I finally got the copies of the radiographs of Ramsey's foot that were taken at the hoof clinic. I haven't had time to finish my next post yet so I am posting these for anyone who is interested.
As you can see in this first film, Ramsey has more than 1/2 an inch of sole under that coffin bone, which is very good. The front of the hoof wall lines up very nicely with the front of the bone, indicating nice, tight lamina connection. The hoof looks good. He does have some sesamoiditis (that is the big knobbly thing at the back of his ankle in the upper portion of the film). That should be round and smooth, rather than bumpy looking.
In this next film you can see that the bones are aligned pretty well, one atop the other and that the coffin bone is parallel to the ground, indicating good medial/lateral balance. Looking at the lower left side of the bone, it does appear shorter than the lower right. That is missing bone from the surgery and gives it a slight appearance of unevenness, but looking at the top of the bone where it joins p2, you can see that it is straight.
And the last film...it still looks like something came along and took a bite out of the bone.
We finally got to Ramsey about mid afternoon. At first, Pete looked a bit disappointed about Ramsey as he was itching to get to that poor jenny in yesterday's post. He wasn't so sure that there would be much to talk about with Ramsey, but I told him that he might just have a surprise for him. That seemed to cheer Pete up.
(For anyone who is new to the blog, here is one of Ramsey's previous radiographs showing what his coffin bone looked like after having surgery at four months old for septic pedal osteitis (an infection of the coffin bone, also known as p3).)
After describing Ramsey's history, diet and environment, Pete immediately wanted to see a new set of radiographs. Luckily, there was a vet able to do digital films right there for just that purpose. While we were waiting for them to set up, he took a look at Ramsey's feet and his first impression was that the sole was too thin and he was unhappy that someone had "rasped' his toe off at an angle.
I am not sure that Pete actually believed me, but NO, I do not trim his foot this way and I did not rasp the toe off. Ramsey manages it all on his own by digging craters in the pasture. It is one of his favorite summertime pursuits. If anyone has any idea about how to stop him doing this, I would certainly like to hear about it. He never does it when I am around, but I see him doing it from the house.
Ramsey digs holes, almost exclusively, with his bad foot. I often wonder if it is a sign of pain or odd feelings in the foot as a result of his surgery. There are a lot of nerves in the foot and many of them had to have been disrupted when Cornell removed a third of his coffin bone. Ramsey often acts like there is an itch in the top of his foot and will bite at his hoof occasionally. Then again, maybe he is just right handed and he likes being an excavator. Only Ramsey knows.
Finally, we got the new films (which I don't have unfortunately. I am trying to get copies and will post them if I do) and these told a rather different story.
One of the things I struggle with the most in trimming this foot is that the external guides that would normally show how much sole there is just don't exist here. It ALWAYS appears that Ramsey's sole is paper thin, and I ALWAYS have to take a deep breath and commend my soul to God before taking a knife to it. It was one of the things I was hoping to get out of this clinic - some secret that my near obsessive study of hooves has not yet revealed to me.
The x-ray showed that, despite what it may look like on the outside, Ramsey has a full 1/2 inch of sole depth and his medial/lateral balance was near perfect. In the end, Pete did not trim Ramsey's feet at all. What he finally had to say about Ramsey was this:
"It is really amazing just how normal the foot looks, I wouldn't have thought it would be possible."
and:
"This donkey needs a lot, but there is not a single thing that I can do for him that you aren't already doing."
So there you have it, I guess all that obsessing really did pay off.
In the end, the one thing that I got out of this clinic more than anything, is a sense of validation. I am not ever going to even try to figure out how many hours I have spent studying feet and trying to talk to farriers.
For a very long time I really felt like I was out in the hinterlands trying to reinvent the wheel. My attempts at getting local help were generally an exercise in frustration. The farrier at Cornell told me I could bring Ramsey in for trimming every 3 weeks (not possible), but he couldn't help me and he didn't think that Ramsey would ever have anything like a normal foot.
A year ago, I had a saddle for sale and a professional farrier, who graduated from the top farrier school in the country and who also had 7 years of experience, called me up about it. I told him I'd trade him the saddle in exchange for trimming lessons. He came down, we talked about Ramsey and all the other feet I was working on at the time and he got real quiet for a long time, just staring at Ramsey's foot. Finally, he shook his head and told me:
"I guess I didn't really hear what you were telling me on the phone. I thought I was going to come down here and say 'this is a nipper and this is a hoof knife and this is how to hold a rasp.' Instead, I am totally out of my depth here and I don't have a clue what to do for your donkey or the other horses you're working on."
I still gave the guy a good deal on the saddle because he'd lost all his equipment in a barn fire and I felt bad for him, but I quit trying to find help after that. In fact, that was about the time that I made a conscious effort to stop studying books and videos or look for external guidance of any kind. I put all the books away and I took all that stuff swirling around in my mind and stuffed it into an imaginary box inside my mind and closed the lid.
