Something that is working...

It's been quite a while since I had a Ramsey update.  No news is good news.  The camera angle was off for this recent photo making it look like the outer wall is much longer than the inner, which is not accurate.  However, it does show that the walls are now straight instead of curving to the side.

The outer wall on the left where the missing coffin bone is, still shows poor connection and a widening of the white line, but it always will.  I think this is as close to "normal" as this foot will ever be.

From this angle, you can see that it is a pretty nice looking foot now.  More importantly, it is a generally sound foot.  That's what matters.  For quite some time, I trimmed it just a very small amount each week.  As the distortions have grown out, I have slowly been able to extend that time frame.  I am now trimming it a small amount every 3 weeks.  It seems to be working well for him.

Ramsey does, occasionally, have some soreness, but it is in the arthritic fetlock joint not the hoof.  I am certainly frustrated by that, but we are managing it well.  I have been giving Ramsey (and Tanner) turmeric each day.  It has been shown to be an effective anti-inflammatory with no negative side effects if given at the proper dose.  I was skeptical at first, but both Tanner and Ramsey have been on it since last Fall with excellent results.

Tanner has had joint issues all of his life and has suffered with periodic episodes of extreme lameness.  He does not tolerate pain medicines well or visits to the vet.  He has not had a single bad episode since starting the turmeric last year (even with the extremely cold winter, which would normally cause him trouble) and no negative effects whatsoever.  I'm convinced.  And I'm happy with this pretty little donkey foot as well.

An Overdue Update

Seems like it's been a long time since I had any foot updates.  Honestly, this winter has been kicking my butt in more ways than one and I know I've been slacking a bit, especially with the blog.  One of the issues that came up with all my recent doctor visits and tests was an extremely low vitamin D level despite the fact that I was taking high levels of supplemental D.  I am now taking stratospheric levels and it has helped, kind of like coming out of a dense fog.  Some of the bone and muscle pain has improved as well although there are other problems there as well. Autoimmune disorders suck.

One of the problems I am dealing with is improper absorption of nutrients as a result of damage to my GI tract caused by celiac disease.  It is ironic to me as I have been delving so deeply into equine nutrition.  Turns out Ramsey and I have had some of the same problems.  In Ramsey's case, the nutrients were missing from his diet.  In my case, I am unable to absorb them.  Different problems, similar results. 

I haven't forgotten my promise to write about nutrition either, it just got lost in the fog for a bit.  I have also been struggling with it to a degree because I have found that many (most?) people are very resistant to talking about it at all.  I have encountered a tremendous reluctance to even discuss the possibility of nutritional issues and this has left me seriously puzzled.  After pondering this for several months, I have come to think that the problem of nutrition is two-fold:  first, it is a complex, often bewildering subject that can't always be easily fixed.  Second, many horse owners take any suggestion that there could be a nutritional problem as a criticism of their horse keeping skills. 

It is far easier and more satisfying to buy a tub of vitamins and feel that we have done right by our animals than it is to go looking for trouble.   Unfortunately, I have come to believe that most of our horses do well in spite of those lovely white supplement tubs rather than because of them.  For those who are interested (and I know there are a few:), I will get around to it one of these days.

For now, a rather overdue foot update:

If you recall, last Fall, Ramsey's foot had gone all sideways on me and was collapsing inwards...
10/26/13

I can't tell you how many hours I have spent looking at this foot as well as all the bones above it and watching how Ramsey moves.  In late Fall, I made a conscious effort to set aside all of the trimming advice I had gotten to date and stopped studying other hoof trimming methods.  I am not saying that any of that information was bad, any skill has to start somewhere after all.  Rather, there comes a point when you have to step away from books and experts and let the foot in front of you tell you what it needs.  I think this is true for any hands-on skill, at least it is for me.  I study everything I can until I come to a point where I have to stop studying in order to learn. 

It is also true that, just as every finger print is unique, every hoof is unique.  Ramsey's foot is a bit more unique yet.  There is no book that covers this foot.  It was obvious that what I had been doing was not working any more. 

I made changes in Ramsey's feed to address nutritional deficits and imbalances and I set about trying to do what this very special and unique foot wanted.  I made some mistakes along the way and they showed up in the foot, as they always do, but I am much happier with where we are now.  This is where we were  2/16/14...

and where we are 3/7/14...(note how much shinier the foot is, that is from the balanced nutrition)

In these next photos, you can see how that abscess he had last Fall slowly grew out.  You can also see how the hoof wall has gradually thickened.  I attribute that to nutrition as well.

