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Discussion on Suspensory ligament problems - how should the horse be shod? | |
Author | Message |
Member: Arvane |
Posted on Monday, Jan 5, 2004 - 11:42 am: Hi Dr O, and everyone else,I have a 11 year old TB gelding. I have been told by the vet that he has chronic suspensory ligament problems in his hind-legs and his vet has pretty much written him off for the kind of work I used to do (low-level jumping). The diagnosis was based on nerve blocks (he had a grade 1-2 lameness in the hind-legs but only tested positive on the flexion test on one hind-leg, which leads me to hope that maybe he does not have DSLD after all). I am planning to take him in for ultrasounds to see exactly how extensive the damage is but since he is not lame at all anymore, and I am only working him very lightly, I have postponed it. I can provide more details on the situation and what I am doing to help him, but thought I'd better get straight to my question: One vet suggested that I shoe him with an extended heel, to support the fetlock. Another vet has suggested that instead of the extended heal, I should focus on setting the toe back as far as possible, to ease the break-over (he has long pasterns). What is your advice when trying to limit damage in the suspensory ligaments? (I have read the articles but have not found anything concerning this question). My inclination is to do both these things, but I feel like I need a second (third) opinion. Thanks for a great website! |
Member: Christos |
Posted on Monday, Jan 5, 2004 - 2:24 pm: James,Shoeing with an extended heel does not necessarily relieve strained ligaments, and may actually worsen the situation under certain circumstances. Setting the toe back and rolling it to assist break over should help relieve some stress. I would check with a good farrier to see that his angles are correct for his conformation and that the frog and heels are working properly to aid the supply of blood to the ligaments under repair. Damaged ligaments take months to recover, James. Riding him lightly in the days that he is not lame may strain newly repaired tissues. Be patient until you see the ultrasounds. |
Member: Parfait |
Posted on Monday, Jan 5, 2004 - 3:09 pm: James,I also would get an ultrasound before moving further. As far as the shoeing is concerned, I have a long pasterned mare that I spent a lot of time messing with..extended heels, half-rounds, squared toes etc. She was always full in the legs, not quite lame but something was always brewing with her. Finally I switched shoers to a Podiatrist and he just trims her right: gets her foot back under her leg, which had migrated forward. He also allows her leg to break-over in the direction it wants to break (meaning he lets her break over toed out) Although I do keep her break-over set back, she doesn't need all the bells and whistles that she used to and her legs stay cool and much cleaner. Something I was not watching before is that when we were backing her shoe up, especially on the hinds we developed a negative plane in the coffin bone. You can see this if you look for the domed dorsal surface. It makes them pretty sore. I don't think my old shoer knew it either. Anyway, I learned that it's not just about the shoes. If your guy is chasing the foot out in front of the horse, you're doomed on a long pasterned horse. You can find a lot of info on The Anvil. Good luck. Kerry |
Member: Arvane |
Posted on Tuesday, Jan 6, 2004 - 11:19 am: Thank you both of you for your replies and advice. Christos, do you know under what circumstances the extended heel may worsen a ligament related condition?Kerry, your mare sounds a lot like my gelding! I have never noticed hindleg lameness, nor has anyone else until this new vet took a look at him (for a front-leg related issue). The horse looked terrible the day we brought him in, but before and after that day, he has looked just fine. Regardless of how serious the condition is, there is definitely a problem. He frequently has filled legs and is a bit lazy/dragging his toes. Kerry, how did extended heels work for your mare? My gelding has had them for a few weeks and he seems to pick his feet up better. As for setting back the toe, my farrier does set it back, but just a little bit (he does that with all horses), which i believe is common shoeing practice. How far back are your mare's shoes set (are they standard shoes)? Is "The Anvil" on the Horseman's Advisor website? (I can't seem to find it..) Sorry for all these questions but I am really lost and getting bombarded with advice from people who have never had these problems or vets that just have a "sell him" attitude. |
Member: Suzeb |
Posted on Tuesday, Jan 6, 2004 - 11:53 am: James,Go to the left hand main menu and go to "Classifieds and Ads". There you will find link ups to the Anvil and also to the "Farrier and Hoofcare Resource". You will find lots of good information to be further bombarded with. You can also run a search on suspensory ligaments in the Farrier and Hoofcare Resource and that will take you to discussions about this problem and how these horses are being shod. I think it is important that you get a correct diagnosis with perhaps the ultrasound that you were considering. At any rate the suspensories are weak or injured and will need proper support and some rest time to heal as much as they can. Hope this helps. Susan B. |
Member: Christos |
Posted on Tuesday, Jan 6, 2004 - 1:17 pm: I can not recall the link to the study, James, though I think it did not describe the exact circumstances anyway, and I am reluctant to analyse such things myself here, as I am not a vet. Dr O?What do you mean by "pick his feet up better", James? A higher step does not necessarily mean he is more comfortable. |
Member: Presario |
