Sunday, July 24, 2016

Horse Health part 2 - si, stifle, hoof issues

(Click on pictures for larger images)
** Since writing this post, Jax has been diagnosed with PSSM (n/P1).  Click the PSSM Label to the left to see more **

Recap of issues, from part 1 and some new info:
  • Starting July 2015, stifles catching horribly in canter to trot transitions, by August canter nonexistent
  • Started getting a sore back when worked (or not worked, really any time) around August 2015 
  • Road rides and anything on hard terrain makes him nervous or grumpy.  The only access we had was to roads, no trails, and he would get really stiff afterwards
  • Seemed to get better for a time around late October 2015 (maybe right after hooves trimmed?), tried to do some trail/obstacle competitions and got extremely sore in early November.  Onsite chiro found right shoulder was atrophied, blamed on saddle fit; also found twist in right hind
  • Back soreness and hindquarter stiffness now an everyday thing, need NSAIDs to help relieve soreness.  Very stiff in walk, no trot now, any type work just makes it worse (stopped riding on his off days, even though vet told me to keep riding him)
  • SI knot starting to develop again along with a bit of a roach back, leading us (me, vet, chiro) to believe the possible SI injury from a year before was being aggravated.  Started having chiropractor out about once a month
  • Around December 2015, could no longer hold up his hind feet for farrier
  • January 2016, colicked, either due to NSAID overuse or hindgut issues from feed (see part 1)
  • Around March 2016 (around the time of part 1) he could no longer stand on his right front to have his left front trimmed.  Has been taking Previcox (COX-2 so it won't affect his stomach) and seems to be helping.  Had farrier trim with mustang roll and chiro visit right after, he had 2 solid weeks without pain
  • After those 2 weeks in March, even with Previcox, lumbar soreness won't go away, SI swelling prominent, no more riding or work of any kind
  • Shaky on trailer rides (though he's proven over and again that he's not scared of the trailer), is this related to pain?  Been doing this since he's been sore
  • Vet and chiropractor services being utilized, to no avail, all through this time

After months of reading veterinarian studies, published horse health articles, and even just personal experiences on internet forums, in early May 2016 I found one issue that I hadn't yet considered: hooves.  While SI issues, sticky stifle, and other symptoms could almost match problems Jax was having, there was always something that didn't fit.  Then I found Long Toe / Low Heel syndrome.  The symptoms for it matched everything that was happening to Jax.  Sticky stifles and SI issues can be aggravated by misshapen hooves and lead to a dead lame horse.

I knew Jax wasn't being trimmed on a proper schedule, due to lameness after every farrier visit I was loathe to put him through it as often as I should have.  Turns out, that was a huge mistake and caused even more distortion in his hoof capsule.  I started reading online and studying books about barefoot trimming, thinking my goal was to "touch up" the trim and keep his feet in decent shape between farrier visits in a way that was less stressful (having his hinds wrenched up for the farrier was the main problem). 


1st Trim in May 2016 showing front hooves.  Didn't think to take pics before trim.  Notice the flaring, cracks, and other issues present.  Had I been a bit more competent with the tools and knowledgeable about hooves, I could have done a much better first trim.  Luckily, with practice comes (at least some) skill, and these hooves will look better fairly quickly.


After about two weeks of reading and studying different cases, I finally tried my hand with a rasp.  It took a long time, and much more study and practice to really get the hang of it (in fact I'm still studying on an almost daily basis), but after about a month I came to one very solid conclusion, his feet were hurting, and the professional trims he had been receiving were not adequate.  He was receiving a "pasture trim," whereas in the past he had received a "barefoot trim."  And, it just so happens that we had to change farriers, and thus trims, right before he lost his canter mid-2015:

  • The first pasture trim from the new farrier was June 14, and the picture of his feet below is just one week later, showing his toes being way too long
  • Trouble started around July/August of 2015
  • Note: we had used this farrier before during the six months leading up to the initial SI injury.  He had been shaky getting off the trailer at the trail head, leading to fatigue and the muscle/ligament strain.  Was he shaky because of foot pain??  Did this whole thing happen because of his feet??

Pic from June 22, 2015.  It's hard to see, but his front toes especially are way too long - taken one week after 1st pasture trim by a certified farrier.  Notice he's standing under himself with the front legs (more on this on part 3).  Also notice the tight muscles around his stifle, point of hip, and over his back and croup.  Shoulders and neck also starting to get tight.  By the time I started trimming him, almost a year later, his hinds would not lift any further than this, and he couldn't keep them up for very long.

Remember the atrophied RIGHT shoulder diagnosed by the onsite chiro at the ACTHA event in November of 2015?  His RIGHT front was the worst hoof.  He also seemed to be suffering from high/low syndrome, where the heels are taller on one hoof and shorter on the other (his fronts were affected, with RIGHT heels shorter).  His heels had been left long in an attempt to make them grow taller.  Turns out, Jax has a bit of a weaker hoof, and he's a heavy weight, so his heels just crushed forward instead.  Also, due to the way Jax walks/moves and due to the way he was trimmed, Jax had high inside heels compared to his outside heels (this can cause MAJOR soundness issues, and is usually evident in the hinds by a slight wobble in their hocks as they walk).  His frogs and bars were never trimmed, soles not exfoliated, and he had severe thrush in his frog (which didn't contact the ground because his heels were too long) and in his white line (because his hoof wall was pulling away due to long toe, making access for bacteria and other nasties).  As his toes grew further forward, his breakover moved forward, and his stifles got worse to the point that it was catching every time he moved his right hind forward.

