CLUB FOOT IN FOALS

Most newborn foals naturally stand very upright on their slender little legs. As they mature, however, the tendons and bones may grow at different rates, and a club foot may develop, usually between about 6 weeks and 8 months of age.

“We see it most often in the fast-growing young horses,” says Mike Pownall, DVM, a veterinarian/farrier with McKee-Pownall Equine Services in Campbellville, Ontario. “There is shortening of the muscle that attaches to the tendon that attaches to the coffin bone. This causes an elevation of the coffin bone at the rear of the hoof.” And, ultimately, the pressure pulls the hoof into a more upright position.

The good news is that farriers and veterinarians have a lot more options for correcting a club foot while the foal is still growing. “The younger the animal, the better the result and prognosis for future soundness,” says Travis Burns, CJF, lecturer and chief of farrier services at the Virginia– Maryland College of Veterinary Medicine. A number of strategies can help to change the course of a developing club foot:

• Monitor foals’ hooves closely as they grow. A first farrier visit at around 2 to 3 weeks of age is an opportunity to make sure the foal is off to a good start, but it’s also important to continue the exams every few weeks as he grows to catch any developing problems early. If the mares and foals are turned out to pasture and not monitored, a young horse may have a serious club foot by the time he is brought in for weaning.

The early signs of a developing club foot can be subtle. Ironically, the more serious grade 3 and 4 cases can be addressed more readily. “In one way these are the easiest ones to deal with because they are obvious; you know you must deal with them or manage them right

away,” says Paul Goodness, CJF,

Club foot often accompanies congenital limb deformities, which are present at birth.

senior member of Forging Ahead, a farriery group practice in Round Hill, Virginia. “By contrast, sometimes the milder ones are not noticed by the owners, so they are not effectively controlled.”

• Provide proper nutrition—not too much.

Club foot can accompany the angular limb deformities that result from developmental orthopedic disease (DOD), a spectrum of conditions caused by overly rapid growth from a diet that is too rich in calories and nutrients. “It pays to have a veterinarian and equine nutritionist involved in the diets of mares and foals and have the correct nutritional plan,” says Burns.

In some cases, a developing club foot may be reversed by limiting the foal’s calories to slow his growth. “If you can start treating these horses when they are very young, often the muscles and tendons will relax a bit, especially if you can slow down their growth and limit their exercise,” says Pownall.

Limiting a young horse’s exercise may be counterintuitive, but it can help reverse a developing club foot. “You don’t want the foal running around and getting stronger, and tightening the muscles and tendons,” says Goodness. “You actually want the muscles to get a little weaker for a while, to relax the tendons. This can be done by keeping the foal more confined and restricting the diet a bit to slow growth. Usually this is how we start dealing with the problem in a very young foal, and it often works well.”

• Bring in a veterinarian to address any concurrent medical issues.

If your farrier identifies a developing club foot in your foal, schedule a veterinary examination to look for and address any underlying causes. Club foot may appear in foals who consistently favor one leg due to pain and/or muscle contracture in the upper leg or elsewhere in the body—often as a result of DOD-related lesions or inflammations.

“This is sometimes treated medically, with a dose or two of oxytetracycline or other medications aimed at relaxing the muscles and reducing tension on the deep digital flexor tendon,” says Goodness. “Oxytetracycline tends to relax tight muscles by interfering with their chemical balance. If done carefully, this medical intervention can get things going in the right direction. This is why it’s best in some cases for the farrier to work with a veterinarian.”

• Have the hooves trimmed frequently and judiciously.

Trimming the hoof to lower the heel needs to be done carefully to avoid putting too much stress on the toe. “In young foals we try to physiologically stimulate the foot to improve—by gently lowering the heel and doing everything we can to protect the toe. It can be very tricky if a person is trying to lower the heel without causing pain/ pressure or increasing the stress and strain on it too much,” says Burns.

“We want to make sure they don’t wear the toe away. When that happens there is little to no resistance to the pull of the deep digital flexor tendon and the problem just continues to get worse,” he adds. “If the heel does not touch the ground after you’ve trimmed it, and the foal is walking on his toe, you have trimmed it too much. It’s often trial and error to try and determine what each horse can or cannot tolerate.”

• Consider surgical intervention.

When medical treatment and trimming are not enough to correct a club foot, a veterinarian may opt to cut the inferior check ligament, a short offshoot of the deep digital flexor tendon (that attaches to the suspensory ligament), in an attempt to relieve some of the pull on the coffin bone without jeopardizing the stability of the leg. “Sometime within the 4- to 8-month window, if the foal has not responded well to trimming or medical treatments, this may be a time to start thinking about surgery,” says Burns.

After the inferior check ligament is cut, shoes are applied to protect the toe and increase the base of support. “The heels are lowered to try to achieve a near normal palmar angle,” says Burns. “Sometimes shoe extensions are used to protect the toe or put the shoe where the foot would be if the toe has been worn away.”

Foals with more severe deformities—a club foot that is vertical, at 90 degrees, or even tipped forward—are more likely candidates for this procedure. “There are varying degrees of success with this approach,” Burns says. “Obviously, the more severe the deformity, the more guarded the prognosis, but it’s not uncommon for young horses to have the inferior check ligament desmotomy and go on to soundness. When a desmotomy is performed, those chances are reduced slightly, but many of them do become sound enough for light riding.”