Severe White line disease case.

This is another interesting case that I started about two weeks ago.  History of problems for almost  year without much change.  Horse is not painful and trots throughout the pasture as nothing is wrong.  This is a draft or draft cross with a 6.5 in wide and 7 in long foot.  So consider the soft tissue parameters.  If we only discussed degree of rotation we would have a many veterinary clinic around the world suggest euthanasia.  However, this is Horn disease not lamellar disease (laminitis). Horn/Lamellar zone for this size of horse could easily be 20/20mm and in this case is 20/36mm in the left and 7mm of sole depth which should be closer 20mm as well.  The bacteria/fungi involved is an opportunistic bug, meaning that there must be an unhealthy hoof wall to begin with that allows this infection to proliferate.  So without addressing the mechanical aspects no drug or treatment will ever be successful.  The horn is breaking down and no longer has the ability to antagonize the pull of the deep digital flexor tendon and allows the bone and lamellae and inner portion of horn wall to be pulled away from outer horn wall.  Below is the Deep digital flexor in yellow and arrows depicting the forces applied to the coffin bone.  Similar situation with Laminitis/founder except the unhealthy attachment is at the lamellar and horn attachment versus in between the layers of horn.  This may also account for the lack of lameness commonly associated with white line disease.

So I made a very large four point rail shoe from 15 inches of 1/2 by 1in aluminum barstock.  Trimmed what little foot I had and applied a very small belly to the shoe.  I really I had more rocker in the the shoe but this is  all I could get on this day.  Plan is to monitor the defects in the hoof wall, I want to see the defect growing down with new hoof growth unaffected by fungal invasion.  If I do not get the response then a more aggressive hoof wall resection and higher mechanics (more rocker) to further unload the Deep digital flexor pull will be needed.  I would possibly add a frog support bar as well.  The Owner will be feeding biotin 100 and treating weekly with White lighting.  I will post after the next visit as well!