St Nicholas Abbey Fracture Fixation Pin Breaks

The horizontal steel pin (top of radiograph, red arrow) was designed to help the injured Thoroughbred bear weight in spite of the fracture in his pastern. This pin, as you can see, is broken and had to be removed. (photo provided by Coolmore Stud)

An important announcement from Coolmore Stud was released today. Coolmore has been judiciously reporting both the good and bad news throughout the ordeal of a fractured pastern suffered while galloping to multiple Group I winner and stud prospect St Nicholas Abbey.

On the Case with Austin Edens: Engineering Prevention of Support Limb Laminitis with a Removable Clog Screwed to a Shoe

The plywood "clog" shoe used to treat laminitis can be a tool in itself or it can be a component of a limb extension and support package, as illustrated in this article about a removable clog used as part of a plan to prevent support limb laminitis. The system was designed by Texas farrier Austin Edens.

The Steward Clog was developed by Dr. Mike Steward in Shawnee, Oklahoma as an economical way for him to treat the rampant laminitis cases in his area.

Standard Steward Clog screwed into foot

He wanted an alternative for the horses of owners who couldn’t afford hand-forged heart-bar or glue-on elevator shoes and tenotomy surgery. He succeeded with a disk of plywood that he literally screwed into a horse’s foot. He charged the client $50. When the clog succeeded and he started telling people about it, farriers and veterinarians had to start adding their own high-tech touches to the world’s most low-tech shoe, whether it was casting tape, non-slip bottoms, shock- absorbing soles, impression material, or even plastic strap-on, strap-off versions.

Before we knew it, the once-lowly Steward Clog was turning into a designer horseshoe with a price to match. Not only that: in a few years' time, the clog design has gone full circle: the same concept can be utilized for both preventing and treating laminitis.

My eyes lit up when I saw a photo of a Steward clog of the latter type that looks like it has been to engineering school. And graduated at the head of the class.

Farrier Austin Edens probably chuckled as he set out to build a three-piece system out of a shoe that was conceived as the anti-system shoe. Consider Austin's illogical but ultimately functional design: he added not one, but two actual horseshoes, of two different metals, to a device that was meant to replace the horseshoe. Are three shoes better than one? The horse will decide.

Attaching the clog to a horseshoe so that the clog can be altered, replaced or removed--using a simple Phillips-head screwdriver and without re-shoeing the horse or disturbing its foot--is the bonus that an engineer-oriented mind like Austin’s can bring to the challenge of preventing laminitis.

Remember that the prospects for fine-tuning a shoe on the "good" foot of a horse with an injured limb are limited after the initial shoeing is done with the horse under anesthesia. The horse is not likely to be able to cooperate much in terms of lifting the good foot for shoe adjustment once he is standing. A removable device that screws onto a shoe and can be slid out from under the foot (and back on again) is a practical solution.

Some people still love a challenge; that is what this business is all about. Thank goodness Austin and people like him (and probably like many of you reading this article) are On the Case.

--Fran Jurga

PHOTO 1

1. I arrived at the vet clinic to find that surgical treatment for lacerated tendons on the injured left front leg of the horse had been completed. The horse was still under anesthesia and the “good” foot had been measured for the application of a support limb laminitis prevention shoe package. The surgeons asked me to add two inches of length to the horse’s right front, or “good” foot to aid in the prevention of support limb laminitis in that foot.

PHOTO 2

2. The surgeon asked me to elevate the "good limb" two inches so that it was the same length as the limb in the cast. The cast and its wear material on the near fore added almost two inches of length. My job was to extend the contralateral limb beyond the length of the cast limb and to prevent support limb laminitis. Using wood was the best way for me to elevate the limb.

The first step in creating the appliance was a beveled aluminum shoe with side clips, which I made from 1/2” x 1” aluminum bar stock.

PHOTO 3

 3. The aluminum shoe was nailed on--not an easy thing to do on a leg that is dangling in the air and bouncing whenever the hammer touches it.

PHOTO 4

4. When I forged the shoe, I made six holes around the perimeter of the shoe, countersunk at 45 degrees. A block of wood (clog) 1.5 inches thick was shaped to the shoe, and also tapered behind the toe of the shoe for ease of breakover. I screwed in six 1 5/8” long wood screws through those holes into the wood. They held in the wood at 45 degrees, giving a good hold across the clog. A simple Delta Challenger horseshoe was nailed (with horseshoe nails) into the clog to prevent the soft wood from wearing.

