Eva and the frog

Eva will be going home at the end of this week and its about time for a recap on her feet and their progress. When she arrived her veterinary report stated she was 3/10 lame RF and this was supported by MRI which showed a severe DDFT tear running from mid-pastern to insertion.

The MRI report gave her a poor prognosis and had recommended extended box rest as the best means of improving her lameness but her owners and vet felt that this would not be suitable for her - and having had her living here for the last 3 months I think they were quite right! 

Eva had been shod with remedial shoes and pads but they had not been successful in improving her soundness. From this angle its interesting to notice that the shoes are distorting the loading of her foot, particularly the medial side, which looks as if it is collapsing.  

By comparison, her foot today (at the top) is loading much more evenly and this is reflected in her improved soundness. It also looks a whole lot healthier today. 

This is the same foot part way through her rehab. With the shoes off you can see the split in the central sulcus which is often a by product of long term shoeing and heel contraction. Its harder to spot when a horse is in shoes but its always a cause for concern. 

Lots of time on good surfaces which are supportive but stimulating has enabled Eva's hoof health to improve dramatically. The photo at the top and this one - from today - are 14 weeks apart. With injuries like hers its absolutely essential that the horse is on comfortable surfaces and has support. Equally without stimulus the palmar hoof will be slow to develop, which is where our tracks are critical.

These shots are interesting because they show how long her toe was in shoes. The wedged heel and pad were intended to "support" the heel but in fact a more effective way to provide that support was to take the shoes off and allow her to build a stronger palmar hoof using the tracks and surfaces here. 

Compare the profile of her foot today. The toe is shorter, the heel less underrun and the hairline is no longer distorted. Instead of teetering toe first on her wedged shoes she is planting her foot solidly heel first. 

And here we go with the sole shots...day one...

...part way through...

...and today. The frog has massively improved, as you can see, but equally important is the better medio-lateral balance. I tend to think that this is the best angle for assessing hoof balance, as looking at it from the sole gives you the clearest idea of how the foot is loading on the ground.

Here are her sole shots from a few days after shoes (on the left) and today. The red line is the mid point of the frog and the green line middle of the heels - together showing where the hoof is loading. 

I hope you can see that the load in the recent photo (on the right) is more balanced and that the heels are much further back and more supportive. Of course its not perfect yet as she still has several weeks of hoof capsule growth to go before all the old hoof is grown out but its heading in the right direction.

These shots illustrate that good hoof balance looks very different from the sole, as compared to from the top of the hoof (where we are more used to judging feet). On the right, her foot is loading better and is more supportive of her limb instead of being twisted and overloading medially.

Of course, this has led to much improved soundness, as I reported a while ago, with footage of her on a circle looking very much better.

The boys done good!

Despite the lack of anything approaching real summer, the rehab horses who've gone back home have been pretty busy. Great updates have come in on several of them today...

First up, Nikki and Dom:

"Just wanted to give you a quick update on Domino from our flatwork clinic today! I went in expecting it to be pretty terrible if I'm honest, more because we haven't had any lessons in years but I think Dom must have decided to show me what he can do with his new hooves because it was amazing! 


He did some lovely trot work, tracking up really nicely and using himself properly without me even really needing to ask him. We had a couple of lovely canters resulting in the instructor, who used to teach us as well as schooling Dom herself a few times a week, saying she's never seen him move so nicely. The best canter she's seen him do and he looks really comfortable and happy!

These comments coupled with some lovely positive words from a fellow livery who was watching, and the comments from his osteopath saying he's never felt better to her either make me so glad I sent him to you back in February. I cannot thank you enough for setting us on this road and you can rest assured that I will continue to do everything I can to keep Dom as happy in himself as he is right now.

I have a supercob and I'm determined to take him out to do a dressage test at the beginning of August so watch this space for updates! So proud of him and all that he is and can do. "

Its always lovely when a physio/osteo/chiro who has worked on a horse for many years and knows them well re-assesses them after rehab, and great when instructors also notice how much better horses are moving on comfortable feet :-) Way to go Nikki, and lovely to hear about your and Dom's aims for the future - a supercob indeed!

I have also heard that Ginger is still on top form - he has not only qualified for the North West Showing Championships with Richard but Danielle has been jumping with him for the first time in 2 years - he went clear, of course :-)

And last but not least, Mr Knightley is looking good in his new home in Shropshire - here showing off for Debbie when she went to visit!

Logical conclusions

Steve Leigh sent me a great article yesterday. It highlights new research that has been done by Northumbria University (if you click on the photo you can enlarge it for easier reading or there is an e-version thanks to Matt Thompson here) comparing biomechanics for runners in shoes and  barefoot. The prof behind the research himself ran the Great North Run barefoot - you have to love a man who is speaking from experience :-)

There are lots of interesting aspects but the study found that - barefoot - runners used less energy and had better biomechanics. There was less impact on joints, shorter stride lengths and less time spent in contact with the ground than when in shoes.

