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Discussion on Which one is causing lameness??? Shoulder pain or chronic heel pain?

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carol enyeart
New Member
Username: cenyeart

Post Number: 1
Registered: 2-2007
Posted on Wednesday, Feb 21, 2007 - 7:12 pm:   Edit PostPrint Post

I have a 6 year old mare with off and on bilateral lameness issues on the front. For 1 year now we have been dealing with lameness off and on. She originally came to me needing "adjusting" which I did and it yielded OK results. She had a shuffling gate and was off. We used the hoof tester on her but it did not show pain but we discovered she had abscesses in both front feet. Thought that was the problem but the lameness continued. We had her feet properly shod with egg bars with a 86 degree angle and that helped...for awhile. We had full X-rays done that showed clean legs so we did a coffin joint injection. The left front had grade 2 lameness with 100% improvement after PD block and the right front 90% improvement. She has been doing better until recently when after being lunged she went lame when we saddled her. I buted her and tried again later. One interesting thing that we noticed was that one shoulder was higher and her LF was higher than her RF. Thought it was a shoeing misjudgment? But, her shoulder was giving her a lot of pain all across her back. (Exactly where she had been adjusted a year ago). She also has an old saddle sore right at that spot. We changed saddles and put on one with a wider tree and she became somewhat improved. We've always thought it was the chronic heel pain that caused her shoulder to drop and back to be in pain but now I'm thinking it is the other way around? Could she be out of alignment and that is causing the other condition? I am a lost what to do next. Oh, she had the injection 5 months ago and has one episode of lameness that came and went on its own. She is currently on 2 grams of bute.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 17841
Registered: 1-1997
Posted on Thursday, Feb 22, 2007 - 6:44 am:   Edit PostPrint Post

Welcome carol,
As far as I know there is nothing that can be manually adjusted in the horses anatomy to "put it back in alignment". Do I understand your post correctly that she now is only lame when saddled?.
DrO
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carol e
New Member
Username: cenyeart

Post Number: 2
Registered: 2-2007
Posted on Saturday, Feb 24, 2007 - 11:23 am:   Edit PostPrint Post

Thanks Dr. O,
She's fine on the lunge line but when saddled and when my daughter gets on, she head bobs. I had a friend who has race horses look at her last night and the problem as he sees it is because she has chronic heel pain, her angle needs to be up high (86 degree) but because she is up on her toes so much she is driving that shoulder down and causing the shoulder and back pain. We are thinking about lowering the angle 2 degrees and chiropracting her. The racing friend thinks a "flip flop" as he called it in her shoe would help stimulate circulation to the frog and still bring the angle down. What other options do I have?
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 17864
Registered: 1-1997
Posted on Sunday, Feb 25, 2007 - 9:56 am:   Edit PostPrint Post

Hello carol e,
Several times I have seen horses only lame under saddle and each time it turned out to be irritated skin with or without tack problems (early dermatophilus, reaction to a coat cleaning product, occult nail under padding comes to mind) that was the cause.

I would never elevate any horse, short of a tendon tear perhaps, to 86 degrees. That is almost a vertical slope to the toe, the horse would be tippy toeing.

You should not do anything till you get a better handle on the problem. You should have the horse examined under saddle and a PDN block will answer the question if it is a foot that is lame only under saddle. If so you can pursue that, for more on this see, Diseases of Horses » Lameness » Localizing Lameness in the Horse.
DrO
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carol e
New Member
Username: cenyeart

Post Number: 3
Registered: 2-2007
Posted on Sunday, Feb 25, 2007 - 6:28 pm:   Edit PostPrint Post

Dr. O,
Yes, been that route before and I think that it's a good idea. My trainer feels that it is not a foot problem as much as it is a problem with the angle being too high. The vet who did the diagnostic testing thought the angle was OK but I am wondering if the farrier did not have them balanced this past time. She had been sound and doing well for 5 months and was quite sore after this last trim and went lame right after she was lunged (which she acted like a wild woman, bucking and racing...). Thank you for your help and I'll keep you posted.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 17873
Registered: 1-1997
Posted on Monday, Feb 26, 2007 - 7:40 am:   Edit PostPrint Post

carol e,
you can learn to assess balance yourself see the articles on foot balance at, References » Equine Illustrations » Leg Anatomy and Conformation.
DrO
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carol e
New Member
Username: cenyeart

Post Number: 4
Registered: 2-2007
Posted on Saturday, Mar 3, 2007 - 7:14 pm:   Edit PostPrint Post

