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EQUINE VETERINARY EDUCATION / AE / NOVEMBER 2020


Limb alignment of young foals should be observed


standing and walking without restriction on the head and neck (not leaning) toward and away from the examiner. Overall body development and maturity should be noted. It is important to take note of foot placement especially when working with distal limb deviations. This will determine the necessity for corrective measures on the feet such as trimming or placement of a composite extension on the hoof capsule to alter the forces on the physis and change the rotation of the limb on contact with the ground. This practice is especially beneficial with a fetlock varus deviation with inward rotational deformities in foals 2–4 weeks of age in which there is a limited time frame for correction.


Carpal/tarsal valgus It is apparent that a mild carpal valgus of 2–5 degrees offers the newborn foal a comfortable stance while nursing and eating off the ground and is considered acceptable. If the deviation exceeds 5–8 degrees then it becomes a concern and should be monitored (Hunt 1998, 2000; Auer 2012). A few days of stall confinement on firm bedding or limited exercise in a small paddock (2–3 times a day) is a rewarding, cost- effective treatment for early carpal or tarsal valgus (Garcia- Lopez and Parente 2011). It may be helpful to digress and briefly mention routine


hoof care before discussing treatment of angular limb deformities. The technique for using farrier tools when trimming foals was discussed under the trim in Part 1 of this review. The veterinary and farriery literature abounds with various trimming methods that are thought to affect the various limb conformations; however, none of these methods have been substantiated or documented to be efficacious. The author trims the heels such that the heels of the hoof wall and the frog are on the same plane, visualises a line across the middle of the foot (located just dorsal to the COR) and then reduces the toe to make the foot proportional on either side of the line across the widest part of the foot. When the trim is complete, the solar surface of the foot will be level rather than having the lateral to medial orientation of the foot changed by rasping one side of the foot more than the other (Fig 8). Farriery texts describe trimming a foal lower on the outside of the foot when the foot turns out and trimming the foal on the inside of the foot when the foot turns in; however, remembering that a toe-out or toe-in stance originates from the limb, this practice will do nothing more than place excessive stress on one side of the hoof capsule. If the angular limb deformity is greater than 5–8 degrees or


shows no improvement in the first few days of life, radiographs should be part of the physical examination of a foal with ALD (Garcia-Lopez and Parente 2011; Garcia-Lopez 2017). Occasionally, osseous abnormalities such as hypoplastic


carpal/tarsal bones will preclude correction of the problem without splints or a cast. Radiographs will also reveal the site and degree of deviation which will allow comparison later. Carpal valgus deformities of less than 10 degrees are generally handled successively with conservative treatment (Garcia-Lopez and Parente 2011; Garcia-Lopez 2017). Conservative therapy for the management of many mild


to moderate congenital angular limb deformities may be successful in the newborn foal. Restricted exercise would be either strict stall confinement or brief periods of turnout (1 h two times daily) in a small area with firm footing. This allows the physis to be stimulated but prevents stress, fatigue and


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Fig 8: Two-month-old foal trimmed to show the proportionality of the foot on either side of a line drawn across the widest part of the foot. Note the hoof wall at the heels and the frog trimmed to the same plane.


compression on the overloaded side of the growth plate from excessive exercise. If the carpus can be corrected by applying pressure with one hand on the inside of the carpus and counter pressure with the other hand applied to the outside of the fetlock, some form of coaptation such as support tape, splints, dynamic splints or tube casts may be helpful. The author uses a splint made from polyvinylchloride (PVC) pipe, cut in half and fitted from the elbow to below the fetlock applied for a few hours 1–2 times daily. It is labour intensive, but the splints must be removed and replaced periodically to prevent laxity. A full-length thick cotton bandage is applied to the entire limb, and then the PVC pipe is placed on the outside of the limb and secured to the bandage with elastic tape. This will distract the carpus laterally and load the limb more proportionally. The splint is often the most cost-effective treatment available but must be applied with caution, paying strict attention to the details of application. Meticulous attention to applying the splint is essential to prevent focal pressure and the propensity of the foal to develop decubital ulcers. As the


foal improves, brief periods of turnout in a small area with firm footing can be considered. Acquired carpal/tarsal valgus deformities can be graded


from one to four according to severity (Fig 9). Mild to moderate carpal valgus will generally respond to restricted exercise and the use of a composite extension applied to the medial side of the foot while the more severe cases require surgical intervention combined with farriery (Hunt 1998, 2000; Greet 2000; Auer 2006; Witte and Hunt 2009; Garcia-Lopez


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