Foot lameness

Tue 19th Mar
Helen meant to ride but once on realised he had lost shoe LH

Wed 20th Mar
Routine farrier visit - explained he had to put a couple of nails a bit high to avoid poor quality hoof.  Seemed to walk and trot fine afterwards so no concerns.  Took him SJ at MW in the evening as per previous blog entry.  No worries.

Thur 21st Mar
Flatwork schooling.  No concerns, worked well.

Fri 22nd Mar
Hack.  As I turned him onto the main road he felt like he took a couple of short steps on his LF but then felt ok so didn't think anymore of it.  During the hack whilst we were on the soft going every now and then he would take a short step like he trod on a stone except he wouldn't normally be like that out hacking.  He was still happy to piss off with me up the hill.  Back onto road back to yard and again a couple of short steps then ok again.  Very odd.

Sat 23rd Mar
Didn't ride as it snowed.  Apparently other liveries saw him looking lame LF with big ball of snow in foot but once it dropped out looked ok.

Sun 24th Mar
Dressage at Parwood as per previous blog entry.  Bit lacklustre warming up for the Novice but no soundness concerns.  Went in and won it on 71%.  Back on lorry for half hour.  Came out to warmup for Elem and definitely lame left fore on a long rein but then picked him up and he felt fine and seemed happy to work.  Took him in for test and he felt a bit weird in right canter but otherwise fine - managed 10m trot circles without any concerns over soundness.

Mon 25th Mar
Didn't ride as wanted to get farrier out to check foot before rode anymore.

Tue 26th Mar
Farrier came out.  Didn't get any reaction to hoof testers or squeezing over nail holes.  Only nail that looked like a problem was at the back on the outside of the LF so he took that one out.  Got on him after to see what he was like.  Trotted up the road ok but felt a bit off on the turn onto the ranges.  Took a really awkward couple of steps LF as we went onto the soft like he trod on something ouchy but then seemed fine.  Back onto the road and the more we trotted the more wrong he felt but never really obvious.  Took him in school and put him on left circle on long rein and he was definitely obviously lame LF.  Right circle he felt fine.  Back on left circle and still lame.  Gave him 2 bute and withdrew from BD on Sat and lesson on Sunday :(

Wed 27th Mar
2 bute morning and 1 bute evening.
Didn't assess lameness

Thur 28th Mar
1 bute in the morning and evening.
Trotted him up and didn't look quite right.  Put him on the lunge and he was obviously lame left fore on the circle.  Tubbed and poulticed as suspected something foot related.  Pulses palpable at fetlock level and heat on lateral quarter of foot.

Good Friday
Farrier came and took shoe off, couldn't see anything apart from some bruising on his frog so put magic cushion and a pad on and reckoned should be sound in 48hrs.
One bute morning and evening.
Some heat and swelling in leg now extending up to the knee.

Sat 30th March evening
Still lame so spoke to farrier who said to tub and poultice.

Sunday 31st March
Still lame, probably bit more so as now really obvious trotting in straight line.
Discussed with farrier who said probably not a lot he could do at that stage so would come out next day if no better.  Tubbed and poulticed.

Easter Monday
Really obviously lame in walk, didn't attempt to trot.  Tubbed and poulticed.

Tue 2nd April 
Stood in field pointing toe, struggling to walk so farrier out, shoe off, still nothing to see and no reaction to hoof testers except when squeezed really really hard at heel level.

So, vet visit in the afternoon.  Really really sore now shoe off, painful all over heel bulb/back part of coronary band outside LF.  Reacted to hoof testers on his heel quite obviously.  Bruising of sole evident on both heels.  Nothing to dig at though.

Advice: cont tubbing and poulticing - make poultice super soggy.  Careful about turning him out with no shoe on as such soft, flat soles.  Start back on bute 1sachet BID.  Given doxycycline 50ml BID to use once it bursts.  Ring again Thur for update.

So, kept him in for the night as didn't have electric fence battery and wont put him out in small paddock without fence being on as he likes to get tangled up.

Wed 3rd April morning
1 sachet bute
Distinctly less sore, walking more comfortably so turned him out with one of Dan's hoof boots over his poultice and he seemed comfy in that.  Just put him in 1/3 of his big paddock that he recuperated from tendon injury in with haynet and his treat ball.

