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Understanding limb length disparity treatment

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  • Understanding limb length disparity treatment

    My horse is club footed on the right front and shows classic signs of limb length disparity. His chest, shoulder, and hip are not equal from side to side. I started using s new farrier back in September when my gelding was foundering and he brought the topic up when he first started seeing us. Said we wouldn't work too much on it at the moment as the biggest task was to get him pass the founder.

    Finally, after a cycle of being flat shod he felt like in February we could start to work on the limb length disparity. He informed me he had consulted with Esco Buff before and would even get a chance to speak with him about my horse personally when they saw each other at a conference.

    Based on feedback he made the decision to put a small pad on his right front only (the club foot). At the time this made alot of sense to me and when the horse went back to work at the beginning of March despite having been on stall rest since September he felt much more balanced then normal and any issues that he had with is right canter lead were gone. Also, his shoulders had evened up when previously they were not.

    I was also told the pad wouldn't be a permanent thing that the next cycle it might need to be increased slightly but that overall the goal would be to work back off of it and that by doing so his club foot would start to grow more normal.

    Well when the horse went back to work it came about that our farrier wouldn't be allowed to shoe him that the trainer's farrier shoes all horses in training. I'd aimed to have both new farrier and old farrier talk to each other but when the time came we couldn't reach old farrier on the phone.

    New farrier about had a fit and said my horses feet are a mess. That why would you put a pad on a club foot that is already high and why would you do something to one foot but not the other? To extent his game plan makes sense too. He of course took the pad off, trimmed back the toe and dropped the heel, and made him a pair of half rounds and on the club foot left a decent amount of shoe off the back for bar support as well as some shoe sticking out at the toe. He explained that this would help encourage the hoof to grow properly.

    Also, interestingly enough he claimed my horse showed no signs of ever foundering that he has a healthy sole with no bruising but that he has hardly any hoof wall. He also says he feet grow just fine despite my old farrier saying his feet had grown pretty slowly since he foundered. Keeping in mind this is the first time the new farrier has seen my horse.

    So what is more important trying to get hoof angles to match ASAP or working on the overall picture of what might be going on with his body. Is this potentially just two different schools of though on how to handle club footed horses?

    Part of me is super nervous because I feel we were going in a good direction with his feet. Then to have another professional say they are a complete mess and he would never do what was done leaves me a bit nervous not only about what has been done but now making a change to his feet.

    Also, I'm sure some of my technicalities aren't quite clearly explained but I am trying to understand to the best of my ability so please don't flame me

  • #2
    Originally posted by Kwalker024 View Post
    Is this potentially just two different schools of though on how to handle club footed horses?
    Yes.
    Maybe both guys have good success with their approach, or maybe one is better suited to your horse. There are vastly different opinions on "limb length disparity"; whether it even exists in the first place, and if it does, what, if anything, should be done. I think the proof of the pudding is in the eating; I'd stick with the guy that your horse goes best for.
    As Peter, Paul, and Mary say, a dragon lives forever.

    Comment

    • Original Poster

      #3
      Originally posted by CrowneDragon View Post
      Yes.
      Maybe both guys have good success with their approach, or maybe one is better suited to your horse. There are vastly different opinions on "limb length disparity"; whether it even exists in the first place, and if it does, what, if anything, should be done. I think the proof of the pudding is in the eating; I'd stick with the guy that your horse goes best for.
      I love my trainer and trust them completely with my horse. It was just super shocking to hear such a negative response to the current state of his hooves. I'm hoping like you said just difference of opinions on how to handle my horses's feet and as long as he is sound, healthy, and happy don't care how we get there.

      Comment


      • #4
        Any farrier that would put shoe out in front of a club foot has no understanding of what creates a club. It will only further tighten the muscle head of the ddf tendon and cause increase pull on the coffin bone making a club foot worse.