PHOTO 5

5. One of the final steps was to pour Vettec’s Equipak into the cavity of the sole, filling up any space that existed between the foot and the plywood. This was a little awkward to do. I used Play-Doh for a dam to hold it in the foot.

PHOTO 6

6. This closeup shows the countersunk screw insets at the toe; there were also two at the heel and two at the quarters, all set at 45 degrees, to anchor the wood onto the shoe.

PHOTO 7

7. The final step, once the EquiPak was set up, was just for insurance. I wrapped the extension in Equicast casting tape.

 About support limb laminitis

Laminitis is usually thought of as a disease with a medical basis, but it can also be caused by mechanical conditions. Both excess concussion, known as road founder, and lack of movement can result in a disruption in the metabolism of one of more of a horse’s feet. The most common scenario is when a horse injures a leg and the opposite, or contralateral, limb bears more than its share of weight. The horse may not shift weight regularly off the “good” leg, or there may be some circulatory or other reason why the laminar junction of of the hoof wall-coffin bone interface becomes compromised. Because the horse may be unable to shift its weight away from the pain of the laminitis, support limb laminitis is especially painful for a horse.

In order to prevent support (contralateral) limb laminitis, many equine hospitals routinely apply heart-bar shoes or go through a special protocol to pre-emptively shoe or cast the good foot when the horse is in surgery for an injury.

 About Austin Edens

Austin Edens is a farrier who is based in Dripping Springs, Texas, and Wellington, Florida, but you might run into him almost anywhere in the world. He is widely known as one of the most successful and consistent international farrier competitors in history (including being World Champion) and a popular judge. Austin’s farrier work today is centered on a sport horse client list and challenging veterinary collaborations such as the one illustrated in these photos. He is also a product consultant and clinician with Delta Mustad Hoofcare in the United States.


On the Case is a new feature of the Hoof Blog. Brief photo- or media-based problem-solving reports on cases from subscribers will be featured. Text and photographs © 2011 Hoofcare Publishing.

© 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.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

Read special Facebook-only news on the Hoofcare + Lameness Facebook Page

Tweet

 

Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Vascular Plastination Casts of Equine Feet Ready for Shipping from Hoofcare Publishing

Note: these casts are temporarily not in stock. Because of the delicate work involved, they will be offered on a "special order" basis in the future. Please contact us to find out what the status of supply is at any time and we'll do our best to assist you. We do also sell beautiful posters of images of the blood supply

A plastinated "corrosion cast" of the blood supply in a horse's foot is created from the foot of a cadaver. Plastic is injected into the veins and, after removing the hoof capsule and processing away any non-vascular tissue, what is left is virtually a three-dimensional venogram. Hoofcare and Lameness is offering these for sale on a special order or as-available basis beginning in November 2010.

This over-exposed and light-enhanced image of a corrosion casting shows the delicate structure of the blood supply inside the hoof capsule.

Hoofcare and Lameness is now taking orders for full-hoof vascular casts, preserved by the plastination process of Dr. Christoph von Horst of HC Biovision in Germany. Dr. von Horst will be shipping these to the USA.

Some of you may have seen the half-hoof cast that has been on display in the Hoofcare and Lameness booth in the past. Everyone wanted it, but it wasn't for sale. A special-order trial set of casts was sold this spring, and new sets have followed.

The cost for a whole hoof corrosion casting in the USA is $352 plus $10 shipping. The casts cannot be shipped to foreign addresses.

The plastic is quite resilient, but these models should be handled with care. It's hard to imagine a better tool to explain why a venogram is needed, or as an asset to an anatomy class.

Photos can be shown to preview a model. They vary in the amount of detail and thickness in the hoof wall and sole; many have high detail in the coronary band papillae and digital veins.

One model that has been popular was affixed to a plexiglas base, making handling easier and insuring longer life. To view the underside, you can just look through the plexiglas. This is an excellent model for anyone who would use the model in a classroom setting.

A great variation exists in the amount of capillary tissue that has clung to the plastic through the mastication process. Models with more external capillaries are attractive to represent the whole hoof and the complexity of the hoof's blood supply; models with fewer capillaries allow better examination inside the capsule and more attractive light transmission for photography. The two models in the photographs with this article illustrate the extremes of these variations.

Partial models mimic venograms of horses with severe laminitis so that the owner can see in three dimensions what the damage to the vascular system might look like. This is just a gross approximation and is not meant to represent any particular case or stage of laminitis, but to illustrate where the damage might have occurred. These partial models are fragile.