Interestingly, the same day as Steve sent me this, I was also sent by M's owner a piece published by a veterinary hospital entitled "Barefoot trimming [!] vs conventional farriery". It wasn't research but a report of a meeting where a leading farrier stated that shoes were necessary "to provide protection, to provide grip and for remedial purposes".

Now, you and I are well aware that shoes aren't a pre-requisite for any of these functions. But what also struck me about the report was that although there was a call for research into barefoot, there was no similar call for research into shoeing.

I am not aware of any studies in horses which measure biomechanics in the way this human study did, but since the Northumbria research indicates that shoes hinder, rather than enhance, human biomechanics let's jump to our first logical conclusion.

Let's assume just for a moment that shoes affect horses in a similar way as humans (personally my suspicion is that horseshoes have a worse impact because they are generally made of inflexible materials and are kept on for extended periods, but that's just my hunch).


Let's therefore assume that barefoot horses benefit from performing without shoes in the same way that human runners do - fewer injuries, less concussion on joints, more efficient locomotion. 

Now let's look at some of the published research into horses with the types of injuries that we rehab here - primarily navicular bone, DDFT, impar and collateral ligament damage within the hoof.

Previously research indicated that horses with these injuries have a poor prognosis for returning to work. In 2009 Jane Boswell of Liphook Equine Hospital reported to the BEVA congress (10th September 2009) that in a follow up study of horses shown on MRI to have DDFT lesions only 10% had returned to their previous level of work; 40% had suffered persistent lameness and 50% were sound but only in light work.  In an earlier study [Dyson, S., Murray, R. and Schramme, M. (2005) Lameness associated with foot pain: results of magnetic resonance imaging in 199 horses (January 2001-December 2003) and response to treatment. Equine vet. J. 37, 113-121], less than 30% of horses with DDFT/collateral ligament damage returned to the same level of work; where the damage extended to the navicular bone only 5% of horses returned to work.

Its because of figures like this that there is a common assumption that these conditions are degenerative and usually get worse over time.

Our research is showing a more encouraging picture; in the abstract submitted to this year's BEVA congress (which was the last time our results were updated) 85% of rehab horses had returned to the same level of work, despite many of them having arrived with damage to the navicular bone and DDFT/collateral ligaments. Of course, for most of our horses, conventional treatments had already been tried unsuccessfully.

In view of the Northumbria research into human runners, as well as our own rehab results, and in the absence of research showing that shoeing horses has a rehabilitative effect, perhaps there is another logical conclusion we should be researching: not that these conditions are inevitably degenerative, but that shoes could be exacerbating rather than improving these conditions?


ETA: I'm apparently not the only one who is wondering this...This conversation was reported to me a few weeks ago:

My new farrier told me recently that X had great feet and asked if I wondered whether I should have taken his shoes off earlier.
"Why do you ask that?" I said.
"Well, horses are better off without shoes" he replied.
"Eh?" I said (thinking he was taking the proverbial).
"Well" he said "Of course, driving six to eight nails into their feet every six weeks is going to ruin them at some point".
"Erm, I am confused" I said "Why would you be telling me this when its your business to shoe horses".
"I am a barefoot runner myself, only using thinly soled running shoes when doing marathons so I know that barefoot is more natural and better for humans and the horse" he declared."And if its the money you think I would be worried about - well, I am not as I make as much profit by doing a quick rasp or minor trim as I do shoeing a horse when you consider the time involved and the cost of the shoes."
"So, why do so many people shoe their horses?" I asked "Is it a bit of 'follow the crowd'?"
"Absolutely" he said.

This speaks for itself...

A lovely update on Bryan. Who said 17.2hh warmblood showjumpers couldn't go barefoot...?!

New girl Candy and more on Legend...

New girl Candy arrived in terrible weather on Monday - luckily she is from the west of England so the rain will not be too much of a shock for her, but I expect better of even Exmoor in July...

In a contrast to the vet I wrote about last week, her vet has been very supportive from the first, which is lovely. In another good omen she is the first "NFU" horse to arrive since the Ombudsman's decision and they have already confirmed her rehab will be covered - great news, and thanks again Catherine!

Candy is 17 and has been shod for many years though she came out of shoes a few weeks ago. Her heels and frogs are weak and the black patterning on her soles is a hint that she has probably had sole damage too.

On MRI not surprisingly she has navicular bone damage as well as DDFT and impar ligament damage.

From this angle you can see the beginning of a better angle change but interestingly she came out of shoes on the same day that Legend arrived here. If you compare his hoof growth over the same period (which I blogged yesterday) to hers, you can see that she is a lot slower - in fact the nail holes are still visible in her feet, which I would expect to see gone normally in about 6 weeks.

Our job then is to speed up the rate of improvement and enable her to grow a much stronger palmar hoof. More on Candy soon!


Meanwhile, I wanted to include Legend's footage which I forgot to add to yesterday's blog...