Wed 3rd April evening
1 sachet bute
It was blowing quite an icy wind but he was wearing a HW rug yet shaking like a leaf from head to toe.  He looked utterly miserable so brought him back up to yard and chucked 2 extra rugs on him and he warmed up quite quickly.  Left him stabled overnight. More bute, more tubbing and poulticing.

Thur 4th April morning
1 sachet bute
Sound in walk without hoof boot on apart from one ouchy step when I turned him.  Was doing tight circles ok and marching out well.  Still noticeably lame in trot - would say about 5/10.  Obvious head nod especially on a gentle bend even with hoof boot on.  Still heat in foot and pulse in fetlock.  Still sensitive on palpation of coronary band caudo-laterally.  Did find a new bit I hadn't noticed before which was where the skin goes down to make the base of the frog there was a sore looking bit on each side, slightly worse on the lateral side - it looked quite ulcerated but strangely he didn't react at all even when I dug my nail in hard yet still seemed sensitive when I pressed his coronary band quite lightly.  Put him out in 2/3 of his little paddock.

Thur 4th April afternoon
Spoke to vet who was very surprised it hadn't burst through heel.  Suggested starting him on the Doxycycline 50ml BID and cont the bute 1 sachet BID, tubbing and poulticing.  Update again on Mon.  If still lame then consider further investigation.

Thur 4th April evening
1 sachet bute
he looked cold again despite 3 rugs - standing like elephant on tub even though not actually shivering.
He was really marching out, seemed very comfy in walk with hoof boot on.  Trotted up in straight line and could barely notice any unsteadiness of his head.
Didn't react much when poked his coronary band, nothing new to see on hoof or heel.  Leg was tight and cold - no filling today.  Pulses still present.
Doused it all in blue spray after tubbing and poulticed again.  Left him in for the night.

Fri 5th April morning
sound in walk, trotted up with overnight poultice on and a bit noddy but nothing hugely obvious.
One bute and abs given in breakfast.
Had to search a bit harder for pulses today although they were still there once I found them but maybe not quite so obvious and vein on inside of leg running down from his knee was maybe a bit less prominent although still more up than it should be.  Foot still feels warm.  Still a bit sensitive on one particular bit of his coronary band just a bit back from right above the high nail hole.  Thought a whole chunk of coronary band looked a bit darker but seems to correspond to being above a black bit of hoof so think it's just pigment I haven't noticed before.  There was a small flakey bit just above the sore area but poked at it and no reaction and didn't seem to go anywhere so probably just flakey due to being soaking wet for the last week.  Sore bit above frog hasn't changed and still no reaction to being prodded there.  Still nothing on poultice.  Tubbed, re-poulticed and turned out in small paddock with boot on.

Fri 5th April evening
Same as in the morning.
Given abs but no bute.
Tubbed.  Applied blue spray, put layer of iodine and sugar onto Animalintex poultice, layers of cotton wool on his sole either side of frog then layer of gamgee before vetrap and duct tape then hoof boot.  Left on for 24hrs.  Slightly sensitive on one small area of coronary band.
Put him back out 24/7

Sat 6th April morning
bute and abs - didn't eat all of it.
Didn't change dressing.

Sat 6th April evening
abs, no bute.
Tubbed.
Poulticed as per previous day.
Leg cold and hard.  Had to search a bit harder for pulses but still bounding.  No pain on palpation of coronary band now.  Still very small flaky area but nothing coming of it.  Coronary band feels really soft and squidgy now but guess that's from the continuous poulticing and soaking.  Trotted up reluctantly in hoof boot.  Difficult to see any lameness as so reluctant.

Sun 7th April morning
gave bute as still pulse. gave abs. ate it all.  didn't change dressing.

Sun 7th April evening
abs, no bute.
Tubbed.
Just poulticed with standard hot wet dressing, no iodine as it hadn't done anything last couple of days.  Had to search around to find his pulse so that suggests not as obvious as it was but once found it I would still say it's quite bounding.  No pain on palp of coronary band.  Flaky area the same.  Feels all soft and squidgy around coronary band.
Lunged him and would still say he's 4/10 lame LF on the lunge on the left rein.  Didn't bother putting him on right rein as he looks just the same as he has for past 2wks apart from those couple of days he went hopping.