Special orders can be arranged with Dr. Von Horst if you are looking for a vascular model of a certain type of foot. The casts available are a mixture of front and hind feet of average-sized, presumably healthy horses with no medical history available.

Please contact Fran Jurga at 978 281 3222 or email fran@hoofcare.com to inquire about the models. They are sold on a first-come, first-served basis. Pre-payment is required on all orders.

Hoofcare & Lameness has some amazing plastinated equine educational tools from HC Biovision.

These models are used in natural history museums, universities, veterinary hospitals, farrier clinics, and natural trimming schools around the world. They are permanent, low-maintenance, colorful, and durable preservations of actual tissue slices of horse hoof and limb tissue.

© 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.
 

Follow the Hoof Blog on Twitter: @HoofcareJournal

Join the Hoofcare + Lameness Facebook Page

Tweet

The Long-Awaited Comeback of Overdose: Laminitis Recovery for the Hungarian Wonder Horse

"Does he look ready to you, Hoof Blog Friends?" Hungarian Thoroughbred trainer Sandor Ribarszki holds the left front foot of his country's idol racehorse "Overdose" in Neuenhagen near Berlin, Germany, last week. Overdose suffered from laminitis more than a year ago. He seems to have hoof casting tape or a wrap (as suggested by one reader--I assumed it was tape since it is so prevalent these days) on this left front and a glue-on shoe on his right front. The Hoof Blog has had a lot of readers from Hungary in the past year; perhaps they are learning about laminitis treatments used on their national hero. Overdose's folkloric comeback is reported on web updates in all sorts of languages. Photo from fOTOGLIF EPA/TIM BRAKEMEIER

Overdose's return to racing has been pushed back again: the racing press in Europe reported him scratched from a race in Berlin, Germany today, but entered in a race at Royal Ascot in England over Memorial Day weekend. That's a tall order for a horse recovering from laminitis. The five-year-old has a huge following all over the world and over 1,000 Facebook fans. They call him "The Budapest Bullet". He's the winningest racehorse to come out of Hungary in generations. Photo from fOTOGLIF EPA/TIM BRAKEMEIER

This video slide show of images of Overdose has a soundtrack of one-liners from the US film Seabiscuit. There are a lot of parallels between the two horses. Overdose was purchased for 2000 pounds in England and went on to win there and in Germany, Italy, Hungary and France. He is the national hero of Hungary and the Hungarians want to see him run again.

Just watch him run; this race was at the beautiful Baden-Baden spa in Germany. It's fun to watch this clip just to listen to the call.

16 May 2010 | Fran Jurga's Hoof Blog at Hoofcare.com

Follow the Hoof Blog on Twitter: @HoofcareJournal

Join the Hoofcare & Lameness Facebook Page

Barbaro Update: Cast changes, heel abscess in right hind

From the University of Pennsylvania today:

“Barbaro was placed under anesthesia yesterday to have his left hind foot cast replaced,” said Dr. Dean W. Richardson, Chief of Surgery. “We also removed the cast on his right hind leg and replaced it with a custom-fabricated plastic and steel orthotic brace to give his foot additional support.” An abscess near the lateral heel of his right hind foot was drained, and the brace that was applied will allow more regular treatment of that foot.

“Barbaro had another smooth pool-recovery and has been comfortable with an excellent attitude and appetite since then,” said Dr. Richardson. “We will probably replace his left hind foot cast under anesthesia again at least two or three times at roughly two-week intervals if his comfort is maintained. We were very pleased with the progress of his left hind foot since the last cast was applied.”

In addition, new shoes were placed on both front feet for additional support.

Barbaro: Cast Removed at New Bolton Center

This just in from the University of Pennsylvania:

"Barbaro has had a significant setback over the last 24 hours. He became acutely more uncomfortable on his left hind foot. The foot cast was removed and some new separation of the medial (inside) portion of his hoof was found. This required some additional debridement (removal of the damaged tissue) last night.

"He is being treated much more aggressively at this time for his discomfort. He is continuing to eat well and is otherwise stable."

Barbaro Update: Morrison Casts Foundered Foot for Stability

Left: Rood and Riddle Equine Hospital's Scott Morrison DVM finishing tendon surgery on a laminitic horse.(Hoofcare & Lameness Journal photo)

On Wednesday, January 3, Scott Morrison DVM of Rood and Riddle Equine Hospital in Lexington, Kentucky traveled to Kennett Square, Pennsylvania. Rattling around in his briefcase were strips of 3M Fiberglas casting tape, Goretex fabric, thick felt, Betadine and a large aluminum bar shoe. One can only imagine what that jumble looked like on the security screen. For once, TSA inspectors waved the veterinarian through.