It's all still there of course. That box is now a building block that is an integral part of my hood care foundation, but on it's own, it can never be more than a house of cards. It is each and every individual hoof that have been the real teachers. I couldn't have done it without that solid foundation, without Pete Ramey's DVD's, but in the end, it was Ramsey himself who taught me how to trim his foot.
People kept coming up to me after the clinic and saying things like, "wow, you must be really happy" and, being the socially inept nerd that I am, I wasn't sure how to answer this. Yes, I am very happy. It's a bit like acing the hardest exam I've ever taken. But, it took a while to sink in and there was this little part of me that that kept wanting to say, ' but wait, we haven't found the secret yet!'.
There is no secret of course, except the secret that every hoof is waiting to tell.
I am very glad that I took Ramsey to the clinic, although I am sorry that it stressed him out. If I hadn't taken him though, I would have always wondered and regretted not doing it. I feel good about where we are and about the feedback I got from Pete. At the end of the day though, this is the thing that makes me feel the most triumphant....
A couple of people have asked how Ramsey's foot is doing. I'm sorry its been so long since the last update. The never ending battles with snow and cold has sapped all my will to keep up with foot photos. I took these photos a couple of weeks ago when we had a brief reprieve in the weather.
Ramsey's foot is doing well. I had a vet out here last Thursday to do dental checks and vaccines. She had not been involved in any of Ramsey's previous foot care and was interested in his story. Her opinion was that she was, "amazed at how normal his foot looks".
This first photo was taken mid trim and you can see that the wall connection is about as good as it ever gets. That crescent shaped cut on the left side of the foot is where that nasty abscess was that he had last Fall. That is all dead hoof and I cut most of it out....
You can see it a little more clearly here after I trimmed further. From this view, it is all that lumpy, rough area on the right.
I have finally gotten the knack of keeping the foot well balanced despite all its opposing angles, twist and missing bits. The large horizontal crack you can see in this next photo is where that abscess broke out at the coronary band.
That crack will continue to keep migrating downwards as new growth comes in from
above. In a healthy hoof, this would ordinarily just grow out
and break off with no trouble. Since this is where Ramsey is already
missing a large piece of coffin bone and the hoof wall does not grow
well on a good day, I will have to keep a very close watch on this when it gets closer
to the ground. I will keep the foot wrapped and may put a cast on the
foot to protect and support it when he loses this chunk of hoof wall. If the snow ever goes away and it gets muddy, I will wrap the foot as a precaution against bacteria invading the compromised area of his hoof.
The one aspect of Ramsey's foot that I am not happy with right now is that I have let it get much too tall. The balance is great and it is nice and straight, but it's way too tall.
This is an object lesson in hoof care - you have to focus on the WHOLE hoof and in order to see the whole hoof, you have to look at the WHOLE donkey (or horse). You can see in this photo that this foot is significantly taller than his other foot making him lop-sided. This can cause serious lameness issues.
One of the reasons this foot got so tall is that it grows a lot more sole than his other feet (I believe that extra sole is his body's way of protecting the foot) and trimming sole is one of the things I find the most difficult. It is especially difficult on Ramsey as he also grows a super tough frog that fills in the collateral grooves. Normally you can get an idea of true sole depth by measuring the depth of the collateral grooves (those are the deep grooves on either side of the frog), but that is extremely difficult on this foot.
Donkeys grow a great deal of very tough sole that will not wear down on its own if they live on soft ground like mine do. It just gets denser and thicker and it has to be trimmed or else the foot gets taller and taller until it fall over. It is why you see so many neglected donkeys who have terribly deformed feet. When trimming horses, you almost never want to touch that sole. When trimming donkeys, you have to. This is the aspect of trimming donkey hooves that I find most difficult.
If you scroll back up to that first picture, you can see that it looks like I am already trimming into live sole, something you would never want to do to a horse. I took a deep breath, screwed up my courage and took off nearly a half inch more after that photo was taken and ended up with this.....
Ramsey was a lot happier after I trimmed this down and the sole looks better than it did in the first photo. The foot is still a bit taller than the other and I will take a little more off each week until it is where it should be. One of the only advantages of the snow is that it does help soften that dead sole that needs to come off. If I take it down as much as I dare each week, the snow will soften the surface and make it easier to see what can still come off.
A perpetual work in progress, but not a bad looking foot all things considered.
The vet was out this afternoon to see Ramsey. The good news is that we couldn't find any sign of life-threatening problems. The coffin bone shows no signs of reinfection or fracture. The coffin bone that he does have is in great shape. The dark blotches that are visible on the right, near the hoof wall are the areas of poor wall connection that I have pared out trying to drain this abscess. The 'bite' taken out of the coffin bone is what was removed at Cornell when he had surgery.
The vet was very happy with how I am trimming his foot. Her words were "an absolutely amazing job", which was nice to hear. Up until this week, I had been feeling very good about how his feet look these days.
