Tag: podiatry
Featured in The Plaid Horse, Pony Edition of August 2021 Issue
The old adage “no foot, no horse” is undeniably one of the truest statements when it comes to the horse. Many intricate structures compose this foundation, and the overall health of the hoof is paramount. So, what happens when a portion of your horse’s hoof is suddenly missing?
Owners Josh and Laura Gross found themselves in this predicament when their barn’s owner, Ayriel Italia, called them to say that their daughter’s Welsh pony had cut herself and needed immediate medical attention. While in the paddock, Blue Melody – known as Melody – had gotten her left hind hoof underneath the gate and suffered a serious laceration.
“We were initially frantic without more information,” recalled Josh. “We consider Melody a family member, and her rider is an eight-year-old.” The self-professed novice horse-owner parents had been learning the ropes of equine health and care through supporting their young daughter Saylor’s passion for horses. They turned to the expertise and guidance of Italia and trainer Shanna Sachenbacher, who immediately called veterinarian Dr. Kathleen Timmins of Palm Beach Equine Clinic.
Upon arriving at the barn, Dr. Timmins saw that Melody had an approximately two-inch-wide section of her hoof missing.
“A full thickness portion of the lateral hoof wall and the coronet band had been completely excised,” described Dr. Timmins. “It was a deep wound that exposed the sensitive laminae of the hoof. Thankfully, a thin section of the weight-bearing portion of the hoof distal to the laceration was spared, and the wound did not go deep enough to communicate with the distal interphalangeal joint or the coffin bone.”
The sensitive laminae are an interlaced network of connective tissue, nerves, and blood vessels beneath the hoof wall. This highly-vascular layer attaches to and protects the coffin bone. Injuries to the coffin bone or joint structures can be devastating, often with long-term effects on the horse’s soundness and on the development of the hoof. In Melody’s case, Dr. Timmins found the laceration to be “more bark than bite,” as it did not affect those critical structures. Although Melody would likely have some degree of abnormal hoof growth from the damaged coronary band, Dr. Timmins had an encouraging prognosis for the pony.
“Dr. Timmins was so responsive that by the time we arrived at the barn to fully learn what had happened, the wound was already cleaned and wrapped, and we were told that Melody would make a full recovery,” explained Josh.
After an initial assessment and treatment of the wound at their barn, Melody was brought to Palm Beach Equine Clinic so that she could be observed and receive comprehensive medical care. Intravenous antibiotics were administered, and the laceration was thoroughly cleaned and bandaged with an added frog pad to support the hoof. Melody progressed well and was able to be discharged only 48 hours later. Along with a lesson in proper cleaning and wrapping of the wound, Dr. Timmins gave Melody’s owners and caretakers antibiotic and nonsteroidal anti-inflammatory medications. She also recommended a biotin supplement to aid in healthy hoof growth and advised that Melody would benefit from a few weeks of shoes with clips, which would provide lateral support to the section of the hoof wall that lost integrity.
With a full team supporting Melody’s recovery, the injury and medical care become less daunting to the Gross family. Only two weeks after the laceration, the wound showed great improvement, and Melody was able to be shod and very lightly worked. Four weeks after the injury, Melody received the green light from Dr. Timmins to resume full work with Saylor in the saddle.
“Dr. Timmins’ responsiveness and calm demeanor made all the difference. She put our minds at ease, took great care of our extended family member, and helped her get back on her feet (hooves!) more quickly than we expected.”
Josh Gross
Injuries to horses’ legs and hooves can be unnerving. Having a veterinarian immediately assess an injury and determine if it affects any vital structures is crucial for recovery. In case of an equine medical emergency, do not hesitate to call the veterinarians of Palm Beach Equine Clinic at 561-793-1599.
Put Your Best Foot Forward
How to Keep Horses’ Hooves Strong Through Summer
Read this article on The Plaid Horse
Proper hoof health is hard to achieve any time of year, but during the hot summer months, a solid, healthy hoof is even more difficult to attain due to an increase in moisture in the environment. Each July, the American Farriers Journal dedicates a week of the calendar to recognize farriers for their dedicated commitment to delivering hoof care to horses. To honor our hoof care experts, we spoke with veterinarian and farrier Dr. Stephen O’Grady on how moisture contributes to a weaker hoof infrastructure and offers steps owners and managers can take to help keep moisture away and strengthen horses’ hooves.