        Comment


        • #5
          I'd stick with the guy that your horse goes best for.
          I don't feel qualified to jump in on the biomechanics, but have enjoyed listening to many vets passionately debating whether "limb length discrepancy" can actually functionally exist in horses, whose front legs aren't "hung" (bone/joint-wise) from the axial skeleton at all. An interesting debate, with (near as I can tell) no consensus in the "where the rubber meets the road" department.

          But I totally agree with what CrowneDragon said, quoted above.
          Click here before you buy.

          Comment


          • #6
            Originally posted by Kwalker024 View Post
            I love my trainer and trust them completely with my horse. It was just super shocking to hear such a negative response to the current state of his hooves. I'm hoping like you said just difference of opinions on how to handle my horses's feet and as long as he is sound, healthy, and happy don't care how we get there.
            The only advice I will give is that in my fairly limited experience with club feet, if your horse needs to be trimmed/reshow really frequently because the clubby foot is dishing out and your farrier is constantly working on him to make the foot look normal, I would be very leery. There is a lot more to managing a club than making the foot *look* normal. The inner physics need to be addressed.
            YMMV.
            As Peter, Paul, and Mary say, a dragon lives forever.

            Comment


            • #7
              I've been throu a lot wi my gelding and his club foot because he also has tendon issues in the same leg. We also consulted w/ Esco and the farrier at New Bolton along with several vets. Bottom line is to do what suite your horse best, I know not a clear answer. We tried several different shoe and pad options, but ultimately decided barefoot where he could wear the foot how he wanted suited him best. Nature has a way of taking care of things. If he needs shoes in the future we will just go with a regular shoe.

              Comment


              • #8
                Originally posted by BumbleBee View Post
                Any farrier that would put shoe out in front of a club foot has no understanding of what creates a club. It will only further tighten the muscle head of the ddf tendon and cause increase pull on the coffin bone making a club foot worse.
                Are you sure?