Its interesting to see how his landing has changed - he is now landing heel first but his long flipper toe is impairing his movement though it is getting better all the time.

For all the reasons I posted about yesterday, it would (IMO) be counter-productive to trim his toe at the moment but once his hoof capsule is grown in at the new angle his landing will definitely be even better.

If anyone is looking for a stunning rescue dog...

...this link has appeared on dogsblog: http://www.dogsblog.com/tulip-5/

You may have seen that we have a fab new addition to the Rockley gang, whom we picked up last week from NW Vizsla Rescue. He is the most affectionate dog you could ever meet and is proving to be an absolute joy (though clueless so far about livestock - like this girl, but its fun to have a training challenge!).

According to Helga, who rescued our boy, this is likely to be his sister so if anyone is looking for a stunning new family member (big, gorgeous and uber-cuddly) then you should go and check her out in Southampton pronto.

This link is also a pretty awful indication of what happens when backyard breeders churn out puppies with no care or thought for their futures. These 2 got lucky and ended up in rescue but who knows what happened to the others.

Feet, flippers and fallacies

Brace yourselves for some fairly dramatic photos :-)

This is Legend  - comparison photos from when he arrived (10 weeks ago) and today (below). He had been in remedial shoes until 6 weeks before he arrived and his feet had "pancaked" with mechanical laminitis  - most probably according to his vet as a result of the shoeing. 

Legend had a navicular diagnosis but the laminitis, gave him a double-whammy of problems in the back of his foot as well as in his sole and toe. Being out of shoes has already contributed to a better angle of growth for the new hoof capsule - just visible under the feathers - but in the horses here I normally see much faster changes in the first 6 weeks out of shoes.  

Once we were able to add in movement on the tracks the growth rate accelerated  - the new growth is not only a different angle but a different texture, with no ridges or rings. 

Recently (as you can see) we have had to trim his feathers (with owner's permission!) as he was getting very itchy - I need to tidy up the long bits but it does make it much easier to see what is happening with his hooves. 

Here is the RF - again when he arrived and today, after 10 weeks. As you can see, I haven't taken his toes back even though - by doing so - I could make his feet look a lot prettier and improve his breakover slightly. 

The reason I haven't trimmed him is  - I hope - much more obvious in the photos from today.

Bear in mind that this horse has had chronic long term weakness and pain in the back of his foot. He is now landing heel first and building a stronger hoof but can you imagine what would have happened if you had simply backed his toe up? 

These photos should illustrate that removing that toe - tempting though it may be from a cosmetic point of view - would tip all his weight back onto the heels.

That will be fine in a few weeks - in just about the time that he has finished growing in his new hoof capsule - but for now it would be too big a change too fast and it would overload the healing palmar structures and not only damage Legend's tendons and ligaments but hinder his steadily improving soundness. 

There is an old fallacy that the long toe will somehow lever the new growth and damage it - that just doesn't happen, because the new growth is far, far stronger and better connected than the old, stretched hoof wall. In fact the old growth wears away easily and quickly, causing few issues. 

Ironically, of course, in a few weeks time trimming won't be necessary because the new hoof capsule will be in place, with the toe naturally backed up and no need for intervention from a knife or rasp. 

Even better, he will have done this to his own schedule, giving his tendons and ligaments the time they need to adapt to the improved loading of this new hoof. 

With correct movement, but without trimming, these hooves are changing radically and very fast. These last 2 photos give you an idea of how much more substantial the frog and digital cushion are. 

Even so, they aren't yet ready to be overloaded. The frog is still well below the level of the heels and backing up the toe is very likely to make him less sound. He is getting better and more capable every day, so I see no justification in risking this. 

Sadly, I know from experience that even a mild shifting back of his breakover will be too much - if you overload the back of the foot before it can cope the horse responds by shutting down movement and landing toe first - which puts us back to square one and a movement which is stressing and damaging tendons, ligaments and bone of the palmar hoof.

I would like nothing better than to speed up the improvements in these hooves but I've learned the hard way that improvements can rarely be achieved (and rarely if ever accelerated) with a quick trim (or even a slow trim!). 

Even if the Legend's movement isn't optimal at this stage (and how could it be when he still has toes like flippers with the breakover an inch ahead of where it will be shortly) the basics - an engaged palmar hoof which can function as it should - are there and the rest will follow with time and mileage - there are no short cuts. 

I'm adding sole shots because they give an idea of how stretched his whole foot (not just the toe) was. The top photo is on arrival, the lower is today. 

You can see in the lower photo the old, damaged laminae in his white line and the "shadow" just in front of his frog is where his breakover will be - its the line of new growth in the sole. You can see the temptation to just trim off all the old rubbishy toe - but I hope you can now understand why its important to resist temptation!

I hope the photos give a much clearer demonstration than I ever could of why hooves need to change at the horse's pace (which is already pretty spectacular) and not ours.