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Foot: heel - sheared

pequis

Introduction

  • A structural breakdown between the medial and lateral heels eventually   →    a change in foot shape.
  • Cause: disproportionate weight-bearing between medial and lateral caudal aspects of the foot.
  • Signs: single/multiple mild to moderate foot lameness   Musculoskeletal: gait evaluation  ; asymmetry within foot; pain on manipulation   Musculoskeletal: physical examination - adult  , with independent movement of heels possible.
  • Diagnosis: clinical appearance.
  • Treatment: trimming and corrective shoeing.
  • Prognosis: good for mild cases; if severe structural damage, life-long corrective shoeing may be necessary.

Pathogenesis

Etiology

  • The result of acute or chronic single heel overload.
  • Conformational fault   Musculoskeletal: conformation   with imbalance between lateral and medial heel   Heel: sheared 01 - dorsal      Heel: sheared 03 - palmar      →    structural breakdown between heel bulbs.

Specific

  • Incorrect hoof trimming, eg over-trimming of medial or lateral heel.
  • Improper shoeing, eg improper use of heel caulks for added traction can concentrate impact on one heel; caudal nails in shoes inserted too close to the heel (should be placed in second to last holes).
  • Chronic lameness   →    gait change   →    weight redistribution on impact.
  • Foot conformation fault, eg toe in or toe out; long toe-short heel; rotational deformity in foals   Musculoskeletal: angular deformity  .
  • Palmar foot pain.

Pathophysiology

  • Disproportionate weight-bearing between medial and lateral caudal aspects of the foot   →    a structural breakdown between the medial and lateral heels, which eventually   →    a change in foot shape.
  • Hoof wall flares on the side of the lower heel bulb and is steep on the opposite side of the hoof   →    abnormal strike pattern   →    uneven loading of the distal interphalangeal, pastern and fetlock joints, plus a rotational torque is created around the point where the foot first contacts the ground   →    undue stress on the joints above, and abnormal concussive forces on the navicular bone and its associated structures.
  • Degree of damage and lameness is proportional to degree and duration of foot imbalance; mild to moderate.
  • If lameness is severe another possible cause of lameness should be investigated. 
  • May   →   : 

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • O'Grady S E & Castelijns H H (2011) Sheared heels and the correlation to spontaneous quarter cracks. Equine Vet Educ 23 (5), 262-269 VetMedResource.

Other sources of information

  • O'Grady S E (2005) How to Manage Sheered Heels. In: Proc 51st AAEP Convention. Seattle, Washington.
  • Stashak T S (2002) Sheared Heels or Quarters. In: Adams Lameness in Horses. 5th edn. Lippincott, Williams & Wilkins, Baltimore. pp 682-684.
  • Moyer W A (1999) Sheared Heels. In: Equine Medicine and Surgery.5th edn. Eds: Colahan P T, Merritt A M, Moore J N & Mayhew I G. Mosby, USA. pp 1508-1509.

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