CAUDAL HOOF PAIN
Caudal (refers to the back, so the heels in this case) Caudal Heels mostly happen when the heels run forward, caudal heel syndrome, underslung, under-run, caudal heels etc, often due to lack of regular correct trimming, good diet and exercise. When the toe has run forwards, trimming it back doesn’t stop the heels from being under-run, it just means that both the heels and the toe are running forward and the heels are further forward instead of at the widest part of the frog.
Under-run Heels
When the heels under-run the quarters can get pushed out to the side and this can be mistaken for flare. Under-run heels can also be an illusion, in that a long flared toe gives the appearance of under-run heels. Flared toes can pull the heels forwards, because the heel and toe walls are connected to each other.
The cause of under-run heels is usually a toe first landing, so it’s best that a flat landing is achieved and do not let the heels be trimmed too low, this causes a reduction or negative angle of the pedal bone, the pedal bone should be at a slight 3-5 degree angle, not ground parallel. Concentrate on growing out the toe flare and don’t do too much to the heels all in one go.
When the horse shows lameness and the prognosis isn’t obvious, it is often diagnosed as navicular, this is a degenerative disease that affects the navicular bone and surrounding tissue. More often than not, horses don’t have navicular, they have Caudal Heel Syndrome.
Some of the potential causes of caudal heel syndrome:
Toes: focus has been on trimming the toes only and the heel grows forward towards the toe and underneath the hoof.
Long Heels: Heels grow at an angle and if left untrimmed the angle continues under the foot. As the heel grows under the foot, it effects how the horse bears its weight.
Contracted Heels: Decreased width of the palmar/plantar aspect of the foot, so that the heel bulbs and buttress are more closer together than normal. Associated with a decrease in frog width in relation to the length. Can also be associated with elongated or collapsed heels. If the heels are too far forward, they become contracted, causing the horse to bear all of its weight on its toes. If this is not treated in a timely manner, it can cause ligament and other injuries.
Toe Landing: When a horse is walking or trotting and only landing on its toes, it could indicate that the heels are sore.
Excessive Heel Landing: The easiest way to spot an excessive heel first landing is when a horse is walking towards you and they are flicking their toes in the air just before they land (sometimes this is mistaken for good extension or floaty paces).
We have often corrected toe/heel landings in the clinics and students are amazed how the trim can make all the difference to the horses way of going, even a tiny adjustment can make all the difference.
Long Toe/Low Heel: describes a hoof that is considered to have excessive toe length relative to the conformation of the heel. The risk of developing a long-toe/low-heel hoof is indicated by an underrun heel, also called a sloping or collapsed heel. A heel is considered sloping when the tubules of the heel are at a lower angle than the angle of the dorsal wall. An under run heel is generally not very short, although it may appear so, there is often a tremendous amount of hoof horn there, it’s just moved to a different angle.
Sheared Heels: Displacement of one heel bulb, proximally relative to the adjacent heel bulb. Thought to result from abnormal loading on one side of the foot.
Managing Caudal Heel Syndrome
Instead of assuming a horse has something as serious as Navicular Disease, it’s important to decipher the cause of lameness in the first place.
- How regularly are the horse’s hooves trimmed?
- Is the trim correct?
- Is the horse’s weight being evenly distributed when standing?
- Are the heels overgrown?
- Is the horse regularly exercised with a good diet?
- What caused the problem in the first place?
Prevention Is Always Better Than Cure.
If the corium that produces the heels has moved, you cannot expect a trim to correct the problem. You need to stimulate the external and internal structures to regain their strength and the hoof capsule will follow.
The frog is often contracted and lacks circulation when a horse has Caudal Heel Syndrome, so it’s important to re-engage it (if need be using pads and hoof boots), stimulating the frog in turn helps recovery of the digital cushion and ungular cartilages, these are soft, but incredibly strong. If you can get a correct landing and provide enough healthy stimulation to the frog and in turn the digital cushion and ungular cartilages, then you’ll find the heels will recover.
When a horse is diagnosed with a Caudal Heel Syndrome, the first step is to trim the feet properly, so the horses weight is distributed evenly across the entire hoof surface. It is not simply just a case of trimming the toes back, because the corium that produces the heels has moved forwards, obviously taking the heels with it.
Remember, the lower you take the heels the more pressure there is on the laminae, increasing the crushing effect.
The heel surface is much further forward than it should be, the laminae are angled forwards and the underlying structures have under-run. The corium that grows the heels has moved forwards, not just the hoof capsule. When the heels are under-run the laminae of the hoof wall are projecting forwards more than they should be, this causes the heel purchase (the part the horse should be landing on) to be further forward. If the heels are too short it reduces the angle of the coffin bone, heel pressure should not be pressing directly on the palmar/plantar processes. The palmar (front feet) plantar (back feet) processes are the little bits that stick out the back of the coffin bone.
In real life the coffin bone does not look much like the triangular wedge you see in an x-ray, instead it is the mini shape of a hoof.