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c6 c7

Swaying Opinion: Can Ataxia Cause Hind Hoof Rings?

May 6, 2023 by Jane @ THB 4 Comments

 

Did laminitis, trauma, nutrition, disease, or something else cause these hind hoof rings?

Recently I came across hoof rehab specialist Daisy Bicking’s view as to an additional cause of these rings. What she said on the subject made me sit up a little – OK, a lot.

Daisy Bicking, School of Integrative Hoofcare (c) Daisy Bicking & Easycare inc

Daisy is an internationally renowned expert of nearly 20 years’ professional standing (see: School of Integrative Hoofcare) who has radiographed hundreds if not thousands of hooves during that time.

Daisy took the picture at the top of this post, and here are her views on what’s happening.

Hind hoof rings and ataxia

Daisy explains that she has seen a correlation between these deep rings and ataxia.

‘Horses that get these repeated deep rings on their back feet (usually not found on the front feet) have been diagnosed or suspected of having some kind of neurological problem which impacts the stability of the hind end.

‘The waves in the hoof come from the horse’s efforts to stabilize.

‘I work on a large population of horses who have neurological issues. Not every one of them gets these rings.

‘But a high level of correlation leads me to believe that if I see these rings (hind feet, deep, symmetrical, predominantly in the quarters) I suspect some instability in the hind end of the horse.

‘It’s not very common but there’s definitely a correlation with neurological problems when I see them like this.

‘When a horse is ataxic, they spend a lot of their time trying to stabilize. This creates a sway pattern that some horses with neurological issues experience more than others.

‘I see it the most with horses who have permanent ataxia from things like EPM, arthritis in the vertebrae, etc.’

Yowzers.

The fact that I’m writing about this here is because within a month, I was able to apply her thinking to two cases I worked with.

Here’s the first.

The horse who convinced me

Fracture hind limb view rear

Take a look at this Australian Stock Horse mare with a very obvious stability issue. At this point, she was recovering from a pelvic fracture.

I can honestly say that in 18 years, I’ve never worked with a horse less stable.

The photo with the hind legs on an angle? Some days, that was the only way she could stand (and yes, she’s lucky to still be here).

pelvic fracture horse hind hooves
Hind hooves of horse destabilised by pelvic fracture. Photo by Jess.

In the hoof pictures, the deep and evenly spaced rings are evident.

Pelvic practure sway front hooves
Front hooves of horse destabilised by pelvic fracture. Photo by Jess.

We might say that these are only caused by trauma, but that doesn’t account for the repeated incidence of these rings, or their spacing.

And just look how there’s a difference in the nature of the front and hind hoof rings. The front hoof rings are raised, but the hind hoof rings are also sunken.

What’s more, trauma and ataxia can go hand-in-hand when associated with the same event.

What’s up with these hind hoof rings?

Daisy explains that the mechanism comes down to changes in blood perfusion in the hoof.

‘Think of the blood flow in the foot like a water balloon. How the foot is loaded greatly impacts where/how the fluid perfuses the blood vessels. The more blood flow, the faster growth.

Blood perfusion - the balloon concept.
Blood perfusion – Daisy’s balloon concept. Swaying achieves a similar effect, on a repeated intermittent basis. For more info: https://www.integrativehoofschool.com 

‘The sway creates a variation of load and subsequently blood perfusion that is unique to horses with certain ataxic conditions. Therefore we see these unique rings crop up in the feet.

‘I think where we see them and how long they stay depends on the degree of ataxia the horse is experiencing. If the neurological issues stick around, then they may have them forever.

‘If they are predominantly unsteady on the hind end then we see the rings on the back feet. Versus having ataxia on the front and hind ends, [when] you may see it on all four feet.’

Assessing a horse with hind hoof rings 

Now, here’s an interesting 5-yo OTTB mare.

I’d previously seen this mare dropping out and running / trotting behind during canter, which had made me curious.

Hind hoof rings are significantUpon meeting her, my eyes were soon drawn to her hind hooves.

Clearly they’ve plenty of problems, as is the case with many horses off the track. I was anticipating low heels and potential issues with pedal angles. But what caught my attention more was the series of rings.

These aren’t as pronounced as those in the above photos, and they’re in a tight band, but they’re certainly interesting. And they made me think about hind end sway.

In fact, they encouraged me to do a simple test: placing her right hind foot across the midline to rest in front of the other.

Hind hoof ataxia
Failure to replace the crossed over foot can be a sign of  ataxia.

Well, that revealed something: this girl didn’t replace her right foot for a long time. And she didn’t do that twice, because I repeated the test.

