One of the more amazing things about equines is how they can survive some of the worst events or traumas but perish as a result of a relatively minor one.

This case study is an example of the former. It involves a very special Miniature Mediterranean Donkey named Lily, who is owned by Loree Doering of Bear Lake, Mich. It is believed that Lily had suffered from ergot, fescue or some other form of poisoning. Lily became very lame, developed a huge hole in her right hind foot and later dropped her entire coffin bone out of it. I have the coffin bone in my possession.

What makes this case amazing is how Lily not only survived this major trauma, but that she continues to survive and remains sound. She can run, buck and play like a normal donkey. Here is Lily’s story.

Jan. 11, 2001. Lily is born with no complications. She shares a pasture and huge run-in barn with nine other donkeys.

November 2002. The tips of Lily’s ears bend over and begin to fall off. Veterinarian suspects frostbite. No other pasture mates exhibit these symptoms.

December 2002. About half of Lily’s ears have fallen off. About 3 inches of her tail has also begun to fall off. Veterinarian still suspects frostbite and no other pasture mates exhibit the same symptoms.

SERIOUS PROBLEM. A hole in Lily’s hoof, through which P3 can be seen. It is believed the lameness and founder that occurred were due to fescue, ergot or some similar form of poisoning.

November 2003. More of Lily’s ears begin to curl and fall off. About a quarter of her original ears remain. Frostbite is still suspected and no other pasture mates are affected.

December 2003. More of Lily’s tail falls off, leaving only about a quarter of the original length. Lily now holding up right hind foot and is very lame, Obel grade 3-5. Veterinarian still suspects frostbite for the ears and tail. Lameness issue diagnosed as a stifle problem.

January 2004. Lily still very lame and getting worse. Her Obel grade rises to 4-5. Lameness issues still diagnosed as stifle problem, with severe thrush in hoof.

CALL FOR HELP. Two of the photos that Lily’s owner sent to the American Farrier’s Association as part of her attempt to find a farrier to work on the case. The AFA forwarded the photos to its members.

March 2004. Lily still very lame, Obel grade 4-5. She is holding the leg up off the ground, shedding hair and skin from the hocks and fetlocks. A pus discharge is noted coming from the heel bulbs of the right foot. Doering requests full veterinarian workup and radiographs.

April 2004. Veterinarian now suspects an autoimmune system problem. Foot is being soaked daily and wrapped in pine tar. Doering contacts another veterinarian for a second opinion. This vet finds a large hollow hole in the hoof and notes that P3 can be easily seen through the hole.

June 20, 2004. Doering writes the American Farrier’s Association office requesting help from any farrier. Case photos are included in the email. Melanee Buttery, director of member services for the AFA, forwards e-mail to membership.

June 25, 2004. I responded with this opinion. “It appears that the donkey has foundered as there are divergent heel hoof rings. P3 has prolapsed and appears to have penetrated the sole. The hoof is very overgrown and in need of trimming. In my opinion, the history doesn’t sound like an autoimmune system problem, rather it sounds more like fescue or ergot poisoning.”

LOOKING BETTER, THEN … These photos show Lily’s hoof in July 2004, along with the coffin bone that dropped out of the hoof during an examination.

I recommended that they stop soaking Lily’s feet and feed her only good quality grass hay, eliminating any grains.

July 2004. Lily’s sole is now growing back and looks healthier. A farrier refuses to work on Lily. A second farrier is contacted and is willing to trim all but the afflicted foot. Both vets volunteer to trim the donkey until a qualified farrier can be found. Doering notes that Lily is less sore and that there is something sticking out of the middle of her foot. When Doering pushes on the object, it makes a squishy, wet sound and moves back into the sole. I tell her not to push on the object because it’s probably P3. Doering is instructed to stall Lily in deep shavings, apply frog supports and contact the veterinarian. The first veterinarian picks up the foot for inspection and sees an object fall out of the foot. It is the entire P3. Doering is advised by veterinarians to euthanize Lily.