Posted on Tuesday, Jan 6, 2004 - 3:27 pm: I too would go ahead with the ultrasound to see exactly what you are dealing with that you can't see from the outside and may not be visibly affecting the leg. U/S isn't that costly. As for shoeing - I wouldn't. More than ever his leg needs to be able to help itself and the best way for it to do that is barefoot. If you feel you need to shoe, I especially wouldn't do any sort of raised heel or extended heel or anything. The most important part of any foot, shod or not, is a proper trim. Do you have pictures of his feet? It could be that his current method of being trimmed has led to, or exacerbated, his suspensory problem. |
Member: Arvane |
Posted on Tuesday, Jan 6, 2004 - 3:45 pm: Susan, thanks for the search tips - I will get right on it tonight. He is resting most of the time and I am trying different supplements (for example SuspensorySaver, very expensive but I figured it is worth a shot), magnetic boots, acupressure etc. He mainly walks when we are out, with 1-2 minutes of trot. But looking at all these posts, I will cut down to walk only.Part of why I havent done the ultrasound is that the vets I talk to say that in the hindlegs you can't see that well what is going on (due to the bones?). As for the part about picking his feet up, he just seems to use his hindlegs more actively, with impulsion (instead of dragging them in the ground). It may be the extended heels/supplements/acupressure/magnetic boots/God's will - I don't know. But it loooks like he is feeling better. As always, thank you all for your advice. |
Member: Parfait |
Posted on Tuesday, Jan 6, 2004 - 4:39 pm: James,I set the shoe back as far as I can. It moves the break-over back and it makes it easier for them. To really do things right I have used xrays. There's a place Called Duckett's Dot (right where P2 and P3 touch) DrOpping a line down, ideally the break-over should be about 1 1/2 to 1 3/4 inches in front of that. Some people say that that corresponds with the point of the frog but if the foot hasn't been trimmed correctly this isn't right. Dr myers in VA sometimes uses the hairline on the corronet because it doesn't migrate. Either way, xrays are the best way to tell as you get to see the bony column which tells you your alignment and where your coffin is sitting in the foot. See, I'm just spending you money left and right... As far as the heels, I have used extended heels and trailers on all my horses for many years. I also have had some puffy tendon sheaths. I don't know if they are correlated. I don't have trailers on this mare in particular. I have extended heels-- Sure, heel support is important. What can be problematic (I think) about trailers, is that there is a certain amount of torque upon landing that maybe you wouldn't want. You could even get that effect with a poorly placed extended heel. What I was trying to say in my last post, a bit unclearly, was that it doesn't matter where you place the shoe if your foot is unbalanced. If your toe or heel is a bit too long, you can still not have enough set-back. I thought that I had enough toe cut off and I was setting the shoe back to 1 1/2 inches but it wasn't enough for her, she was developing coffing inflamation. The mare is now in aluminum shoes in front -not Natural Balance though, light plates behind. I don't know what your situation is James, these are just some things that I've tried. One thing I have learned is to be more flexible. Just because I have read that it should work doesn't mean that it does! I've learned to be willing to try new things like, go for the shorter pasterned horse (that's my next move). Have fun! |
Member: Christos |
Posted on Tuesday, Jan 6, 2004 - 5:39 pm: James,a horse's hoof is made to land either flat or heel first. When heel first, its round, soft bulbs assist the loaded hoof to rock smoothly to flat. If you make that landing heel hard and sharp by extending the shoe, you increase the vertical velocity of the toe, i.e. the toe will slap the ground and jerk the whole lower limb forward. That is a bad thing on a leg loaded with 1000 lbs and I would expect noticeable stress to travel as high as the hock. Think of it like the different effect you get when you walk fast with dress shoes vs sports shoes. |
Board Administrator Username: Admin |
Posted on Wednesday, Jan 7, 2004 - 8:48 am: Hello all,Traditionally it has been recommended that support with slightly extended heels in the form of an egg bar shoe will help support the fetlock and therefore the suspensory. The recommendation has merit but still lacks objective proof of efficacy. More recently we are also recommending moved back breakover in the form of rockered and rolled toes to decrease strain on the support structures during movement. DrO |
Moderator: DrO |
Posted on Wednesday, Jan 7, 2004 - 8:49 am: Hello all,Our recommendations for shoeing and other therapy for suspensory problems are at Equine Diseases » Lameness » Diseases of the Lower Limb » Suspensory Desmitis, Strain, & Sprain. DrO |
Member: Christos |
Posted on Wednesday, Jan 7, 2004 - 9:20 am: James,In deep footing, an extended heel may dangerously delay breakover and add significant stress to the flexor tendons and the suspensory ligament. I have the suspicion that extended shoes are used in most cases as an attempt to bring the bearing surface closer to the middle line of the cannon bone, and that is in my opinion over-simplification of the mechanics of the lower limb. |
Member: Arvane |
Posted on Wednesday, Jan 7, 2004 - 11:14 am: Thank you all for this long string of interesting feedback. It seems that setting the toe back more may be the way to go, and perhaps get rid of the extended heels. Jordana; in theory I agree with your point about barefoot but he was barefoot for years and really seems to move better now that he has shoes. I agree about the pads, I've heard horror stories about them.Kerry, I don't mind you "spending my money" - as all of you probably agree, money is not really the issue. 'Problem is knowing what exactly to spend it on :-) I will have new X-rays taken asap. |