"Sidebone" is calcification of the collateral cartilages of the hoof. It seldom causes lameness. ©EQUUS Magazine

Q: My 15-year-old half-draft mare has had on-and-off lameness for the past year and was diagnosed with sidebone in her right forefoot. The barn veterinarian injected her with cortisone, but after two weeks of rest she continues to carry herself differently. She doesn’t bob her head but she “swivels” her left front hoof to limit the amount of time her right front carries her weight. And when at rest, she points her right forefoot forward without bearing weight on it, which is causing separation within. She has isolated herself from the rest of the herd and stands in the muddiest part of the lot.

My farrier has suggested putting shoes and pads on her. However, due to past trauma, this mare has issues with having her feet trimmed. After working with her for several months, I have gotten her to stand for the farrier. However, I am not sure if she will tolerate shoes. Are shoes her only option?

I have read that lameness isn’t caused by sidebone but is a symptom of another problem. What could be causing my mare’s lameness and what I can do to help her return to soundness?

A: The problems you describe---lameness, altered gait, standing in mud---all point not to sidebone but to laminitis, the inflammation of the soft connective tissues within the hoof. Of course, I’d have to examine your horse to be sure, but based solely on your description, I can make a good guess.

A horse with laminitis will typically point the affected foot forward and seek out cool surroundings or water. As the problem progresses, wall separation in the toe will develop. You’ll need to call your veterinarian for a definitive diagnosis, a process that will likely include taking x-rays of the foot.

In my experience, the most effective treatment for mild laminitis is a properly applied heartbar shoe. If the coffin bone has become detached from the hoof wall and rotated down toward the sole (a condition called founder), pour-in padding will make the horse more comfortable. And, yes, you will need to continue to train your horse to accept the farrier, because if she has laminitis, she will need long-term expert hoof care to keep her comfortable.

Sidebone rarely causes lameness. This condition is the calcification of the collateral cartilages within the hoof---in other words, the pliable cartilage tissue ossifies, or develops into hardened bone. Sidebone is more common in heavy horses, and I have seen it most often in those who are toed-in. If the calcified cartilage fractures, the horse may have a little period of mild lameness, but not the disabling problem
you describe.

Mike Miller, MD, CJF, FWCF
Huntsville, Alabama

Even though you're kicking like mad, your horse just won't pick up the canter. Or maybe every time you try to jump, he refuses the first fence two or three times. Or perhaps he walks so slowly when you go trail riding that you always seem to be 10 yards behind your friends.

Worse, your horse happily cruises along on trail rides, but every time you try to do flat work in the ring, he pins his ears, wrings his tail, and even kicks out at your legs. These are all exasperating, but common, problems.

The most common reason for sluggish behavior is personality-a quiet horse who doesn't have a whole lot of get up and go. Honestly, he's kind of a couch potato and would prefer to watch other horses work than actually use his muscles. This isn't generally a bad problem to have because this personality tends to produce safe, bombproof mounts. After all, it's a lot of work to misbehave.

Fitness or, more likely, lack of fitness often contributes to sluggishness, especially in large, quiet breeds, like draft crosses or old-school warmbloods. An overweight horse is like an overweight human-not really keen on activity because it's just plain hard and tiring.

But your horse might not be overweight, especially if you're careful about the amount or type of feed he gets. He could be like a naturally skinny teenager or adult, one who's never built the muscles he needs to actually do a sport. Consequently, he's so easily tired by exertion that he's disinclined to go anywhere.

Poor riding or training can also sour a horse and make him sluggish. The horse may have been ridden in a way that didn't encourage him to go forward, perhaps because whoever was riding him was afraid of his size or stride. Or perhaps the rider couldn't sit the canter or trot unless they were just mincing along. Consequently, the horse hasn't been taught to move forward or away from the leg aids; they've never been taught that rule No. 1 is "go forward."

Sometimes horses become sluggish because they've spent time being jarred by a novice rider or perhaps even by a rider with poor body control, making them sore. Poor riding could also make them mentally sour, forcing them to sort of retreat inward, seeking to protect themselves.

And some horses just plain have a sour attitude. They don't want to work. These are the toughest.

