Balanced Stride

This is the radiograph of the left front foot and lower leg and what it is showing us that the lowest bone, the "coffin" bone is not in line with the other bones of the lower leg. This is what is referred to as the rotation of the coffin bone and it is the amount, or degree, of rotation that is measured when determining the effect of the that the foot disease has had on the foot itself. In this particular case the rotation is quite severe and the degree of rotation is quite high. Initial decision of Dr. Valcheck was not very positive; he had stated that this was most likely the worst case of founder he had dealt with to date and the only reason that the horse was able to stand was the quality of the horseshoeing. But, the owner felt that there had to be a way of making the horse both comfortable and that there had to be a way to prolong both the horse's life and increase the quality of life that the horse was experiencing. This is where I was brought into the team and asked to see what I could do for the horse.

This is a closer view of the radiograph of the right front foot showing an even greater amount of rotation due to the founder condition. These radiographs were taken after I shod the horse the first or second time, on that point I am unsure. I state that so that you might realize that when I stated with the horse that it was even worse than this.

This picture shows the out side of the horse's feet as they appear to the eye. The right front foot shows the most possible damage from the outward appearance and the amount of dead foot that has been cut away from the area of the toe. In this case I have extended the shoe out to where the foot should be; doing this will allow for the proper amount of support for the foot and give the greatest amount of comfort to the horse.

This is a close-up of the right front foot and shows the amount of dead tissue that had to be removed from the area of the toe. The removal of this dead tissue is crucial due to the fact that if the dead tissue is not removed it will continue to kill more and more tissue around it. The decision also has to be made as to the amount of dead tissue that can be removed and still allow enough foot to be able to attach the shoe to the foot and allow for the greatest amount of comfort of the horse. This horse is on a four week shoeing schedule. This decision was made to allow for the removal of the greatest amount of dead tissue at a time and to keep correcting the angle of rotation of the coffin bone, as shown in the previous radiographs, by the removal of hoof tissue at the area of the heel.

This photograph shows the type of pad that was used to create the correct amount of frog pressure to aid in the progress of the horse and allow the horse to move around in a more comfortable manner than before. The pad is being used in this particular situation since the danger of the coffin bone protruding through the bottom of the sole is quite great. Protection and stabilization are the two main goals at this time. Beneath the pad is a two part silicone mixture that stays somewhat soft, this gives support to the entire foot area and allows for a cushioning effect also. Up to this point I have used just a regular horseshoe that has a good wide web and I have also rolled the toes quite considerably to allow for the smooth mechanical operation of the entire leg.

Here I am removing the pad and shoe from the right front foot to be able to work on the horse for the third time.

Once that the shoe and pad are removed you can see that the silicone product that I use completely fills the cavity of the foot. Using this quality product protects the foot from any foreign objects from getting into the area between the pad and the foot that could cause discomfort to the horse. In addition, the filling of the open cavity area with the silicone product allows for the maximum support at this time and to take some of the weight bearing off the affected area and distribute it throughout the entire foot more equally.

In this picture it show that I am only removing foot tissue at the heel area of the foot. This is accomplished to allow the angle of the coffin bone to be brought down to a more natural angle and make the horse more comfortable and to be able to distribute the support throughout the entire foot.

Here I am finishing the foot and preparing it to be able to attach the special shoe that I will be using that will support the horse in a manner that will allow for the greatest recovery time and comfort after the field surgery.

Once that the foot has been properly trimmed and finished, on the bottom, we can then make an assessment of the angle change that we have accomplished. At this time I am quite pleased with the progress that was made and the angle that was achieved with today's efforts.

Once that the bottom of the foot has been finished and prepared for the applying of the shoe there is a need to also work on the area of the toe and accomplish what is referred to as "backing up the toe". This is accomplished to; remove dead tissue that is at the toe area (that dark area behind the rasp), stimulate the healthy tissue that remains to grow at a faster rate (to be able to replace the dead tissue) and to obtain a more uniform shaped and looking foot to allow for a more balanced operation of the foot.

Once that the foot has been "dressed down" and "backed up" it is easier to see the overall condition of the foot. The area of the front of the foot that has been removed is all dead tissue, there is a great amount of dead tissue remaining in the foot but this is all that I will be removing so that I will be able to attach the shoe properly, correctly and securely.

I am holding the amount of foot that I removed at the area of the heel. A farrier has to be somewhat aggressive, while at the same time use good judgment, in the areas of heel removal and the backing up of the toe area to be able to allow for maximum positive results in the treatment of chronically foundered horses.

Here the foot is finished on the bottom and on the top. The bottom is prepared for the application of the shoe and the toe has been backed up to allow for the removal of dead tissue and the maximum comfort should be achieved. 

