Does My Horse Have Pyramidal Hoof Disease?

Also known as “buttress foot,” this condition primarily affects horses with poor leg conformation in high-impact disciplines. A veterinary podiatry expert explains.
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pyramidal hoof disease
As pyramidal disease worsens, the shape of the hoof changes significantly and becomes more narrow and square. | Photo: Courtesy Dr. Raul Bras

Q.I recently bought a young prospect who passed a fairly rigorous prepurchase exam (PPE). When she got home my farrier came to shoe her and told me he believes she has “pyramidal disease.” I’d never heard of this hoof condition before but have found a few references to it online. How do I know she has this condition, what causes it, why wouldn’t it have been included in the PPE, and what’s the long-term prognosis for her as a sport horse?

Via e-mail

A.Pyramidal disease is a form of osteoarthritis in horses which affects the coffin joint (low ringbone) or the pastern joint (high ringbone). Specifically, pyramidal disease is the fragmentation of the extensor process of the distal phalanx (coffin bone, or P3). It is thought to occur due to trauma, osteochondrosis, or presence of separate centers of ossification. Forelimbs are more commonly affected than hind limbs

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Raul Bras DVM, CJF, grew up in Puerto Rico where he showed and bred Paso Fino horses. He earned his undergraduate degree in animal science from Louisiana State University, graduated from Ross University Veterinary School in 2005, and completed his clinical year at Auburn University. In 2005, Bras completed a surgery internship at Rood & Riddle Equine Hospital, in Lexington, Kentucky. The following year he stayed on as an associate veterinarian in Rood & Riddle’s podiatry department, where he’s now a shareholder. Bras completed Cornell University’s farrier program in 2007 and became an American Farriers Association Certified Journeyman Farrier in 2010. In addition to providing his expertise in equine podiatry in Lexington, Bras travels throughout the United States and internationally to treat horses. He’s devoted to the betterment of the vet-farrier relationship. In 2015, he was inducted into the International Equine Veterinarian Hall of Fame.

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