Just some thoughts for today.

Hello everyone,  we are pleased to announce we have been granted a distributorship for Nanric.com.  This will allow us to sell Nanric products to you at a comparable price as their online pricing but save you money on shipping cost.  Please call us or email us at innovativeequinepodiatry@hotmail.com if you have any questions or would like to try some shoes.  


We had decent turnout for our first coggins clinic last saturday and we are planning a couple more in the next 6-8 weeks.  I am also planning 2-3 half day demonstrations regarding radiographic and external evaluation of the equine hoof.  These will be low cost or potentially free presentations open to veterinarians, farriers, trainers and horse owners.  I am trying to give a little taste of what you will be exposed to with Dr. Redden's in depth podiatry lecture October 14-15 here in Tulsa.  Please be on the lookout for those dates and places, and if you are interested in hosting demonstration please let me know.  


We made a few changes to the Blogsite to include an up to the minute news reel from the thehorse.com and some videos we have on youtube.  Keep checking back for the latest equine news especially regarding the lastest information on EHV outbreak.  If you have any questions regarding the health and wellbeing of your equine family please do not hesitate to call.  


We are rechecking the severe white line disease case this weekend to be sure to look for a new blog regarding updated cases next week!

God Bless and keep all the tornado victims in your prayers.

Upcoming Podiatry Clinic with Dr. Ric Redden.

Go To Our Website, http://www.innovativeequinepodiatry.com/ to download a brochure to fill out or click on the link to register online.  See you There. 

We have many of the details completed and it is a go for hosting internationally renowned veterinarian/farrier Dr. Ric Redden for a very intense lecture and demo.  You will be exposed to a very detailed evaluation of the equine hoof and its mechanical forces.  Don't miss out!

Please Call, text or email if you have any questions.   918.235.1529, innovativeequinepodiatry@hotmail.com

We are getting prepared for the Magnolia Tx clinic and I should have some good photos and images from this weekend.  Hope to see many of you there.

Follow up on the Severe White line Disease case

Hello readers, I hope this finds you well.  It has been a very dry Spring here in Oklahoma and fires are really causing troubles in many areas.  We definitely keep the firefighters in our prayers.  We had a busy weekend in the podiatry world.

On to the Case.  A very good response is noted since our last visit.  I consider a good response in a severe white line disease to be new hoof growth without fungal invasion.  The hoof defect noted in the soft tissue lateral radiograph is growing down.  The left front has 13mm  of new hoof growth with out cracks.  There is still  uneven growth rings from toe to heel but greatly improved.  Sole depth has increased but is still considered severely thin soled.  If you look at the upper portion of the barium paste you can see the new hoof wall growth that is growing down more parallel to the front/face of coffin bone/P3.  Patient has been in a small paddock and fed Biotin 100 from nanric.com daily.  I will be posting photos and radiographs from first visit and this recent visit.

first day pre shoe

first day post shoe

Before glueing 5weeks after initial visit.  Added a little more mechanics/belly/rocker to shoe.

With Superfast,  Due to poor quality walls I like to add a little extra holding power.  I drove nails but left long and create loop in end for glue to attach to

Initial visit post shoeing radiograph

Recent visit 5 weeks later, Notice the hoof wall defect growing down without fungal invasion and more parallel to front of coffin bone.  I also added a little more rocker to shoe to increase mechanics that allow further unloading of deep digital flexor tendon.  This image is after reset of shoe.

Left front day one

reset Note new growth without cracks in the upper hoof wall 

Now on the Right Front.....................................................................................................................................................

Day one

day one right front

Post Shoe day one with superfast.

Post shoe at 5wk reset.

5 week reset pre superfast.

After super fast

Day one post shoe radiograph

5 week post shoe radiograph.  Notice new growth at upper coronary band that is growing more parallel with front of coffin bone/p3

 So to restate the purpose of the use of the Rockered Rail shoe.  The Rails give us 5-7 degrees of heel elevation and the added rockering adds a self adjusting air wedge to allow further unloading of the tension in the Deep digital flexor and decreasing the pull at the inner layers of the horn wall.  The rocker action is also thought to increase the circulation of the entire foot which will enhance hoof growth and quality.  With the rocker action Digital breakover is greatly reduced.  I also added in a positive pressure frog bar to help prevent buttress/frog prolapse and spread weight distribution across the back of the hoof.

The most important aspect of why the rocker shoe is successful is it's ability to greatly reduce the action of the deep digital flexor tendon.  The deep digital tendon and it's action is the "big dog" force in the Hoof.  You must consider it's action and the forces it applys to the coffin bone and the space around it.    It pulls tension on the bone to hoof connection and a downward compression force on the solar corium below the tip of the coffin bone.  We must always first consider the action of DDF  and all other aspects of shoeing will be secondary to that.  I like this approach versus wedging alone as it can be difficult to acheive this much DDF tension release and breakover reduction with wedges.  Additionally the rocker motion greatly enhances the healing environment and speeds up recovery.  The addition of the superfast  at the quarters and over the toe adds stability  and connection of the whole hoof once again.  I do not feel it is required but does help hold the shoe longer.