 12/4/13                                                                                  2/12/14

Starting to look like a decent foot, (note, I don't usually trim the frog much at all, but Ramsey's is so tough that it does not wear down at all in the snow.  It was growing well past the bottom of the foot.) 3/7/14

The above photo is interesting to me because you can so clearly see where the missing coffin bone is.  Picture the "bite" taken out of the bone and you can see it clearly in the upper left side of the foot.  The right side shows lovely wall connection and a very tight white line.  That line turns into a 1/2 inch thick, wobbly area on the left of the foot where the bone is gone.  Those dark spots are weak, poorly connected areas. 

The bone loss shows up on the outside of the hoof as well, in the line that runs down the side of the foot...

 12/4/13

We have managed to maintain good wall connection at the toe and the heels are slowly strengthening.  I would like to see the entire foot about a 1/2 inch shorter than it is here...

2/12/14

Getting there....slowly.
3/7/14

Finding its way?

A Ramsey update.....

I think the last time I talked about Ramsey's foot, I mentioned the concerns I have about the way the foot is distorting laterally as you can see so clearly in this photo from 10/21/13...

I have been doing very tiny trims each week trying, not to "fix" the foot, but hoping to guide it and stabilize it until we can get more growth.  One of the really big problems that my feed analysis revealed was a bad phosphorus deficiency coupled with high calcium and manganese, both of which further inhibit absorption of phosphorus.  This is the main cause of angular limb deformities, early arthritis and hoof deformities in growing babies.  I really am going to get around to talking about this more, I am just finding it difficult to figure out just how much anyone wants to hear.  People's eyes tend to glaze over when I start talking nutrition. What, if anything, would you folks like to know about equine nutrition?

Anyway, there has been some improvement, 12/4/13....

There is a spot on his sole, below where the coffin bone was removed, that is going to slough off.  It is hard to know, but the recent abscess he had may have originated there or it migrated to the weak point.  Fortunately, I caught it quickly and it seems to be growing out.

I think it is interesting to note the color variations on the entire lateral (on left above and right below) wall.  All the white, irregular areas along the upper left side of the foot, mirror the irregular bone beneath.  There is certainly a lot going on in this one tiny foot.

I am pleased with the new growth that you can see here that has occurred since correcting the nutrition issues.  The white line, which is that very thin white line that runs around the outer edge of the foot, is much cleaner and tighter looking.  The curve in the frog has straightened some as well, which, I hope, means that we have managed to stop the twisting distortion of the hoof capsule.  It is hard to see here, but the new growth where the coffin bone is missing is coming in better as well.  Hopefully we can continue that way.

10/21/13                                                                         12/4/13

What I hope, is that I can help support the foot and the leg as they both continue to find where they need to be and gain strength now that the major mineral imbalances have been accounted for.  It is both a blessing and a curse that donkey feet seem to react to environmental pressures faster than horse feet do.  When things go wrong, they go very wrong very fast.  But, they also come right faster when given a chance.

***

As I am always posting pictures of bad feet I thought I'd add some of a GOOD foot.  Below is what a nice donkey foot should look like.  It does have a steeper angle than a horse foot and is a bit more upright, but it is still compact, tightly connected with a nice low heel.  The front of the foot is perfectly straight, with no deviations, indicating a well connected hoof wall.  If I ever had an x-ray taken of this foot, the front of the coffin bone would be parallel with the front of the hoof wall and there would be plenty of sole thickness.

The entire back third of the foot is thick, well developed frog, extending well past the back of the heel buttresses, as it should.  This is one of the biggest differences between donkey feet and horse feet.  That massive frog combined with the greater elasticity of the hoof are what make donkeys so amazingly sure footed on rough, rocky terrain.  The small, narrowness of the foot is also why they do not do so well in mud, snow and ice.

Living on soft ground like mine do, a donkey foot will never wear enough to keep up with growth and will not self trim.  The soles of donkeys on soft ground need to be trimmed back or the foot will just get taller and taller until it falls over.  This is why it is so much more common to see extreme hoof pathology on neglected donkeys then it is to see it in neglected horses.  X-rays of Ramsey's other foot showed that, even after trimming the sole back as much as I had thought was safe, he still had 15 mm of sole depth.

The foot is well balanced and I have no doubt that an x-ray would show the bottom of the coffin bone to be ground-parallel.

This foot toes out almost as much as his other foot, but remains balanced to his conformation and is a highly functional and sound foot.  If I were to try to "correct" his stance, I would cripple him.  Pretty-is-as-pretty-does and this is a very pretty foot.

