Rood & Riddle Equine Podiatry

12/04/2024

Case of the Month!

A three-year-old Thoroughbred filly race horse presented with severe atrophy of the left gluteal muscles and a significant knuckling over left hind fetlock gait abnormality.

The causative agent of the muscle atrophy was found to be EPM. The subsequent focal de-innervation of the rump created a disparity in muscle tone between the seemingly normally innervated inner muscles of the thigh (semimembranosus and semitendinosus) and those greatly affected and atrophied laterally. It is thought that those stronger muscles created more tension than the affected muscles could counteract and left the fetlock in an abnormal position.

The severity of the fetlock positioning would alter the filly’s ability to walk normally and would likely result in significant hoof deformation over time left untreated.

Conservative treatment was initially sought to improve the fetlock articulation via a wedged Nanric ultimate cuff, which proved unsuccessful. Secondly, a custom thermoplastic leg brace was fitted in an effort to gently stretch the soft tissue muscle attachments and position the fetlock in an extended manner. Unfortunately, the reciprocal apparatus of the horse’s hindlimb created an issue of lifting the heel within the leg brace during movement and eventually created pressure sores over the heel bulbs.

The decision was made to cut (tenotomy) the superficial digital flexor tendon mid-cannon to release the tension preventing the fetlock from achieving its normal anatomical configuration. A half limb cast was applied while the horse was suspended in a sling in an effort to prevent potentially catastrophic loading of the deep digital flexor tendon and suspensory while the superficial was healing. There was no way to know prior to surgery, but there was also a certain amount of deep digital flexor tendon contracture that became apparent after the superficial tenotomy seen in the video close up of the hoof and fetlock. With the fetlock now capable of normal anatomic position, it was decided to not pursue a deep digital flexor tendon tenotomy at that time.

After approximately four weeks in a half limb cast, the mare was once again placed in a wedged shoe to accommodate the tension within the deep digital flexor tendon while the surgery site continued to heal.

A neurologist with the aid of an EMG study, applied Botox to the neuromuscular junctions of the medial gluteal muscles in an effort to relax the musculature and lengthen the musculo-tendinous unit with some apparent success. The heels do remain slightly elevated from the ground barefoot at rest and the mare remains in a modified reduced wedge ultimate cuff. She is quite comfortable turned out in a field daily and is currently pregnant.

12/02/2024

Thank you to Equine Podiatry & Lameness Centre and SoundHorse for organizing a great clinic, and to Dr. Craig Lesser for generously sharing his knowledge, skills and expertise.

Together, we're making strides in equine podiatry--one hoof at a time!

11/28/2024

🦃Happy Thanksgiving!!🦃

Today, we pause to reflect on the blessings in our lives--big and small. It's a time to gather with family, reconnect with friends, and cherish the love and laughter that fill our hearts. Wishing you a beautiful Thanksgiving filled with gratitude, happiness, and the company of those who mean the most.

May your day be filled with warmth, joy, and maybe even a little time spent with your favorite four-legged friends.🐴

11/20/2024

It is with heavy hearts that we share the unexpected passing of our beloved colleague and friend Dr. Matt Wimer. Dr. Wimer is a member of the Kansas State University College of Veterinary Medicine Class of 2014. After graduation, he completed an internship in the podiatry department at Rood and Riddle Equine Hospital in Lexington, KY. We know that Dr. Wimer’s commitment and care to his community have had a profound impact on many people and friends. A friend like no other. Your infectious laughter, unwavering support, and genuine kindness touched everyone who knew you. We shared countless adventures - endless days devoted to helping horses and their owners, each one filled with your unique spirit. While your physical presence is gone, the memories we made together will forever live on in our hearts. You taught us to embrace life to the fullest, to always find joy in the little things, and to be there for one another. We will carry your legacy with us, always remembering the incredible person you were. Rest in peace, dear friend.🙏🙏

11/11/2024

Today, we give heartfelt thanks to all the brave men and women who have served our country with courage and dedication. Your sacrifices make our freedoms possible, and we are forever grateful.