Just Got off the phone with Dr. Ric Redden and things are coming together for the October lecture and demonstration.  I will have brochures ready within the next week.  October 14 will be an all day lecture and then on the 15th will be a demonstration at the 181 ranch in Bixby Oklahoma.  It will be a very informative seminar and hope you can make it.

Thanks for reading,                    Sammy L. Pittman DVM

Follow up Venograms and Radiographs of the Backyard Mare project.

. Hello everyone, I hope you are enjoying this site and potentially learning something as well.  Please feel free to ask any questions in the comment segment.  So we are just a little over four weeks into this shoe cycle with the low score mechanical rocker shoe.  In the plain film soft tissue farrier friendly radiograph we can measure right at 14 mm of sole depth in the left.  We started with 8mm of sole depth when we pulled her out of the pasture with bare feet and slightly tender on the rocks.  She has been ridden fairly regular which does slow down foot growth.  Again, what I am attempting to demonstrate is how the rocker shoe application enhances the  foot mass noted by increase in sole depth and the accompanying venogram changes. In my experience and the experience of many others, the rocker shoe is the fastest method available to regain foot mass and quality.  We are getting close to normal sole depth  of 15mm after 4wks in the rocker shoe.  I find that many foot ailments and lameness' improve drastically with added foot mass.

 The first image is today's and the second is the initial radiograph March 8, 2011.  Notice the great improvement in sole depth.

The Most notable change here is the terminal papillae are getting longer.  These are the little finger like projections.

In this view the terminal papillae continue to become longer and  more robust.  This will continue as sole depth increases.  When we achieve a healthy sole depth of closer to 20 mm we should have a very prominent terminal papillae and a vascular depth of around 10 mm.  

Below I am going to post a recent venogram on a chronic laminitis case.  This gives something to compare to.  Note the severe lack of contrast over to face of the coffin bone and below the apex of the coffin bone.  Just to refresh the memory the white tree branch like things you are seeing are the arteries and veins within the hoof.  In the image below there is no blood flow below the coronary band in the front (to the left).  There is still slight filling of the terminal arch which is supplying the coffin bone its nutrients and is keeping it from completely dying.  There is considerable bone resorption as almost 1/2 of the coffin bone is gone due to the lack of normal blood supply.  

 Keep checking the blog as next week I will be rechecking the Severe white line disease case that I have already posted.  We will be repeating radiographs and evaluating response to the rocker rail application. 

We hope everyone is enjoying the Spring.  

We are in the planning stages of hosting Dr. Ric Redden of International Equine Podiatry Center of Versailles, Ky for a 2 day lecture and live demonstration on October 14 and 15.  I will post the details when we get them nailed down.  

We will also be traveling to Magnolia, Tx to help renowned farrier Jimbo Stewart put on a clinic demonstrating radiographic technique, how to treat common foot problems and to read radiographs.

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!

2 weeks post initial venogram and rocker shoe application.  I will admit that she lost a shoe the next day and I replaced with a rockered four point with super fast added to thicken the branch and increase mechanics.  Measurable sole depth is about 12mm which is more sole than she had on initial rads but insignificant at this point.  This measure will continue to increase rapidly.

Same story as the right but a greater increase in sole depth but still  not easily notable .  Below is a couple of the venogram shots.  I labeled a few important aspects.  We are only doing venogram on the left front at this point.  I definitely notice a change in the terminal papillae, in that they are becoming longer and more robust. This should be more obvious at sole depth increases.  I realize everyone that may read these may not understand all the lingo and importance involved.  If you have specific questions please comment and ask!   We also took radiographs of my wifes mare, Harley, which has never had shoes and has been in a paddock/stall for most of her life and she has amazing feet and maintains great sole depth.  I will add in her radiographs at the bottom as well..  Thanks and please come back for more reading.

Think about these measurements and there relation to the venogram.  For more info on soft tissue  measurements and venograms go to www.nanric.com and go to archives and look for "how to measure soft tissue parameters"  TONS of good info there.

Welcome

This is a first for me and an exciting new way to get information from my daily practice to any who are interested.  Please tell all your friends, horse owners, farriers and veterinarians.  I will discuss my thoughts and hopefully post pictures and radiographs.  Feel Free to ask questions and make comments.  The above Pictures are just me playing to see how the images would be uploaded.  I plan to upload an ongoing case study that I started on our discussion board on Facebook.  I will likely carry that case study here instead of Facebook but continue to send images and reminders to Facebook to keep everyone informed about the new BLOG.  Good evening.