                Comment


                • #9
                  Originally posted by Kwalker024 View Post
                  My horse is club footed on the right front and shows classic signs of limb length disparity.
                  Absent actual measurments of the bony column, and in spite of what some have written, it doesn't exist. What does exist are musculo-tendinous inequalities. And said inequalities can be due to several different factors including, but not necessarily limited to pain, injury, stance, 'sidedness'.
                  His chest, shoulder, and hip are not equal from side to side.
                  the 'hi-lo syndrome' is usually noted in the contra-lateral front-hind pair and can be rather successfully managed in the hind but is only managed in the front if the horse is comfortable with any changes that are made. Extra credit: Why?
                  Finally, after a cycle of being flat shod he felt like in February we could start to work on the limb length disparity. He informed me he had consulted with Esco Buff before and would even get a chance to speak with him about my horse personally when they saw each other at a conference.
                  I know and like Esco but I don't agree with his hypothesis regarding alleged limb length disparity. And bear in mind that at this time, a hypothesis is all that it is.
                  Based on feedback he made the decision to put a small pad on his right front only (the club foot). At the time this made alot of sense to me and when the horse went back to work at the beginning of March despite having been on stall rest since September he felt much more balanced then normal and any issues that he had with is right canter lead were gone. Also, his shoulders had evened up when previously they were not.
                  Glad to hear it. Besides the pad, what other changes were made, front and hind?
                  I was also told the pad wouldn't be a permanent thing that the next cycle it might need to be increased slightly but that overall the goal would be to work back off of it and that by doing so his club foot would start to grow more normal.
                  Sounds good in theory.
                  Well when the horse went back to work it came about that our farrier wouldn't be allowed to shoe him that the trainer's farrier shoes all horses in training.
                  You perhaps needed a different trainer.
                  I'd aimed to have both new farrier and old farrier talk to each other but when the time came we couldn't reach old farrier on the phone.
                  Go figure
                  New farrier about had a fit and said my horses feet are a mess. That why would you put a pad on a club foot that is already high and why would you do something to one foot but not the other?
                  Ignorance is no excuse.....
                  To extent his game plan makes sense too. He of course took the pad off, trimmed back the toe and dropped the heel, and made him a pair of half rounds and on the club foot left a decent amount of shoe off the back for bar support as well as some shoe sticking out at the toe.
                  Sounds like he's trying to swim in deep water when he should have stayed in the shallow end of the pool.
                  He explained that this would help encourage the hoof to grow properly.
                  Mushroom fertilizer. ymmv.
                  Also, interestingly enough he claimed my horse showed no signs of ever foundering that he has a healthy sole with no bruising but that he has hardly any hoof wall.
                  How was the original determination of 'founder' made? Are you aware that there is a school of thought that says that a clubby footed horse that has dishing of the dorsal wall as part of the presentation, is mechanically foundered? And, since there is/was no bruising present (and by this I take it that is meant to say, 'anterior to the apex of the frog'), perhaps you 'old' farrier was on to something......
                  He also says he feet grow just fine despite my old farrier saying his feet had grown pretty slowly since he foundered. Keeping in mind this is the first time the new farrier has seen my horse.
                  Might want to ask him on what he is basing his observations/comments.
                  So what is more important trying to get hoof angles to match ASAP or working on the overall picture of what might be going on with his body.
                  As concerns a hi-lo horse, especially concerning the front end, trying to get the angles to match is a fool's errand. ymmv.
                  Is this potentially just two different schools of though on how to handle club footed horses?
                  Possibly. At least one has a 'game plan' with some basis, even if only theoretical.
                  Part of me is super nervous because I feel we were going in a good direction with his feet. Then to have another professional say they are a complete mess and he would never do what was done leaves me a bit nervous not only about what has been done but now making a change to his feet.
                  I think you have a right to be nervous. However, I haven't seen the feet, either before or after.
                  Also, I'm sure some of my technicalities aren't quite clearly explained but I am trying to understand to the best of my ability so please don't flame me
                  Its a 'Rock and a hard place' situation. However, since what the first farrier did seemed to be helping, I'd want to 'ride that horse' further down the trail to see if the trail was a dead end or not.
                  Last edited by Rick Burten; Apr. 1, 2013, 08:13 AM.

                  Comment


                  • #10
                    Originally posted by BumbleBee View Post
                    Any farrier that would put shoe out in front of a club foot has no understanding of what creates a club. It will only further tighten the muscle head of the ddf tendon and cause increase pull on the coffin bone making a club foot worse.
                    I guess I should amend that statement to say unless the horse is young and growing, being treated with tetracycline or recently had a surgical procedure to either the check ligament or ddf that would make a toe extension a useful temporary therapeutic option.

                    Comment

                    • Original Poster

                      #11
                      Originally posted by CrowneDragon View Post
                      The only advice I will give is that in my fairly limited experience with club feet, if your horse needs to be trimmed/reshow really frequently because the clubby foot is dishing out and your farrier is constantly working on him to make the foot look normal, I would be very leery. There is a lot more to managing a club than making the foot *look* normal. The inner physics need to be addressed.
                      YMMV.
                      He is on a 6 week shoeing cycle and I have noticed since September the dishing out how greatly decreased so I guess this is a positive.

                      Comment

                      • Original Poster

                        #12
                        Originally posted by ArbGrl View Post
                        I've been throu a lot wi my gelding and his club foot because he also has tendon issues in the same leg. We also consulted w/ Esco and the farrier at New Bolton along with several vets. Bottom line is to do what suite your horse best, I know not a clear answer. We tried several different shoe and pad options, but ultimately decided barefoot where he could wear the foot how he wanted suited him best. Nature has a way of taking care of things. If he needs shoes in the future we will just go with a regular shoe.
                        Barefoot down the road has been discussed he is in training 5 days a week and shown pretty regularly so at this point it might not be a feasible goal to do successfully. Glad to hear things have worked out for your horse!