Morrison used those materials to create a temporary supportive foot cast for Barbaro, the champion 2006 three-year-old colt whose right hind leg shattered soon after the start of the Preakness Stakes last May. Since then, Barbaro has been a patient at the University of Pennsylvania's Widener Hospital for Large Animals at the university's rural vet school campus called New Bolton Center. In July and August, the colt fought the painful disease of laminitis in his "good" hind leg. He was left with one broken leg and one hoofless one, but he struggled to survive. The damage to his laminitic foot continues to be the greatest concern.

Laminitis is the devastating disease that ended the lives of great racehorses like Secretariat and Sunday Silence, the Standardbred champion Nihilator, and more recently, the two great European champion dressage mares, Annastasia and Poetin.

Morrison, who heads Rood and Riddle's innovative podiatry clinic, was sought as a consultant to assist with the foundered (a common term for a foot that has been ravaged by the disease of laminitis) foot. He first saw the horse on December 20 for an evaluation, then returned on Wednesday to try to help stabilize the foot.

On Friday, January 5, Dr. Morrison told me that the cast was applied, "because the foot is so unstable. He's just not growing enough wall on the medial (inner) side, and he's bearing most of his weight on the arthrodesis (surgically-fused) leg."

Morrison padded the bottom of the foot with thick felt soaked in Betadine (iodine solution); the hoof wall was padded with Goretex fabric padding which was then covered with 3M casting tape. The cast extends up over the pastern area to just below the fetlock, according to Dr. Morrison.

"He lands on his toe when he walks," Morrison commented, "and that needed to be addressed. I had asked them to take radiographs before I got there, and they showed demineralization (thinning or actual deterioration) of the coffin bone (pyramid-shaped bone in the base of the foot, encased by hoof capsule) at the toe and on the medial (inside) wing.

"I attached a big aluminum bar shoe to the bottom of the cast to help with derotation, to try to get that coffin bone more parallel to the ground."

Morrison observed that the horse was uncomfortable at first with the change in footwear, but that surgeon Dean Richardson reported the horse was more comfortable with it the next morning.

An ancillary purpose of the cast is to stabilize the foot in the event that the horse needs to be moved out of his intensive care unit home at New Bolton Center. Speculation is that the horse will be moved to an as-yet unnamed farm, possibly in central Kentucky, to continue treatment in a more active setting. No date has been announced for his discharge from New Bolton.

Dr. Morrison is the founder and head of the podiatry clinic at Rood and Riddle; his unit is the largest such clinic in the world. The clinic currently employs four foot-specialist veterinarians and five lameness-specialist farriers, as well as a staff of technicians and administrative support staff. Morrison is a specialist in laminitis and consults on cases all over the world. He is also a consulting editor to Hoofcare and Lameness Journal.

His most recent article chronicled the transplant of frog tissue on the bottom of an injured foot via the punch biopsy tool method; he was able to create a germinating bed of new frog tissue in a damaged area. Ironically, he is probably most renowned for an article detailing his use of sterile maggots to debride many cases of infected hoof tissue. That article can be downloaded at http://www.hoofcare.com.

© 2007 Hoofcare & Lameness Journal/http://www.hoofcare.com
Contact: tel 978 281 3222 fax 978 283 8775 email bloginquiry@hoofcare.com

All's Quiet on the Barbaro Front: Latest News from University of Pennsylvania's New Bolton Center

Barbaro is improving slowly and steadily according to veterinarians at Penn’s George D. Widener Hospital . “We are pleased with his progress,” said Dr. Dean Richardson, Chief of Surgery. “He is wearing the cast on his right hind limb well; we continue to monitor it closely, and we expect to change the cast and radiograph the leg within the next seven to 10 days.”

In addition, Barbaro, winner of the 2006 Kentucky Derby, continues to stand comfortably on his laminitic left hind foot. “The left hind foot is progressing well, especially as it grows down from the coronary band,” said Dr. Richardson. “However, we remain cautious, because Barbaro will still need several more months of healing before we’ll know how well the overall hoof structure can be restored.”

--end of official report from New Bolton Center

In an interview in The Thoroughbred Times, Barbaro's trainer Michael Matz said that he was still concerned with the possibility of laminitis in the front feet.

Read a FAQ page on laminitis with Dr. James Orsini of New Bolton Center: www.vet.upenn.edu/newsandevents/news/Laminitis.htm