When this foal was born the owner
immediately noticed an unusual sickle
shape to his right hock. What had not been
so immediately apparent to the owner was
his bilateral hind-limb flexural deformities
(contracted tendons) and marked right hind
fetlock varus. It was suspected that he might
have a problem with incomplete ossification
(abnormal development) of the bones in
his hock.
X-rays taken at 36 hours old fortunately did
not confirm this, although there was still a
concern that the tarsal (hock) bones might
start to collapse if the current sickle shape
could not be significantly improved. The x-rays
demonstrated the very marked right fetlock
varus (16.8
®
) and also a mild left fetlock
varus (4.4
®
). Cost was a significant concern
and it was decided to try conservative
treatment in the first instance but to review
the case at the 2 week stage and discuss
whether surgery was required.
The foal was heavily sedated, given a mild
pain-killer and placed on his side before a
light dressing was placed on the left (more
normal) hind-limb. A strip of padding bandage
material was placed followed by multiple
layers of pre-cut casting material moulded
along the back of the leg before a top layer
of padding bandage material was applied,
thus forming a padding/cast sandwich along
the back of the leg. The whole limb was
bandaged with reasonable pressure using a
cohesive bandage to encourage the half cast
to form to the limb as it set. In order to reduce
rubbing, the padding material was cut longer
than the splinting material, and the ends of the
splint were rolled away from the leg.
Whilst waiting for the splint to set the foal
was treated with a high dose of intravenous
oxytetracycline. This is an antibiotic which
has long been known to have several useful
side effects, and is particularly useful in the
treatment of flexural deformities.
Once the splint had set on the ‘good’ leg it
was removed and bandaged onto the ‘bad’
leg with reasonable pressure applied during
application to encourage the leg to assume
as normal a position as possible. Because
the splint had been ‘custom made’ for the
foal, minimal padding was required when
compared with conventional gutter or
wooden splints.
The foal was allowed to recover with
assistance. The owner was directed to remove
the splint daily to check for any rubbing and to
apply gentle physiotherapy, by way of upward
pressure on the foal’s right hind toe. The splint
was then reapplied and each day the limb
was able to be pulled further into it. The mare
and foal were kept on box rest. One week
after birth the farrier attended to gently reduce
the inside wall of the right hind foot and thus
encourage the foal to stand straighter.
After two weeks a very pleasing improvement
was seen. The varus angle was now less than
2 degrees! As the improvement was so great
and the foal now no longer fit his original
splint the decision was made to continue with
corrective farriery only. The shape of the hock
had improved slightly and there was no
deterioration on subsequent x-rays. The
contracted tendons had relaxed well. The foal
progressed well and has now gone away to
be backed.
ALD TREATMENT
Veterinary surgeon
Sam Cutts
XLEquine practice
Hook Norton
Veterinary Group
CASE REPORT...
Sam Cutts MA Vet MB MRCVS,
Hook Norton Veterinary Group
Case study:
ALD treatment
with farriery and splinting
Figure 1
Figure 2
Figure 3
Figure 4:
Figure 5
Figure 6
Figure 7
Figure 8
Figure 1:
Right hind fetlock varus
Figure 2:
X-ray of the right hind
fetlock
Figure 3:
Setting up
Figure 4:
Applying the first cast
layer
Figure 5:
Waiting for the
casting material to set (left leg)
Figure 6:
The splint in action
(right leg)
Figure 7:
The foal 2 weeks later
Figure 8:
X-rays at 2 weeks after
initiation of treatment
13
EQUINE MATTERS