A Semblance of Normality

I am still recovering from a very bad case of bronchitis and a sinus infection, which has been especially annoying as this is my favorite time of year and the weather has been unusually wonderful.  I have to admit, I have been feeling just a bit sorry for myself.  Still, I am getting a bit better and it is Spring, so things are looking up.

It has also been unusually dry (worrisomely dry in fact), which is providing a very rare window of opportunity to get some things done that normally aren't possible this time of year.  I have had several loads of firewood delivered (which is just a bit bittersweet as it is great to have so early, but I am soooo sick of firewood at the moment), there are two truckloads of stone headed my way tomorrow to help deal with the major mud problems I had around the barn this winter and....well, the list is long, long, long.

With all of this going on, I have decided to take some time off from work and from the computer.  Blog posting the rest of the week could be a bit erratic.  With that said, I wanted to show you these pictures of Ramsey's foot that I took this afternoon, I find this fascinating and encouraging....

If you look close at this foot, you will see that the bottom third is smaller than the top with the heel pinched in.  I drew more lines on this photo to show what I mean...

The lower part of the foot is what was grown months ago and used to be above the surgical site.  It is still somewhat deformed and contracted.  However, I am very encouraged by the new foot that is growing in above it.  Donkey feet grow faster then horse feet do and Ramsey is already well on the way to growing in a good foot.  I don't know what exactly caused the lower portion of the foot to be so much smaller then what the new foot clearly indicates it should be, but I strongly suspect that it was from nearly four months of constant bandaging, lack of weight bearing and lack of exercise.  I also find it very interesting that the hair just above the foot is still growing in wavy instead of smooth as it is on his other foot.  That is also the result of the bandaging.  

Looking at the foot from the bottom, it is finally starting to take on a semblance of normality.  There is a little bit of concavity and the heels are much less contracted.  The frog is still badly prolapsed downwards, but the cleft at the back of the foot is beginning to open a bit, which is the first sign of healthy growth I have seen. 

For all of it's trials, this foot is beginning to look like a healthy foot.  Most importantly, it is functional.

I still find trimming this to be very tricky.  I have actually been trimming it almost weekly in tiny amounts rather then trying to make larger corrections less frequently.  I know I have made some mistakes and doing very small trims helps prevent me messing up too badly.  Mistakes do tend to show up fairly quickly so I can correct them before they cause too much trouble.

The one thing that still has me concerned is that the wall at to toe is still not growing in well.  It may be that it is because of the missing coffin bone and it will never grow in correctly, but I think I am battling some ongoing fungal or bacterial trouble as well and I have been treating it.  I think all this dry weather will help.

If you look close at the lower left part of the sole, you can see some pink areas.  That is inflammation that occurred weeks or months ago and is just now growing out.  When I first started trimming him after his last trip to Cornell, nearly the whole bottom of his foot was pink and bloody looking like that.  Then it was both sides and it is just now getting to the point where it only shows a bit in the left side.  There was a whole lot of inflammation in this tiny foot.

I have to say, this is one of the things that really takes a lot of courage to trim through.  That bruising shows up and you would swear that I was cutting into live tissue.  I know I let myself get scared off by this several times and I probably didn't trim as much as I should have at first.  I had to give myself some pretty stern lectures and get my courage up to keep at it, but I think we are getting it figured out finally.  I can understand why it takes a certain kind of bravery to be a surgeon and I can doubly understand why surgeons should never have to operate on anyone they love.  This would be so,SO much easier to do on an animal I did not have a connection with.

We are getting there though.  Compare this...

to where we were a few months ago...

We're not that far off form looking like his good foot.  Speaking of...there was quite a while that I could not trim his good foot well because it was too hard for Ramsey to stand on his bad foot.  This foot shows almost the exact opposite of his other foot, the lower third is larger than the top of the foot because it was bearing so much more of his weight for so long.  That extra weight and lack of trimming showed up as a somewhat larger hoof capsule and a slightly underrun heel.

When both feet look like the top potion of this foot, we will be in good shape. 

We've come a long way baby!:)

A Very Different Picture

Cornell sent me a disk with all of Ramsey's x-rays on it.  He has had more than 60 radio-graphs taken.  Most of them were clearly taken during his surgery, probably for guidance and to make sure they had disease free margins.