Summer can bring scorching temperatures, so we tend to use more water to keep horses cool, both at competitions and at home. In many areas of the country, the humidity levels also increase during this time of year, adding moisture to the air and preventing hooves from drying as quickly. What happens to a hoof with excess water is similar to what would happen to a wooden plank that’s placed in a water trough: it becomes waterlogged, then softens and becomes weaker as a result.
Within a horse’s hoof, there is an exchange of fluids between the outer hoof wall and the inner section of the foot which consists of the bone, blood, and soft tissue structure. This fluid gradient helps keep the hoof wall healthy and promotes overall hoof health. When there is excessive moisture on the outside of the foot, the fluid gradient shifts toward the hoof wall and becomes overloaded with moisture, thus, the foot becomes saturated and the interchange of fluids is no longer effective, affecting a hoof’s mechanical properties.
The lack of flexibility caused by excess moisture creates a softer foot, which ultimately, as the weight of the horse presses down on the hoof, leads to issues such as flattening of the sole, flaring of the hoof wall and hoof wall cracks. A soft foot is also prone to losing shoes, due to its inability to hold nails well. The hoof structure was not designed to withstand as much water as we often subject it to during the summer months. However, there are ways to limit exposure to moisture, even in the hottest temperatures.
It is best to tackle issues that accompany moisture by going straight to the source and minimizing the amount of water that comes in contact with the hooves. This can be accomplished in several ways:
1. Give your horse fewer baths.
Cutting down on how many times per day a horse is hosed can be difficult with competition horses that need to stay clean and that may be exercised, ridden, or shown several times per day. Still, it is important to be strategic about using water, especially on the legs. At home, try to occasionally let your horse air dry in front of the fan if a bath isn’t entirely necessary. Body clipping will help your horse’s heat tolerance this time of year and you may not have to use the hose after every ride.
2. Avoid standing water
If you must bathe, be sure the horse isn’t standing in excess water that rises over the hoof capsule. Try to shower off the horse in a dry area so the surface underneath the horse does not contribute to the moisture level. After being bathed, move the horse to a dry surface so their hooves can thoroughly dry.
3. Use hoof shields to direct water away from the hoof.
A good preventative tool to use while hosing is tight-fitting bell boots that cover the hoof and prevent external water from running down onto the hoof. The same effect can be accomplished with a gallon-sized Ziploc bag. Simply cut the bottom of the bag, place the horse’s foot inside, and seal the bag just below the fetlock to prevent excess water from sliding down the hoof.
4. Stand the horse in sawdust.
Sawdust and similar materials have a drying effect on hooves. If hooves become saturated for any reason, let the horse stand in deep sawdust to extract the moisture. Shavings would work also, but sawdust is the most effective for absorbing moisture.
5. A shellac-type hoof dressing product can help prevent the hoof from absorbing too much water if applied before baths or turnout.
The majority of hoof dressings are intended for this purpose, however. Ask your farrier or veterinarian to recommend options that will do the job when used one to two times per week. Boric acid powder can also be applied to horses’ feet once or twice a week, serving as an astringent for the hoof.
6. Avoid turning out early in the morning.
When humidity is high, the grass at dawn will have a high dew level, meaning horses will be standing on wet surfaces during the first hours spent outside. Though temperatures are cooler as the sun is still rising, for overall hoof health it’s best to wait until the grass has dried.
7. Farriery may need to be changed during the summer months to compensate for the increase in moisture.
Open the lines of communication between veterinarian and farrier. Veterinarians and farriers often do not communicate regarding a particular horse. This is a crucial step to ultimate hoof care. Each professional has a reason behind their decisions, and if the two work together as a team, the horse has a much higher chance of achieving optimal hoof health than if they each operated on their own agenda.
Achieving a healthy hoof is not solely a farrier’s job; it is a whole team effort and requires dedication and attention. By implementing these recommendations into your horse care routine, you can play a role in how moisture affects your horse’s hooves. When considering the effects of excessive moisture on the hoof wall, it’s important to understand there are other factors involved, including the age of horse, breed, genetic makeup, foot conformation, and current farriery practices. With open communication and implementing these measures as a team, you are on the right track to achieving a stronger and overall healthier hoof.
