the ground as the foal exercises. The sole in the foot of a foal is extremely thin and as much protection as possible is necessary to protect the immature developing structures above. Removing excess sole with a hoof knife is a primary cause of sole bruising in foals and often leads to flexural deformities as a result of the pain response. The health of the foot throughout the animal's life is based on a good, solid heel area. The heel base includes the hoof wall at the heel, the bars and a nice wide frog. The bars are needed to stabilize the hoof capsule and are never removed. The heels are rasped gently from side to side until the rasp just comes in contact with the frog. The hoof wall at the heels will now be on the same plane with the frog. The excess hoof wall at the toe and quarters is then lowered as necessary, using a rasp placed at a 90° angle, just in front of the sole wall junction (white line). When the desired amount of hoof wall is removed, the outer sharp edge of the angle is removed *Figure 1a by running the rasp around the perimeter of the hoof, thus creating a nice rounded edge (Figure 1a). This will help to prevent cracks and chips in the hoof wall. The method of using the rasp on an angle leaves the hoof wall and the adjacent sole on the same plane, allowing both structures to share the bulk of the weight when the animal moves (Figure 1b). This appears to stimulate the horn to grow thicker and stronger. Foals do not grow an *Figure 1b excessive amount of hoof wall in the first few months of life and our ability to influence the foot/limb by excessive trimming on one side of the foot in the horizontal plane is limited. If it becomes necessary to lower one side of the foot past the point of being level due to a developing hoof capsule distortion or to affect landing, it should not be any more than 2‐3 millimeters at one time. Trimming at two‐week intervals may be useful in this situation. The traditional theory of lowering the lateral side of the foot on a foal that stands toed‐out and lowering the medial side of the foot on a toed‐in foal is inaccurate. In fact, it is more likely to be harmful than beneficial. The cause of the foal having a toe‐in or toe‐out stance is rarely in the foot. The problem is generally found in the axial alignment of the limb above the foot; therefore, when one side of the foot is lowered excessively, the www.faep.net
cosmetic appearance may be improved, but over time, will lead to distortion of the hoof capsule. Or worse, this practice will place stresses on the physis and overload the joints on the side that is being lowered. This can be shown radiographically a few days after trimming. This can lead to axial skeleton issues later in life. Rotational limb deformities. Rotational deformities are very common in foals. Most are due to the narrow chest together with the relatively long limbs which cause many foals to adopt a base‐wide stance in front, which is often accompanied by outward rotation of the entire limb. As the foal moves, the outside of the hoof wall of the foot contacts the ground first as a result of the foot flight pattern caused by the rotated position of the limb. These foals should be trimmed level and not have their feet lowered on the outside wall. If attempts are made to "correct" this physiologic stance by lowering the lateral wall, there is a risk of creating an angular limb deformity where none existed previously. Therapeutic trimming does not offer favorable results in the rotationally malpositioned limb, as this deformity is corrected through growth. As the musculature of the chest increases, the elbows are pushed outward, rotating the limbs inward. Angular limb deformities. Angular limb deformities are common limb abnormalities in foals that require early recognition and treatment.1,2,4 The primary lesion is an imbalance of physeal growth; for various reasons, growth proceeds faster on one side of the physis. Angular limb deformities can be further classified based on the direction of the deviation. Valgus deformities occur when the deviation occurs lateral to the axis of the limb, and varus deformities occur when the deviation is medial to the axis of the limb. The most common location of valgus angular limb deformity is the carpus, while varus deformities are most often seen at the fetlock. Mild carpal valgus deviations of 2‐5 degrees are considered acceptable. However, deviations exceeding 5‐8 degrees become a concern and should be monitored (Figure 2a). Radiographs should be part of the physical examination in a foal with an angular limb deformity. Occasionally, osseous abnormalities such as hypoplastic carpal bones will preclude correction of the problem without splints or a cast. Radiographs will also reveal the site and *Figure 2a degree of deviation, and allow comparison at a later date. Conservative therapy for the management of many angular limb deformities may be successful in the newborn foal. 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 the early carpal valgus. This allows the physis to be stimulated, but prevents stress and compression on the affected side of the growth plate. If the The Practitioner 7