Auburn University: Ampututation and Prosthesis Create a Dolphin's Tale Story at Vet School Hospital for Miniature Donkey Foal

Emma, a miniature donkey foal, was just two days old when she arrived at Auburn University's John Thomas Vaughan Large Animal Teaching Hospital with a severe hind limb deformity, one that required amputation of the limb and the placement of a prosthesis.

Auburn University's College of Veterinary Medicine and the Hanger Clinic, formerly Hanger Prosthetics and Orthotics, have been working together since April on this case that could have implications in the treatment and rehabilitation of horses, donkeys and other equids with congenital deformities or injuries.

Dr. Fred Caldwell, an assistant professor in the Department of Clinical Sciences and equine surgeon, performed the amputation procedure, and is working with clinician Billy Fletcher from Hanger Clinic – the same company which made the prosthetic tail for Winter, the amputee dolphin and star of the film "Dolphin Tale" – to develop a prosthesis for her limb. The two worked out a plan to both allow Emma time to heal from the surgery and transition from her cast to the prosthesis.

Emma's fitting session for the new pink prosthesis that accommodates her growth.

"Billy was excited and enthusiastic to assist," Caldwell said. "Once we proceeded with the surgery and amputated the distal limb, he provided a small footplate to incorporate into the cast to even out the length of her hind limbs so she could bear weight until we could get the surgical site healed and have her fitted with a prosthesis. It has been a group effort on behalf of many caring individuals willing to go to great lengths to save her."

Emma's case is providing a unique and beneficial teaching opportunity for everyone involved. The practice of using prostheses with large equids is relatively uncommon because of their size and weight-bearing limitations.

But because Emma is a miniature donkey, she will be fairly small as an adult, weighing approximately 350 pounds when fully grown. This gave Caldwell and Fletcher hope for a positive prognosis and success in Emma's treatment.

Emma is now 11 weeks old and has been thriving with her prosthesis, making an impression on everyone who has worked with her.

An earlier version of Emma's prosthetic hind limb.

"She absolutely loved it from the get-go," Caldwell said. "It was a very impressive design and she did very well in it. She has progressed to the second iteration of her prosthesis, which doesn't incorporate as much of the limb and allows her more range of motion. She is getting stronger; she's growing and doing wonderfully."

Fletcher said that as Emma grows, she could potentially transition through eight or nine variations of the prosthesis before reaching her full size. At that point, she will be fitted with a piece that is more permanent.

The prosthesis is made of carbon fiber, Kevlar and fiberglass. These are materials that are strong and extremely light, and are the same materials used for prostheses for Paralympic athletes. The materials are also flexible and adjustable to allow for growth and progression in Emma's gait.

The first finished prosthesis weighed less than a pound; the most recent iteration, which is pink, is smaller, but weighs a little more to provide stability as she's grown taller and almost doubled her weight since surgery.

"The next step is trying to make sure we keep the prosthesis set up so she's ambulatory and she can run and play and do things uninhibited, but also, to keep the area of concern, the surgical site, offloaded so Dr. Caldwell can do his job in keeping her completely healed," Fletcher said.

Emma shows off her latest prosthesis. Notice how it cups the hock.

"As time goes by," he continued, "we'll continue to provide a prosthesis that's going to allow for growth. We want to provide her with full range of motion, but also give her the ability to use full strength. I think she's got that in her current set-up, so the big thing now is keeping everything offloaded so she heals completely; we'll continue to increase the size of the prosthesis as she grows."

Caldwell said he has learned a tremendous amount from the case and it has given him hope that in the future amputation and prosthesis could be a more feasible option for larger horse patients.

Story by Carol Nelson, Communications Editor at Auburn Univeristy

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.
 

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Hoof Balance Perspective: Duckett and Caldwell Speakers at Oakencroft’s October Podiatry Conference in New York

Do you know the difference between Duckett's Dot and The Bridge? For years, the Dot stuck in people's memories but the Bridge was probably where most people thought the Dot was. This is a useful illustration technique used in Dr Lisa Lancaster's book, The Sound Hoof, for her explanation of Duckett's system.