                        Comment

                        • Original Poster

                          #13
                          Originally posted by Rick Burten View Post
                          Are you sure?
                          Originally posted by Rick Burten View Post
                          Absent actual measurments of the bony column, and in spite of what some have written, it doesn't exist. What does exist are musculo-tendinous inequalities. And said inequalities can be due to several different factors including, but not necessarily limited to pain, injury, stance, 'sidedness'.
                          His chest, shoulder, and hip are not equal from side to side.[/quote]
                          the 'hi-lo syndrome' is usually noted in the contra-lateral front-hind pair and can be rather successfully managed in the hind but is only managed in the front if the horse is comfortable with any changes that are made. Extra credit: Why?

                          I know and like Esco but I don't agree with his hypothesis regarding alleged limb length disparity. And bear in mind that at this time, a hypothesis is all that it is.

                          Glad to hear it. Besides the pad, what other changes were made, front and hind?

                          Sounds good in theory.

                          You perhaps needed a different trainer.

                          Go figure

                          Ignorance is no excuse.....

                          Sounds like he's trying to swim in deep water when he should have stayed in the shallow end of the pool.

                          Mushroom fertilizer. ymmv.

                          How was the original determination of 'founder' made? Are you aware that there is a school of thought that says that a clubby footed horse that has dishing of the dorsal wall as part of the presentation, is mechanically foundered? And, since there is/was no bruising present (and by this I take it that is meant to say, 'anterior to the apex of the frog'), kpkerhaps you 'old' farrier was on to something......

                          Might want to ask him on what he is basing his observations/comments.

                          As concerns a hi-lo horse, especially concerning the front end, trying to get the angles to match is a fool's errand. ymmv.

                          Possibly. At least one has a 'game plan' with some basis, even if only theoretical.

                          I think you have a right to be nervous. However, I haven't seen the feet, either before or after.

                          Its a 'Rock and a hard place' situation. However, since what the first farrier did seemed to be helping, I'd want to 'ride that horse' further down the trail to see if the trail was a dead end or not.[/QUOTE]

                          I do get the the whole limb length disparity is being a total hypothesis at the moment. Old farrier did state before we even started down the road of "treating" the inequality with the pad only on the right front that it might not do a darn thing for him. I was and am quite comfortable with that plan. I was just shocked that new farrier had such a strong reaction to how he was currently shod.

                          Here is a link to pictures of his feet and x-rays through the end of December. Keep in mind that "old farrier" didn't start shoeing this horse till November 2012. The farrier who was doing him previous to this is responsible for September and October 2012.

                          http://s1297.photobucket.com/user/Kc...ibrary/?page=0

                          Before the pad was put on the right front x-rays were re-shot in February and everything looked stabilized and the vet was comfortable with us proceeding with the game plan.

                          As a quick back history he originally foundered in his left front (not club) as he came up off one day (long story took almost a month to be diagnosed as foundering). Since then it has been identified that he is IR and is being treated as such.

                          I'll track down copies of x-rays from February as well as pictures of his feet from then as well as pictures from when he was shod by the new farrier this past weekend.

                          I wouldn't say major changes were made other then choice of shoe. He is now in half rounds the farrier made for him, the back of the shoe is perhaps a bit longer then previously, as well as on the right front (the club foot) there is a bit sticking out in front of the toe. Old farrier at one point also had a bit of shoe stick out of the toe on right front as seen in the pictures from December 2012 so that concept doesn't alarm me in particular (hopefully it shouldn't??). Other then that both old and new farrier had concerns about his back feet and that he was crushing his heels and was another issue for us to address. It would appear that their process for correcting this though is the same.

                          I am appreciating all the feedback and again please excuse the fact that some of the wording isn't probably quite right. I do trust my trainer just the whole issue with his feet makes me more on guard then I used to be (probably a good thing). I will also say all the other horses in the barn that he does appear to have good feet from what I can tell and perform well too. I was just shocked at his reaction to my horse's feet and his opinions.

                          Again thank you guys!

