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Jineen's Thread -- Now it's about the feet
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Jineen Walker
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 Posted: Tue May 15th, 2012 07:09 pm
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Hi Dr. Deb,

I've been needing to ask for your help with this, as I've already worked with my vet and haven't really come up with any answers.

I purchased my Arab horse about 5+1/2 years ago, when he was 4 yrs. old, and noticed that his front upper incisors were worn and chipped like he cribbed and they were stained.
I also saw him eat mud a few times, and after realizing he wasn't a cribber, but mouthy, figured  he just put his mouth where it didn't belong and stained and damaged his teeth.

Two years ago my vet suspected  EOTRH, but wasn't sure. Last year she wanted me to rinse his mouth with Nolvasan, but wasn't convinced he really had EOTRH, as there really hadn't been any change in his mouth, but she was learning more about it, and this year I noticed quite a bit more staining, receding gums on a chipped tooth and she gave him a definite diagnosis. The vet added that it is usually seen in horses over 15, not his age and certainly not as young as when I first got him and saw the damage.

She said the cause isn't known, so neither is the cure and wants me to continue to flush his mouth with Nolvasan even though it isn't thought to work, so that doesn't make any sense to me.

I was curious as to any information you or anyone else would have on this disease, how best to treat and how much pain is he going to be in and what to do about it as his teeth rot. I can only relate it to me when I have a cavity that exposes the nerve.When/do I have his teeth pulled ect.

I was also curious to know if there is any genetic or breed pre-disposition that I could look into.

Any guidance will be appreciated.
Thanks so much,
Jineen Walker


DrDeb
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 Posted: Tue May 15th, 2012 08:19 pm
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Jineen, I think you are being scammed. However, we'll reserve final judgement on that until you go take a photo of the horse's teeth and post it here so we can see what you mean by "staining" and "chipping".

And also, for the courtesy of everybody else, a "translation" of the terminology that Jineen has received:

Equine = horse

Odontoclastic -- a compound: odonto = tooth + clastic = substance being removed from

Tooth resorption = part or all of the tooth being resorbed by the body

Hypercementosis -- another compound: hyper = excessive + cement = the cementum substance of the tooth + osis = a process involving or a disease of.

The gist of the meaning is that a tooth is in a process of breaking down not by infection or breakage but by being resorbed by the body, while at the same time there is a proliferation of cementum, probably from cells living in the lining of the alveolus or tooth socket. -- Dr. Deb

Jineen Walker
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 Posted: Wed May 16th, 2012 11:00 am
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I can't post the photo as it is too large. I've never had to reduce one before, and it's the same camera I used before. Any help would be appreciated.
Jineen

DrDeb
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 Posted: Wed May 16th, 2012 06:47 pm
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Jineen, surely you have some type of image-processing software in your computer. So you upload the image from the camera. Then you open the software, and there will be a function that tells you "file size". In this window there will be options for the width of the image either in pixels or inches, and the number of dots-per-inch or "dpi". Set the width to 6 inches and the dpi to 300. Then "save" this image to a file inside your computer that you create (the file from which I upload images to the Forum is called "Forum images"). When you save it, save it in .jpg format. When the window for that comes up, there will be a slider-bar that runs from 1 to 8; set it to 5 and then push OK. This will save the image in a moderately compressed form. Between doing that and re-sizing it, you should be good to go then to upload the image from your computer to the Forum.

If you don't understand this, find any teenager. -- Dr. Deb

Jineen Walker
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 Posted: Fri May 18th, 2012 02:52 am
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Thanks for someone else's software.

This horse had the chips in the bottom of the top teeth, the staining and the cavity when I got him.

Note in the gums the red pustules.
The vet thought that they were infection tracts from the teeth rupturing through the gums.
She decided against antibiotics at the time, three months ago, and wanted to see what the Nolvasan did. She told me there was no known cause and therefore no known cure. I didn't believe the Nolvasan was worthwhile.

Thanks for your input.
Jineen



Attachment: Teeth 100_5613.JPG (Downloaded 817 times)

DrDeb
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 Posted: Fri May 18th, 2012 09:30 am
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Jineen, now that we have a photo that we can all look at, I take back everything I said about your vet using big words in order to fuddle you: their terminology is exactly correct and appropriate.

You say the horse is about 10 years old. This is early for the onset of hypercementosis.

The hypercementosis is obvious and a textbook example. Usually we see hypercementation on the molar teeth rather than on the incisors. In either case, it is provoked when the teeth in an old horse, having been worn down so that there is very little reserve crown length still in the tooth socket, begin to be loose in the socket. They then rock with every chewing stroke. The rocking pulls on the alveolar ligaments and the lining of the alveolus, where the cementum-depositing cells live. This stimulates the cells to go into high gear, depositing cementum in an attempt to "cement" the tooth into the socket. The process will eventually in fact be successful.

In the molar teeth, what this results in, in the horse upwards of his mid-twenties, is what is called "pseudo teeth", i.e. teeth that are so coated and surrounded by cementum -- having only a small "core" left of the true tooth, which has almost completely worn out -- that chewing then occurs mostly upon the cementum. My Sadie mare was fortunate enough to have this happen. I say fortunate, because pseudo-teeth work well enough to allow the animal to chew grass to some extent, when if they did not have pseudo-teeth they would have no teeth at all, or at least none that had enough crown height left to make occlusion with the tooth in the opposite jaw and thus allow mastication. Also, once the molar tooth is firmly cemented into the socket, the chances of abscessing due to food material getting packed into the space between the gum and the loose, rocking tooth is minimized, so that gumline cavities and tooth decay with eventual abscessing are much less likely.

So what you see from this is that hypercementosis is not at all a bad thing. It will likely never proceed as far with the front teeth as we see with the molars, though, because with most horses, when the molar and premolar teeth -- the cheek batteries -- have either totally fallen out or worn completely out, the animal will still have incisor length and will still be able to grasp grass with the incisors (horses do not chew with their incisors). So you will never see your horse's incisors entirely drowning in cementum as happens with the molar teeth.

Nonetheless it is still a good thing, because the hypercementation that is visible in the photo shows us that the teeth are pretty well along in the process of being cemented firmly in, so that they do not rock.

As to the other processes that are visible: the ruffled distal margins of the upper incisors as well as the deep grooves in the anterior faces of the teeth are due to one of two causes -- either the horse's permanent incisors did not properly form when it was young, so that the enamel surface of the teeth did not thicken and/or harden as it is supposed to; or else your water, or the water where this horse lived for most of its life, is acid.

This second point is easy to test. Beg or borrow a pH meter -- perhaps from your ag extension agent -- or else purchase the type of pH test kit that uses strips but you read the color by comparing the dipped strip to a spectrum chart. If your water is acid, as much of it on the East Coast and in New England is -- then you definitely need to remediate that. Write back to us to report; even if your horse's teeth were not affected, Jineen, this is so important that it will also impact the health of every other horse or cow you own.

The photo shows food material -- bright green -- packed into all the grooves in the surfaces of the incisors, as well as around the rims and in the interdental spaces. This is normal given the unusually deep contours in this horse's teeth, which, as I am indicating, are due either to malformation of the teeth or else to the slow erosion/destruction of the teeth by acid drinking water.

As to the pustules, Jineen -- we talked about this when I visited you some years ago. We did not talk about pustules per se at that time, but we DID talk about pokeweed (Phytolacca americana) that you have growing in your pastures. I would have another look at that, and I would also look for klamath weed (St. John's Wort) or any other forb or feedstuff that would cause either primary or secondary photosensitization. A "pustule" just means a "blister". One in the photo is clear; the other has some blood in it so appears red. The gums are blistering either because they are being burned by something, or else because the horse has ongoing liver disease and/or photosensitization.

The reddish staining on the teeth is normal. Horse teeth are variably pigmented, as are the teeth, for example, of shrews.

So let us know (1) the age of the horse and (2) what your pH meter reveals to begin with. And you can stop worrying about the hypercementosis. I would worry about the pustules -- you want to get your horse away as soon as possible from whatever may be causing them. -- Dr. Deb

Attachment: Hypercementosis Jineen Walker.jpg (Downloaded 796 times)

Jineen Walker
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 Posted: Fri May 25th, 2012 04:08 am
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Hi Dr. Deb,

Been doing my homework.

First off, thank you for your time in explaining the cementum, and that I don't have to worry about that part of this. So the cementum covers the tooth as it loosens and is absorbed so there shouldn't be pain from cavities. I will confirm though, that this horse has always dunked his hay, and the vet floating his teeth does not believe that his teeth had anything to do with the habit. He will also grab a mouthful of snow if it is clean, as he eats, so I believe he is in some sort of pain.

The horse is going to be 11 the end of June. I purchased him at 4 years of age. His teeth were stained and chipped then, and had the cavity.
I checked the ph of the water both at the faucet and in the bucket, and it is slightly low, but not extreme.The total alkalinity is very low.

As to the blisters, I was referring to the dark pink marks higher up in the gum above the teeth.I went back to his mouth to check what you had pointed out. The objects you pointed to were gone, so I believe food particles, but also, the blisters I was referring to were gone as well.
I will agree with you about irritants that he is eating. (My vet thought that the root of the tooth was infected and leaking though the gum.) It looked more surface to me, not a deep tract like that.

Your memory is great- I have eradicated the pokeweed and am working on a few other plants.

I have clover-all over. In the hay as well. White mainly, red and alsike, not so much.( I am hand weeding 7 acres and loosing the battle. It loves my soil.)

I posted about a skin problem this horse had two years ago, and you pointed toward liver problems and told me to go with my vet first. I always go to you last, not first-after I am extremely frustrated.  Asked my vet about clover, and her answer is everyone has it, don't worry about it, nothing you can do about it.

My vet does not believe that there can be any liver issue involved, not now, not ever. That the horse would show signs of illness, not be so healthy and active.

Also, He doesn't have any problem with the french link snaffle, but I was wondering if in the future or now, should consider a hackamore, side pull ect. I am aware that his teeth have to be in real good shape so as not to cause any cheek discomfort.

So, if I can't clean up the pasture, I can remove the horse to a dry lot. How do I keep him happy doing nothing all day?

Thanks so much,
Jineen

DrDeb
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 Posted: Fri May 25th, 2012 09:48 pm
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Jineen, I think by far the simplest thing for you to do is to continue working with whatever veterinarian you have and whatever equine dentist/veterinarian you have. There are so many misunderstandings and wrong ideas concerning your horse -- including for example why he dunks his feed -- that it would take me a month of Mondays to straighten them all out -- if indeed that really would be possible at all. So I say, it will very likely be best if you just do whatever your vet tells you. -- Dr. Deb

Jineen Walker
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 Posted: Sat Jul 21st, 2012 08:38 pm
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Hi Dr. Deb,

In reading other threads, I have ordered an electronic water ph tester, as well as magnesium and sea salt, I won't bore you with the related details, but I did post about the magnesium for this horse previously, and you and Pauline Moore helped greatly.


What I am adding at this time, is I have also tested and treated this horse for Lyme since my last post, which adds to the long line of symptoms, some of which are similar to sugar problems. (On a side note, I have also treated my dog for Lyme and liver problems, and got to research and see first hand knowingly the symptoms of liver disease.-in regards to scratches in horses)  


What I am concerned with right now is farrier work.

I have had the same farrier work on this horse for 6 years.
Over that time, the horse has developed a dish in his club foot, then a crack at the toe. I have discussed this many times with both the farrier and vet, because I am concerned about his calf knee on this same leg being overly strained.

The vet says that she likes and approves highly of my farrier, and stated except for the dish, he does a great job, not concerned at all about the dish.

Yesterday I had the associate vet out to do x-rays.
The x-rays confirm what you can see with your eye, a dish, long toe. The angles of the bones in the lower leg are out of balance as well.
The second vet defended the farrier stating that he does a good job, but that it will take at least 6 months to correct his feet. So I am left to believe it must have taken some time to develop the problem.
Should I give the farrier the benefit of the doubt that he couldn't have seen it changing? That the inside doesn't always match the outside? Am I wrong to believe that if there is a dish, that may or may not be what is happening inside?

I also had another horse x-rayed who has been lame and positive to Pauline's rump test. I had this horses shoes pulled and had resigned to retire him as he was too lame and tripping to ride safely.
Within the last 4 weeks, both the chiropractor and farrier state that there is nothing wrong with this horse, just stiff. So I had him x-rayed on Pauine's hunch that his front feet could be the problem. X-rays confirm what you can see-long toe, dishing and possible founder episode.

I won't have a copy of the x-rays till Monday, but I have the horses, so I am going to attempt to mark up as Adam Till has shown and have also ordered the Inner Horseman 2003 to get a clear understanding.

In the meantime, I have gotten a contact for a farrier who has been taught by Gene Ovnicek. He isn't close to me, so I don't know if he'll work with me.

Or, should I show the x-rays to my farrier, and hope he understands what needs to be done?

Thanks,
Jineen

DrDeb
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 Posted: Sat Jul 21st, 2012 09:53 pm
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I have no idea what to tell you, Jineen. Your question relates to your own personal relationship with someone I don't know.

I do repeat here, however, that it is you yourself who needs to learn how to interpret the foot XRays.

It is also you yourself who needs to know which farrier to call, or whether one farrier or another is or is not doing a good or correct job. It is the OWNER WHO MUST KNOW.

No one should ever depend upon another person's degree, letters after their name, certification, registration, or what-have-you to tell whether the said certified or degreed individual knows what they are doing. There is only one way to know whether they know what they are doing, and that is for YOU to know what a proper job looks like and what proper results are.

This is why I write the conformation column in Equus Magazine -- so that you, the owner, may learn what proper conformation looks like, or what a good job of farriery looks like.

Jineen, you have access to all the publications we offer here under my authorship which relate to the hoof, trimming and shoeing: particularly the 2003 Inner Horseman disk. I believe you own that disk. Have you not been able to learn from that disk what to look for?

Have you NO idea why horses develop toe cracks? Why does a horse develop a persistent (deep) toe crack?

Have you NO idea what a dish in the toe of the hoof means? Have you checked to see whether the toe-dish goes with run-under heels or run-forward heels? What does a dish in the toe generally imply about the orientation of the coffin bone inside the hoof capsule?

Perhaps you would benefit from coming to take the anatomy class, Jineen. We are offering the class in Oregon during the last week in October this year. We do spend quite a bit of time on hoofs, trimming, and orthopedics during that class.

I do all I can to educate people, but Jineen, in the end, you're going to have to get over being so damned goofy, because until you get over that and get to where you can remember stuff and take the full responsibility for learning correct information correctly, neither I nor anybody else will be able to help you -- because you have a very slippery way of avoiding helping yourself. If you are too ill to be able to learn or remember, perhaps you should consider giving up owning horses. -- Dr. Deb

Jineen Walker
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 Posted: Sun Jul 22nd, 2012 09:05 pm
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Dr. Deb,

I am not forgetful, I just ordered the inner horseman disk.

 I asked questions I do know the answers to. I do know about dishing, I do know about toe cracks, otherwise I wouldn't have discussed it. Over the years I have hired and fired veterinarians, farriers, saddle fitters and riding instructors for reasons I now take the responsibility for.

I didn't trust in myself in that I don't have the degrees that either you or my vet or farrier may have.  I am not ill, but you are right. I have ill placed my trust in someone who I thought after 30 years would be working for my best interest, and I didn't want to see that she didn't, and I didn't understand that, and that was undermining my trust in my knowledge. That is the slippery part.

Your reply has kicked my brain in gear.
This vet is not going to disagree with this farrier to a degree that jeopardizes their working relationship on a daily basis. Their "click" if you will.
It reminds me of a pirate movie quote "They've done alright by them. You can't expect any different than that."

Also, David Genadek's story on "Trust" is right on.