Dr. O,
Update on the mare- sound on the front but has developed an abscess in hind so we're soaking and getting that taken care of. My trainer and I are now trying to figure out what to do next. I've read the articles concerning Navicular and CHP. Did I read correctly that they are the same and that X-rays can come back "clean" but the mare could still be symptomatic? My trainer's position is confused why we were treating it like navicular when the navicular bone was OK and she is concerned about the degree (which is 56 degrees NOT 86 degrees which I incorrectly posted earlier- sorry)As I mentioned she feels like she is up too high. On the other hand the farrier feels this is necessary along with egg bar shoes to keep the heel from any pressure. He also went back to 6 week shoeing schedule instead of the 4 weeks we had originally done. The mare has really not had an extended period of soundness so there is a lot of disagreement on how to do things, especially when she goes lame and sound as quickly as the wind blows.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 17928
Registered: 1-1997
Posted on Sunday, Mar 4, 2007 - 7:21 am:   Edit PostPrint Post

Hello carol e,
Have you read the article on treating abscesses? Yes you can have horses with CHP and normal navicular radiographs.

I would not be counting the degrees so much as assessing the balance of the foot. Some horses would be balanced at 56 degrees (see reference above). Concerning the frequency is there a pattern of increasing lameness toward the end of the shoeing cycle?
DrO
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carol e
New Member
Username: cenyeart

Post Number: 5
Registered: 2-2007
Posted on Sunday, Mar 4, 2007 - 8:43 am:   Edit PostPrint Post

Dr. O,
Yes there was a pattern of increased lameness before the injection- she could not go more than 4 weeks and would become very lame. We kept her on a 4 week schedule until the last 4 months when by accident she went to 6 weeks. Now she is sore up to a week after being shod.
Yes I read the articles about abscesses and they helped a lot. My trainer helped me as I am a novice and she uses maxi pads.
Carol E.
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carol e
Member
Username: cenyeart

Post Number: 6
Registered: 2-2007
Posted on Sunday, Mar 4, 2007 - 8:51 am:   Edit PostPrint Post

Dr. O,
Two more questions. Should a horse with CHP be shod according to her natural angle or does corrective shoeing give the horse a better angle than what the horse naturally has? I'm not sure if I am explaining this right. We originally had a Morrison shoe on and this farrier switched to egg bars - could that make a difference??
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Aileen
Member
Username: sunny66

Post Number: 1686
Registered: 9-2002
Posted on Sunday, Mar 4, 2007 - 11:25 am:   Edit PostPrint Post

Hi Carol,

Could you post some pictures of her feet? Does she land heel first? That would be my determination of what steps I would take. Please digest Dr. O's fabulous articles, they are full of pertinent information with many options. The one I would definitely determine first is if she indeed has a balanced foot. I had been told by 4 farriers that my horses' feet were balanced, and they were far from it. This is MOST important and can lead to MANY other issues with the horse.

I made the mistake of trusting my farriers, and due to that, my horse has MANY issues. We are now in the long process of getting his feet properly balanced.

I would ask your farrier to teach you. Ask him to map out the foot, measure the widest part of the foot and draw a line on the widest part of the foot, then measure from that line to the heel, then measure from that line to the toe. The measurements should be very close. My horse had a short measurement to the heel, and a long measurement to the toe. This proved his feet were not balanced. I think this is caused by not landing heel first, therefore the heel growth is lessened and the toe grows longer and in turn stresses the MANY tendons and ligaments in the hoof.

The farrier should be supporting the heel and increasing the breakover by setting the shoe back. I write this assuming that your horse has low heels and long toes.

My two cents...
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carol e
Member
Username: cenyeart

Post Number: 7
Registered: 2-2007
Posted on Sunday, Mar 4, 2007 - 4:59 pm:   Edit PostPrint Post

Thanks for the info. I'll take pictures and try to post them. This is a good point and one that I have been battling- not sure this is the farrier for me but the one that comes to our barn. To answer your question about coming down heel first- no, not often, it's mostly on her toes. That's why my trainer feels the angle is all wrong. Yes, she has low heel, long toes and conformation wise has lots of issues including high withers and goes downhill. I meet with the farrier soon and our chiropractor. Thanks,
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 17943
Registered: 1-1997
Posted on Monday, Mar 5, 2007 - 9:02 am:   Edit PostPrint Post

carole e, you need to point out to your farrier that the horse itself is telling him 4 weeks, no longer. The correct angle is most likely the best angle, but this is explained in the article. I am uncertain what a Morrison shoe is but many folks have moved away from eggbars as a first line shoeing apparatus for CHP.
DrO
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Aileen
Member
Username: sunny66