The horse not noticing foot placement in this way is a sign of possible neurological issues. They will usually replace it immediately.

Next, I lifted the right hind leg up and found it to be super stiff and heavy. It look real effort to lift it. Same with the left.

That’s not at all what I’d expect with a healthy young TB. And in case you’re wondering, her lumbosacral area was definitely weak – yet with sacroiliac pain, I’d expect a hind foot to be quickly lifted high, either medially or with a lateral ‘be careful’ flick. She did neither of those things.

What about the location of those rings?

Parallel rings are starting to emerge
It’s possible that parallel rings are developing in line with the stability issue.

By their position and general speed of hoof growth, the rings could be backdated to an event about 6 months ago.

This doesn’t change an assessment of instability – quite the opposite, as a fall might have caused ataxia OR it might have resulted from existing ataxia.

And looking closely, it does appear that the some parallel spaced rings are emerging (red arrows). Could this be a developing issue?

And could she be ataxic in front too?

More circumstantial evidence: the mare was unable to place her foot on a ramp while walking freely forwards.

The final images shows what kept happening when she tried placing the foot, without success, before stepping back.

Possible ataxia
A problem placing the foot. If a horse does this over and over, there may be a proprioceptive issue.

This she did several times, getting it wrong each time, despite having loaded on this vehicle before. You’d expect her to quickly figure it out after learning where the slope was.

It appears to be a proprioceptive issue, as her timing and spatial awareness are somewhat off.

If Daisy is right here, we can speculate that the hoof rings are reflecting ataxia that currently affects hindlimbs, but is also affecting the forelimbs to a degree. And there’s more than one known pathology that could be causing this.

Where to next?

Daisy Hoofcare summit
Daisy speaking at the International Hoofcare Summit

I’m finding this exploration interesting and will keep making my own observations. I really believe that it’s worth checking in with a new idea by looking at how it plays out with your own cases. Even then, it’s important to test the idea and consider it as a possibility rather than gospel truth.

That said, one thing I’ve learned through research is that fresh scientific findings frequently begin not only with published literature, but also with strong anecdotal evidence gathered by experienced observers over a period of time. Sometimes, solely so.

As these professionals then research the literature, further context is provided by previous studies – if they exist, that is.

I truly hope that the data Daisy has generated and the insight she has developed through hoof rehabilitation does find its way into the equine scientific literature.

Horses can only benefit from new findings that bring greater understanding to hoof-body relationships in the domestic horse.

More about Daisy

Daisy Bicking DEP, APF-I, CFGP, CLS, CE/CI is passionate about helping horses and the people who care for them.

Through Daisy Haven Farm, she supports the equine community by providing whole horse hoof care and rehabilitation services, designed to promote physical, mental and emotional well being.

She also spearheads the School of Integrative Hoofcare which provides education about the hoof and horse via in-person workshops, one-on-one mentorships, and virtual educational courses.

 

Filed Under: Bodywork Tagged With: ataxia, barehoof, c6 c7, daisy bicking, ECVM, equine neurology, GA, hoof rings, hoof trimming, natural hoofcare, neurological issues, Wobbler

Why I Now Believe My Warmblood Gelding Had the C6-C7 Problem – Reader Story

November 16, 2017 by Jane @ THB 14 Comments

“I went through three years of horror…”

So speaks a Warmblood owner, reflecting upon a truly dreadful period in her life. Like many other owners, she has gained belated understanding of her horse’s problems after reading about research findings into the C6-C7 malformation (article) led by Australian gross anatomist, Sharon May-Davis.

Sadly, this is a bittersweet moment: there is a temporary relief as everything finally makes sense, yet with it comes the realisation that there is nothing that can be, or could have been, done for a treasured horse bearing the more extreme version of this malformation.

Here, Diana from Michigan, USA, gives her story of the desperation and – ultimately – heartache she experienced when trying to find out what was wrong with her horse of a lifetime, a young Oldenburg gelding, “the kindest horse I ever had”.

Note: We are not identifying the lines of the individual horse in this story. If you’re thinking we should, perhaps remember that it’s a litigious world out there.

But for now, over to Diana.

© All text copyright of Jane Clothier, www.thehorsesback.com. No reproduction of partial or entire text without permission. Sharing the link back to this page is fine. Please contact me for more information. Thank you!

 

Diana’s Story

I purchased a stunning 3-year-old Oldenburg to fulfill my dream of developing a young horse through the upper levels in dressage. I cashed in the 401K [retirement savings plan] for the horse and bought a Schleese saddle.

