Use of a radiograph to assist with therapeutic shoeing and trimming
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Use of a Radiograph to Assist with Therapeutic Shoeing and Trimming. Debra R. Taylor, DVM, MS, DACVIM Associate Professor Department of Clinical Sciences College of Veterinary Medicine Auburn University. Equine Podiatry. The specialty dealing with the equine hoof the hoof capsule

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Use of a radiograph to assist with therapeutic shoeing and trimming l.jpg

Use of a Radiograph to Assist with Therapeutic Shoeing and Trimming

Debra R. Taylor, DVM, MS, DACVIM

Associate Professor

Department of Clinical Sciences

College of Veterinary Medicine

Auburn University


Equine podiatry l.jpg
Equine Podiatry Trimming

  • The specialty dealing with the equine hoof

    • the hoof capsule

    • coronary band

    • all anatomical structures with in the hoof capsule

    • all tendons that affect the hoof

  • Requires the veterinarian and trimmer or farrier to work together


What does the horse need l.jpg
What does the horse need? Trimming

  • A veterinarian and a trimmer or farrier team who are willing to work together

  • A team that enjoys podiatry and is committed to doing their best work


What does a farrier or trimmer need from the veterinarian l.jpg
What does a farrier or trimmer need from the veterinarian? Trimming

  • A veterinarian

    • who understands what is healthy and what is not

    • who understands diseases affecting the hoof

    • who can consistently take an informative radiograph of the foot

    • who is willing to work as part of a team

      • Take the time to show him the radiographs

        • Pre- and post- trimming or shoeing

      • Learn to speak the same language

        • Many overlapping terms


Slide5 l.jpg

Why do you need a radiograph to monitor shoeing Trimming

or trimming a horse?

“Quality radiographs are to podiatry what ultrasound is to reproduction”

Learning curve

Without ultrasound or radiographs

With ultrasound or radiographs

Ability to make a positive change

Time

Time


Traditional radiography of the digit l.jpg
Traditional Radiography of the digit Trimming

Goals

  • To evaluate the proximal and distal interphalangeal joints, integrity of bony structures, and to view radiographic degenerative changes in the foot.


Traditional radiography l.jpg
Traditional Radiography Trimming

  • Beam focused at coronary band

  • Foot packed

  • Ground surface not always demarcated

  • Dorsal hoof wall marked with rigid object

  • Apex of frog and heels not marked

  • Hoof not always directly against cassette




Radiographic goals l.jpg
Radiographic GOALS Trimming

  • Consistent informative films

    • Take the same view every time

      • Ability to monitor small changes with accuracy

    • Evaluate the soft tissues of hoof

    • Evaluate P3’s relationship to capsule and ground

    • Evaluate how the bone and the soft tissues relate to each other

    • How the bone and soft tissue relate to the ground

  • Learn common parameters of breeds

    • What is common is not necessarily healthy

    • Horses have only rarely been bred for hoof quality

      • Popular breeds are notorious for poor hoof health


Radiography for shoeing and trimming l.jpg
Radiography for Shoeing and Trimming Trimming

  • Center on bottom of P3, not coronary band

    • measure sole depth

    • Palmar/plantar angle

    • medial to lateral balance of P3

  • Clearly demarcate (with barium paste)

    • Dorsal hoof wall – care to start paste exactly on hairline

    • Lateral heel bulb – care to start paste exactly on hairline

    • Apex of frog

  • Clearly demarcate ground surface – lead in wooden block

  • Hoof touching cassette

  • Heel bulbs parallel to primary beam and perpendicular to cassette

  • Do not pack the foot

    • Measure sole depth

  • Standardize distance from film to machine


Methods l.jpg
Methods Trimming

  • Center on bottom of P3

    • Blocks match machine

      • metal wire in top

  • Barium paste on dorsal hoof wall

  • Barium on apex of frog

  • Barium on heel


Much better l.jpg
Much better Trimming

  • Centered bottom of P3

  • Dorsal hoof wall marked

  • Ground Surface Marked

  • Not packed

  • Heel marked

  • Apex marked

  • Note: -ok that bone is too light, not as worried about boney detail here as relationship of the bone to the soft tissues and ground