                          Comment


                          • #14
                            Not sure who you have consulted with regarding this, or where you are located, but I know of a farrier who is very knowledgeable on LLD. He is actually coming to us in Wisconsin to do a clinic regarding LLD in July. Let me know if you would like his contact info. He has written a book about LLD and is the best of the best!

                            Comment


                            • #15
                              Originally posted by jkilty View Post
                              He has written a book about LLD and is the best of the best!
                              That would be Dr. Esco Buff, PhD. And written or otherwise, LLD is still a hypothesis. In his book, "Proper Balanced Movement", Tony Gonzales wrote about LLD many years ago. Not much, if anything, has changed....

                              Comment


                              • #16
                                Originally posted by Kwalker024 View Post
                                I do get the the whole limb length disparity is being a total hypothesis at the moment. Old farrier did state before we even started down the road of "treating" the inequality with the pad only on the right front that it might not do a darn thing for him. I was and am quite comfortable with that plan. I was just shocked that new farrier had such a strong reaction to how he was currently shod.
                                Having now seen the photos, I can perhaps understand why...
                                http://s1297.photobucket.com/user/Kc...ibrary/?page=0

                                Before the pad was put on the right front x-rays were re-shot in February and everything looked stabilized and the vet was comfortable with us proceeding with the game plan.
                                Stabilized how? IMO/IME, if p3(RF) is not de-rotated you are headed for bigger problems down the road. And if nothing is done to help the LF phalangeal alignment, you're going to have problems there too.
                                As a quick back history he originally foundered in his left front (not club) as he came up off one day (long story took almost a month to be diagnosed as foundering).
                                How was it determined that he had foundered in only his LF? Bear in mind that the rads of the RF show a classic definition of rotational founder.
                                I'll track down copies of x-rays from February as well as pictures of his feet from then as well as pictures from when he was shod by the new farrier this past weekend.
                                That would be helpful.
                                I wouldn't say major changes were made other then choice of shoe.
                                A pity because IMO, changes need to be made.
                                He is now in half rounds the farrier made for him, the back of the shoe is perhaps a bit longer then previously, as well as on the right front (the club foot) there is a bit sticking out in front of the toe.
                                For what purpose, to what end?
                                Other then that both old and new farrier had concerns about his back feet and that he was crushing his heels and was another issue for us to address. It would appear that their process for correcting this though is the same.
                                So why is it not being addressed and what is their 'process' for dealing with this issue?
                                ... I will also say all the other horses in the barn that he does appear to have good feet from what I can tell and perform well too.
                                Do these other horses have hoof issues of the type and degree as those exhibited by your horse?
                                I was just shocked at his reaction to my horse's feet and his opinions.
                                In the absence of a detailed, accurate explanation, I think I'd be shocked too....

                                Comment


                                • #17
                                  Looks like a classic case of toe shoeing. There is obvious deterioration of the distal end of P3 in the club foot over the time period shown by the x-rays.

                                  Multiple farriers over the years applying a shoe to the dish in the toe instead of removing the dish and fitting the shoe to the geometry and mechanics of the coffin joint . . . how sad.

                                  Comment

                                  • Original Poster

                                    #18
                                    Hey sorry for the lack of response I've been swamped at work. I'll respond tonight though and again thank you the info I've read through so far is enlightening!

                                    Comment


                                    • #19
                                      I have to say the photos are shocking! I opened this thread interested, as my horse is “high low” (but very very minor compared to this), and I have read some of Esco’s writings on “limb length disparity” (I figured he was the expert in question when this came up, as he is the one I have seen push this theory the most).

                                      Barefoot, and very frequent (think every two weeks) trims since 3 months old (now 6 years) has been working well for my horse. She still ALWAYS has a scissor grazing stance (just like her mother), and grows more heel on the right front, toes have to be kept back on both – and she is sound and moving well.
                                      APPSOLUTE CHOCKLATE - Photo by Kathy Colman

                                      Comment

                                      • Original Poster

                                        #20
                                        Originally posted by Rick Burten View Post
                                        Having now seen the photos, I can perhaps understand why...

