Decisions for Treating ALD

I’m writing to you regarding the article “A Non-Invasive Option for Correcting Foals’ Limbs,” which featured in the January/February 2019 issue of American Farriers Journal. The conservative, nonsurgical management of angular limb deformities (ALDs) by hoof trimming and/or glue-on extensions is well described in references such as “Adams’ and Stashak’s Lameness in Horses” (chapter 11). In my experience, the results of conservative management are assessed for several months before surgery is considered for unresponsive cases.

The veterinarians and veterinary surgeons we have consulted for ALD did not rush to surgery or adopt the “wait and see” mode described by the author. Radiographs of the affected limbs are helpful for identifying the precise location and possible cause of the deformity, which will inform the best course of therapy. Stall rest is strongly recommended to prevent excessive loading that can damage malformed joints and/or interfere with natural bone remodeling that will straighten the limb. Therefore, I think the author is incorrect in stating, “In fact, normal — not excessive — turnout time is required to feed the new loading data to the foal’s ossification processes to imprint.”

The required bone remodeling can and does occur with limited activity during stall rest while minimizing the risk of damage to the limb. For large or heavily muscled foals such as Warmbloods, a change in the mare’s diet may help by slowing the foal’s growth and counteracting bone growth plate abnormalities. As the author notes, many of these cases (not…