We also remember the incredible equine heroes who stood by our soldiers throughout history. From Sgt. Reckless, who carried supplies and ammo to Marines under fire in the Korean War, to Comanche, the valiant horse who survived the Battle of Little Bighorn - these horses embody loyalty, strength, and resilience.🐴

This Veterans Day, we salute every veteran - two-legged and four-legged - who has answered the call to serve. Thank you for your courage, loyalty, and unwavering dedication.

11/07/2024

This serves as a reminder of the importance of creativity and adaptability in equine care, especially for complex hoof health challenges. Each horse is unique, and every success is a testament to the power of innovation!

11/01/2024

🚨🐴CASE OF THE MONTH!!🐴🚨

MECHANICS + TIME

Cash, a 10-year-old Quarter Horse rescue, presented to our Saratoga location in early April. His owners shared that he was frequently sore, despite wearing various shoes and boots, and struggled to keep his shoes on due to his small, weak feet. They also mentioned a possible laminitic episode before his adoption.

Upon evaluation Cash was barefoot, moving slowly, and clearly in pain. Both front hooves showed multiple growth rings, that were narrower at the toe and wider at the heels. He also had a concave dorsal wall, thin soles, and separation of the hoof wall around the toe. X-rays revealed rotation, severe demineralization, and remodeling of the coffin bone, along with reduced sole depth. These findings pointed to Chronic Laminitis.

To support him, we decided to realign the coffin bones and use mechanical aids to increase his palmar angle to over 20 degrees. This adjustment helped reduce the tension from the deep digital flexor tendon, encouraging sole growth.

Six weeks later, Cash returned for a recheck. He was walking more comfortably, though, unsurprisingly, he hadn’t grown much sole. Given the severity of his bone changes, it’s clear that both blood supply and the integrity of the papillae, which form new hoof growth, are seriously compromised. However, his alignment with the shoe’s mechanical principles was still intact, indicating that the mechanics we set up are continuing to function well. As a result, we decided to keep the shoe unchanged for another six weeks to let these mechanics continue working.

After another six weeks (12 weeks from the start), Cash returned, and everyone was eager to see the new X-rays. His comfort continued to improve, and he was finally responding to the treatment. He’s now growing significant sole depth! In this case mechanics were applied correctly, but they needed time to allow reperfusion. While results may appear in as little as six weeks, more challenging cases can take even longer.

Seeing that Cash is responding well to treatment, we transitioned him to a simpler shoe that maintains the same mechanical principles. Six weeks later (18 weeks from the start), Cash continues to improve, growing more sole than ever. With this progress, we’re now planning to transition his care back to his regular farrier, who has already applied one set of shoes that Cash is thriving in.

Cash and his owners are enjoying his renewed comfort and quality of life. His case is complex and he will require ongoing, dedicated attention to his feet. Regular X-rays are essential to monitor his progress and ensure that the mechanical support provided continues to preserve his hoof integrity. As always, it takes a committed team of owners, veterinarians, and farriers working together to make a lasting difference in a horse’s life.

10/23/2024

📢🐴Calling All Veterinary Students🐴📢

We are excited to announce that Dr. Craig Lesser will be speaking on Podiatry Management for Infections of the Equine Foot on a webinar for vet students hosted by the Cornell University Student Chapter of AAEP.🎓

🗓 Date: 10.28.2024
🕧 Time: 6:00pm EST
💻 Platform: Zoom Webinar
🎟 Contact your local SCAAEP for the Zoom link

🌟 This is a unique opportunity to learn from one of the best in the field, get your questions answered, and gain valuable insights into Equine Podiatry. Whether you are passionate about equine health or just looking to expand your veterinary knowledge, this is an event you won't want to miss! 🌟

Tag one of your vet student friends and share to spread the word!

Contact your local SCAAEP for the Zoom link!

10/04/2024

🌟We want to hear from you!!🌟

As part of our amazing equine podiatry community, your input is very valuable. We want to make sure that our content is useful, engaging, and informative for all of you.🐴

👉What kind of posts or content would you like to see more of on our page? Is there a topic you're curious about? A question you need answered? Let us know in the comments.👇

We're here to support you and your equine partners, so don't be shy---drop your suggestions below.🎯

10/01/2024

🚨🐴CASE OF THE MONTH🐴🚨
Reyne was referred to us mid June, she was going through an acute episode of severe laminitis and had granulation tissue protruding from the sole of the left foot. Her regular veterinarian had taken a radiograph and diagnosed her with laminitis, and due to the severity of rotation recommended that she come see us.

