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Diagnosis: 11.1.  Suspensory ligaments injury

              1. Author of texts and photographs: Ing. Jindrich Vincalek, CE-F


            2. Literary review: Horseshoeing, 42.2.2. Diseases of the suspensory ligaments and superficial digital tendon,

                ISBN: 978-80-7490-052-5, Print Pálka 2015

            3. Patient data No. 11.1.

                Breed: Czech Warmblood

                Sex: Gelding

                Age: 9 years

                Color: White

                Work use: Sport horse


  • Problems complained of by the owner: Lameness on both forelegs

  • Duration of the problem: about 4 months

  • Stabling: In the stall, paddock

  • Feed : Common for a sport horse

  • Bedding : Straw

  • The surface on which the horse most often moves: Sand riding hall, horse walker with a sand surface, grass pasture

  • Frequency of hoof treatment : Shod regularly at 7-week intervals.

  • Shoeing type: Equilibrium single-clip horseshoes with wedges for raising the heels, sole filled with mesh and Vettec Equi Pack cushion

4. Anamnesis:
5. Case description:

Fig. No. 1 .: Posture of the forelegs from the side

In the sagittal plane, both limbs significantly standing behind with markedly taut suspensory ligaments and their branches in the frontal plane, a slight offset of the carp and in the horizontal plane a small inward rotation of the phalanges.

Fig. No. 2 .: View of the hooves from the side

The hooves have extremely high heels, the dorsal coronary bands are pushed upwards due to excessive loading of the toes

  • Evaluation of the hoof care:

When trimming the hooves, heels were obviously left too long, probably in order to align the axis of the digites - see. Fig. 2


  • Evaluation of the type of shoeing:

Horseshoes with raised branches are completely inappropriate. Together with the high heels, they put a heavy load on the supporting apparatus of the digites and thus also the suspensory lilgaments. The remains of the net and cushion in the sole area were irrelevant to the health of the hooves. - viz. Fig. 3 and 4.


Fig. No. 3 and 4 .: Left - Left and right front hoof when viewed from below before shoeing

  • Examination results

Video # 1:

Movement of forelegs on a hard surface before shoeing

When walking on a hard surface, the horse showed reluctance to move and landed significantly on the toes with a double impact. The lameness was pronounced in trot, and especially on soft surfaces.

Video No. 2 .: Example of a positive test

The digital balance extensiometer test was positive on both limbs at 8 ° on the left limb and 11 ° on the right limb.


The tolerance of a healthy limb to palmar extension is 25 ° - see. Video No. 2


Sonographic examination revealed injury to the supsensory ligaments on both limbs.


6. Chosen measures
  • Selected hoof treatment - Trimming:

The heels were trimmed to almost the base of the frog so as to minimize over bending of the fetlock joints relative to the coffin joint. This will increase the load of the deep digital flexor tendon a thus reduce the load of the suspensory ligaments.

  • Shoe preparation:

Horseshoes Mustad Libero 25 x 8 size 2 were chosen for shoing. The size of the horseshoes was chosen a number smaller, because the ends of the branches were forged to a width of 20 mm and thus increased the size of the horseshoes to 3. After fitting, extensions eith maximall width of 8 mm, were welded on the inner edge of the toes of the horseshoes, between the third nail holes. The edges of the horseshoe branches were grinded so that the ground surface of the branches was narrowed further to 18 mm, and the desired difference between the width of the dorsal part of the horseshoe and the branches of 15 mm was achieved. The length of the horseshoes was chosen just behind the heels, because the support of the heels with too long shoe is not required.


Fig. No. 5 and 6 .: Left - Left and right front hoof when viewed from behind after shoeing


Fig. No. 7 and 8 .: Left - Left and right front hoof when viewed from below after shoeing

  • Shoeing:

Horseshoes with dorsal extension were chosen for shoeing, because the horse moves most often on a soft surface. The narrow branches of the  allow the heels to sink on the soft surface compared to the wide dorsal part, thus further reducing the load on the suspensory ligaments. The horseshoes were nailed on with Derby 4 nails in the front holes

  • Veterinary measures and rules of further care:

Initially rest in the box, after 14 days walking on hand on a hard surface, sonographic check before the next shoeing.


  • Rules of the further care:

The most important principle is to leave the limb in its natural position and with balanced load on the tendons and ligaments. High heels always mean overloading of the toe.

7. Follow up – Development of changes
  • Effect of the 1st selected hoof treatment - Trimming effect:


























  • Changes in shoe choice and shoeing:

The horse was shod twice with horseshoes with dorsal extension, then the owner chose another farrier.


  • Effect of farrier measures - treatment effect

Before the second shoeing after 7 weeks, the horse was sonographed and a large improvement was confirmed. The horse's movement also improved and the lameness subsided.


  • Result of care - Result of the care

Even before the second shoeing, the horse was lightly loaded under the saddle. After the second shoeing, he was perfectly fine, he did not limp even on a soft surface and was included in sports training.

Video No. 3 .: Demonstration of a horse on a hard surface after shoeing.

The adjustment of the hooves and the reduction of the heels brought above all a regular gait and a regular load of the limb.

9. Take home message

In adult horses, it is absolutely necessary to maintain the natural structure and balance of the limb. This case is clearly caused by poor farrier care and high heels kept in order to align the axis of the digits which disturbed the dorsopalmal balance of the limbs and hooves.

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