]]> http://www.equisearch.com/uncategorized/get-your-sluggish-horse-moving/feed/ 0 http://www.equisearch.com/uncategorized/put-end-nagging-hoof-pain/ http://www.equisearch.com/uncategorized/put-end-nagging-hoof-pain/#comments Sat, 01 Dec 2007 00:00:00 +0000 Heidi Nyland http://www.myhorse.com/put-end-nagging-hoof-pain.html Your horse doesn't need to live with chronic foot pain. You can beat it.

You've heard it before: "No foot, no horse." Although it sounds trite, and it's a no-brainer, the fact remains that you can't overestimate how important the feet are to soundness, movement and attitude. Chronic foot pain leads to alterations in gait as the horse struggles to find a way to be more comfortable, and few things are more likely to dampen enthusiasm for work than having constant pain that you can't escape.

SYMPTOMS
Because more weight is carried on the front feet, most hoof problems occur in front. When there is severe pain in one leg and the horse is limping around, anyone can see it. Mild-to-moderate pain in both feet is another story. This is especially true if the pain comes slowly. The changes can be so gradual that they're easy to miss. Symptoms include:

Hind-Foot Pain

Symptoms of hind-foot pain may include:

• Toe-first landing.
• Pain going up a grade on the lameness scale.
• Pain when jogged off after standing with the toe elevated on a block.
• Positive reaction to hoof testers with pressure applied across the heels or from frog to quarters.
• Long, contracted heels with a poorly developed frog (may also be the cause of hind-foot problems).

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• Abnormal Stance. There is a tendency for horses with heel pain to stand under themselves, with their feet back more toward their belly rather than directly underneath. The reverse holds for horses with pain along the toe/front of their foot. However, this isn't absolute. The individual horse may stand either way regardless of where the pain is.
• Weight Shifting. Sore-footed horses may "tread," shift weight from one foot to another, or, pointing feet in front of them. Alternately, they may decide it's best to move as little as possible and will be rooted in place for prolonged periods of time.
• Elbows Out. Horses with foot pain will sometimes stand with their elbows pointed out. This is often associated with atrophy of the triceps muscle, the large muscle above the elbow.
• Rigid Head Carriage. Horses with foot pain will often carry their heads either higher than normal, or extended unusually forward and low. The normal head movements present at the walk and canter are reduced.
• Shortened and Stiff Stride. "Choppy" and "wooden" are terms that usually describe how a foot-sore horse moves. Many horses with hoof pain also move low to the ground, in a shuffling-like gait. At the most extreme, the horse will have a "walking on egg shells" look.
• Stumbling or Tripping. Because they move low to the ground, stumbling or tripping may occur.
• Preference for Soft Ground. This is almost universal with foot-sore horses but may be less noticeable if they are shod. When on hard ground, there is both more concussion and more vibration. Most of the weight is carried on the walls, so the walls spread slightly and the sole drops.
• Shoulder, Back, Hind-End Stiffness. Nagging foot pain leads to the horse carrying his entire body in a stiff and guarded way. There's less swing to the back, and weight is often shifted to the hind legs more than normal, both when moving and standing. Many horses with nagging front-foot pain are diagnosed as having back or hock problems, treated for that to no avail.
• Reluctance to turn sharply or travel in a tight circle. These movements shift more weight to the leg on the inside of the turn and can increase the horse's pain.
• Ear pinning, "bad attitude." Can you blame them?

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Better diagnostic tools for imaging the horse's hoof are shedding new light on navicular disease and navicular syndrome in horses. There's a difference between navicular disease and navicular syndrome, although they overlap, and researchers are now uncovering several more causes for the symptoms in horses that have previously all been labeled "navicular."

The Navicular Bone
The navicular is a small, flattened bone, wide in the center, that resembles a flying saucer from an early sci-fi movie. It sits deep within the back portion of the foot, nestled between the coffin bone (P3 - third phalanx) and the short pastern bone (P2 - second phalanx).

If you were looking at the bottom of a normal horse's hoof, the navicular bone would be sitting inside the foot at roughly the level of the middle of the frog. Working your way out from the navicular toward the ground surface, the next structure is the navicular bursa, a fluid-filled cushion, the deep digital flexor tendon, the digital cushion, and finally, the frog. In other words, there's lots of padding.