                                        Stabilized how? IMO/IME, if p3(RF) is not de-rotated you are headed for bigger problems down the road. And if nothing is done to help the LF phalangeal alignment, you're going to have problems there too.

                                        How was it determined that he had foundered in only his LF? Bear in mind that the rads of the RF show a classic definition of rotational founder.

                                        That would be helpful.

                                        A pity because IMO, changes need to be made.

                                        For what purpose, to what end?

                                        So why is it not being addressed and what is their 'process' for dealing with this issue?

                                        Do these other horses have hoof issues of the type and degree as those exhibited by your horse?

                                        In the absence of a detailed, accurate explanation, I think I'd be shocked too....
                                        Okay status on up to date x-rays is that the vet is going to send me the most recent.

                                        I know when the last set was done both farrier and vet were pleased with them. If I remember correctly in regards to his RF when they talked about the de-rotation of P3 is that the relation of the hoof wall above where the hoof dishes out to P3 was good.

                                        Can you explain address the LF phalangeal alignment further? From my understanding when this first started P3 was rotated quite a bit and was now improved. Is this not the case?

                                        Sorry I didn't explain further you are right he did founder in both fronts. It started as lameness in the left front and the rotation was discovered and it was treated with a heart bar shoe. Upon my insistent I had them x-ray the right front a few days later to check on the status since I know usually founder would happen in both. At that point previous farrier and previous vet felt that the right front was fine and "normal" for a club foot and no need to do anything to treat it.

                                        I did not agree with this at all and should have fought against it more because I was worried that due to the LF bothering him the stress of him loading the right more would cause problems. Not surprising within about 10 days of treating the LF he came up lame on the RF. X-rays were re-done and increased rotation was found in the RF as well as the deterioration of P3 you see. At this point previous vet and previous farrier were replaced as one I didn't feel they were taking the situation seriously and were basically just wanting to write my horse off. In comes current/old farrier whose work is from November to February in the pictures.

                                        I know I also previously mentioned that behind he is/was crushing his heels and again I should have been more clear current/old farrier was working to correct it while working on all his other issues. Current/old farrier had been working to handle the issue without applying hind shoes but there was talk of it after our last appointment in February. Trainer's farrier doesn't feel he needs hind shoes and that the problem was the trim, which I'm not sure if current/old farrier could have corrected this problem completely in the 3 shoe cycles he shod him. I will also say trainer's farrier didn't do my horse until he was 2 weeks over due at 8 weeks as opposed to 6 weeks due to scheduling.

                                        Trainer's farrier said he preferred the half rounds for him as he felt it would be least restrictive for the flight and landing of his hoof and allow the horse to decide what was comfortable. In regards to the change in shoes and losing the pad on the right front I'm not sure if this has affected him or not. I went down and rode today and I can't say I can tell a big difference. I will say that with the pad on the right front I felt he had an easier time picking up the right lead canter and I now have to set him up a little more for it. However, the trainer says now with the shoeing change that he is more relaxed over his topline and tracking up more from behind. So I'm not sure what is the best trade off. Or if we had worked with the pad longer and the more conditioned he became (he has only been back in work since March 1) if we would have seen him relax more across his top line and improvement in tracking up.

                                        I was going to take pictures of the current trim and shoes while I was there today but as luck would have it he pulled the RF while we were riding. Thankfully it came off cleanly and trainer's farrier warned it might happen. I'll see him again Friday and I'll make sure to grab pictures then. As well as track down pictures from when he was shod in February.

                                        Trainer's farrier has worked on a similar problem with one of the trainer's personal horses. Club footed on the LF and I will say that horses feet look good to me no dishing etc.

                                        I'm "hoping" that trainer's farrier and my current/old farrier just have different philosophies and I am enjoying the feedback I'm getting here and find it very education. Thank you so much!

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