Post Number: 1694
Registered: 9-2002
Posted on Saturday, Mar 10, 2007 - 7:41 pm:   Edit PostPrint Post

Hi Carol, I think my email is in my profile, if you like, email me the pictures and I'll put them up for you.
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carol e
Member
Username: cenyeart

Post Number: 10
Registered: 2-2007
Posted on Sunday, Mar 11, 2007 - 9:13 am:   Edit PostPrint Post

Thanks! I sure will try.
Carol
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Aileen
Member
Username: sunny66

Post Number: 1695
Registered: 9-2002
Posted on Sunday, Mar 11, 2007 - 10:43 am:   Edit PostPrint Post

Pics for Carol:







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Aileen
Member
Username: sunny66

Post Number: 1696
Registered: 9-2002
Posted on Sunday, Mar 11, 2007 - 10:46 am:   Edit PostPrint Post

Hi Carol,

I think Dr. O likes to see the lateral pics more to the side with the camera on the ground, so he can see the angles better.

I honestly don't know what to say about the pics...good or bad... Can you take a confirmation picture of her as well? It's best to take those at the shoulder I think.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 17985
Registered: 1-1997
Posted on Monday, Mar 12, 2007 - 6:14 am:   Edit PostPrint Post

Aileen is right, we do need true laterals from the side, taken a bit closer to the ground to really judge ap balance. From the front you need to take the picture again closer to the ground but you have to stand in front of each of the horse's leg and take individual photos. In this horse to be in front of the horse means you will be quite a bit to the outside because of the remarkable outward rotation of the legs. Does this horse have bilaterally bowed tendons or is this just the light?
DrO
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katrina
Member
Username: kthorse

Post Number: 811
Registered: 11-2003
Posted on Monday, Mar 12, 2007 - 7:13 am:   Edit PostPrint Post

Just wanted to say that when my horse had bad heel pain, If I had not known what it was I would have thought shoulders or something as they don't move properly because of the pain. He could not lunge or do circles at that time. Heels fixed movement fixed. Note that this is my horse it might have nothing to do with what is going on with yours.
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carol e
Member
Username: cenyeart

Post Number: 11
Registered: 2-2007
Posted on Monday, Mar 12, 2007 - 2:45 pm:   Edit PostPrint Post

Thank you- I will try to get those when I go back, but she has be shod and trimmed. My farrier and trainer are really at a disagreement at what to do with her shoes. I tend to agree with the farrier and like the post above, think that the feet are causing the shoulder pain and she can't be lunged in tight circles- ever.
Carol
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Beverly
Member
Username: jockyrdg

Post Number: 46
Registered: 12-2005
Posted on Monday, Mar 12, 2007 - 6:25 pm:   Edit PostPrint Post

Hi all, My eye is not trained and photos always lie - but your girl looks like she has a toe-out conformation, but the feet don't seem to quit flow the same. Picture? Comments group? Something in that particular photo just doesn't seem comfortable to the eye and that usually is a symmetry problem.
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Julie Masner
Member
Username: juliem

Post Number: 152
Registered: 9-2002
Posted on Monday, Mar 12, 2007 - 9:56 pm:   Edit PostPrint Post

How long has she been in eggbars? They offer absolutely no frog support. In fact, the frog is totally non weight bearing, not allowing it to offer the support it is designed to give to the digital cushion and coffin bone. I agree with your trainer regarding the angle and balance. Also have the same feeling as Beverly--these feet just don't look "right."
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 18000
Registered: 1-1997
Posted on Tuesday, Mar 13, 2007 - 9:09 am:   Edit PostPrint Post

carol I don't think bad feet cause shoulder pain and if the lameness persists I continue to recommend a good lameness exam with localization to determine the source of the lameness.
DrO
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carol e
Member
Username: cenyeart

Post Number: 12
Registered: 2-2007
Posted on Tuesday, Mar 20, 2007 - 7:12 pm:   Edit PostPrint Post

I've tried to upload pictures again, but still no good. The chiropractor came and looked at my horse and wasn't very impressed with her feet- completely unbalanced and in bad shape. I am looking into another farrier for it will take 2 months to undo the damage. She will also need another coffin joint injection as well, but the prognosis looks good. The abscess is healing too, so maybe show season will work out alright?
Thanks and I'll keep you posted.
Carol
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