can a horse founder from being trimmed too short

I got some Biotin to supplement him, But I’m not sure what the problem is if it’s founder or something else. Wild hooves and healthy domestic hooves with uniform sole thickness tend to have their collateral grooves (at the deepest part) about ¾” off the ground at … A little bit too much sole bothers horses far less than having too little, so I tend to begin by erring on the side of caution. The back feet may be involved too, but the front feet bear 50% more weight than the rear so they usually hurt more. With Spring here and her being young it shouldn't take to long. Following are the most common causes of equine lameness: 1. reluctant to pick up first front foot but was fine when i got to the other one. 4. An ounce of prevention is worth a pound of cure. Your feet are soft and sensitive. From 300 quotes ranging from $650 - $8,000. During… The hoof-pastern axis is a straight (yellow) line, there’s adequate depth of the sole (little white line), the foot looks to be long enough (even though we can’t measure it). Member: ajudson1 The veterinarian will administer a nonsteroidal anti-inflammatory drug (NSAID) to relieve pain and inflammation. Traumatic injuries: Sprains, strains, fractures and other injuries to the musculoskeletal system including bones muscles, cartilage, tendons, ligaments and joints; damage to the nervous system including the brain, spinal cord, and nerves 2. 3. Topics include Nutrition, Soundness & Lameness, Equine Behavior, Farm & Barn, Older Horse … You wouldn’t be very happy if you had to run around in a pair of shoes that was a couple of sizes too small,  Don’t do the same thing to your horse. Thyroid hormone supplements will be given if your horse is found to have Cushing’s disease. Lameness in horses has multiple causes, some obvious and some that are difficult to diagnose. Look for the following: 1) Proper hoof-pastern alignment (yellow line); 2) Parallel alignment between the hoof and bone (blue line); 3) Adequate sole depth (yellow and green lines); 4) Proper shoe placement (white line). In addition, I think that the branches of the shoe should be placed as far back as possible, without being so far back that the horse steps on them and pulls the shoe off. You could give her some bute for the pain. These structures need protection; that protection is the hoof. There are many reasons. Guidelines such as 48-55° for the front feet, or 52-60° for the rear feet are not appropriate for every horse. When the Iaminae become inflamed, they start to break down--and your horse is said to have laminitis. Trimming to get hoof form that results in a ground-parallel coffin bone, and reduced leverage on the toes. Should we be worried about this if he has been walking great and pain free for years? (See Founder page.) So, your horse is limping! So, see if you can tactfully ask your farrier to avoid scooping out large amounts of sole with his or her hoof knife. In some cases, horses with underlying lameness issues (old, arthritic horses for example) are more lame after having had to stand for the farrier. Buy one. Founder is possible in a horse trimmed to close but as long as she is getting better, even if slowly, I would not worry. At the end of June this year I was called to take care of this pony as his foundered hoofs have flared up and he was very sore; he was also eating too much grass and gained more weight. If you’re interested in medicine, riding, training, or any number of equestrian topics, please check out their website. 2. For horses that are barefoot and sore after trimming, the sole will usually harden and begin to grow out and slowly the horse should show less soreness over a few days. Good information which you can use to help separate fact from fiction. With well-intentioned regularity, the horse’s hoof gets picked, oiled, conditioned, supplemented, trimmed, and shod. Your bevel will be stronger on a thick walled foot, less pronounced on a thin walled foot, … What can you do to address the problem and how should you go about it? Of course, no one wants to stand by and see a horse suffer. Ditto your horse, and if he can play basketball, you’ve really got something. ... wrong angles, short trim, sore from being ridden with a short trim, and possibly bruised, and inflamed bursa? One of the leading causes of founder is from obesity, but there are other suspected causes as well, which are: As with any veterinary visit, you should be prepared to tell the veterinarian your horse’s medical and vaccination history. First aid in a nutshell, if your horse does founder: 1. You will need to keep your horse in a small and private area with enough bedding to keep support on the frog. Regards Dr Callum Turner DVM, Treatment for mini mare infoal that has foundered, she has rotation in pedal bones. The next morning my horse could hardly walk. If there is not enough sole thickness the collateral grooves will be too shallow." For more than 200 years, homeopathy has failed to demonstrate that it is anything more than water. Hello Eliz, Yes it can take a full 3 days to 12 weeks to get well depending on the horse and how closely trimmed. You can’t ride the pretty picture of what someone else thinks he ought to look like. Hey, let’s look at if from the inside! I wouldn't ride a horse with one of those problems, much less jump him with all of them. Is this signs of stress founder. Please see my practice site:Visit Ramey Equine. With both feet being sore the horse's steps shorten and become slower making the horse or pony look stiff. Here are facts. On a reasonably healthy