Foot soreness, especially for jumpers, become more noticeable as the winter equestrian season winds down in Florida, according to well-respected veterinarian and farrier Dr. Stephen O’Grady of Palm Beach Equine Clinic.
Foot Soreness Issues Surfacing Toward the End of Winter Competition Season
Dr. O’Grady has been treating horses for 45 years across the country. He also travels extensively all over the world, teaching and training other veterinarians and farriers on therapeutic farriery solutions. It’s obvious to Dr. O’Grady why foot soreness and problems are more common later in the horse show season.
“When horses arrive in Wellington, Florida, in December, foot care starts with bar shoes, pads, pour-ins, etc. as a form of prevention for the busy three months. Perhaps it would be more appropriate to start the competition season by doing a conservative trim, leave horn on the bottom of the foot, and make sure the proper size shoe is selected. The various farrier products may actually add pressure to the structures in the beginning of the season” says Dr. O’Grady.
“When it comes around to March, the structures of the foot have been compromised by the intensity of the competition schedule. The protective farrier products have already been used and there’s nothing more to absorb the shock and energy at the end of the season.”
Preventing Foot Soreness in Competition Horses
Dr. O’Grady adds that it is okay to use different medications and anti-inflammatories as long as the proper dosages and rules are followed as prescribed. But to properly fix foot problems, he has one sure solution.
“Time is the best cure,” Dr. O’Grady says. “The feet are the slowest structures on the horse to recover. There isn’t a magical fix.”
However, Dr. O’Grady has an idea that might help if you cannot give your horse sufficient rest despite the numerous classes and repetitive nature of the show schedule.
As the season wears on, whether it’s WEF or HITS, Dr. O’Grady believes that decreasing the amount of warm up, schooling and lunging makes a world of difference in protecting the hooves.
“But if the feet are sore, the feet are sore,” adds Dr. O’Grady. “There’s no quick fix. It’s all about prevention.”
Snowballing Effects of Foot Soreness
Sore feet can cause numerous problems elsewhere, according to Dr. Robert Brusie, head surgeon at Palm Beach Equine Clinic.
“The horses with sore feet tend to land funny, which can cause strained suspension ligaments or tendons,” says Dr. Brusie. “There also could be sore heels. Sore feet tend to make them short-strided and that could lead to a sore back and or a sore neck.”
Dr. Brusie says one way to notice a horse with sore feet, especially among jumpers, is their reluctance to jump the fences.
“That can be hard on the riders, too,” adds Dr. Brusie.
The foot is the closest to the environment and if you have a sore-footed horse, it could lead to lameness and poor performance, according to Dr. Brusie. Another possibility that could lead to sore feet is being too wet.
“Horses that are to show or play (polo) sometimes get two or three baths a day,” explains Dr. Brusie. Coupled with rings that are sprayed with water to help the footing can lead to problems, he said.
Both Dr. O’Grady and Dr. Brusie believe that taking proper care of your horse’s feet early helps the horses in the long run by eliminating other problems.
Palm Beach Equine Clinic is proud to be the Florida distributor of DJM Sole Supports. DJM Sole Supports can safely be used to give instant relief for many common hoof ailments in horses. They are especially helpful for horses suffering from laminitis, punctured soles, infections, foot abscess, pre- or post-surgery support, foot and heel soreness, sole pressure related issues, barefoot trims and extra support to travel long distances.
Facts about DJM Sole Supports
DJM Sole Supports are 100% breathable, easy to apply and provide instantaneous relief due to uniform support for the entire foot. The supports can be used in conjunction with any medicated gel to help an injury or infection. Once the pad has formed its shape, it will not alter.
The supports can be washed in warm salty water, allowed to dry naturally and reused for up to two weeks. The pads can also be left on for several days at a time. However, if there is a discharging wound, the pad should be removed, cleaned thoroughly and reapplied every 24 hours.