For the first two years (ages 3 and 4) we were champion every time out.

At age 5, however, my trainer noticed he began to drag his left hind toe. Then his impulsion began to deteriorate, and months later he became too unstable to safely handle. He was euthanized at 7 years old.

Looking back, I now believe that all his quirks were directly related to this problem. I am going to briefly list the oddities I experienced with this wonderful horse.

I am not a vet or tech, and am only sharing my experiences in the event that it may help someone else, because my journey was one of the most emotionally draining experiences in my life.

 

Possible Signs of this Warmblood’s C6-C7 Problem

I purchased my gelding on his 3rd birthday and he’d had 30 days under saddle. The oddities of my gelding: he was extremely sweet and willing – the kindest horse I ever had.

He required a tremendous amount of leg every step. Although there seemed to be no ‘self-carriage’, I attributed this to his being green and still learning.

He would buck EVERY TIME he was saddled (I was very conscientious about slowly tightening the girth, tried every type of girth, pads, had adjustable saddle, etc).

Again, I attributed the bucking to youthfulness, and would let him buck out for a few laps, and then wondered if I had created a habit, because this occurred every schooling.

  • If he wasn’t lunged first, he would explode into a non-rideable rodeo with absolutely no warning.
  • He had a very difficult time bending to the left – he would try, but would drift.
  • Two separate times after mounting at the block, he felt like he arched or sucked his back up about 3 inches before walking off.
  • After 25 mins of schooling he would start rooting at the reins, or if the lesson was a short one, as soon as I’d give him his head to cool out.
  • He was a stumbler – not often – again, I attributed it to youth.
  • He could not be shod or trimmed without being sedated.
  • Once, a friend said it looked like he couldn’t put his head down to reach hay. Of course, I thought she was nuts until I witnessed it first hand.

Questions, thoughts or comments? Join us at The Horse’s Back Facebook Group. 

 

Investigating the C6-C7 Problem

During my discovery phase, he was diagnosed with moderate PSSM. So, he and I spent 9 months testing sugar levels in hay, with turnout in a dry lot.

There were periods he would barely walk forward when leading, and at the time I thought he was tying up, but it didn’t seem like what I had read, and I have never witnessed a horse tying up.

Then in his latter days, his neurological issues became more obvious with each passing day.

I did have a myelogram done on him, and it revealed compression of the spinal cord at C3 and C4.

Vets at Michigan State University did finally identify malformations of both C6 and C7 through radiographs. Their report stated:

The intervertebral foramen is severely reduced at C6-C7. A minimal amount of osseous proliferation is noted along the dorsal aspect of the articular processes at C5-C6.

Interpretation: Multifocal cervical articular degenerative joint disease (C4-T1), most severe at C6-7.”

I had a very difficult time with the decision to euthanize him, because his neurological issues would fluctuate. Some days, no evidence all. On other days, he would fall against the stall wall when turning him around in the stall.

In any event, I euthanized him, believing that he was experiencing severe pain from the narrowed foramen at C6 and C7.

I believe they were the reasons for the bucking, for needing to be sedated for the farrier, for not being able to lower his head, for rooting on the reins, for barely walking forward when I thought he was tying up, and the bizarre lifting of his back. He also had a very difficult time holding his right lead, and would swap unless you really held him.

I am so, so glad I ran across this website and article because I will go to sleep tonight knowing that euthanizing was for sure the right thing to do. Thank you!

Diana

 

 

If you’re about to purchase a horse that falls into the ‘at risk’ category for this malformation, do your due diligence as a buyer, and have the caudal cervical vertebrae radiographed as part of your pre-purchase examination. A protocol for radiographing for the malformation is on this site.

The following papers also cover radiographs and CT imaging of the C6 malformation:

Ex Vivo Computated Tomographic Evaluation of Morphology Variations in Equine Cervical Vertebrae, Veraa, S. et al,  Veterinary Radiology & Ultrasound, Vol. 57, Issue 5

Prevalence of Anatomical Variation of the Sixth Cervical Vertebra and Association with Vertebral Canal Stenosis and Articular Process Arthritis in the Horse,
Spriet, M. and M Aleman, Veterinary Radiology & Ultrasound, Vol. 57, Issue 3

 

If you wish to comment, please feel free to do so below, but please do so with respect for an owner who found herself in a nightmare situation. Alternatively, come over the blog’s discussion group on Facebook.

Filed Under: Bodywork, Sharon May-Davis Tagged With: Anatomy, c6 c7, cervical vertebrae, oldenburg, Sharon May-Davis, warmblood, wobbler syndrome, wobblers

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