Alternate Opinions 1 & 2

I've sought out other opinions regarding the possible problems that Mocha may have. I've encountered so many helpful individuals that I cannot thank enough. I did not pay for most of the services that I am going to discuss in this post, so I will not include any names. I really want to express how grateful that I am though! These individuals have not actually seen Mocha, but they reviewed pictures and the radiographs of her front hooves. I am aware that there is nothing like seeing the horse move and holding the hooves in your hand. I am also wary because the quality of the radiographs is not as good as when my vet was looking at them on her computer screen after development.

Alternate Opinion 1:

The radiographs show slight rotation of both front coffin bones, more on the left, and the photos distinctly show divergent growth rings and divergent toe angles on both front feet, visible about 1/3 of the way down from the coronet bands. Sole thickness is adequate (in fact, ample), and white line disease is present in the left front. All this leads me to conclude that your horse appears to be suffering from chronic laminitis, a very common and easily treated condition. The comment you made about "Mocha" remaining sore for a few weeks after being shod with pour in pads makes sense to me now, as a strictly thin-soled horse should typically have immediate relief. As equine veterinarians we tend to separate white line disease (WLD) from laminitis and treat them as distinct entities. Jaime Jackson feels that WLD is a manifestation of laminitis, and after practicing natural hoof care for 7 years I am in full agreement. I feel that in all cases of WLD there is a laminitis component and by treating the laminitis, the WLD grows out and doesn't return.

Mocha is in good body condition- not too heavy, nor too thin. As for pedal osteitis, that seems to be a catch phrase for a condition we diagnose when nothing else seems to fit. Many veterinarians do not believe it is actually a disease... much controversy, I'm afraid. My experience with bone loss affecting the coffin bones (deterioration) is limited to cases of chronic laminitis, particularly long standing cases, and deep seated long term bone infection (osteomyelitis- does not apply to "Mocha"). I did'nt appreciate a significant amount of bone loss in the x-rays you sent, nor would I be concerned about it. In fact, I did'nt see anything to suggest we're dealing with an incurable condition. My guess is that natural hoof care and a properly fitted pair of hoof boots on the front feet would render her rideable in a short period of time. Again, I shy away from long distance diagnoses, but this seems to be pretty straight forward.

Alternate Opinion 2:

I received a hoof consult and here are the results:

To be honest, the coffin bone doesn't look too bad to me, but I can't give a diagnosis as I am not a vet! Pedal osteitis is given as a common diagnosis but I am not convinced in many cases. Even so, if you remove the cause of the inflammation then you can usually restore health. You are right that it is not likely that she will improve if she stays in shoes. If you can find a good barefoot trimmer and are prepared to give her time to heal in boots and pads then I would recommend that route. It's hard to predict how well she will respond but I really don't think she is a particularly bad case and she has youth on her side. I've seen horses with way worse coffin bone damage go on to be sound so don't give up hope on her too quickly.

Anyway, these other opinions have given me some hope. I am taking Mocha to see another vet for a second opinion on Wednesday. We'll see how it goes!

Diagnosis and Treatment of Pedal Osteitis

DIAGNOSIS:

Well, the results of the radiographs were not good. Mocha was diagnosed with pedal osteitis. According to the vet, her right front hoof is much worse than her left. This is opposite of what I would have thought, because lameness presents more often on her left front than her right front. However, there was a void on her front left (at the time the vet thought it may be an abscess), which could have made this hoof more sore at this point in time.

This diagnosis is very disheartening for several reasons.

First, this means that Mocha has been in pain for a very long time. According to my understanding of the diagnosis, pedal osteitis is a deterioration of the coffin bone. This is can be a result of thin soles being susceptible to chronic sole bruising, which in turn results in chronic inflammation of the tissue surrounding the coffin bone. This chronic inflammation causes a deterioration of the coffin bone. She must have been suffering from chronic sole bruising for quite some time for the coffin bone to begin deteriorating.

Second, this condition can not be reversed, the coffin bone can never regenerate. At this point, it is only a matter of management and preventing any further deterioration of the bone. She is only 5 years old. This also means that Mochs is not going to be able to jump. She would likely be sound enough to be a trail horse. This isn't great because I've only been on 3 or 4 trail rides in my life, the barn where I board her does not have trails and I don't know anyone who trail rides consistently. I am thinking that she may be sound enough for some low level dressage.

I am not planning on riding her anytime in the near future. regardless.

The radiographs used in the diagnosis:

Front Right:

I was told that Mocha has a bone spur on this hoof, which is supposed to be common in cases of pedal osteitis.






Front Left:

Notice the void, which turned out to be white line disease.





DIAGNOSIS:

The vet recommended the following:

1. Monthly injections of Adequan I.M.
2. Supplements: Hoof and Joint
3. Pour pads in front

Implementation:

On May 31, 2011 the following Mocha had her front shoes back on and Equipak pour pads put on and the first adequan injection. During the shoeing, it was discovered that the void, evident on the radiograph, was white line disease, which was also present on her rear left. She continued to be lame on her front right for 11 days, with intermittent lameness still continuing at the time of this post.

Here are current photos of Mocha's hooves, including the pour pads and white line disease removal:

Front Right:







Front Left:






Front Left White Line Extraction:




Back Right White Line Extraction:




Mocha's current body condition:






I am apprehensive about the current path Mocha and I are on, but more on that later.