August 2004. I tell Doering that in my experience, few animals live long or can maintain soundness without a coffin bone. I noted that the tissue on P3 was necrotic and that the bone seems to have been detached from sometime before it fell or was pushed out. I tell her I am concerned about what was going on with the blood flow and tendons. The first veterinarian pressures Doering to euthanize Lily.

P3 CLOSEUP. Another look at the coffin bone. It is believed that the bone had become detached from the other hoof structures some time before it fell out.

September 2004. Lily seems to be doing remarkably well without a coffin bone. Her feet are long, as no farriers will work on her. After consulting with Doering, I make plans to travel to Michigan for a lecture and to work on Lily.

May 2005. I travel to Michigan. The second veterinarian who worked on Lily takes photos and radiographs prior to any treatment. The vet and I agree on a trimming plan that involves dramatically lowering the heels and removing the dorsal toe.

We estimate the amount of dorsal toe to remove by using P2 and P1 as a guide. We do the work and take radiographs. Lily is sore for a day, and then starts moving as if she is having no problems.

July 2005. Lily’s foot is growing rapidly both in heels and toe. Gregory Gray, a certified journeyman farrier from the Wolverine Farrier School, performs farrier work. The heels are lowered and more dorsal wall is removed. Lily still seems to be moving with no problem.

BEFORE SHOTS. A photo and radiograph of Lily’s foot before it was worked on in May 2005.

September 2005. I return to Michigan for another lecture and to work on Lily, who continues to show no problems.

December 2005. I again return to Michigan for farrier one-on-ones and to work on Lily. Lily has now gone 18 months without a coffin bone and continues to show no problems in her movement.

So What’s Going On?

In most horses, P3 and a small part of P2 are within the hoof capsule. The normal distance from the top of the hoof capsule to the top of the extensor process is around 3 to 5 mm. In a donkey, P3 and about two-thirds of P2 are within the hoof capsule. The normal distance from the top of the hoof capsule to the top of the extensor process is still being averaged from my research, however it appears to be around 10 to 12 mm.

BEFORE AND AFTER. Shots taken before, left, and after, right, Lily’s footwork in July 2005.

AFTER SHOTS. A photo and radiograph of Lily’s foot after the May 2005 work.

Due to the fact that there is no P3 in this case to take this measurement, I estimate this distance by measuring down from the articulation of P1 and P2. Radiographs of Lily’s foot show no dropping of the phalanx bones into the hoof capsule.

I believe that the cornified sole as well as “who-knows-what” is helping keep the remaining phalanx bones from descending into the bottom of the sole.

Other Findings

SNUG EARS. Lily wearing a hat made to protect her damaged ears from cold weather.

The coronary corium continues to receive blood as it produces good hoof wall. The solar corium is not producing sole. There is no visible white line, therefore the terminal papillae of the sensitive laminae are not producing and nourishing the white line. The frog corium is producing and nourishing the frog, as it is of normal consistency, alive and viable.

The paracuneal artery and the coronal artery appear to be functioning normally. The circumflex artery, terminal arch and vascular capillaries are probably nonexistent.

Lily moves along as if sound and her tendons palpate normally. I can only speculate as to what is holding the deep digital flexor tendon and extensor tendon in place.

The sole is a large, cornified mass and is extremely hard and non-viable.

When animals are suffering from active infectious osteitis of P3, they become increasingly lame as they lose more of P3. I know of no other animal without a P3 that is completely sound. I have seen only a minimal number of surgeries where the infection was curetted out and the animal maintained any reasonable degree of soundness.

Possibly, Lily’s case could be used to develop new treatment options. We know that surgical removal of P3, or cases in which animals are born without P3, results in euthanization because they are unable to bear weight or move on a limb. Perhaps a chemical or pharmaceutical option could be developed to replicate what happened to Lily.

It’s also possible that this is a unique event that will never be repeated. I plan to continue to study Lily to see if there is anything else that can be learned from her unusual case.