The navicular bone doesn't just sit in place on its own. It is held there by several ligaments. The impar ligament is a short but thick and strong ligament that runs from the bottom surface of the navicular bone to the coffin bone. There are also ligaments running from either side of the navicular to the larger bones, and ligaments connecting it to collateral cartilages, large "wings" of cartilage extending back from the coffin bone that expand and contract upon weight-bearing. A major function of these ligaments is to hold the bone in place. But because all ligaments have some "give" to them, they also allow controlled movement in a variety of directions.

What Does It Do?
That's a very good question, without too many solid answers. Because of the way it projects out behind the coffin joint, the navicular bone changes the direction of the deep digital flexor tendon before the tendon inserts on the coffin bone. When the foot is off the ground, however, and the toe is back, the pull is in more of a straight line. Whether this is of any mechanical advantage to the horse is not clear.

The navicular bone also gives some wiggle room to the coffin joint. The collateral ligaments that flank the coffin bone secure the short pastern bone to the coffin bone in tight alignment so that they function almost as one. This is an advantage in weight-bearing. That arrangement would work fine if all the ground the horse travels over were completely flat and smooth. But in reality, the horse has to deal with uneven ground surfaces all the time, so there needs to be a way for the foot to absorb uneven forces. The soft tissue cushioning and shock absorbing structures (frog, digital cushion, collateral cartilages) do just that, but it looks like the navicular is involved as well.

It is thought that the position of the bone and its attaching ligaments allows it to absorb and compensate for uneven ground surfaces. The navicular bone of horses that are exercised is also more dense than that of inactive horses.

As team roping has evolved and the price of a decent horse has escalated, more people are having a horse they are interested in buying evaluated by a veterinarian for state of soundness before writing the check. I believe there has evolved a greater ability to evaluate the status of the horse by way of greater knowledge, experience and advanced technology from the veterinary profession. However, there are still situations where the decision to buy or not buy a horse based on a soundness evaluation can be in question.

The major factor of a soundness evaluation is a thorough physical examination of the horse. Abnormal findings physically or conformationally are noted, and then one proceeds to moving the horse at the trot on a hard, level surface in all directions. Tests such as applying hoof testers and flexion of the leg joints are evaluated. With higher prices for horses, radiographs of important structures are often done either because of a request by the prospective buyer or questionable findings on the physical exam. When all is said and done, it seems horses fall into one of four categories.

The first category is the horse with no evident problems physically and no apparent changes radiographically. The second category is the horse that seems fine physically, but has some subtle changes radiographically (on X-ray imaging). Interpreting the significance of these changes can be challenging. Many subtle changes radiographically are considered non-threatening, or in a way normal, for an experienced horse that has been working hard in his lifetime.

The third category is, in my opinion, the most difficult to make a decision on. It's the horse that is moving soundly and has been performing the job, but has more serious radiographic changes. This horse may also have some abnormal response to hoof testers or flexion tests. The fourth category is the horse that is not moving soundly and has radiographs with changes that explain why.

As I mentioned, horses that fall into the third category present a dilemma to everyone concerned. The decision on whether to buy the horse or not often comes down to other factors. Factors such as how well the horse "fits" the prospective buyer, knowledge of the horse's recent performance history or the price relative to the horse's ability. In other words, it's a calculated risk.

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Aadland, Dan

Cleaning stalls with the horses still in them, Matthew Mackay-Smith, DVM. (C) 350/85

]]> http://www.equisearch.com/horses_care/equusindex_123106/feed/ 0 http://www.equisearch.com/horses_care/health/anatomy/pasternproblems_012706/ http://www.equisearch.com/horses_care/health/anatomy/pasternproblems_012706/#comments Fri, 27 Jan 2006 20:09:00 +0000 admin http://www.equisearch.com/pasternproblems_012706

Your horse

Ah, the well-turned pastern: slender, shapely, yet incredibly strong, the bearer of thousands of pounds of pressure relentlessly imposed during the million steps of a lifetime. So much rides on the pastern, and so little goes wrong with it, at least compared to the fetlock above and the ever-challenged hoof below. Accidents, including fractures, cuts and abrasions, do afflict the area, for sure, and strains and pulls of tendons and suspensory ligaments crisscrossing the pastern do occur. But only two abnormalities--ringbone and sidebone--pop up on the pastern often enough to have earned labels in common stable parlance.

