Q: My 20-year-old Thoroughbred mare has been wearing egg-bar shoes since re-injuring her right front suspensory two years ago. The shoes seem to really help her, and she is going great. My problem is that she repeatedly cuts her left elbow on the shoe. I suspect she does this when she gets up after lying down. She usually doesn't cut her right elbow, but has nicked it a couple of times.
The first time she cut her left elbow, the injury required two sets of staples, then a set of stitches, all of which kept getting ripped out. We finally left the wound open and let it heal on its own. However, she has cut the elbow again twice since then.
I did get a boil-boot, which she wears when not being handled, but she is still cutting herself. I'm at a loss for what else to try. I need to find something she can wear for long periods of time that won't interfere with her ability to stand comfortably.
A: Elbow injuries are among the most troublesome. The elbow area is in motion so much that surgical intervention is fruitless and can even encourage the formation of bulkier scars. Once injured, the healed elbow becomes a larger and more tender target for reinjury--the site originally damaged by a sharp edge becomes vulnerable to duller ones. Often, pressure from the ground is all that it takes to pull apart old elbow scars.
The strategy for preventing elbow trauma is simple in concept, but challenging in application: keep the offending surface-the ground or shoe edge-away from the target area. I have two suggestions that might help. First, if your mare is stabled much of the time, try keeping her on a "deep litter" bedding system, removing only manure and soiled bedding while adding small amounts of new bedding daily. Eventually you'll build up 12 to 18 inches of spongy stall floor that will provide extra cushioning. I also recommend that you try a thicker shoe-boil ring than the one you have used. Look for one that sticks out at least two or three inches beyond the egg-bar shoe. You can experiment with padding and duct tape to make your current shoe-boil ring larger if you cannot find one this bulky.
--Matthew Mackay-Smith, DVM, EQUUS Medical Editor
This article first appeared in the June 2001 issue of EQUUS magazine.