Started with looking at him with hoof boot on - trot up in straight line almost sound, trot right rein lunge sound, trot left rein lunge 3/10 lame. Without hoof boot on approx 6/10 lame LF left rein lunge. Lots of bruising coming out on his heel now but much less sensitive about having it prodded than he was last week. Still obvious reaction to hoof testers outside heel although less so than last week.
Then did palmar digital nerve block LF - trot up straight line sound, trot left rein lunge about 80% improved, now 1-2/10 LF, trot right rein lunge lame RF 1-2/10 (yes, that does say RF)
Xrays of his feet at all angles - only have the LM and DP views here but also took varying views of his navicular inc skylines. He stood like an angel for all of them with no sedation bless him.
Findings: broken back hoof-pastern axis worse LF than RF. Very flat pedal bones. Angle on LF is 1%. Angle on RF is better at 2%. Both soles paper thin. Medio-lateral foot balance good. No changes of any concern to navicular bones. No evidence of OA in DIP or PIP joints. No problems with pedal bone.
Discussed MRI scan but feel soft tissue injury within hoof is quite unlikely given presentation. Can always go down that route if no improvement in next couple of weeks.
Recommendations:
- Can have RF shoe back on but LF shoe to stay off as feel that bruising so significant if put pad/shoe on there now will hurt him more
- Bute 1sachet BID twice daily for 5d then 1sachet SID for 5d
- Box rest or small paddock rest for next 10-14d. If turned out must pad soles well and wear boots.
- Reassess once off bute - if sound then need to get him shod with different type of shoes and pads - vet will discuss with farrier which will be best for him but aiming towards Natural Balance type shoes to bring back his breakover point and pads to help protect the sole and give his heel some support.
- Likely has bilateral coffin joint pain due to chronic broken back hoof-pastern axis. Once he is shod again then will reassess coffin joints. Will probably need to block joints to confirm and then consider treating with steroid injections
with his snazzy trainers and socks on:
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