Who: Farriers and veterinarians

What: 5th Annual Farrier/Podiatry Symposium

When: October 15-16, 2010

Where: South Bethlehem/Selkirk, New York (near Albany)

Presented by The Clinic at Oakencroft and Greene County Horseshoe Supply

A Hoofcare + Lameness Recommended Event

Sometimes I sit in the dark watching speaker’s slides at conferences and think like an Irish country matchmaker. I’d like to see her talk on the same program with him, or get this German together with this Australian, or whatever, and see what they come up with when a horse walks in to be evaluated.

When I heard British educator Mark Caldwell roll through the results of his research that had compared different hoof balance methods over a shoeing period, I wondered if Dave Duckett knew that someone had put his “Dot” (and Bridge and all the rest of his landmarks) to the test not just of measurement, but of time.

As it turned out, he didn’t know, but the news got his attention. Now it’s time for the two to present their versions of what hoof balance was, is or will be, side by side on the same program. It's a speaker-match made in hoofcare heaven.

Two years later, the man with all the hoof balance testing tools and the man with all the ideas in his head instead of on paper will present their views on hoof shape and balance together, and perhaps re-define or update their studies, or influence each other. Consider this: is the best trimming method for a foot the method that leaves the foot looking balanced when the farrier drives away, or is it the one that prepares the hoof to grow out evenly and maintain a balanced base and flat landing over the four or six or eight week shoeing period?

 A foot map to where, exactly? This exercise included mapping out the foot as it existed at the time of trimming. Caldwell sketched in the wider base of frog that is one of his goals for this foot to show his students where the foot would be going, if it was trimmed not for the moment but for the continuum until the next farrier visit. If you're trying to help the horse develop the frog, would you trim differently than someone who thought this foot was acceptable as is? Should you map the foot the horse has or the foot the horse is capable of having?

THE SPEAKERS:
David Duckett FWCF: The well-known and highly honored British farrier and farrier competitor now lives in Pennsylvania. By my math, this year should be roughly the 25th anniversary of his first major hoof balance lectures. Based on observation and a lot of dissections and anatomy studies, Duckett’s idea was to get farriers interested in hoof anatomy by giving clever names to landmarks. His hoof balance system strives to inspire farriers to focus on the points on the horse’s foot least likely to change rather than to dwell on shapes that can and do migrate or grow unevenly. In spite of his system’s simplicity, or perhaps because of it, it is very often misunderstood and the points are transposed.

Mark Caldwell FWCF instructs the farriery courses at Myerscough College in England. He trained as a farrier in the British Army and then became a specialist in shoeing horses for lameness problems at a veterinary hospital before turning to teaching. His research studies use gait analysis and weight-scanning mats; his quest is to define what he calls “evidence-based farriery”.

Mark is currently involved in a post-graduate PhD program studying "limb loading and the effects on hoof capsule morphometrics" at the University of Liverpool Department of Veterinary Clinical Science in Liverpool, England.

Together, these two speakers can explain where the ideas come from (Duckett) and what happens when you put the idea to a test that filters out the subjective tricks we play on ourselves when we evaluate horses’ feet (Caldwell). This clinic is a chance to hear “from the horses’ mouths” where in the world “Duckett’s Dot” came from…and perhaps where it is going in the future.

In other words: this will not be a shoemaking clinic. This clinic most likely will be about looking at feet and identifying/evaluating the matrix that dictates a foot’s shape and growth pattern.

THE CONFERENCE:
The Clinic at Oakencroft’s Podiatry Conference is a casual and friendly event in a beautiful location in rural New York near the Massachusetts and Connecticut borders, just south of Albany. The Clinic hosts monthly meetings with local farriers and they feel at home there—you will, too.

The format of the conference is presentations, discussions, and lots of great food. There are hotels nearby.