Mon 8th April morning
trot up straight line in field - couldn't see any lameness.  lunge right rein - sound.  lunge left rein - 3/10 lame LF.  pulse again harder to find but still fairly obvious once found.
No pain on palp of coronary band.
Didn't give any bute - wont give him anymore now as doesn't seem any worse without it. Gave abs. Didn't change dressing

Mon 8th April afternoon
last dose of abs.
Changed dressing and applied dry Animalintex.  Didn't tub.  Couldn't find pulse but was only doing quick check.  Strap from boot starting to rub slightly across pastern so padded out with more cotton wool.  Spoke to vet and booked in for nerve blocks/rads on Wed :(

Tue 9th April afternoon
Pulse still palpable but takes bit of feeling round to feel it - definitely not bounding now.
Quick trot in straight line - appeared sound.  Lameness intermittent on left rein on the lunge - mostly around 3/10 but occasional couple of steps much worse.
Nothing on poultice  Some bruising showing around caudolateral coronary band but not sure if might be from the boot and bulb of heel gone white as well which suspect is pressure/rubbing from boot.   Left boot off tonight and just padded up well with cotton wool/gamgee.

Wed 10th April - visit to Liphook - see separate entry

Thur 11th April
1 bute BID.
Separation at coronary band slightly bigger.  Bruising on heel seems to have gone.  Bruising on caudal sole still visible.
Still obvious pulse - perhaps even fraction worse than it was last couple of days as would describe as bounding again.
Redressed both feet with cotton wool/gamgee padding and hoof boots. See separate entry for hoof photos.

Fri 12th April
1 bute BID.
Left RF alone.
Dug out split area at coronary band on LF - really did look like something had burst out of there even if it was just a little big that I hadn't noticed on his dressings.  Dug out bit looked a lot like Llewi's did after his abscess although didn't have the obvious under-running down the hoof wall.  Still pulse and heat.  Redressed with Animalintex with sugar/iodine mix on top.

Sat 13th April
1 bute BID.
Trotted up well.
Lunged in school with hoof boots on and for first time in weeks couldn't see a head nod and he was really pinging.  Pulse still there though although much fainter and still heat on lat quarter of hoof.
Farrier came and rasped the edges of that hoof.  Looked at the bit I'd dug out yesterday at the coronary band but didn't really say much.  Re-shod RF.  Tried some natural balance xmas tree wedge pads on him which immediately made his HPA look much better - dread to think how much they cost.
Used thermal imaging camera on him - see separate entry.  Obvious heat around the high nail hole and white hot above the bit I dug out yesterday where the heat still is and where the pain on palpation was previously.
Thin layer of bruising evident on his coronary band again.  No obvious pain on palpation around coronary band.  Nothing came out on poultice from overnight.  Dug out area looks happy and smooth.  Farrier didn't get any reaction to hoof testers.
Dont like look of foot at the moment - growth ridges a third of the way from the top, deep ridge about 1/4 of the way down, crumbling at the bottom, bulge at the top, HPA broken back - yuck.  Farrier laughed at thought of taking him barefoot - thinks would be recipe to pedal osteitis as soles so thin.  Booked in for farrier in 10days time to shoe him with the pads - thinks he might struggle to keep them on.  Reminded me we tried a NB type of shoe few shoeings ago but he wore his toes right down so went back to toe clips.  Not sure the NB shoe will work but the shallow wedge pad did make his angles look a lot better so might be worth a go - thought he might need some kind of permanent over-reach boot on them or will likely just lose them.  Left him in stable tonight as weather miserable and gives a chance for him to have hoof boot off as concerned how much that is rubbing him.   Poulticed with sterile plain poultice (Kruuse) and honey.

Sun 14th April
1 bute BID.
Evening - lunged - 1/10 lame LF left rein, sound both legs right rein.
Still has a pulse.
Repeated thermal imaging - no change from yesterday in terms of heat in left fore and nail hole.  Right fore colder today though - it was a bit warm yesterday as just been shod - today sole and foot cold as they should be.  Makes left fore look even more obviously scalding hot though.  Medio-lateral balance looks pretty good in that the heat lines around the hoof are equal - no increase on inside or outside suggesting more pressure going up one side of the foot.
No reaction to hoof testers. No reaction to palpation on coronary band.   Nothing came out of poultice from yesterday.  Feels a bit squidgy above coronary band still but nothing looks like wants to come out.  Dug a little at nail hole and the area I dug out a few days ago but nothing.  Sole looks a bit more bruised all over.  Line of bruising around heel as before.  Redressed with honey and plain poultice.

