Remodeling Bone

QUESTION: 

Dear Dr. Tom,
 
I just wanted to tell you how much I appreciate your informative articles. Sometimes I feel like I am so alone in my thinking that shoes do more harm than good. I am surrounded by people who say "It's always been this way, what you're doing is radical and wrong" or "A barefoot trim is just a fancy and expensive term for a pasture trim". I see it as just the opposite...I am trying to give my horses the most natural life possible in an unnatural situation for them. I am quite interested in your comments regarding bone remodeling. I have had success with one of my horses with coffin joint arthritis and a barefoot natural trim.  We tried the traditional egg bars, then wedge pads, injections and he only got worse. I forgot to mention he was only 7 at the time. Then I figured..."What do I have to lose?" and contacted Gwen. He's a new horse!!! Now he's completely sound and moving  beautifully like the horse I always knew he could be . I have another horse, a fancy 13 yr old warmblood breed who was given to me because he has a bone cyst on his navicular. He could not hold himself up on a circle at a walk, much less trot or canter. His feet were in terrible shape when I got him, he was wearing wedge pads and had severe sole bruising from his coffin bone. I had his shoes pulled and had my farrier do a pasture trim on him. He is significantly better, but still  off at the trot. Is it possible for a bone cyst to remodel to a more normal structure with a barefoot trim or is this something he'll have to deal with for the rest of his life?
Thank you so much for your time.
 
Khristine Field
 
DR. TOM'S ANSWER:
 
Hi Khristine,
 
Congratulations on your successes and your dedication to the horses!  We have a long term resonsibility to education for generations to come concerning horsemanship issues...one of these issues is hoof care.
 
I suspect that your horse with the navicular bone cyst will improve as his tissue mass improves inside his hooves.  His digital cushions, cartilages and coriums are all likely atrophied (shrunken) due to improper care all those years, but we know that these tissues can regenerate a fair amount.  It will be a long term project for you and the horse.  The actual cyst is probably NOT going to be the horse's biggest problem in the long run.  This is something that shows up on x-rays and so we often times point at it and our attention is drawn to it, but I can pretty well assure you that there are other soft tissue problems surrounding the bone that will have to rehabilitate, and when they do, you'll still likely have a cyst present in the bone (to some degree) but the horse just won't care about it.  If we had better ways to image the soft tissues in the hoof we would be looking and pointing at those problems that would show up.  It's a matter of being critical of what we can see, which in this case is bone change...don't get too wrapped up in it!  This impression has come to me through dissecting many hooves so that I can see both bone and soft tissue with my own eyes.  I think the cyst is a consequence of what has happened, not a primary cause of a problem right now...you're looking at the smoldering ashes of a fire that needs to be extinguished and the area replanted in order to get new life to the area.  Some scarring will remain, but the vitality and function will return for as long as you can provide appropriate care.
 
Give the horse the time to heal if you are able...that would be awfully nice of you considering the way he was treated all these years past,
 
Dr. Tom T.

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