The horrible shape of his frogs.  This is the left front, right front is much worse with a deep cleft in his central sulcus down to the hair line.  This pic was taken June 3, 2016, after I had started trimming but before I was brave enough to touch the frogs.  Since I'm so new to trimming, I've taken a "less is more" approach, and was trimming small amounts each day (I've also learned that "pathological" hooves don't hold shape, so they need trimmed more often).  By the end of July his foot started holding its shape.


Also taken June 3, you can see the coronary abscess that broke out, and the underrun heels.  Let me stress, this horse NEVER had an abscess while receiving a barefoot trim.  This is his right front, the same leg that had the atrophied shoulder.  Concerning the abscess, turns out NSAIDs can slow down the progression of an abscess, causing more pain for a longer period of time.  This abscess finally burst after taking him off Previcox for a few days.

There were myriads of bruises in his hooves.  Bruising above the quarters which were flared, in the heels which I could only see after rasping his hooves down, in the toes and white line due to tearing and stretching of the lamina, and then we get to this beauty:


Picture was taken July 15, 2016 of right front.  I had been trimming and working with the frogs since some time in late June, and had seen this bruise earlier (but it looked a lot smaller, I think this is growing down from inside his hoof capsule).  After two treatments of liquid White Lightening for thrush (which works amazing!) I could see this dark spot under a flap of frog, so I trimmed back the flap and found this.  Notice there is a bruise on the sole beside the frog, I suspect this bruising was caused by impacted bars (once I learned how to trim bars, I had to do it every day as they seemed to "grow down" really fast).  Since my horse is high energy and runs through his pasture like mad (especially since I've started trimming him), it's possible this bruise was due to impact rather than hoof shape. 

An interesting aside, in early June, a couple weeks before finding this bruise (or at least realizing the extent of it), Jax went lame enough on this right front foot that he wouldn't pick up his left, resulting in me taking him to the vet.  (Keep in mind the left front is the same one he stopped picking up for the farrier around March of 2016).  Vet suspected navicular and used hoof testers and found nothing (he used a LOT of pressure, something that should have made even a sound horse flinch, but Jax never did - darn stoic horses).  After looking at pictures and seeing things when trimming I know this bruise has been around for at least a month, probably longer.

Front hooves, July 18, 2016, after another round of White Lightening.  Cracks are gone, flares growing down, mustang roll keeping chips from forming.  Still have a ways to go to get good hoof form, but he's becoming much more active in the pasture and no longer stiff in his hindquarters, except for the hitch and slight stiffness in his right hind.  Still has some lumbar soreness as well.

 
I've been trimming his feet for a little over two months now, definitely no expert, but the changes we are seeing are phenomenal and his feet are starting to look really good.  His right hind had been catching/hitching with every step forward at a walk and trot (canter nonexistent) before I started trimming him, and now he canters decent (on lunge, I'm only riding him at a walk right now), and the trot looks great except for the occasional catch in his stifle.  All of his feet, but especially the right front, is still showing old bruises growing down in the hoof wall, and he's slightly touchy on that right front most days, but with hoof boots seems to feel good.  While this is all great, his hooves looking better and so on, what about that stiffness/hitch in his right hind still present at a walk?  And the lumbar soreness?

After watching videos with SI injuries, stifle problems, hock issues, along with kissing spines and neurological problems, still nothing fit that explained that right hind hitch.  Then I saw a video, I think on the easycare blog, about a horse that had its soles trimmed too thin by a new farrier.  That horse had the EXACT same hitch in his hind legs that Jax has!  So I looked up videos of laminitic, navicular, even foundered horses, anything related to hooves, and ALL of them had that hitch to their hind legs.  What's more, even if the problem was in the front, the hind legs still hitched.  And it seems, rather than a diagonal (right front sore so left hind hitches) issue it created an issue on the same hind as the sore front.  So, with all the right front problems, the right atrophied shoulder, and the hitch in the right hind, it would seem the right front hoof is the problem, and has been for over a year!  No one, from the vet (at least 3 different ones) to the farrier, pointed out that his feet were pathological.  Long toe / low heel is not rare, some think it's normal.  Jax may be affected more because he's such a large horse.  And, since the problem appeared to be hindend related, no one was looking at the front feet.

Because his feet were extremely sore, it would also seem that he has been holding himself in an unnatural posture due to hoof pain, which may be the actual cause for the slight SI swelling, as well as the sore lumbar area (his roach back was fixed after one chiro visit and didn't return, but the soreness kept coming back, leading me to believe the roach back eventually would have come back as well without chiro intervention).  After each chiropractor visit, Jax would be nice and loose for a week or two (sometimes only a couple days), then right back to where he started because the initial cause hadn't been fixed - it was all in his feet. 

In Horse Health part 3 I'll discuss methods we're trying to relieve body soreness from unnatural posture that seem to be successful so far, namely stress points in the muscle and getting back to the trails!  Keep in mind though, as long as the hooves are in bad shape, no amount of chiropractic, massage, or ridden/in hand work is going to fix this.  Stay tuned!


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