Mon 15th April
1 bute in evening.
Still digital pulse morning and evening.
Nothing on overnight poultice.  No reaction to hoof testers.  No reaction to palpation on coronary band/heel.  Bruising on heel/sole as per yesterday.
Long discussion with vet.  Dont think he really understood the thermal image I sent him - seemed to be focused on the fact it looked like lots of heat coming from coffin bone but it's not as it's only on the outside of the hoof and you cant see the coffin joint on thermal imaging - it's superficial heat.  Mentioned the hotspot over the nail hole but it got brushed over again.  Feel like banging head against a brick wall.  Discussed the plan - he thinks unlikely any infection in foot as getting better.  Make sure no pain in heel when get shoes put on.  Plan is to get shoes on next Wed.  Then he is to have bute BID for 3d then SID for 3d as change in angles likely to make him sore.  Then reassess and talk to vet again.  If seems comfy then can have vet back out to do steroid/local into coffin joint and see if that makes him sound.  If it does then will likely be sore for another 5d or so but if it works can then start gentle work but will all have to be on a soft surface - wont even be allowed to hack initially :(

Tue 16th April
1 bute in evening.
Only evening visit today and didn't redress foot.
He came galloping, bucking and squealing around the field for his dinner.  Did a lovely, floaty, sound passage up the fenceline too.  Not really what he's meant to be doing.   Nice to see him express himself but rubbish that he is so cooped up he feels the need to behave like that.  Have cut food right down to fibre nuts, fast fibre, readigrass and Happy Tummy with a handful of mix.  The grass is growing though - even in his little paddock I can see it growing.
Really struggled to find a pulse tonight - it was still there but definitely fainter.  Thought maybe there was some slight filling in his cannon bone region but didn't feel hot.

Wed 17th April
1 bute in evening.
Only evening visit.
Put him on the lunge - he looks slightly short on left rein still but no worse than Sunday which is good as he's now down to one bute.  Not sure if short because got trainer on or if because it still hurts.  Right rein he's noticeably holding himself bent to the outside - I assume to avoid over-weighting his right fore.  I actually think the sounder he becomes on the left fore the more obvious it is that his right fore hurts him.  It's odd though because it's something physio mentioned last November and I've been aware of his tendency to not want to bend to inside to the right for a long time.  Always put it down to his dodgy right hind though.  Even on the lunge I've noticed him holding himself bent to the left but just assumed it was his old reluctance to bend right rather than not wanting to weight the right fore.  It's something that's certainly been evident since he returned to work end of last year and maybe was even present before he damaged his tendon yet doesn't seem to have got worse or stopped him doing anything.  I'm wondering how difficult it's going to be to sort out as it's pretty chronic now :(
Pulse was almost gone on left fore today, really faint and no reaction to hoof testers.  Bit more of coronary band gone a bit mushy looking but then I did leave a hot wet poultice on for 48hrs.
Got the camera out again and there was definitely less different between the feet.  If imaging both at once the left one now looks red rather than white.  That nail hole still looks very hot but then the dip I dug out at the coronary band looks white hot and now I'm starting to wonder if that's just because it's a dent in the surface of the hoof rather than truly hotter?  Dont know enough about the imaging to really know.  I do know the whole thing looks less hot though so that has got to be a good thing.
Doused frog in blue spray as smelt a bit - might be going a bit thrushy as been covered up so long.  Also put blue spray round coronary band and nail hole.  Redressed with hot wet poultice.

Thur 18th April
1 bute in evening
Really really struggled to find digital pulse - just about got it faintly eventually.  Hoping this is good news!
Didn't redress

Fri 19th April
1 bute in evening
Redressed with hot wet poultice

Sun 21st April
no bute
Took off dressing from weekend - small bit over nail hole that almost looked a bit pussy but hole itself looked completely dry so cant have been.
No reaction to hoof testers on either front foot
No reaction to palpation over coronary band - still feels a bit squidgy but nothing looking like it wants to burst
Little bit of bruising over heel bulb but probably from boot rubbing.
Couldn't find digital pulse
Trotted up sound
Lunged sound on both reins - yay!
Tried with thermal camera again - foot much hotter than other one but had just been wrapped up.  Possibly less heat around coronary band, more of a normal thermal pattern.  Still red spot over nail hole but have dug out hoof wall there so possibly just due to that.
Redressed with some blue spray around frog clefts and a dry poultice.

