Have you ever heard the old fairy tale about the princess and the pea? Long story short, there is this princess, and some fussy queen wanted to check that she was a real princess and not an imposter. They made the princess sleep on top of 20 mattresses stacked one on top of the other with a pea hidden under the bottom one. Apparently only a real princess would be sensitive enough to feel the pea under all those mattresses, so when the princess comes down in the morning moaning about how uncomfortable the bed was and what a bad night of sleep she had, the queen decided she was good enough to marry the prince. Lucky guy???

Why, you ask, do we give a meow about this silly story? Well, it turns out horses are real princesses too! But the pea under their mattress is the balance, conformation, and health of their hooves. Tiny changes in hoof angle can have huge implications to the soundness of your horse. They are sooo sensitive to changes in their feet, for better or worse. That’s why I want to talk to you today about taking routine X-rays of your horse’s feet.

I don’t mean just taking X-rays when you know there is already a lameness problem. Yeah, of course you will do that. My goal is to help you prevent lameness. My docs advocate a preventative approach, looking for subtle issues with hoof balance that may not yet be causing a problem, but if left untreated can worsen and cause lameness. Long toes, negative palmar/plantar angles, incorrect hoof pastern axis, under-run heels, and medial-lateral imbalance are just a few of the subtle problems that can be assessed by foot radiographs. Some of these issues are evident on a physical exam if they’re bad enough, but why wait until they’re really bad? Mild to moderate imbalance can still be present on a relatively normal looking foot. The best way to diagnose them precisely is to evaluate the position of the bones within the hoof through X-rays.

What will X-rays show?

For routine preventative X-rays of the hooves, my docs take two views of each foot – one from the side (the lateromedial view) and one from the front (the dorsopalmar view). These images show the bones inside the hoof and pastern in relation to the outer hoof wall and sole. Some of the structures that can be seen include the coffin bone and coffin joint, the pastern bones and pastern joint, the navicular bone, and the hoof wall and sole. My doc can get a sense of the health of the bones, look for early arthritis, and check the depth of your horse’s sole.

If your horse already has a lameness problem, X-rays can help to optimize management. Horses with caudal heel pain (navicular syndrome), laminitis, and other lameness problems benefit from regular checks to make sure the hoof care is appropriate for the disease process. For example, a long toe and a negative palmar angle can exacerbate pain coming from the heel area, so a horse with navicular problems will be very sensitive to these measurements. Likewise, a horse with a tendon injury will benefit from a trimming and shoeing plan that will help to protect the tendon as it heals.

The individual structures of the foot aren’t the only focus – also critically important is how they are positioned in relation to each other and the outer hoof wall. Think about the size of the horse versus the size of his limbs and how much weight his relatively small feet and legs have to carry. Very small abnormalities in the positioning and angle of the structures in his feet can cause a lot of extra stress and wear.

My doc can check how your horse is distributing his weight and make sure he’s not putting extra stress on the bones, tendons, and ligaments of the limb. Hoof imbalance is a really common factor on the road to lameness. It can be caused by your horse’s natural conformation – for instance if he naturally has a club foot, a low heel, or his hock angles are relatively straight (post legged). It could also be attributable to the hoof trim, shoeing, or the time between farrier visits.

Medial-lateral imbalance causes uneven loading across the hoof as well as the joints of the lower limb. In a normal horse, weight is borne evenly across the whole hoof and up the limb, but an imbalanced horse carries more strain on one side, predisposing him to injuries and wear on the joints. Abnormal patterns of growth can also give insight into impending foot problems.

When should I have X-rays done?

It’s really useful to have X-rays taken when you purchase a new horse so that you’ll have a baseline to be able to compare to later on. Ideally, these will be done as part of a full pre-purchase exam, to help you avoid any unpleasant surprises in your horse-purchasing experience. After that, we generally recommend taking x-rays every 6 months. If your horse has had lameness problems or tricky conformational issues, they might be needed more frequently. We can do the X-rays at the clinic or right on your farm!

My docs work closely with farriers so that your horse has the best team to help him stay sound and happy. They can review your horse’s X-rays with your farrier and make a plan together. Certainly, they’ll do this if a lameness problem comes up, but the best time is before your horse ever takes a bad step. Your farrier can use the X-rays to optimize the trim and correct any imbalances. This is especially useful when horses have conformational issues or sensitive feet, but any horse will benefit from the best possible trim to extend his soundness and athletic career.

It’s easier to make necessary changes to maintain soundness than to reverse years of wear and tear that have already caused lameness issues. This also makes long term sense for your wallet. Preventative care is usually a lot cheaper (and more successful) than trying to fix long term problems. So treat your equine princess to some foot X-rays so you both can spend years of happy, sound riding!

Until next week,

~Tony

This hind foot has a negative plantar angle (meaning the coffin bone is tipped backwards a few degrees from where it should be) and a broken-back hoof pastern axis, causing extra stress on the upper limb.

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