soft tissue injury in hoof?

Question
I have a 9 year old pleasure-bred quarter horse who has the typical build..16.1 with small feet. About a year ago I noticed that he was pointing his left front foot. He was also showing signs of discomfort when turning to the left, making a sharp turn to the left. We tried natural balance shoes, we tried plastic shoes, we tried shoes with pads, and he seemed to gradually get worse. X-rays showed a "mildly thin sole", no signs of navicular, but some possible evidence of pedal osteitis. When the vet pointed out softness around the outside edge of the coffin bone, it was minimal, these are digital X-rays...you might not notice it if the horse wasn't lame. My farrier wasn't sure how to help him, and suggested pulling his shoes and putting him in boots for a few months so that he would have some decent hoof wall to work with. So we pulled the shoes, and the poor horse thought he was going to die..but he lived, and a few months later the left foot was good, but now the right hoof is lame! He has been off on this foot for a couple months. His hoofs look beautiful...the hoof wall is strong, the sole is hard, the frogs look great.(no pedal osteitis on this foot) In fact he doesn't react to hoof testers at all, on either foot. His legs are clean, no pulse in the hoof, no heat. So the only thing we can figure is that he's got some sort of soft tissue injury inside the right front. He hates to make a turn to the right, even on mats, when barefoot. Our ground around here is rock hard, except for the arena, but he does quite well with his easy boots, which also have pads. He also does well barefoot in the arena, which is soft river sand, and fairly deep. My farrier is careful, thoughtful, and not afraid to ask for others' opinions, but he's stumped, (as am I). He's thinking it might be the blood vessels that run along the side of the hoof are getting compromised, it might me the digital cushion, or the lateral cartilage, or it might be none of these! Any ideas? It was interesting that since we pulled the shoes, the left foot, which is flatter, seems better, and now he's off on his right. I'm not against putting shoes back on him - I just want him to be comfortable!

Answer
HELLO LORI...THANKS FOR YOUR QUESTION...

GREAT QUESTION !! I normally don't get "challenged" like this.
I definitely "feel your pain and your horse's".

I have had a "few" horses like this in my career...as you and your farrier already know...each one different and responds differently.

The right hoof getting worse; I feel is a slow compensation for
having to bear more weight. Was the right hoof radiographed for
pedal osteitis and was the navicular bursa looked at also??

The fact that the left fore got better, has me leaning more toward
shallow solar depth of both hooves. A venogram or some ultrasound
equipment will detect "soft tissue/tendons,ligament damage". I would have that done if possible.
I had one case, that had a very weak impar ligament cause all the trouble and 6 veterinarians and one vet school "swore" the the horse had changes in his navicular bone...but no clear or concise x-ray
could prove it. No rough edges, no cysts, no fractures of any kind !

As your farrier and vet know...the T-ligament,impar ligament,
collateral ligaments are in a "traffic" jam inside the hoof capsule.
Having small hooves,tall/big body adds to the problem.

I would use the "easy boots" only if I was riding right now(if he's able?) No pads...no natural balance shoes. The fact he does well in the sand or softer ground is a VERY GOOD SIGN. IF the vascular system
was compressed or compromised in anyway; the horse would STILL BE LAME
on BOTH hooves...and he is not.
IF there was a soft tissue injury at this point...it could show up as a "dark blemish" on an x-ray...a venogram or ultrasound would detect it also.
ALSO...he's one tough horse and they "get mental" being sore for a long time. Horses DON'T reason like we do. It hurts or it doesn't.
Many horses will expect pain even after being "fixed" and at times 3/4 hours later they start getting better and don't limp again.
Kinda like we would say..."gun-shy".

Maybe I'm "off in my opinion"...but I would leave him barefoot. If
he gets too wet, toughen his soles with an iodine formula. If he's too dry, use a good conditioner than penetrates the coronary band.
In other words,keep a real good balance. If the right hoof has
already been radiographed and they find "nothing"...then again I would wait him out in keeping him in good ground. Solar bruising on a shallow sole horse takes awhile too heal properly...sometimes months.
If he's allowed to "rebruise" that much longer!! I would feed a quality hoof supplement(if not already)to "boost" internal healing.

Like yourself...I'm on the outside looking in. :)
You have told me alot of "good" that's going on with this horse, because of all that you and your farrier have done! So my opinion is worth a try.

Thank you again...Best to you!
Joepaul Meyers.C.J.F.