Operating A full-time shoeing practice in Wenatchee, Wash., we’ve been fortunate to have many opportunities to work with area veterinarians on a number of interesting equine illness and injury cases.
This is a case study of Kuiatan (Sugar Me Sweet), a 15-year-old Appaloosa mare that simply wouldn’t die. Nobody wanted to see this mare suffer and her quality of life was definitely an issue.
She didn’t lie down, she never lost her appetite or her feisty nature. Against the advice of several equine industry professionals, the owner wanted to try and save her life.
August 2: While on a trail ride in the summer of 1997, she was kicked by another horse. This resulted in an open fracture of the right olecranon process. Non-weight bearing on the right forelimb, she was taken to Washington State University for surgery.
August 27: Open reduction surgical repair of the fractured olecranon was performed with a plate and screw.
September 12: The mare was discharged and trailered 150 miles home. The owner reported the unaffected left front hoof was barefoot and sore after the ride.
October 6: The mare was presented to us suffering from severe laminitis in the left front hoof, resulting secondarily from the right elbow fracture. We consulted with Dr. Jeff Kerr of Countryside Large Animal Clinic in Estacada, Ore., and began a multi-level treatment program that included pain management, infection control and improved nutrition.
October 8: The veterinary chart read: “Mare grade IV-V/V lame on left front. Severe cavitation of hoof around 75 percent of coronary band and sole dropped as well. Hoof wall sloughing very probable; prognosis appears very poor at best. Owner desires time for decision on pursuing treatment or euthanasia.”
November 4: The chart read: “Chronic left front laminitis with severe P3 rotation and coronary band cavitation. Treated with hoof wall resection of toe and quarters, debride sole and bandage.”
The hoof capsule was detached around the entire coronary band. Since time had passed since the onset of laminitis, there was growth at the heels. We removed the toe and quarters, leaving a small amount of horn at the heels.
Without a way to sling the mare, we were reluctant to remove all of the hoof capsule. Since the infection was severe, we cleaned and bandaged the hoof and taped on a Lily pad.
The mare was treated with bute, topical and systemic antibiotics and started on Farrier’s Formula. The right front foot was shod with a heart bar, rocker toe shoe. The hind feet were shod with Eques-Tech frog support pads.
November 6: The chart read: “Mare grade V/V lame. No evidence of hemorrhage noted from sensitive tissues of dorsal hoof wall or sole. Clean and flush sensitive areas and re-bandage.”
November 10: The dorsal surface appeared dry and free of infection. We applied medicated Equilox and shod the hoof with an aluminum hospital plate and a small rubber frog support wedge.
November 13: The vet’s chart read: “Mare appears slightly more comfortable. Bearing weight slightly when standing and walking somewhat better. No evidence of discharge around dorsal bed of granulation tissue. Acrylic material feels firm and adherent.”
November 18: The chart read: “Mare remains grade V/V lame. Evidence of further P3 rotation of one or two centimeters. Moderate discharge following five-day bandage. Prognosis appears very guarded to poor.”
Over the next few weeks, hoof wall regeneration began to take place. The hospital plate was removed regularly and the area cleaned and disinfected. While the mare remained very lame, she was able to partially bear weight on the foot.
December 30: Dr. Kerr debrided the solar surface of necrotic tissue. We removed the remainder of the detached heel area and applied more acrylic. Since the sole was dropping to the aluminum plate, we added a rim of acrylic around the entire solar surface.
January 22: The vet’s chart read: “Mare appears slightly more comfortable, weight bearing more often than before. No further distal displacement of P3.”
February 16: The chart read: “Heel growth appears good, yet both sole and dorsal hoof wall growth is very slow.”
March 11: The chart read: “Mare walking on hard surface fairly well. Most of solar surface keratinized. Dorsal hoof wall in place, though distal portion fairly deformed.”
By this point, we were confident the mare would recover. Since we now had enough hoof to work with, we removed the acrylic and shod the front feet with heart bars with rocker toes. The hind shoes were pulled and the feet trimmed. We re-shod the mare this way every four or five weeks.
In July, Dr. Kerr considered Kuiatan grade III lame at the trot. We continued to shoe the mare in heart bars with rocker toes in front and left her barefoot behind.
This horse lives in a mountainous, snowy area that’s difficult to access. We used the heart bar shoes until the weather made it impractical. From then on, we left the mare barefoot with a regular trimming schedule.
At best, we had hoped for a comfortable cripple. As you can see in the most recent photo on page 20, Kuiatan has a normal-appearing hoof. She’s still slightly lame when trotting on hard surfaces, but the mare is sound enough for light work.
Avoid The Fads
In our shoeing practice, we try to stay with basic principles and avoid fads and trendy “cure-all” treatments. We also try to keep an open mind.
We’ve had both success and failure with heart bars, the Equine Digit Support System and coronary grooving.
This was a very dramatic case for us, as we had never gone this far with a situation this severe in the past. With no previous experience to draw from, we used our best judgment and had great results!