On presentation Reyne was very lame on the left front but also sore on the right front. A venogram was elected to determine the severity of the vascular compromise. On the weight bearing view she has significant dorsal shunting along with leakage and prolapse of her circumflex artery. This loss of vascular supply caused the lamina in that region to be compromised and is a significant reason why the rotation occurred. Thankfully on the non weight bearing view and the view in a large wedge the dorsal blood supply was significantly improved, meaning those vessels were crushed when standing barefoot but when weight is removed or we are wedged the blood supply returns.

She was shod in this wedge shoe and a treatment plate was installed to allow for treatment of the pr*****ed granulation tissue through a window in the bottom of the foot. We were almost immediately more comfortable after shoeing as the forces causing the rotation were counteracted and the sensitive areas were protected. The granulation tissue was treated with antibiotics and larval therapy to clear the infection, followed by packing with iodine until the area was completely cornfield.

Two weeks later we were already growing significant sole depth over the toe, and at 6 weeks our sole depth was almost back to normal. This is because the foot has mechanically set up for success. Even though there is a significant amount of new growth the rest of the foot is still severely compromised this is because it takes about a year for a new hoof to grow out. A week ago Reyne started getting lame again, and an abscess was opened in the toe. Abscesses are very common in horses post laminitis episodes because they have this large mass of necrotic foot that needs to grow out. After a new hoof has fully grown out the risk of abscess is greatly decreased.

Thanks to the diligent care of Reyne’s owner and veterinarian, Reyne is on the road to recovery and plans to start tack walking soon!

09/30/2024

Keeping our colleagues, clients, and their horses in mind during this disaster. The Foundation for the Horse is the charitable arm of the American Association of Equine Practitioners. Please support their efforts in helping horses in need.

We are devastated to see the disastrous effects of Hurricane Helene that have impacted thousands of people and equines far and wide. Please join The Foundation for the Horse, the AAEP's charitable arm, in aiding the victims of the hurricane with a donation to help those affected.

The Foundation for the Horse works directly with equine veterinarians on the ground to make sure supplies, hay, feed and veterinary care are provided to animals in need.

Pictured is an example of the devasting effects the residents of Hendersonville, NC have suffered during Hurricane Helene.

If you would like to join us in aiding those affected, donate at: https://membership.aaep.org/FFTH/Shared_Content/Donation-Pages/Give-Now.aspx?ItemId=DISASTER_RELIEF&SourceCode=GiveNow&fbclid=IwY2xjawFnmcNleHRuA2FlbQIxMAABHaHxoC1eLyh3A4yhmAjxmWHPmr_MlVVwcEAQlS7eG9dEchYSrXaPsyTwdQ_aem_XLRekJJPklcJ9rVpFvH-Tg

09/03/2024

🚨💪CASE OF THE MONTH🧲🚨
If you are around horses long enough, you will have to treat an abscess. They usually present as an acute lameness and the lameness goes away just as fast once the pressure is relieved. However, when an abscess recurs or drainage doesn’t stop it's time to get your veterinarian out to take some radiographs.

Thats exactly what happened to Jerry, a yearling thoroughbred. He had been dealing with a recurrent abscess for a few weeks prior to presentation. There was active drainage from the toe and we were currently 3/5 lame. Over the past few weeks we would go lame, drain, then be sound again.

We took radiographs and discovered why the abscess continued to happen. There was an infection on the coffin bone shown from different angles on the radiographs in the blue circles. Traditionally these infections would be debrided and the horse would be started on regional perfusions and systemic antibiotics. However we have a better technique that involves a shorter layup time, higher success rates, and allows us to be better stewards of antibiotics. That is the utilization of larval therapy to debride the diseased tissue.

We started by applying a treatment plate shoe. This would elevate the foot off the ground to encourage drainage while also protecting that area from concussion and giving the larvae protection to go to work. With it being a yearling it was elected to glue the shoe on to ensure it doesn’t get pulled and we are not having to nail into a thin walled horse that is already experiencing lameness issues.

