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Throughout my fifteen years as a farrier, I have observed many club footed horses. Club feet vary from not serious to very serious. Once the condition is discovered, a farrier and veterinarian should be contacted. Together they will hopefully provide a positive outcome for the horse. A club foot normally gets worse; it usually does not self resolve.
A club foot can be distinguished visually. The affected foot has an upright appearance and is usually found on one front foot. The heel will be higher than that of the opposite foot. The foot is smaller in width and shorter in ground length and normally has a dish appearance in the front hoof wall.
There are four grades of club feet:
When a horse has a club foot, the horse is reluctant to take up the lead on the affected foot. Horses are either right handed, left handed, or ambidextrous. From my observations, when horses grow up with a club foot, they condition themselves to favor the normal foot because the club foot is the outcome of the horse’s leg bones elongating through growth at a pace that the tendons and muscles can not keep up with. Therefore, the deep flexor tendon, which connects to the bottom of the coffin bone, runs up the back of the leg, and connects to a powerful muscle, is pulling the hoof backwards and up. This pulling causes a degree of discomfort experienced in the deep flexor tendon. The heels are coming up off the ground and the horse finds it uncomfortable to place the heels flat on the ground. This causes the heels to grow faster than the toe in order to make contact with the ground.
The club foot may also be caused by pawing, which causes excessive wear at the toe. Pain in a foot or leg for an extended period of time such as with an injury, joint pain and/or soft tissue injuries may make the horse reluctant to use the limb and therefore promote a club foot. Lack of exercise deprives the tendons and muscles to elongate and may cause an acquired club foot. When horses are young, they tend to place one foot forward and one foot back under themselves in order to reach the ground. Normally they will have the same foot forward and vice versa, which may cause or contribute to a club foot. A good idea is to feed the young horse up off the ground in order to minimize this stance.
When a foal has a flexural deformity, oxytetracycline can be given as a treatment. Oxytetracycline is a broad-spectrum antibiotic which will cause a neuromuscular relaxation. This antibiotic should not be given to a foal which has a flexural deformity in the fore, let’s say, and weak suspensory in the rears. I feel that oxytetracycline induces a rubber-band like state in foals. They become loose, relaxed, and exhibit a drunken state. The Treatment worked extremely well on one of my foals for whom all four legs were affected. The foal actually stood on its tippy toes for a period of twenty-four hours. With the help of oxytetracycline, the foal was able to place all four heels on the ground. Afterwards, a careful eye with subsequent heel trimmings took place. I also kept a bottle of muscle relaxant at hand just in case history started to repeat itself but never had to use them. Today that horse is four years old and has great looking hooves.
A toe extension at the ground surface (elongating the ground coverage from heel to toe) will help with the stretching of the tendon and muscle involved with the club foot. The foot is properly trimmed before such an application is made. I allow this set up to be in place for two weeks. If there is not a notable difference for the better, I then suggest that a veterinarian be consulted to perform a check ligament desotomy. This procedure relieves some pull of the deep flexor tendon. The check ligament is connected to the deep flexor and is attached at the back of the leg just below the knee. Before this procedure is performed I prefer placing the toe extension in place in order to compliment the surgery. If the toe extension is not in place, the horse’s foot breaks over too quickly and, therefore, the foot more or less stays the same. With the delayed break-over (extension in place) and the check ligament severed, the tendon and muscle stretches easier and farther. Horse owners must still keep a watchful eye on the hoof or hooves to make sure progress is in the right direction. Afterwards, have the heels trimmed every two weeks or as needed. The farrier and veterinarian should guide in the aftercare.
Horses which are over nine months of age have little chance of being rectified to what we consider normal. If a club foot is minimal in grade, there is a good chance that this horse can be shod in such a manner as to enhance its movements. First, if the heels are trimmed parallel to the true frog and the heels do not touch the ground, a wedge should be utilized in the shoeing. If the heels do touch the ground, then shoe the horse with a flat shoe with the breakover of the shoe placed in alignment with the front of the coffin bone. It is important to incorporate a smooth rollover into the shoe. For example, human running shoes are designed to minimize strain in muscles, joints, and tendons; this rollover also propels us forward as we engage a gear in our forward movement.
A rollover modification can be incorporated into any existing shoe, as well. The dorsal wall should be rasped back in an attempt to remove any dishes. The dish is caused by the leverage created at the toe when the break-over is too far forward. On the second shoeing, I like to the address the difference in height from one knee to the other. This is done by looking at the nodules on the inside of the knee (distal radial physeal regions). These nodules are built in guides. We can not go wrong using them to help the horse move, feel, and perform better. While the front hooves are trimmed and unshod, I place different degree wedges on the opposite foot, which will be lower in angle than the cub foot. I then choose the wedge which places the knee nodules on the same plane; the wedge is placed on the hoof surface of the shoe and the package is nailed on to the hoof. The foot with the wedge should have a frog and sole support system in place. The frog and sole should be made responsible for carrying some of the load and give the heels a break.
All subsequent shoeings focus on keeping the club foot going in the right direction and repairing the long toe/ low heel on the other. The club foot will be less notable as the other foot increases in angle. Cosmetically, it can sometimes take a year for the desirable outcome or maybe the horse’s lifetime. Nonetheless, the horse will travel better with the correct package on its feet. This can only be done through shoeing. If the horse is left barefoot, the long toe/ low heel and the club foot will not repair itself; it will only get worse. Many horses with this condition are left barefoot in the first place because they are sometimes unsound to ride. Trimming by itself will not get the horse sound enough to ride and perform as an athlete right away.
Horses whose heels do not touch the ground after the trim require a different technique. They are shod with however many wedge pads it takes to unload the deep flexor tendon. The horse will then become accustomed to bearing weight on the affected limb. As time passes, at every shoeing the horse is observed with the wedges off and the foot trimmed. If the heels are closer to the ground, however many wedges are removed to match the height and replace the package. This is repeated on every shoeing. If the heels eventually touch the ground, then the horse can be shod with a flat shoe that has a rollover at the toe.
While it is true that lowering the heels may make the horse sore in the tendons and muscles, it is no different than us stretching for the sake of performing a split. We will not be able to do it right away, but in due time it will happen. We do not have the constant pull on our tendons and muscles and neither does the horse for they can rest any limb that they wish to.
Every case is different. What works in one may not work in another. Varying techniques should be considered.