foot, bring the wall about an 1/8″ above sole plane, and bevel back to the waterline. Here’s an X-ray that gives you an idea of how a horse’s hoof should look when it’s been well-trimmed and had a shoe placed on it appropriately. To do the same thing for their soft and sensitive parts as shoes do for you, horses grow hooves. But if enough cell death occurs to damage or destroy the interlocking bond between the hoof wall and the coffin bone, the coffin bone ca… Then we cut the rest off to prevent it from happening again. Thus, there’s nothing at all to prevent folks from their opinion about your horses’ hooves (of course, you would never do anything like that). Founder itself is really nothing more than the health of the hoof being compromised to the point where the coffin bone can no longer remain attached or held secure in it’s proper position. 1. Initially at the laminitic stage, the horse walks with short steps as if it were walking on stones after being trimmed too short. It’ll save you both a lot of pain. He still standing. He is back barefoot and doing well. Even if your horse’s hooves are long enough, there has to be a certain amount of hoof material in the sole to protect those sensitive structures. He is missing the entire piece that you might expect to be nailed to the shoe so his sole is exposed. To protect them, you wear shoes. he's overweight, but runs around fine, his front feet buckled a couple of times and resulted in him collapsing once. The best way to do this is by immersing your horse’s foot in ice water for approximately 72 hours. Your Farrier will be able to indicate whether there is any other anomalies with the hoof to discuss with your Veterinarian. Horses are good healers. Generally, trimming the toe properly is relatively simple. He foundered about 5 years ago, he's a teenager. A shoe that looks to be fairly well fit to the horse’s hoof. PROPER PHYSIOLOGICAL HORSESHOEING:  WHAT IS IT? The veterinarian will then ask you to trot your horse to observe the muscles and joints in motion. We went to an area that is way tougher then the horses are used to. Belinda, Auckland A: Great question Belinda. If, in spite of everything else, you can manage to get these things done, you’ve got a decent chance of avoiding major hoof problems with your horse. Box 4018 All about one of the most important parts of your horses body. But not as important as you think. This is extremely painful and in some cases it may be necessary to euthanize. It is also one of the most common reasons for disability and lameness in ponies and horses. If she was trimmed to short there isn't all that much that you can do. Appears to be near hind leg. The options for surgical repair are deep digital flexor tenotomy or a hoof wall resection. *Wag! We are about to purchase a mini horse for our daughter. Proper attention to your horse’s wounds can help ensure a successful outcome. The diagnostic tests needed include an endogenous ACTH, serum glucose and insulin levels, complete blood count, chemistry panel, bacterial and fungal culture, and packed cell volume (PCV). Items are sold by the retailer, not Wag!. In addition, the veterinarian will need to get x-rays of the feet to check the alignment of the coffin bone and may do an ultrasound as well for a more detailed view. Regards Dr Callum Turner DVM, My husband and I just got back from a trip. Horse B has heels that are noticeably high. Trim to the angle that’s appropriate for your horse. Have a horse on prepurchase trial. If your horse is moving well, and isn’t having lameness problems, it’s probably because things are going pretty well. Now there’s one final thing that I want you to keep in mind. A pound of prevention is way too much. Use a big enough shoe that’s fit appropriately. And keep in mind that “appropriate” is an individual thing. The horse is no longer used for any work. Sunland,  CA  91041, David Ramey, DVM This means that if a horse has too much sole, the collateral grooves will be too deep. So I’m not going to try. Why your horse limps, and what to do about it. We've had horses that were trimmed to short, kind of how "we" trim our own nails too short, we wrapped their hooves with cloth on the bottom or used duct tape - it helped them alot until the hoof could grow out. Recognizing what lies ahead can help you take stock of your resources so in the face of any eventuality you're well prepared to make the best decisions for yourself and your horse. 4. Unfortunately, the inevitable does happen occasionally when a horse is sore after a hoof-care appointment. While some horses are able to withstand the treatment or heal on their own, others may be in constant pain and may need to be euthanized. The way to screw up a good relationship is to constantly pick on it (come to think about it, those are probably good words to live by in a lot of areas). Inside the hoof are a lot of important, and very sensitive structures. Even though this is in simplified terms, the reality of the matter is that it’s extremely painful for the horse … Instead, think of a straight line running down the front of your horse’s pastern, to the ground (this is called the hoof-pastern axis). You used to read things like the “proper” angle for front and back feet; turns out that the old standards were just plain wrong, because they didn’t consider the individual horse. First devised in the late 1800s by an ex-grocer, chiropractic still has not shown it is worth. Make sure your horse’s hooves are long enough. Jun. Treatment of founder depends on the cause. The prognosis for founder in horses is guarded. Sudden lamness. