I sold my horse on Feb 3, 2011. I agreed with the buyer that they could have a post-purchase evaluation done and that if

You are most certainly welcome :) Could I actually ask a favour of you. Would you mind reposting the URL's into the chat screen I am having trouble accessing the entire address from the original question.

Thank you that link worked!

Is there a second link as well or just the first link?

They are not labeled as to which foot is being radiograph but I will assume these are images sent over by the Purchasers Vet of the right forelimb. Did they take any additional views of the right front foot to your knowledge asides from these three ? (for example a view called a 'skyline' view is missing from the series to be complete).

Alright thank you for all the additional information. Give me some time to take a careful look over what we have here and I will be in touch with you shortly.

Thanks for your pateince. The Vet performing the prepurchase exam states that there is a grade 2/5 lameness in the right forelimb. This could have been present all along as many owners would not be able to pick up a grade 2/5 lameness. It could also have been a result of the feet being newly trimmed that cause Denver to have a mild lameness picked up by the practitioner. If it remains consistent a few weeks down the road then the lameness is likely not a result of the trimming and may be due to "caudal heel pain syndrome" basically pain originating from structures in the back of the horses heel. The fact that the horse was sensitive over the heel region at the time of examination also could be related to both farrier or caudal heel pain syndrome. If the horse was trimmed at a different angle than he was used to this could place temporary excess strain on the structures at the back of the heel causing a positive response to the placement of the hoof testers. Now in terms of the radiograph we have two views. One view is looking at the leg from the side and the other view is looking at the leg from front to back. There are two images out of the three images you provided looking at the foot from front to back. One of these images is under exposed ( meaning too white) and can not be used to make any diagnosis conclusions. On the other image although better I am still not seeing very good detail. This may be due to the x-ray having been converted into a jpeg from its original DICOM version. On this view here I am looking for spurs coming off of the flexor surface of the navicular bone where the deep digital flexor runs over. From these images its very difficult to determine if there is a spur or not. Normally I should see a structure called synovial invaginations and I can't even make these out on the radiograph. If there are spurs at this location, no this would not have been caused by the farrier and it would have been developing over some time (age related changes). Many sound horses can have changes to their navicular bone. In some horses this can be significant and other times has no impact on the horse. This is likely since on radiographs we can only see 50% of the structures that being bone. There are many important soft tissue structures in that area that can not be assess with radiographs. On the view from the side the region where the impar ligament attaches to the navicular bone may be subjectively larger than normal and perhaps this is what the other Veterinarian is referring to as a spur. Again this would not be a recent change.

I went over the image from the side and did my own measuring of the angles ( sorry it took so long I was trying to figure out how to use their system so I could make my own measurements!). The results are as follows:

The first measurement I did was to determine if there was distal displacement of the coffin bone. Normal horses have a measurement of 13-20mm and he came in at 16.6mm so he has no distal displacement of the coffin bone.

The second measurement was to determine palmar rotation:

Normal horses should have less than a 4 degree angle.

He came in at about 5.9 degrees I will probably just take a re-measurement of that to be sure now that I can work the measuring angles on their system better given me one more moment.

Going back and measuring I am getting less than 4 degree so there is no rotation or displacement of the coffin bone.

If anything he has evidence of navicular heel pain based on the findings from the Vet (lameness and pain with hoof testers)

I am not sure if your own Vet could see any spurs but I am having a hard time making them out if present on the radiographs you provided.

Is he a quarter horse by any chance?

He is the right breed for caudal heel pain almost all of the quarter horse breeds eventually seem to develop issues in their heels. Its hard to tell on those radiographs in regards XXXXX XXXXX spur maybe they can be seen on the DICOM version. However if he is sound regardless of the presence of the spurs that makes the findings on radiographs less significant. The question is on the day of the exam was he sensitive due to recent farrier work or has he had heel pain for some time.

It is possible he had a grade 2.5 lameness while you had him especially if he was used for trail it may never have been too pronounced to be noticed from anyone asides from a Vet fluent in detecting lameness.

That is correct by just looking at the foot I can see why it may appear the coffin bone is tipped but if you measure out the angles all the values are within the normal reference ranges.

The real determination will be to determine if the grade 2/5 lameness is still present in a week from now once the horse has time to adjust to the trimming. If he does still have lameness at that time caudal heel pain is more likely the culprit. This is a degenerative process (basically age related changes) but can be managed if it ever does prove to interfere with the horses intended use.

With caudal heel pain we recommend keeping the heel long and toe short to encourage breakover and not put excess strain on the back of the heel. Shoes are not always necessary but some horses do better in plain shoes setting them slightly behind the toe to again encourage break over and prevent excess strain in the heel region. Others eventually may require steroid injections directly into the coffin joint and the occasional Bute. Some horses have severe cases and with these horses if they are refractory to all other forms of treatment we perform a procedure called denerving to take away pain sensation coming from the foot.

You are most certainly welcome it is my pleasure to help! If you have any other questions in the coming days this page will stay open in a question and answer format after you press the accept button and we can communicate at any time for no additional charge.

I always enjoy a good question :)