NOTE: Trimmers and farriers appreciate viewing the hoof in the direction it

would be if they were looking at the horse, RF point toe to right, LF point toe to left


Equine podiatry radiology l.jpg
Equine Podiatry Radiology Trimming

Primary beam is 1 cm off top of blocks

Build blocks to match your machine so can

Set the machine on the ground and horse

Will be in correct positions

NOTE: need two blocks

So horse is standing level


Breakover l.jpg
Breakover Trimming

Breakover


Podiatry radiology measurements l.jpg
Podiatry Radiology Measurements Trimming

  • Breakover

  • - The horizontal distance from the tip P3 to where the hoof “breaks over” or pivots.

  • 0 – 3.5 cm is ideal, depending on the horse

  • optimizing breakover

    • decreases sheer force on P3 and hoof wall

    • decreases tendon and muscle strain



Podiatry radiology measurements18 l.jpg
Podiatry Radiology Measurements Trimming

  • Palmar Angle

  • The angle that is formed from the palmar/plantar surface of P3 and the ground. - 2- 10° degrees normal (Adams)


Sole depth l.jpg
Sole Depth Trimming


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Podiatry Radiology Measurements Trimming

  • Sole Depth

  • Soft tissue opacity just distal to the plantar surface of P3

  • The sole should be greater than 10mm in depth.



Podiatry radiology measurements22 l.jpg
Podiatry Radiology Measurements Trimming

  • Horn: Laminar Zone

  • Distance from the dorsal hoofwall to the dorsal surface of P3.

  • Measured at both the dorsal proximal and dorsal distal ends of the foot.

  • Should be uniform and < 20 mm


Ce zone l.jpg
CE Zone Trimming


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Podiatry Radiology Measurements Trimming

  • CE Zone

  • - The CE Zone is the vertical distance between the Coronary Band and the Extensor Process.

  • Ideally < 1cm.

  • Need great care in marking the hairline, because plan to monitor change in this number


Slide25 l.jpg
Cup Trimming


Podiatry radiology measurements26 l.jpg
Podiatry Radiology Measurements Trimming

  • Cup

  • The radiolucent area distal to the sole

  • Measure to the ground surface

  • Some horses have none


Bone angle l.jpg
Bone Angle Trimming


Podiatry radiology measurements28 l.jpg
Podiatry Radiology Measurements Trimming

  • Bone Angle

  • Angle formed at the junction of the dorsal and palmar/plantar surface of P3



Evaluation of lateral view l.jpg
Evaluation of Lateral View Trimming

  • Horn: Laminar Zone

    • Should be uniform ( < 20 mm)

  • CE zone - <1 cm

    • coronary band - extensor process

    • “halo effect”- coronary band invagination

  • Sole depth

    • mass (> 10 mm)

  • Cup

    • Black area between sole and ground surface


Evaluation lateral view l.jpg
Evaluation Lateral View Trimming

  • Palmar Angle

    • Angle formed between palmar surface of P3 and ground

    • The horse wants it positive 3-9 º

  • Digital Breakover

    • distance from the tip of P3 to where hoof breaks forward

    • The horse wants it short, maybe even negative?

    • The horse wants it optimized.

  • Bone Angle

    • angle formed between dorsal and palmar surfaces of P3



Anterior posterior projection l.jpg
Anterior – Posterior projection Trimming

  • Looking for medial lateral balance of P3

  • Uniformity of joint spaces

  • Is the medial and lateral coronary band level

  • Evaluate growth rings if use barium



Moral l.jpg
Moral Trimming

  • TAKE the radiograph the correct way

  • Evaluate the parameters

  • Use the film to make goals

  • Evaluate whether goals were met

  • Work together!!!!