Full conference, hotel and registration information can be downloaded at this link:
http://www.oakencroft.org/Articles/5th_Annual_Podiatry.Farrier_announcement%5B1%5D.pdf

The clinic fee is $300 for both days, $200 for Friday only or $150 for Saturday only. Registration should be complete by October 1st. Late registration will be at the discretion of the Clinic, as space allows.

Registration can be done online, by mail, or by phone. If you have specific questions or wish to contact the clinic, you may call 518 767 2906 or send a fax to 518 767 3505.

© Fran Jurga and Hoofcare Publishing Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.

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The Big Event: 25th Cornell Farrier Conference This Week Features Mark Caldwell

by Fran Jurga
Exclusive to Fran Jurga's Hoof Blog; published November 2, 2008.

British farrier instructor Mark Caldwell FWCF (Myerscough College and the University of Lancashire) began his lecture once with this slide. He said this was the group of shoes he had made up for the week ahead. Looking at them lying on his shop floor, he realized that there were no normal shoes among them. Was he doing something wrong that the horses he shod required ongoing orthopedic support? (Mark Caldwell photo)

On Saturday and Sunday, November 8-9, Cornell University's College of Veterinary Medicine will celebrate its 25th annual farrier conference. The college welcomes farriers from all the US and Canada, and provides a first-class setting for a range of speakers and demonstrators.

The two "lead" speakers this year are two farrier instructors from Great Britain, Mark Caldwell and Neil Madden. Both have earned the FWCF level of recognition from the Worshipful Company of Farriers and are currently at work as the instructors of the world's first official Bachelor's degree program in farriery.

Additional speakers are Steve Kraus and Bruce Matthews, along with Cornell's Dr. John Lowe.

On Saturday, Caldwell and Madden will compare video-based gait analysis and sensor-embedded pressure mats to demonstrate hoof balance quantification. Sunday will be a full day of lectures in the high-tech lecture theater.

Cornell is located in Ithaca, New York; it is approximately in the center of the state. There is a very good reason why this conference has succeeded and lasted for 25 years: it is simply excellent. Hoofcare and Lameness is proud to be associated with this event.

Click here for more information or call 607-253-3200 to speak with Amanda Mott about registration. A full conference brochure can be downloaded from the Cornell web site.

Caldwell's lectures can ask as many questions as they answer. Here you see two views of the right front foot a horse brought to him "to be fixed".

I've heard Mark Caldwell speak several times and it's hard to say what the audience at Cornell should expect. I remember one video example shown by Caldwell was a time delay over four strides. As the load came over the medial heel, the medial heel became a fulcrum point around which the hoof rotated outward, slightly.

Video analysis showed that over the four strides of the two-beat gait, synchronization of the loading feet was delayed by .020 seconds. As we all know, synchronicization is crucial to a horse. Without it, he is likely to forge or interfere, or even stumble. At the very least, the horse falls out of the collected frame.

At this point in farrier science, we probably don't know how much variation in timing a horse can compensate. In Caldwell's sample case, by the fourth stride, the horse had to compensate for his imbalance by “hanging” on the left rein while it re-collected itself. With a lot of horses, that's one "long side" of the ring. Horses can get away with a lot and keep trying; it takes an experienced rider (or, sometimes, a bigger arena) to sense what is really going on; a good rider can help a horse.

Caldwell's example makes a good case for not evaluating a horse based on a single isolated stride on high-speed video...or even several strides. Even with the best scientific aids, farriery still requires the art of looking at a horse in motion and recognizing rhythm and cadence, before one can even begin to dissect the horse's problem. You just might look in the wrong place.

Caldwell talks a lot about the marriage of art and science that is necessary for good farriery. His and Madden's lectures at Cornell this weekend should be a great update for new ways to approach studying the hoof.

See you there!





© Fran Jurga and Hoofcare Publishing. No use without permission. Permissions for use elsewhere are mostoften easily arranged.

Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page).

To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found.

Questions or problems with this blog? Send email to blog@hoofcare.com.