Thanks, and I'm done slipping now,
Jineen

Jineen Walker
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 Posted: Sat Jul 28th, 2012 03:16 am
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Hi Pauline,

I'm glad to post anything I've been learning about here. I know how valuable everybody's input has been to me, so I hope to pass on whatever to anyone who needs it.

I've been extremely busy this week.
Sent the x-rays to Cody Ovnicek for help, as well as to find a farrier.  There was a few listed on his website in my state, one who actually is in my town-go figure!

I had her come out to interview, and the knowledge that is in this girls head, and her ability to relate, explain what she saw, what caused it and how she would trim to start to fix the hoof toward a correct balance, and what that should be was such a great learning experience.
She made sure I saw and knew what I was looking at, and why it was there from the inside structure of the hoof. Everything I have so far learned was crystal clear, and supported all of my questions and ideas that I had posed to my farrier and vet. I hired her, and have already trimmed all six horses in the barn.

Per his request, I have sent "before" trim pictures to Cody Ovnicek, and then "after" trim pictures as well. He wanted to see the outside of the hooves as well, to better guide me in what needed to be done in the trimming. I haven't heard back yet. I sent him pictures and x-rays of two horses.

There is damage to my four horses laminae due to possible sugars, she said.
One of my horses that I have posted about, can't remember the thread, but was having all kinds of behavioral problems. I had pulled his shoes this spring and was retiring him as he felt too unsafe to ride. I also x-rayed him due to ongoing lameness, and who had tested positive to  your rump test. He has dropped soles. So I was also correct in believing him to be IR back when his problems started.

That never would have been clear to me without your and Dr. Deb's help. I now know what I need to do, but I also will remember how dynamic the whole situation is, and just keep looking at what is presented to me.

I have also started the magnesium and sea salt two days ago, and yes, please clarify teaspoon amounts, and increases/decreases as when there is rain after a drought.
I have read through the "give up on your horse" thread, and am using 1/2 teaspoon magnesium bath flakes, and 2 tablespoons sea salt two times a day. Bath flakes are hard to measure- I am guessing by the amount in the palm of my hand.(I cook, so this should be close). Both horses love it.

I had been watching the salt block( I had marked it) and after one week, out of three of the horses turned out together, no one touched it. So giving them measured salt is going to be the best way to go.

 I am limiting pasture and tested the ph of the water. It came in at 6.4 in the outside trough, 6.0 in his stall one day after filling and his dunking of hay, so I'll work on that as well. These x-rays are of Trey. He is also pictured in another thread "bone measurements" so you can see the pose that caused the club foot. I also have the x-rays of the other horse if your interested.

I also have photos of his feet when I got him six years ago.

Thank you,
Jineen





Last edited on Sat Jul 28th, 2012 03:24 am by Jineen Walker

Jineen Walker
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 Posted: Sat Jul 28th, 2012 03:22 am
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One more comment from the vet taking the x-rays, was the bone deviation from straight in the first x-ray in the first pictured.

Trey was also lame to a flexion test of his right fetlock. Definitely not his elbow or knee.

Last edited on Sat Jul 28th, 2012 03:46 am by Jineen Walker

Jineen Walker
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 Posted: Sat Jul 28th, 2012 03:26 am
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Hey Dr. Deb,

How do I edit the pictures so as not to show personal information? The x-rays will load up, but I can't do anything to them to cut off the vet's name.
Jineen

DrDeb
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 Posted: Sat Jul 28th, 2012 03:59 am
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Yes, you can, Jineen. You do all that part in Photoshop, or in other "image processing" software before you ever try to load the photos here.

After the images are completely right, then you size them as follows: either 35 inches wide @ 72 dpi, or else 7 inches wide @ 300 dpi. You do this procedure in Photoshop also.

After that, then you post the images. Your initial efforts did not actually post, and the reason for that is that the filesizes were too big. So you be sure you re-size them as per the directions above before you try posting them.

To post them, you have the images in your computer somewhere. Then you press the button at the bottom of this screen that says "browse", then go to the file in your computer and click on it. Then you press "send" and they should post just dandy.

Thank you for the effort on this, Jineen, because without some documentary XRays or photographs, we can't really comment or help you very much. -- Dr. Deb


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