Once the shoe is applied the larvae are applied to the abscess pocket and the treatment plate is screwed onto the bottom of the foot. Over the course of the next week these larvae will debride the dead and infected tissue and grow in the process. (The video is from another case on day 5 after application). After about a week the larvae were done cleaning up the infection and we switched to packing with iodine soaked gauze under the treatment plate. We were now sound and no longer draining, however we still had a large defect on the bottom of the foot. A shoe was kept on the foot and after a few cycles the abscess tract was fully grown out and we were returned to barefoot.

Usually an abscess is easily resolved, however if it persists there could be something bigger going on. With Jerry this was the case, but thankfully after some intensive care and many bandage changes we are able to continue on to be an athlete. 🐴💪

08/30/2024

🌟Excited to be part of such an incredible opportunity🌟
Looking forward to contributing and seeing the next generation of veterinarians thrive in their passion for equine practice!🐴

08/23/2024

🐴😂Funny Friday!!😂🐴
Have A Great Weekend!!

08/08/2024

Excited to share this fantastic podcast featuring Dr. Andrew van Eps, who was one of our esteemed speakers at our International Podiatry Conference! Don't miss out on his insights and expertise.

🚨 NEW STALLSIDE EPISODE ALERT! 🚨

Breaking Ground in Laminitis Research with Dr. Andrew van Eps

In this episode of StallSide, we are joined by Dr. Andrew van Eps, originally from Australia, who is a leading researcher at the University of Pennsylvania specializing in equine laminitis. Dr. van Eps shares his groundbreaking findings and the latest advancements in understanding, preventing, and treating this debilitating condition focusing on cooling therapy. Discover insights and gain valuable practical knowledge from the van Eps Laminitis and Endocrinology Laboratory at New Bolton Center, which is dedicated to unraveling the critical events driving laminitis under different circumstances to develop reliable means of prevention and treatment.

👉 Watch now: https://youtu.be/M788CQHNdKI?si=KJC5hPHwY3A_uf_a

🔔 Subscribe for more behind-the-scenes stories from the world of equine veterinary care!

08/02/2024

Case of the Month!

This has been a unique and challenging undertaking, but we are very excited with our current progress.

An 8 year old warmblood presented to the clinic for a chronic non-healing wound of approximately four years duration of the medial right hind pastern and coronary band. The wound was prone to re-injury and had developed extensive scar tissue and inflammation of the adjacent skin. The medial heel was sheared proximally further preventing healing due to excessive motion and interference of the scar tissue during fetlock excursion under load. Upon evaluation, canker was found within the body of the frog and extending onto the caudal aspect of the scar between the heel bulbs.

A multi-faceted treatment plan was initiated to improve hoof morphology and the impinged sheared heel, debride and treat canker, excise the non-healing scar tissue, and lastly to treat the coronitis/skin inflammation throughout the pastern.

A steel modified bar shoe (we have named it the St. Louis Bar Shoe due to the arch) was applied to allow access to the canker debridement area while also allowing aggressive floating of the medial heel from the chronic quarter crack caudally. The hope was to allow the hoof to settle down out of the way of the pastern.

Aggressive canker debridement was performed via surgical removal of diseased tissue and extensive cauterization. A hospital treatment plate was placed to protect the affected area and allow medication to be administered long term.

Not to be taken lightly, the decision to proceed with complete wound revision was chosen as the best chance for this horse to heal. Bulk surgical excision of the scar tissue was performed under general anesthesia in the afternoon following morning shoeing and canker debridement. The tissue was removed deeply and just superficial to the underlying collateral cartilage and neuro-vascular tissues feeding into the hoof. Light cauterization of the surgical site was performed to assist with bleeding as well as "resetting" the previously affected tissue.

The picture series spans approximately 10 weeks with the last just being taken recently. The wound site healing, hoof conformation improvements, and canker treatment are extremely promising. Barring unforeseen complications, this horse should be able to re-enter a show career and live a normal life.

07/26/2024

😂🐴Funny Friday🐴😂
Have A Great Weekend!!!