We recently worked on a special horse who was out of service because he was lame.He had been misdiagnosed with a knee problem and suffered for two years. We found him under weight and in a state of stress. Additionally, he walked with a great deal of discomfort and was absolutely unable to trot. He has a severe "pigeon toe” conformation, thus the name of the horse, Pigeon.It was quickly apparent the diagnosis had been incorrect. Sidebone was obvious by simple palpation. Despite the extreme conformational defect for more than 10 years, Pigeon was a lead horse on the 50,000 acre Nail Ranch in Albany and the preferred mount of top hand Johnny Stuart.We brought Pigeon to the shop and formed a treatment plan. We custom fit a pair of sidebone shoes for him. These shoes must be hand forged from straight bar stock because there are none available on the market.He was then examined by Dr. Joe Cooke, Heritage Lameness Center's veterinarian. In addition to a full evaluation, Dr. Cooke floated his teeth and gave Pigeon an anti-inflammatory. By the next day, Pigeon was free from most of the fasciitis, and was able to trot. He began to put on weight as well. By Saturday, we were able to ride him and he was comfortable in all three gaits.So what is sidebone and how does a horse get it? Sidebone is ossification of the lateral cartilages. That is a fancy way to say the lateral cartilages in the foot become bone. The cartilages protrude just above the hairline in a healthy foot and submerge into the hoof capsule. The condition can occur on one or both sides of the foot. It can be the product of a trauma injury, or it can be from continued use with a lateral/medial imbalance. Lateral/medial imbalances can be compounded by doing work over hard terrain.In the case of Pigeon, we can safely assume that because of the severe angular limb deformity and his job as a ranch horse on the Nail, that lateral/medial imbalance is the source of the sidebone. Horses with toe-in conformation (pigeon-toed conformation) should always be trimmed to the short axis indifferent of the application of shoes or going bare foot. The bone growth was restricted to the later (outside) cartilage, so the sidebone shoe seemed the logical choice for this horse.A sidebone shoe is severely rolled from the medial toe to the lateral heel. The function of this shoe works as an additional point of articulation and allows for some "give" where the bone growth is causing discomfort.We are happy to report that in less than four months, Pigeon is completely sound and in good health. He has put on a considerable amount of weight, and is comfortable on his feet. He always looks alert and content. He is back in service, and not only is he able to do everything he use to do he seems to enjoy it; especially when you put a cow in front of him. Derrick Cooke is a Certified Journeyman Farrier with the American Farrier's Association and has been shoeing horses more than 28 years. If you are interested in similar results as portrayed above, have questions or would like to make an appointment for your horse, please contact Heritage Lameness Center at 817-771-8779.