Radiograph review of a large horse with pedal bone rotation: planning breakover and support with the vet

By Mark Humphrey AWCF, Master Farrier and Liveryman of the Worshipful Company of Farriers. Published October 2026.

In short: For a large horse with more than 7 degrees of pedal bone rotation on the worst foot, I reviewed the radiographs with the vet and discussed a softer clog on the less affected foot, an EVA foam pad and a shorter toe to move breakover back.
HorseAtlas (name changed), large horse, about 17 hands
ProblemPedal bone rotation, over 7 degrees on the worst foot
Veterinary involvementRadiograph review and bloods by the horse's vet
SeasonSpring 2026

History

Atlas had a long barefoot-trim history. Another farrier then shod him in egg bar and heart bar shoes because his heels had sunk. No radiographs had been taken before that shoeing, so the first X-rays were taken afterwards.

What the radiographs showed

I reviewed the images with the vet. Rotation was described as more than 7 degrees on the worst foot, with a possible mediolateral imbalance on the dorsopalmar (DP) view. He is large, around 17 hands, and heavy, which affects how much load each foot carries.

Options discussed with the vet

  • A softer clog on the less affected foot, either a Moreaid plastic clog or an EVA Total Foot Protection Clog 2.0.
  • An EVA foam pad.
  • Shortening the toe so breakover sits further back.

The vet took bloods and is awaiting the results. Diet and hay allowance were also discussed. The vet will email the radiographs and liaise with me on the plan.

What this case shows

Radiographs before a change of shoe show where the pedal bone sits, so the plan is built on the foot as it is, not on how the hoof looks from outside. In a large horse, load and breakover matter even more.

Progress

This case is ongoing. The plan will be updated here as results come in and reviews are completed.

Questions this case answers

Why take radiographs before changing a horse's shoeing?

They show the position of the pedal bone and any imbalance, which a visual check cannot, so the shoeing plan is based on the actual foot.

Why does breakover matter?

Moving breakover back reduces the leverage on the toe, which can ease the load on the front of the foot.

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General information from case notes, anonymised with the owner's consent. Horse names have been changed. It is not veterinary advice: diagnosis and treatment decisions stay with the horse's vet. Mark Humphrey AWCF, Master Farrier, Bunny Hill Farriery, Costock, Loughborough LE12 6XN. [email protected] or 07971 063407.