Both "bones" are evidenced by visible irregularities on the pastern, yet neither is always or even often the cause of lameness. Sidebone, especially, is usually more a matter of abnormal appearance than of altered function. Ringbone, on the other hand, does disable horses, sometimes temporarily, sometimes permanently.

Your greatest ally in deciding the seriousness of a pastern irregularity is the horse himself: You can bet that no matter how awful the landscape there may look to you, if the horse isn't limping, there's no cause for panic. Even if he is "off," the lumpy pastern may well be blameless in the lameness, an unfortunate concurrence with another painful place in the lower leg. By familiarizing yourself with the normal pastern landscape and function, you'll be prepared to determine which lower-leg lumps are harbingers of trouble and which are merely blemishes.

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The Normal
The two bones called phalanxes or phalanges that make up the pastern are equivalent to your two longest finger bones. Your third phalanx resides within your fingertip and the horse's within his hoof, where it's called the coffin or pedal bone. So little movement takes place in the pastern joint connecting the long and short pastern ones that casual observation would lead you to believe a single bone links the fetlock and hoof. Yet the joint is visible just below a pair of dimplelike depressions on the inside and outside of the pastern two or more inches above the hoof. This pair of hollow spots is one of the "good" irregularities you'll find on the normal pastern. The joint connecting the short pastern bone and the coffin bone is not visible and barely palpable because it's just within the hoof capsule and overlaid, on its sides, by thick cartilage pads (collateral cartilages).

Flexibility is the primary feature of your own joined phalanxes, allowing you to curl your fingers to grasp and manipulate. In contrast, the equine design requires rigidity between the upper two bones so the pastern can act as a stiff strut and firm anchor for the soft-tissue "straps" that hold the leg bones in line. Because of the tendons' pulleylike action, which wouldn't be possible without an immobile pastern joint, the fetlock and the coffin joints rotate in concert with each other and the larger hinges up the leg during the touchdown, support, liftoff and airborne portions of each stride.

The tendons and ligaments on a weight-bearing pastern are difficult to discern because they hug the bone surfaces so tightly. If you lift your horse's leg and manipulate his hoof while palpating the pastern with your other hand, you should be able to feel the play of the extensor branches of the suspensory ligament angling forward over the sides of the pastern just below the fetlock. The deep digital flexor tendon lies along the rear aspect of the pastern joint: The one small window of opportunity for palpating it is in the vaulted arch formed by the superficial flexor tendon where it encircles the deep tendon just above the cleft between the heel bulbs. The extensor tendon, the strap that advances the in-flight foot to its landing position, runs down the front of the pastern toward the tip of the toe. On fine-skinned horses, these supporting structures are discernible not as bulges or lumpiness but as clean-edged ridges slanting across the bones.

The joining of hoof wall to skin is accomplished at the coronary band or coronet, the raised, rather hard area encircling the foot from heel to heel. Just inside the coronet, on the sides and toward the heels, are the cartilage pads overlying the coffin joint. These collateral cartilages, so called for their location on each side of the hoof, are partly within the hoof wall and partly above it. In addition to serving to smooth the transition between the slender column of the pastern bones and the wide "mouth" of the hoof capsule, these cartilages contribute to shock absorption and circulation. Rigid enough to protect the blood vessels and nerves passing through them to the hoof's interior, these cartilages are just sufficiently flexible to participate in the hoof's expansion and contraction during weight bearing and flight. Normal collateral cartilages are readily visible and palpable as smooth, somewhat "giving" bulges that are wider and higher near the heels and taper toward the toe. Draft horses and other individuals with blocky, upright pasterns may have collateral cartilages that, even when healthy and functioning normally, are quite prominent.

]]> http://www.equisearch.com/horses_care/health/anatomy/pasternproblems_012706/feed/ 1 http://www.equisearch.com/uncategorized/heal-horse-hoof-abcesses-quickly/ http://www.equisearch.com/uncategorized/heal-horse-hoof-abcesses-quickly/#comments Sun, 01 Jan 2006 00:00:00 +0000 Heidi Nyland http://www.myhorse.com/heal-horse-hoof-abcesses-quickly.html

One-Stop Shopping

While it's not too difficult to pull together supplies for dealing with hoof abscesses from what you would normally have around the barn, or easily be able to get at the store, Plum Shade Farm ($39.99, www.plumshadefarm.com 610-486-0708) has a kit called the HOOFix Kit that contains everything you need to deal with an abscess. The kit includes a pack of Epsom salts for soaking as the initial step, a soft, stretchy band that protects the coronary band, Epsom salt packs for the bottom of the foot, elastic bandage for securing the pack to the foot, a heavy duty plastic bag that goes over the assembly before putting it into a padded, fabric boot with Velcro closures.