The DJM Sole Support engineering was developed by farrier David Mangan, who now solely devotes his time and knowledge into designing innovative products for horses. The Sole Support is unique and superior to other products due to its patented composition. When a horse’s foot is sore and inflamed, the sensitive laminae swells, causing pain from any load or movement. The DJM Sole Support aids in reducing the sole’s movement, evenly distributes the pressure and minimizes the downward movement of the sole from loading.
Proper Application of a DJM Sole Support
Proper application of a DJM Sole Support will give rapid relief to the horse in a majority of cases. In the case of Laminitic horses, DJM Sole Supports can provide relief by supporting the sole to reduce the pull of sensitive inflammatory tissues (Laminae) as it separates from the hoof wall. Sole Supports can also offer full protection and comfort while travelling long distances by trailer or plane. Horses that are preparing or recovering from surgical procedures can benefit from the use of Sole Supports to reduce the loading on supporting limbs and stabilize the injured leg. In cases where horses suffer from corns or stone bruises, the Sole Support can reduce inflammation, provide protection and comfort with, or without, a shoe. The supports will also give instant relief to horses that are sensitive to shoeing and typically require a few days to recover. The sole supports are an excellent, clean alternative to “hoof packing” after a hard day’s work. Additionally, for horses that have lost a shoe and rely heavily on those shoes for soundness, the Sole Support may be used to protect the foot while waiting for the farrier to arrive.
DJM Sole Support pads are available in three sizes to fit most horses.
If the pad is larger than the foot, it is safe to allow excess to cover the heels and or provide a rolled toe. The support pads are available in either “soft” or “firm” types, with the softer compound more suitable for the very tender footed horse.
Always on the forefront of medical advances, Palm Beach Equine Clinic is proud to distribute DJM Sole Supports in Florida. For more information, please visit https://paniolo.online/product/sole-support/ or call the experts at Palm Beach Equine Clinic at 561-793-1599.
A 12-year-old show jumper is moving nicely just 2 months after laboring to walk.
Palm Beach Equine Clinic Staff Surgeon Dr. Weston Davis operated on a severe lameness case on July 5 that had quickly progressed into an emergency situation.
Evaluation and Diagnosis
Annabelle was referred to Palm Beach Equine Clinic for advanced imaging and evaluation of severe subsolar abscessation in the Holsteiner mare’s left front foot that was not responding to aggressive therapies.
She was diagnosed with infectious pedal osteitis in the left fore and early stages of support limb laminitis in the right fore. Pedal osteitis is an infection of the coffin bone. Annabelle previously showed in the Adult Jumpers with her owner, Jennifer Knobel, but the infection had advanced to the point that she could barely walk.
Local veterinarian Dr. Kim Snyder vigorously managed Anabelle’s foot condition in the field before referring the case to Palm Beach Equine Clinic. She performed digital radiographs at the farm, but they failed to adequately define the lesion. She requested an MRI study of the foot to more accurately image the underlying causes of the persistent foot abscess, such as a foreign body, bone infection, sequestrum, or tumor.
Advanced Medical Imaging Technology
As the radiographs were not definitive enough alone, the team at Palm Beach Equine Clinic used their state-of-the-art MRI technology for a more detailed analysis. The MRI showed excess fluid and severe inflammation within the coffin bone. The infectious pedal osteitis had caused the bottom of the coffin bone to begin to deteriorate. Worsening the situation, Annabelle was reluctant to bear weight on her left foot. Then she developed mild laminitis in her right foot due to the increased load on the supporting limb to relieve pressure. The development of support limb laminitis determined the emergency status of the left fore lameness as laminitis could be a fatal complication.
Dr. Davis and the team at Palm Beach Equine Clinic took immediate action using the MRI scans for accurate surgical mapping. The MRI study documented exactly where the infectious pedal osteitis was located. This mapped position was used in comparison to the previously taken radiographs. Both imaging modalities were used intra-operatively to guide Dr. Davis precisely to the area of infected bone.
Surgery and Recovery
Annabelle was placed under general anesthesia, and the left front limb was prepared for surgery. A 5 cm long x 3 cm wide window was cut through the sole down to the surface of the coffin bone, through which the necrotic (infected) bony tissue was removed. Prior to recovery, the surgical site was packed with antibiotic powder and a full distal limb bandage was applied. Additional support of Soft-Ride boots and sole supports were positioned. Medical grade maggots were applied to the foot the day after surgery to safeguard absolute full debridement of all necrotic/infected tissues.