Mon 22nd April
no bute
didn't redress
couldn't find a pulse
apparently he was galavanting around like a loony in the evening

Tue 23rd April
no bute
didn't redress
no pulse palpable

Wed 24th April
Farrier - shod both front feet with NB wedge pads (with Magic Cushion underneath) and a slightly set back shoe to bring back the breakover point.  Back shoes left alone - have been on 5weeks but as he's done no work they haven't worn and he doesn't grow any foot so they still look fresh.  He seemed comfy walking in the shoes afterwards.  I hope they dont make him sore in the next few days.  Have had to put overreach boots on as apparently high chance he will pull them off.  He's now in almost the whole of his small paddock.
Gave him one bute in his dinner
Thank god for no more dressings.
Cost of shoes: £35 for shoes, £40 for pads, £20 for Magic Cushion.  Randomly charged me £60 for travelling 3 times (I guess for the taking off of the left shoe, then putting back on the right shoe and today?)

Thur 25th April
Vet did say to give him 1 bute BID for 3d then SID for 3d but he seems very comfy so I am just giving it to him SID and I might just do 3d as long as he carries on ok.  No pulse in foot tonight, shoes still on and marching around quite comfortably on them.
One bute in his dinner.

Fri 26th April
Still happy on his feet.  Came cantering over when he saw me.  Thermal imaged both feet and both were the same temperature - yay!
Stuck him on the lunge - he looked sound on both reins, happy to strike off into canter of his own accord on the right rein.
Got on him and walked him around for 10mins - gave him a little trot on each rein on a long rein and then picked him up and he seemed happy enough.  He was generally lazy and behind my leg but then that's not unusual for him, esp after time off.  He's much better when he's fit and full of it.
One bute in his dinner.

Sat 27th April
30mins in walk in the school - felt more buzzy and up for it than yesterday.  Did some walk-halts and some basic lateral work.  He tripped a couple of times but then that's not unusual for him - he's always falling over his own feet.  Watched him walk up the yard and he's landing nicely heel first.
One bute in dinner

Sun 28th April
30mins walk in the school - felt very much up for it.  Let him do a couple of circles in trot on each rein and he felt quite weird though - stilted perhaps?  Could well be lame on both front feet or just getting used to new shoes.  Need to talk to vet tomorrow.
One bute in dinner

Mon 29th April
usual Monday day off
no bute
turned him out in big field with Sox for the day, back in his little paddock at night
text vet but he didn't phone me back :(

Tue 30th April
spoke to vet - slightly baffling conversation - certainly hard work anyway.  He said all good that he's sound, get him back into work over next 2-3weeks then start jumping again but need to be careful about the ground as it's getting hard now.  I said what about the underlying lameness that we discovered when we blocked his left fore.  Oh yeah, that!  He said no point looking at him again now as he's had a month off so not likely to show true extent so best to look in a couple of weeks time.  Said most competition horses not insured so would often just go with high index of suspicion being coffin joints and inject them but best practice would be to block out each foot and see whether that makes him lame on the opposite foot - this is what I had been thinking would be the sensible thing to do anyway and there's very low risk with a palmar digital nerve block whereas injecting steroids into the coffin joint carries significant risks of infection and laminitis so I said to him I want to do whatever is gold standard, not skip steps or try and plaster over the cracks.  Therefore he is booked in at Liphook again 2wks tomorrow as facilities at my yard are rather lacking for assessing a minor foot lameness properly.  In the mean time he said he doesn't really want me doing road work with him.  Happy for me to hack him on soft surfaces or do school work.

So, today we did 40mins in the school, mostly in walk with a bit of trotting, mostly in a deeper stretchy outline with a few trot-walk-trots in a normal outline.  He has put on a fair bit of weight last few weeks and got out of puff fairly quickly so didn't do too much.  Initially I thought he felt a little bit funny on his feet but the more he trotted the better he felt so perhaps just him getting used to how they feel.  We did a couple of lines of 3 trotting poles on each rein.  He insisted on jumping them on the right rein several times before I finally convinced him to trot sensibly and then left it at that.  Lots more work on halting square in front - so hard to get him to step up - he always wants to leave a front leg trailing!