Serenity Equine - Case Studies

Case Studies

Examples of normal changes to be expected following surgery.

Paint Stallion
2 Years Old
Acute 22 Degree Rotation

30 DAYS				Photo of foot one month after surgery and derotation or repositioning of coffin bone parallel to ground surface; Photo of bottom of same foot showing coffin bone (P3) protruding through sole of foot.
90 DAYS				Three months post-op showing hoof growth has reached heel bearing surface; Photo of bottom of same foot showing scar tissue at toe where exposed bone had been 3 months ago.
180 DAYS				Photo of foot 6 months post-op showing bearing surface has reached quarters of hoof i.e. New growth is bearing weight to the quarters; Photo of bottom of same foot showing new growth at sole. Open wound completely healed.

American Saddlebred
3 Years Old
Compression Fracture, 25 Degree Rotation & Acute Hoof Wall Separation

45 DAYS				Photo showing same foot 45 days post-op, derotation and coronary band separation (note new growth at coronary band).
75 DAYS				Hoof separation 75 days post-op (note healing tissue of coronary band); Photo of same foot showing loss of old hoof tissue. Separation severe enough to allow scissors to be inserted between hoof wall and separated lamina.
14 MOS				Same hoof 14 months post-op; Note: Hoof wall integrity has been restored.

Paso Fino Mare
12 Years Old
Chronic 15 Degree Rotation

Day of surgery; Note chronic pain stance (hind feet tucked under relieving the weight on the front feet).

Six weeks post-surgery.

DAY 1				Photo of feet the day of surgery. After surgery, before derotation. Note how imbalanced and damaged the hoof capsules are.

90 DAYS				Photo of left hoof three months post surgery. Note balanced and healthy hoof capsule; Photo of left hoof three months post surgery. Showing balanced hoof capsule and new hoof growth to heels.

Arabian Mare
12 Years Old
Acute Grade IV Rotation & Sinking

				This mare presented in severe pain; The left fore sole was open and the bone exposed; The right fore hoof was sinking.

DAY 1				Condition of left fore sole at time of surgery; Note exposed bone (arrow).

30 DAYS				30 days post-surgery; Note new growth.

90 DAYS				Although sinking had occurred with complete loss of hoof capsule, we were able to maintain it as a "cast" over healing hoof tissue for 90 days.

120 DAYS				At 120 days the mare has new soles, heels, and the beginning of new quarters.

180 DAYS				At 6 months, the mare was sound with new hoof tissue.

180 DAYS				The mare is ready to return home.

American Quarterhorse Gelding
13 Years Old
Chronic Acute Grade IV Laminitis

				This middle-aged Quarter Horse was rescued by Cashvan Family Memorial Equine Fund. He was presented to us six months after acute laminitic bout. He was unable to stand.

PRE SURGERY				Condition of legs showing hyperflexion of fetlocks and abrasions of fetlocks.

POST SURGERY				Shows correction of fetlock hyperflexion. Capsular derotation complete. The horse is able to stand and walk comfortably.

PRE AND POST SURGERY				The radiograph on the left was taken before surgery and capsular derotation. The radiograph on the right shows the bones of the hoof back in their correct position.

180 DAYS				The hooves have been returned to normal shape and size.

180 DAYS				Ready for adoption.

Fatal Sinker Syndrome

Fatal Sinker Syndrome is the worst case scenario in Laminitis. These horses have traditionally been put to sleep. Dr. Ric Redden of Versailles, KY started investigating saving these horses through a procedure known as transcortical fixation and hoof wall ablation. As of this writing 9 research cases have been tried, 3 were at Serenity Equine. We have a survival rate of two horses in our hospital. It is critically important that the horse reach surgery before all blood flow is lost to the foot. Once the hoof dies, it contracts, acting as a tourniquet causing bone and lamellar death. By placing pins in the cannon bone, removing the hoof capsule and casting the leg so as to cause weight bearing at the cannon bone while suspending the foot in a non-weight bearing mode, we are able to save the blood supply and the lamina. In a matter of weeks the lamina will harden and new hoof will grow. In one year all new tissue is normal. We expect our 2 cases to return to their previous abilities.

		Fifteen year old Quarter Horse Mare at presentation.
RIGHT FORE LEFT FORE		Venograms of Right Fore & Left Fore. Note the lack of blood supply to Right Fore and congestion of blood above coronary band. Left Fore has adequate blood supply and is a Grade IV rotation that required a deep flexor tenotomy.
		The hoof capsule after removal or ablation appears normal from the outside, but once turned on its side shows the congestion and swelling from the dying lamina.
		After 3 weeks in a cast, hardening of the digital corium (hoof wall) and solar corium (sole) is almost complete. The cast & pins were left on for a total of 11 weeks (note arrows pointing to transcortical pins).
		14 weeks post-op mare is comfortable enough to try and escape from stall.