Once everything is in place, water is added inside the plastic bag using a syringe that also comes with the kit. The Epsom salt pack on the bottom of the foot breaks down, creating an Epsom salt bath/poltice inside the boot. Although the kit is best geared for solar abscesses, the coronary band cushion can also be soaked with Epsom salt solution to encourage exit via that route.

One large, nasty abscess we had in a test horse surfaced at the coronary band and drained within two days using the kit. The one-size-fits-all boot is generous enough to hold thick padding material but did not stay in place on turnout. Kits are available from vets, farriers and horse supply-stores, and can be ordered directly online.

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Sooner or later, just about every horse owner is going to have to deal with a hoof abscess. You'll come to the barn to find the horse that looked fine when you last saw her is now lame-really lame. Fortunately, the pain normally rapidly abates once you can get the abscess to drain, and the hoof heals uneventfully-provided you have the equipment and knowledge to handle the situation like a professional horseman.

Any puncture wound to the foot that enters live tissue, including misplaced shoe nails, carries bacteria into the tissues and sets the stage for abscess formation. Letting the feet go too long between trims, especially when barefoot, leads to white-line stretching, and cracks can form that are then avenues for bacteria to enter. Prolonged exposure to wet conditions can soften the feet and make them expand more, which can also make the white-line connections weaken.

Horses recovering from laminitis are at particularly high risk. Infections can enter the foot through weakened laminar connections in the white line and often find collections of blood that are a perfect medium for growth. Laminitis can also result in the formation of "sterile abscesses," collections of damaged tissue that trigger an inflammatory reaction. These dead tissues and pockets of inflammatory fluid will eventually exit the foot just like infections do. Keeping laminitic horses on anti-inflammatory medications for extended periods of time can actually prolong their pain by slowing the exiting of abscesses and fluid collections.

Finally, a horse that's obviously sore a day or two after being trimmed may have unresolved abscesses. Trimming changes the mechanics of the foot, resulting in different forces being applied to walled-off abscess collections. This can cause abscesses to leak, causing pain and inflammation.Diagnosis

In the classic scenario, a horse with a hoof abscess will have a hot foot, pounding digital artery pulses at the back of the ankle, even swelling extending up the pastern or higher. However, it's also possible for abscesses to be the problem when you have none of these external signs, even no reaction to hoof testers.

The one symptom that is always present and should make you think hoof abscess is pain. Hoof abscesses are one of the most painful problems a horse can have and more often than not they will completely refuse to bear weight on the foot, what is commonly called "broken-bone lame" or "three-legged lame." If the horse is recovering from laminitis, the pain from an abscess is often worse than the original laminitis was.

A visit by the veterinarian and an X-ray to make sure the problem isn't a broken bone or laminitis attack is usually warranted. Most abscesses don't show up on X-rays, although they may if the organisms involved produce gas. In most cases, it will be a completely clean X-ray that clinches the diagnosis of hoof abscess.

Although there may be no response to hoof testers in some horses, they should always be used to attempt to find the site of the abscess. If a soft spot in the sole is found over a tender area, your vet or farrier may choose to remove a few layers of sole to help it drain easier. The frog clefts and frog itself should also be checked carefully to make sure no nail, piece of wood, etc. is embedded. Be sure to check under any flaps in the frog.

]]> http://www.equisearch.com/uncategorized/heal-horse-hoof-abcesses-quickly/feed/ 0 http://www.equisearch.com/uncategorized/understand-horses-hoof/ http://www.equisearch.com/uncategorized/understand-horses-hoof/#comments Sun, 01 Feb 2004 00:00:00 +0000 Heidi Nyland http://www.myhorse.com/understand-horses-hoof.html The Exterior of the Equine Hoof

• The Coronet-the band around the top of the hoof where the hair stops. Also called coronary band. Point of growth for the hoof-if damaged, growth of hoof wall will be interrupted at that point-damage will be evident as hoof grows out.