Annabelle was placed on a range of antibiotics. Pain was managed with local nerve blocks and anti-inflammatory medications. Her pain improved rapidly in the operated left limb and signs of laminitis in the right fore resolved as well. During her stall rest recovery, the foot was soaked routinely in Epsom salts. Betadine soaked gauze was applied over the frog and surgery site each day and the hoof was wrapped for protection.
Snyder continued to care for Annabelle in the post-op period. Synder’s husband and farrier, Jim Gilchrist, applied a shoe with a treatment plate to protect the bottom of the foot. This allowed for routine access by removal of three simple screws.
The initial cause of the abscess or why the infectious pedal osteitis progressed so aggressively is still unclear. Dr. Davis speculates that it was possibly a spontaneous abscess and for whatever reason, whether the depth into the foot or the presence of a highly infectious bacteria, Annabelle was just unlucky. Instead of draining like a “normal” abscess, this particular case established an infection within the bone. This made it impossible to clear the infection with even the most aggressive medical therapies apart from surgical removal.
Annabelle’s infectious pedal osteitis has cleared and her hoof is healing well. Now she is walking sound and has a favorable prognosis for further improvement with hopes of eventually return to work.
Thoroughbred Brazilian Triple Crown winner Bal a Bali was admitted to Palm Beach Equine Clinic on August 3, 2014. The elite athlete was treated for life-threatening laminitis by board-certified surgeon Dr. Weston Davis of Palm Beach Equine Clinic, in conjunction with Dr. Vernon Dryden, just months after his Triple Crown win in March of that year.
Brazil’s 2014 Horse of the Year, Bal a Bali (Put It Back—In My Side, by Clackson) took an impressive win in the Grande Premio Cruzeiro do Sul (Brz-I) to become the country’s 12th Triple Crown winner. He finished the race in track-record time at Gavea racecourse.
Following his last start in June 2014, Bal a Bali was purchased by Fox Hill Farm and Siena Farm and imported to the U.S. in late summer, but unfortunately suffered from laminitis brought on during his travels. Bal a Bali was in a Florida quarantine center scheduled to fly to trainer Richard Mandella’s stable in California when the problems developed.
Bal a Bali Admitted to PBEC Equine Hospital
Bal a Bali was quickly moved to Palm Beach Equine Clinic in Wellington, Florida, where he was received by Dr. Weston Davis, who would oversee his care in the equine hospital for the next three months. Palm Beach Equine Clinic set aside an entire section of the hospital barn as a quarantine unit to meet the horse’s final import requirements while he was treated with aggressive cryotherapy – a gold standard of laminitis care. Hospital staff carefully monitored Bal a Bali and treated him with consistent cold-water spa treatments for several days throughout the severe acute phase of this disease. He was gradually weaned out of the spa as he improved clinically.
On two occasions, Dr. Davis performed intravenous regional perfusions of the horse’s feet with advanced stem cell treatments. A myriad of other medical therapies were administered throughout his stay. The progression of his laminitis was closely monitored with the use of diagnostic imaging and meticulous farrier care. Farriery care included ensuring optimal sole support and proper mechanics to decrease strain on the fragile lamina. By October, the horse was cleared to travel to Siena Farm in Kentucky. There, Dr. Dryden continued to treat the horse and he was then flown to California in January.
Winning his Battle with Laminitis
After a nine-month recovery process, Bal a Bali made a miraculous return to the track for his North American debut in May 2015. He cruised to victory in the $100,000 American (G3), a one-mile turf race for three-year-olds and up at Santa Anita Park. At that point, the five-year-old had captured 12 of 13 career starts and earned $570,078.
Bal a Bali’s comeback was no doubt a result of the outstanding care he received at Palm Beach Equine Clinic under the extraordinary supervision of Dr. Weston Davis and Dr. Vernon Dryden.
Thank you Fox Hill Farm and Siena Farm for the trust you placed in Palm Beach Equine Clinic.