EasyCare:Horse Hoof Problems. Submitted by Devan Mills, EasyCare Customer Service Representative. The equine world is very diverse, as you all know.
A lot of comment is made about 'long toes' and many a poor horse has had their toes dumped or worse in an attempt to correct a problem by addressing a symptom without.
Fig. 3. Dorsal view: the hoof should be symmetrical. A line drawn between any two comparable points on the coronary band should be parallel to the ground. The hoof should be symmetrically related to the distal limb such that a vertical line should bisect the third metacarpal bone, the pastern, and the hoof (courtesy of Dr Andy Parks). Fig. 6. Conformation of the foot as it relates to the digit can be depicted with a triangle. A line drawn down the dorsal surface of the pastern and hoof is the hoof-pastern axis. A vertical line that bisects the third metacarpal bone should intersect the ground at the palmar aspect of the heels of the hoof capsule. Connect these two lines with the angle of the dorsal hoof wall and the ground surface of the foot to form a triangle (courtesy of Dr Andy Parks). First, the foot-pastern axis describes the relationship between the angles made by the dorsal hoof wall and the dorsal aspect of the pastern with the ground. Ideally, the dorsal hoof wall and the pastern form the same angle with the ground so that the angle between them is 180° and the axis is considered straight. Second, an imaginary line that bisects the third metacarpal should intersect the ground at the most palmar aspect of the ground surface of the hoof. These two guidelines used in conjunction with the angle of the dorsal hoof wall and the ground surface of the foot combine to form a triangle of proportions that represents the relationship between the hoof and the distal limb regardless of the size of the horse (Fig. 6).1 Evaluation of the hoof capsule from the side view should begin with the coronet as this structure can provide very useful information. The healthy coronary band should have a gentle, even slope from the toe to the heels, and the hair should lie flat against the hoof capsule; hair projecting horizontally may indicate excessive forces on the associated hoof wall.13 The coronary band is dynamic, and its shape can be affected by chronic overloading.14 A proximally directed diffuse arch at the quarters or a focal directed arch toward the heels is evidence of chronic overloading of that section of the foot (Fig. 7). A coronary band with an acute angle at the heels relative to the ground that bends distally at the heel to form a "knob" appearance is an indication that the foot has poorly developed or under-run heels and the hoof wall at the heels has migrated dorsally (Fig. 8). Fig. 7. A section of the coronet in the palmar section of the foot has been displaced proximally (focal arch). Note the relationship of the heel of the shoe and the origin of the defect, which denotes excessive load. The foot on the right shows a change in angulation of the horn tubules, curvature of the growth rings, and a proximal displacement of the coronet (dorsal arch). Fig. 8. Foot with under-run heels showing the "knob" appearance. Note the curve in the growth rings as the heels migrate dorsally. There will often be a depression ("thumbprint") showing the extent the heels of the hoof capsule have migrated forward (arrow). Palmar view shows the decrease in structural mass of the digital cushion. Fig. 9. Clubfoot. Note the coronary band has lost the slope and is almost parallel with the ground. Also note the flare in the dorsal hoof wall. A coronary band that is horizontal relative to the ground and often accompanied by a flare in the dorsal hoof wall would denote an upright or clubfoot conformation (Fig. 9). Asymmetry of the height of the coronary band in the quarter/heel region on one side occurs when the horse develops a "sheared heel," a hoof capsule distortion resulting in proximal displacement of one quarter/heel bulb relative to the contralateral side of the foot.15 The medial heel bulb/quarter is more commonly displaced proximally, as it is more common for the foot to be offset laterally. The angle of the coronary band can be used to estimate the position of the distal phalanx within the hoof capsule. One study described the angle of the coronary band of apparently normal front feet to be 23.5° ± 3°.16 If the angle of the coronary band is >45°, the plane of the solar margin of the distal phalanx will decrease. At the other extreme, a coronary band parallel to the ground is indicative of a high palmar angle, which is often associated with a club foot or rotation of the distal phalanx. The width of the growth rings below the coronet should be equal from toe to heel. A disparity in the width of the growth rings between the toe and the heels is indicative of non-uniform circulation of the coronary corium or excessive forces below because wall growth is generally inversely related to load. An example of this disparity would be chronic laminitis typified by more horn growth at the heels than toe growth. However, regional irregularity in spacing of growth rings is not uncommon; the most frequently observed is a decrease in spacing at the quarter associated with proximal displacement of the coronary band as noted with sheared heels.10 The angulation of the horn tubules from dorsal to palmar should be noted because horn tubules that are parallel with the ground in the heel area are associated with under-run heels. Flaring or concavity of the dorsal hoof wall accompanied by underrunning of the heels is readily appreciated from the lateral side. The presence of hoof wall flares or cracks are often caused by chronic, excessive overloading of the hoof wall in the region in which these defects are found.10,11,14,17 Vertical cracks in the quarter are more likely to occur with a sheared heel. Horizontal cracks are usually the result of a disruption of production of horn caused by coronary band trauma or when a subsolar infection ruptures at the coronary band. 7. Palmar Aspect The heels are evaluated from the palmar aspect for their overall width and height. The heels frequently become narrowed when the foot itself is narrow. Additionally, the central sulcus of the frog may extend proximal to the hairline so that a cleft becomes apparent in the skin of the pastern between the heels. The overall height of the heels is readily assessed from the lateral aspect, but viewing from the palmar aspect is useful to compare the relative heights of the two heels. For example, in the case of the sheared heel, one heel is displaced proximally in relation to the other. Another example is mismatched feet in which there is a marked disparity in heel height. The contour of the junction of the heel bulbs with the skin can be evaluated relative to the width of the hoof wall at the heels and the thickness of the digital cushion (Fig. 10).
1. Introduction. Palmar foot pain is thought to be the most common cause of lameness in the horse. 1 The diagnosis of palmar foot pain using palmar digital perineural.
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