Here is where the special shoe is attached. I am using what is know as an "Egg Bar" Shoe. This shoe was designed specifically for the adding addition support to the area of the tendons. Since we are going to be doing a tendon surgery on this hose and affecting the integrity of the tendon area this shoe will offer the greatest amount of support and allow the healing process to be maximized. 

This shoe needs to applied in a manner that will allow the back of the shoe to stick out to be equal with the back of the foot (the bulbs of the foot) as illustrated in this photograph. You might start to realize that the foot is starting to look more normal and the ability of the horse to apply pressure and support weight with this foot without  great amount of pain. The foot is close to operating at it maximum potential at this point.

This is the view of the foot from the front with the shoe attached; it is balanced, supported and allows for the greatest comfort at this time. 

This is a picture of the left front foot and what I am seeing is a potential for the horse stepping on the edge that is sticking out past the inside edge of the foot. First it needs to be explained that the foot has become somewhat distorted and misshaped from all that is happening internally. Our main objective with the shoeing process is to protect and balance, this foot is out of balance and needs to be brought back to its proper shape to allow it to protect the internal parts and operate in a balanced manner. What I am saying is in order to accomplish what needs to be done the shoe needs to stick out to that point and allow the foot to heal.

Here I have added another acrylic product that will fill in the area that was left hanging out from the foot. This allow for the shoe to be placed on the foot where it is needed and at the same time help prevent the horse from stepping on that area of the shoe and pulling it off.

This is the same foot once that the acrylic product has dried and I was able to dress it down to be more uniform with the foot. Again notice how much of the toe has been back up and removed to allow for the removal of the dead tissue. 

It is at this point that the shoeing of the entire horse was completed and Dr. Valcheck began to prepare to do the field surgery. Initial tranquilizing drugs were administered to assure that the horse would stay quite during the entire preparation process. Here he starts with the initial removal of the hair in the area where the surgery will take place.

This photo shows that the area of both lower legs have been prepared since we are doing a surgical procedure to both of them at the same time.

Next the entire area in and around that is to have the surgical procedure is scrubbed with benedine solution.

The next step is to shave the areas that are to receive the surgical procedures.

It is at this point that what is know as a "blocking" procedure is accomplished. This will deaden the area that is to be worked upon and allow us to complete the field surgery without injury to the horse or ourselves.

After the lower legs have been blocked there has to be time for the procedure to work, this is a good time to wash off the lower legs of the horse so that we can go onto the next step of the preparation.

The reason for this photograph is to show the detail of the lower leg and the strain that the rotation of the coffin bone has placed upon the entire tendon structure of the lower leg. The indentations that are showing up in this picture are referred to as the "fluting" of the tendons and in most cases it is not this defined and/or tight. As we accomplish the surgery this pressure will be released and a more natural look will appear.

This is the last step in the preparation process and it is the application of the surgical wrap. This is used to protect the area once that it is clean and to help keep out unwanted items in the area of the field surgery.

Here the first surgical cut is made. It was not very long less than three inches. All that is necessary is to be able to be able to get inside of the leg and locate the necessary tendon that needs to be cut. In this case it is the Deep Digital Flexor Tendon.

Here I am holding the leg up and in a relaxed position to make it easier for Dr. Valcheck to locate probe and locate the necessary tendon.

Here the Deep Digital Flexor Tendon has been located and is brought into a position that makes it easy to accomplish the cutting of it.

It is at this point that the actual cutting of the Deep Digital Flexor Tendon is accomplished.

After the tendon has been cut the foot is placed on the ground and the horse is allowed to stand on it, the surgical wrap is removed and the closing or stitching process is begun.

This photograph was taken seven to ten days after the surgery and it is showing a great amount of progression. The overall shape of the foot is much more relaxed and the stimulation of better foot growth is also evident. The horse is walking around much more freely and has a better quality of life.

This is a close up of the same foot to show much more detail. The plan is to take some new radiographs at about four weeks after the surgery. This will be done to allow for evaluation of repositioning of the coffin bone as results of the combined efforts of the veterinarian and farrier.

It has been between two and three weeks since the surgery and I have once again gone back to monitor the progress of Rawleigh. What I have found is a much more active and happy horse. I do believe that the progress already made by this horse more than made the whole effort well worth it. Rawleigh is standing with both feet under himself and with equal amount of weight balanced on both front feet.

Here is a photo of Rawleigh's front feet from the front that show just as much comfort and support as from the side.

The feet are continuing to show progress in all of the right areas and each time I see him his feet are becoming more and more normal in appearance.

This is what makes it all clear. Rawleigh is relaxed, comfortable, has a soft eye and is getting back to his old self again.