• The Hoof Wall-the horny exterior of the hoof-grows downward from the coronet-similar in construction to the human fingernail-insensitive-subject to disintegration at the lower edge from excessive wetness or dryness.Underside of the Hoof

• The Frog-the triangular, spongy portion in the center of the underside of the hoof-absorbs shock-aids in pumping of blood to interior structures of hoof.

• The Sole-the concave, insensitive underside of the hoof-protects the sensitive sole inside-may be bruised or punctured by treading on stones or nails.

• The White Line-the narrow strip where the bottom edge of the hoof wall meets the sole. Inside the Equine Hoof

• The lower part of the short pastern.

• Digital Cushion-fattylike substance that helps put the brakes on the bones in the hooves as they descend down toward the frog during the leg's weight-bearing phase.

• Frog Stay-helps divide the cushion spread outward into the heel buttresses above small pockets found above the bars.

• The Coffin Bone-shaped like a hoof-held in place by the sensitive lamina and the insensitive lamina, which form a bond-separation of these can cause rotation of the coffin bone as is found in Laminitis.

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• The Navicular Bone-a small bone that fits in the space between the short pastern and the coffin bone. The surface at the back of the navicular bone is covered with smooth cartilage, which aids in the movement of the flexor tendon, which passes over it-degeneration of the navicular bone and the protecting cartilage results in Navicular Disease.

• The Lateral Cartilage-wings of cartilage on either side of the coffin bone-contributes to the elasticity of the hoof-absorbs shock by spreading on impact-calcification of the cartilage (thought to be caused by excessive concussion) results in Sidebone-shock absorbing qualities compromised-lameness may result.

]]> http://www.equisearch.com/uncategorized/understand-horses-hoof/feed/ 0 http://www.equisearch.com/horses_care/health/lameness/ringbone_050903/ http://www.equisearch.com/horses_care/health/lameness/ringbone_050903/#comments Fri, 09 May 2003 16:51:00 +0000 admin http://www.equisearch.com/ringbone_050903

Some breeds, including Thoroughbreds, are practically immune to ringbone and sidebone.

That some breeds and types of horses (Thoroughbreds, most notably) appear practically immune to ringbone and sidebone, and other breeds and types (drafts and warmbloods, for instance) have more than their share of pastern bulges would seem to indicate an inheritable condition. But the prevailing wisdom sees the heritability in terms of conformational predisposition, not direct genetic cause and effect. In other words, certain limb constructions concentrate strain on the pastern, and, given a little encouragement by occupation or inappropriate farriery, inflammation and tissue changes eventually happen.

The following conformational shortcomings put the lower limb at risk:

• Upright pasterns increase concussion experienced by the pastern joint, raising the possibility of high ringbone.
• High heels and short toes, especially in conjunction with a "choppy" gait, encourage low ringbone by stressing the extensor tendon and suspensory attachments at the front of the foot.
• In toed-in or toed-out legs, the joints, soft-tissue attachments and collateral cartilages are stressed unequally, contributing to sidebone on one quarter, "true" ringbone on the overstressed aspect of the joint and periarticular ringbone where tendon and ligament anchors pull at their insertions into the bone. Toeing in or out and being base narrow or base wide are the variations to beware of.
• Faulty joint design, in which the surfaces of the long and short pastern bones don't correspond precisely to each other or the central ridge of the short pastern bone is too low, has been described as a contributor to ringbone. The imperfect or insecure matching of the two bone ends allows excessive wear of the phalangeal joint surfaces.

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Most cases of sidebone and ringbone occur in the forelegs, where concussive and weight-bearing forces take special advantage of a compromised pastern and where even accidental blows seem to occur more often. However, high ringbone occasionally shows up in the hind pasterns of horses under age 3, an expression of the same developmental orthopedic disease (DOD) that more commonly produces osteochondrosis in the stifle or hock joints. In these cases, nurture, in the form of diet, plays a big part, but genetics also may be a factor.

Excerpted from "Pastern Problems" in the March 1997 issue of EQUUS magazine.

For more on ringbone, see the June 2003 issue of EQUUS magazine.

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