The one thing we did not find is a clear area of infection or an easy fix. There is no track that we can follow to drain the abscess. I am generally adamantly opposed to draining abscesses from the bottom of the hoof, but with the missing coffin bone and poor wall connection in that area, Ramsey is always at a much higher risk of a repeated bone infection, which would likely be the end of him. If we could have isolated the infection, we could have tried draining it. I know that it is in his heel and I think that is why it just won't rupture. It is hiding out, deep in the soft tissue at the back of the foot and because the tissue is so soft in that area it just "makes room" for the abscess rather that forcing it to find a way out and finally heal. I think that the shadow I've outlined below may be the infection, hiding in amongst the most vital and sensitive of tissues. That is definitely the area where all the pain is.
The only thing to do is to keep trying to draw it out. I've changed my approach to that today. I have been soaking, wrapping and using Magic Cushion. Tonight, I packed the foot with a sugar-dine poultice instead. That is just a mixture of sugar and betadine mixed together to form a paste. It is a strong antiseptic that will also draw moisture out of the foot, hopefully bringing the abscess with it.
On another positive note....Since she was here with the x-ray machine, I had her take a new film of the fetlock. I wrote here in some detail about what Ramsey's foot looked like at this time last year and the arthritis he had developed at that time. We didn't see any sign of arthritic changes today however and the sesamoid bone (that knob on the right) is much smoother looking. Goes to show that, if caught early and treated right, arthritis can heal.
Now, if we can just this this darned abscess to pop without causing any other damage, he'll be in good shape.
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.
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...
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.
I feel like we dodged a bullet today and it wasn't from a crazy hunter. With the coming of the cold, wet, miserable weather Ramsey has been somewhat lame on his bad leg. It wasn't the hoof, but the arthritis he has developed in the fetlock joint. At least, that is what it was until a few days ago when he came up VERY lame and I opened an abscess in his bad foot.
I have to admit, it's been a rough few days. This foot is far more vulnerable to another bone or joint infection then normal and another such infection would be the end. I was on the phone with two of Ramsey's vets last night listening to a discussion about doing regional limb perfusion again and....well, it was a rough night.
Fortunately, Ramsey is still a very good patient and this morning, he was significantly better and still no hint of fever. I think, knock-on-wood, that all is well, something to be very thankful for this week.
I am going to continue treating the foot well past the point of my extreme paranoia and will probably put a cast on it for a couple of weeks to protect the sole and prevent any possibility of reinfection.
Speaking of treatment, I have been using a product called Magic Cushion made by Absorbine as a sole packing underneath a bandage and I truly believe that this stuff helped avert disaster. It will be in my emergency kit and hoof care arsenal from now on and I would highly recommend it, especially for treating any kind of sole pain and for removing false sole. It is sticky and messy and you will probably have to swear at it a lot, but it works. It is a thick, black, tar like substance that has an oddly pleasant herbal smell to it.
Wear gloves. It does not wash off well.
The stuff may seem a bit pricey, but a little bit goes a very long way and I think it is the best abscess treatment I have ever found. It's worth it. I especially like the way it draws out infection while simultaneously sealing out and killing bacteria. It is a topical anti-inflammatory and analgesic as well. I was skeptical about all of its claims at first, but I have used it for several different applications now and have been pleased every time. It's earned a place on my shelf.
Aside from this darned abscess, I had been cautiously pleased with Ramsey's feet and had been planning on writing an update soon. I think there has been some improvement in the lateral distortion I have been concerned about. I decided to sort of throw out the instructions I had been given about his foot and try to let it tell me what it needs. I have been "trimming" very minutely every two weeks, trying to encourage healthy growth and mimic his natural wear pattern. Taking only what I think might wear off naturally if he were walking on more abrasive ground. I am mostly just trying to let his foot do whatever it needs to while keeping it from overgrowing and distorting.
Aside from the nasty stone bruise that abscessed, I think it is working. The feedback I got from the Donkey Sanctuary when I sent them photos a while ago was basically, "You're doing a great job trimming feet. Try not to over-analyze too much:)."
Thank you to the great folks at the DS, I certainly appreciate all the input. And as for that last bit....let's just say you aren't the only ones to tell me that I think too much:) I'll try.
I actually have a bunch of very interesting feet pictures to share along with some equally interesting nutrition stuff. The two are very much related. Hopefully I will get to them soon. With all the snow, high winds and below zero temps that have descended on us, maybe tomorrow. I'm sure not gonna want to go out and actually deal with it. In fact, I'm off to go hide under the covers.
This is the second of two posts today regarding donkey feet. If you missed Ramsey's, just hit "older post" at the bottom of the page.
Emma's feet. I am going to let the pictures speak for themselves. I think her feet are not bad. I struggle with keeping them balanced, how much sole to trim and I worry about too much grass.