The first two pictures are the first ever taken on Nov.2 and were how the vets diagnosed septic pedal osteitis.  I am no expert at reading x-rays, but if I have read this right, this is a front to back view of the right foot.  The bottom most bone is the coffin bone or P3 (the third phalanx), and is where the infection was.  If you look at the right hand side of the bone, you will see that it has fairly clear, well defined edges.  The left side of the bone appears fuzzy with vague borders, that is the infection.  Below the bone, there is a dark oval, I think that is a pocket of abscess.  The dark spot on the bottom right is where there was a piece of hoof cut out of the sole.

I think this is looking down through the top of the foot.  Again, the right side of the bone is clear, the left is a dark, fuzzy shadow.

These were taken during Ramsey's surgery on Nov. 3.  I think the needles were used as markers to gauge whether the margins were clear.

They took some bone out, repeated the x-rays and then took more.  Several times.

They were never able to tell for certain if the joint was involved so they treated it as if it were and flushed it with antibiotics.  You can see the needle inside the joint capsule.

These were taken on Nov. 30 to check Ramsey's healing progress.  The margins of the remaining bone are sharp and clear.  No infection.

A lateral view, also taken on Nov. 30.  You can still see the hole in the side wall of Ramsey's hoof.  The shape of the hoof and the position of the coffin bone is good.  The bottom of the bone is mostly parallel to the ground.

Compare the above image to this one taken on Feb. 25. (this was taken after the farrier trimmed most, but not all, of the foot).   The length of Ramsey's heel is longer here then above, but squashed underneath him.  If you are a horse or donkey owner and you hear the term "underrun heels", this is it.  It makes the coffin bone tip back a bit.  You can also see that the coffin bone is higher up in the foot then it is below.  This can get much worse in donkeys or horses whose feet have been neglected for a long time and allowed to over grow into a slipper shape.  The farrier at Cornell started to correct this, but it will take some careful trimming over time to get this foot back where it needs to be

I think this last film is the most striking for me.  You can see at a glance just how much of the coffin bone was removed and is just plain gone forever now.  That won't grow back.  You can also see where the ragged edge of his hoof wall corresponds with the missing bone.  That won't grow back fully either.  It is amazing to me that Ramsey can even walk let alone be out playing in the snow with his mom.

A Foot Update

It feels like progress has slowed a bit with Ramsey's foot.  The hoof wall is still growing fast, but the sole has a long way to go yet.  I think there is still a lot of dead tissue that needs out grow out before we get healthier hoof.  The back of the hoof wall keeps curving in toward the frog more and more as well.  I don't know if that is caused by the internal damage to the foot or the constant bandaging.  Since it has not happened on the other side of the hoof, I suspect the former with the latter possibly being a contributing factor.  I will share these photos with the vet, see what he says.

Right after I took these photos, I massaged some of my ointment into the foot and all of that scaly stuff on the side finally came off.

To me, it looks like the coronet band has become oddly stretched and elongated.  I have not ever seen anything like this before.  I really think it is the result of 3 months of constant bandaging and I have been trying to think of different ways to wrap the foot that would allow more air circulation, but I haven't come up with anything yet.  It has to be foolproof so I haven't dared experiment much.

In spite of how odd everything looks, Ramsey seems very sound on the foot.  He moves easily and freely with no limp and no sign of pain so I am not terribly worried.  I have been trimming the foot just a little bit each week, hoping to maintain it in tiny steps rather than trim it all at once weeks from now.  I think we will see much healthier growth once he can go without a bandage.

Speaking of bandages, I had been trying to stretch out the bandage changes to every 3-4 days, but I think I am going to have to go back to doing it every other day.  The back of his heels get so dry that the bandage rubs and chafes, making it sore.  I am still using my beeswax salve on it, which has really helped, but it needs to be reapplied more often.  I don't want him to get sore and I certainly don't want it to get infected again.  His heels were looking really good, but we seem to be losing ground so, back to every other day.  Not only is this time consuming, but between bandage materials and medicine, it costs about $10 every time I change it.  Oh well.  I have been trying to make the bandage lighter, but....

When I did this bandage change, I noticed that Ramsey now has a tiny white spot.  I don't think it is genetic though, it certainly wasn't there before.  It looks to me like a tiny scar, which often grow back in white.  It makes me wonder if this could have been the original injury that caused all of this.  I always assumed that it was a stone bruise that started everything, but it is possible that a puncture wound in the leg could have been the route in for bacteria. 

Both of the donkeys love to scrounge and nibble in whatever brush they can find, Ramsey could easily have punctured his leg on a twig or thorn.  Given how tiny this spot is and how thick and dark Ramsey's fur is, I doubt I would ever have seen it.  The actual scar under that white fur is about the size of a sesame seed.  

Ah well, now Ramsey can boast of a light point after all.