for a little bounce......

Of pure joy.

The latest 'navicular' is hacking out bootless, sound on grass and is improving over hard ground.  And has stopped biting their carer.  Main lifestyle changes?  Yes - treated like a lami and moved yards.

Very lami shetland - had literally gone through the bottom of his feet is apparently doing some bouncing of his own during his regular 'parades'.  Main lifestyle changes? Yes - dirt paddock and daily heart beat raising walks.  Although the carer reports that the term 'walk' is misleading because he is prancing about and tows her along and has turned into a 'naughty little ********' but I think they are quite happy about that :-)  And he comes to call which is really nice because he must be enjoying his jaunts.

Both are on DIY livery.

Hoof shape and shoes

Same hoof as previous; but solar view. Note how the widest part of the foot is moving towards the heel. You might find it hard to see, but the sole is increasing (slowly) in thickness and concavity. Also note how the frog has quickly widened and how it was somewhat cramped by the shoe.

30 05 11

24 07 11

11 08 11

Navicular and 'metabolic' - 10 weeks 3 days

By kind and generous permission of the carer.

Vets have given a 'Navicular' diagnosis.  Horse on presentation has very thin soles, fronts are running forward, heels are collapsed, bulbs pointy rather than full, toe wall has been rasped out in places, frog is squishy (but not rotten, just unused), digital cushion is undeveloped (on palpation) and there is some red in the white line. 

Subsequent trial and error shows the horse is sensitive to grass, probably oats and haylage.  Does better on night time turnout with soaked hay in the day.  Horse is on/off footy depending on circumstances but is generally improving.  Progress would probably be faster if 24/7 turnout on a grass free track could be provided.  But this carer has chosen to learn how to manage a tricky case, at livery, because long term they want to know how to provide for this horse.  Even so, and even with some set backs they are making progress.

In the photo array the first picture (top left) was taken 30/05/11, the last (bottom right) 11/08/11.  Can you see the differences?

Mind your language - laminitis/LGL/Sub Clinical Laminitis

No pictures today.  Just a bit of a health warning.

You have probably realised that the words laminitis and navicular are used a lot. But unfortunately they mean very different things depending on who is using them.

For example there has been some research publicised this year which promotes the finding that fructans do not cause laminitis.  Now this might very well be the case.  But for this particular piece of research the definition of laminitis does not include all those horses which we barefooters observe going footy after X length time out on grass.  The definition for the research is quite limited and only includes (if I understand my source correctly) cases where there has been (their words not mine) rotation of the pedal bone.

My source tells me that for the purposes of the research (and in other areas too) laminitis is viewed in the same way as a heart attack; kind of on or off.  It is not viewed as something with a continum.  So the spectrum of symptoms/degrees of problem that many barefooters are so familiar with are not recognised by the veterinary community involved in the research.  Or if a back office technician wants to recognise it they are not allowed to because of the directives they are working under.

Second element of health warning.  The research also promotes the idea that obesity alone is the causal factor for laminitis.  This research seems to quietly ignore all the thin horses that get laminitis and the separate piece of research that shows that a high proportion of in work/fit racehorses also have sub clinicial laminitis.  I did raise this point and it is not that the researchers are unaware of these points, but they don't fit the story and are not allowed to discuss them. Which naturally makes me then question the research; because research shouldn't have an agenda and findings should not (in my opinion) be reported 'pick and mix' style.

So what does the research show?  Well to be grossly over simplistic; if you put a large and completely unnatural bolus of fructans by stomach tube into a horse then they won't get rotation of the pedal bone.  And that is about it - from a practical point of view.

How does it help the barefooter who knows that 30 mins on spring/summer grass will make their thin/fit horse lame?  Not at all. So it is back to bare paddocks and grazing muzzles for now.

Now onto 'navicular'.  Not everyone is aware that the diagnosis of 'navicular' is a rather loose one.  That changes to the navicular bone on x-ray can be pretty meaningless, that lots of horses have changes and are perfectly sound and lots don't have changes and are lame.  Equally 'navicular disease' is confused with 'navicular syndrome'.  Again unfortunately the latter tends to be the diagnosis when the horse has caudal heel pain (pain in the back of the foot) and the source of pain can not be identified.

What research does show is that soft tissue damage of the DDFT happens in advance of damage to the navicular bone.  What is starting to happen is that people (a very small minority) are realising that poor foot health is a key contributor and if the foot is brought back to health (yes you have guessed, good diet, appropriate exercise, natural trim) then the symptoms resolve.  No need for drugs or expensive shoes.

But it is important to distinguish between 'disease'; usually referring to damage to the navicular bone and 'syndrome' which is a catch all that sometimes involves damage to the DDFT but not always. I don't know anyone who is claiming that the barefoot approach mends diseased bones.

Please also be aware that 'syndrome' can include any kind of caudal heel pain, even if the horse only actually has a bad case of thrush. (and that comes from personal experience)

So in summary be very careful to check that when you are having a discussion about laminitis or navicular that all parties are talking about the same thing.  Unfortunately at the moment, it can't be guaranteed.

Why barefoot works - or rather why shoe a foot in this condition?

Well to be honest, just a hint, because to do the whole thing would take longer than I have today.

Regular followers will remember the cadaver post from Texas *I often wonder how the heck that horse got into that state.  Today, somewhat to my horror I freely admit, I got a bit of an inkling.

I try to avoid forums (not good for my blood pressure), but they do have a use, which is to inspire some of my posts.  Well today I came across a post about a horse just diagnosed with navicular. *

See post 59 for photos and some thoughts.

The diagnosis of navicular was made on very thin grounds.  The horse, with obvious central sulcus infection, possibly a trace of LGL/lami, underrun and contracted heels has been shod with heart bars and gel pads.

Add in some 'interesting' trimming, including heavy rasping out of flare, add a few months and 51 states and there you have it.

The hoof in the first link is from the US, the second from the UK, but you can see how the US hoof may have started out looking something like the UK one.  Now that I find seriously scarey.

But not as scared as the poor horse should be with all that ********* nailed to the bottom of his foot.

So why could barefoot work in a similar case to the 'navicular' in this post?

Well for a start, without a shoe on it is much easier to:  a) treat the central sulcus infection b) for the heel to decontract  c) the underrun heel to be addressed and d) dietary issues are much easier to identify

As an added bonus it is much cheaper too.

But the downside is that the responsibility is transferred from vet and farrier to the owner.  So pay your money make your choice.  Please just don't ever let your horse suffer (let alone die) for it.

* Please note that barefoot hooves can end up with tall heels, central sulcus infections etc too.  It is all about the overall management.  Also in no way is this post criticising the owner of the horses concerned.  Without proper advice and experience we can all end up in a jam.  And many years ago I wore that T-shirt too, which is why I went barefoot in the first place.