CASE 3:  Paso Fino Mare, 12 Yrs Old -- Chronic 15 Degree Rotation



case_paso_fino_1-2BEFORE: Day of surgery - note chronic pain stance (hind feet tucked under relieving the weight on the front feet).

AFTER: Six weeks post-surgery




case_paso_fino_3Day 1: Photo of feet the day of surgery.  After surgery, before derotation.  Note the imbalance and damage of hoof capsules.





case_paso_fino_4-590 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.



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CASE 4: Arabian Mare, 12 Yrs Old -- Acute Grade IV Laminitic Event



case_arabian_1This 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 post-surgery. Note new growth (arrows).






Day 90: Although sinking had occurred with complete    loss of hoof capsule, circulatory collapse was not fatal.






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




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





Day 180: The mare is ready to return home!







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CASE 5: American Quarterhorse Gelding, 13 Yrs 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 an 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.






Day 180: The hooves have been returned to normal shape and size, and was ready for adoption.






 Ready for a new home.






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 CASE 6:  Quarter Horse Mare, 15 yrs old -- Fatal Sinker Syndrome

case_fatal_sinker_1Fatal 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 nine research cases have been tried, three 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 two cases to return to their previous abilities. 
case_fatal_sinker_2Venograms 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. 



case_fatal_sinker_3The 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.



case_fatal_sinker_4After 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.






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CASE 7: Two year old Friesian gelding with bilateral solar penetration following acute episode of Potomc Horse Fever- a Grade IV laminitic event





Day 1- radiograph showing penetration of sole by tip of coffin bone- note that the sole below the bone has dropped to the ground.








Day 1- showing solar surface of left fore and exposed solar corium and bone. 









Six weeks post-surgery and digital realignment showing new sole growth and excellant alignment. Note- the dark area at the tip of the toe. This is the area that has grown out that was compressed circulation.







Day 1 radiograph of right fore showing same pathology as left fore.








Day 1 showing prolapsed sole and exposed bone and solar corium on right fore.









Six weeks post surgery showing new hoof, sole and digital alignment.








One year post surgery, horse was purchased with a clean pre-purchase exam and won his Keuring.




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