Pathological hoof: What I see

Good call everyone! All your comments about how long this hoof was, the state of the frog, and the atrocious angles were spot on. I saw a couple of other things on top of that I'd like to point out. Before I get started I do want to say one thing: I'm not telling you this with the expectation that you're going to go out and start trimming on your own, I want to give you some more tools to use in assessing hoof health so you can know that the person you're paying to take care of your horse's feet is doing a good job.

Okay then, let's get started. You can click on all of these photos to get a larger view.

I'll start as I would if this were a new client of mine: First of all, I'd look at the length of toe, in a healthy hoof the toe is 3 to 3.5 inches long. This foot looks much longer than that. Obviously I can't measure it, but in this case I feel I can trust my eyes. Now check out that crack, which is in a very odd spot. Typically, hooves crack in two places: if the quarters are long they will crack along the sides at the quarters, if the toe is long it will crack straight down the center of the hoof. But this crack doesn't correlate with either of those scenarios, it makes me suspicious that something sinister is happening inside that hoof. Let's look past the crack for now and look at the hairline- can you see that hump along the medial edge? That's excess hoof wall pressing up the flesh, notice how there isn't a hump on the outside. From the front of a healthy hoof, the hairline should form a line parallel to the ground.

Now check the hairline from the side. In healthy hooves the hairline is a straight line that angles down to the heel from the toe in a 30 degree angle. This hairline is nearly ground parallel and distinctly arches upwards in the quarters, showing that the hoof is much too long in that region. Now look at the heel purchase, can you see that the heel this horse is standing on is nearly in the middle of his foot? His heel purchase should be at least a half inch further back, he's got a pretty good case of forward foot syndrome going on. And by pretty good, I mean pretty bad. Fortunately his heels haven't collapsed, which says good things about the strength of his hoof wall. All overly long toes will show a toe crease like this guy, where the hoof wall gets too long and creases under pressure. In hindsight, I wish I'd put another arrow above that dip over his toe, that's where I think his foot should actually end.

Many of you mentioned looking at this horse's diet, I'm assuming you all thought that because of the rings in the hoof wall. Personally, I'm not sure this horse is laminitic (which doesn't mean he's not) because this hoof isn't flaring outward, it's contracting in, which says good things about the integrity of the hoof walls and laminae. Instead, I think the rings on the hoof wall are caused by concussion from the ground. The hoof wall is so long that most of the rings you see are actually past the lamina, since that excess material isn't really attached to anything it's much easier to distort. Think of the hoof wall as being closer to a liquid than stone, it's more malleable than you think.

Let's take a closer look at those heels now. You could all tell that those heels were WAY too long, so let's ignore that for now. What pops out at me is that his hairline isn't parallel from side to side- his heels are sheared. This photo also shows you that this hoof isn't just contracted in the heels, he's contracted all the way around. Look how his hoof is narrower at the ground than at the hairline. Because of that contraction all of the structures inside his hoof, like the coffin bone and corium, are being severely pinched. There's no way this horse has proper blood flow in there.

Here's another view of those sheared heels. What you can also see from this angle are his lateral cartilages- not only have they been pushed way up into the fetlock, they've been pushed up asymmetrically from the inside by this horse's badly overgrown bars.

Heel contraction in this hoof has two causes: 1.) thrush, 2.) badly overgrown bars. He also has a sole that is just jam-packed with at least a half inch of dead material. That's part of why his hoof is so long from the front and side. As anyone who lives in a desert will tell you, dry, hard ground tends to have this effect on hooves that have compromised hoof mechanism. If the hoof isn't flexing, it can't pop out the excess material. His hoof also gives a bit of an optical illusion, because the heels have pulled so far forward the toes don't look that long. But if the heels were trimmed down to where they below you'd see that toe is at least a half inch longer than it should be.

Thrice weekly oxine or white lightning soaks are necessary for this horse, but this hoof will not decontract until those bars come out. The thrush came first, shrinking the frog down to a slit, but then the bars grew around it like a concrete wall, holding that contraction in place. Removing those bars will take months, especially since they've jammed so far upward into the hoof.

So what would I do if this were my client?

First I would warn the owner that this horse is going to get worse before he gets better. All that pinching contraction had damaged the internal structures so much that, once this foot frees up and starts flexing again, he's probably going to start abscessing pretty badly. It sounds awful, but it's necessary, abscessing is the only way the body can get rid of dead and damaged tissue. I would also guess that this horse has some muscle and tendon issues from walking around like this, he's going to be quite stiff and lame for a while. I would say that this horse can be helped, but it will take time and patience.

Then I'd do my trim and hope for the best.

If you have questions, please ask. My brain isn't being very cooperative this morning and some of what I've written probably doesn't have the clarity I wish it would.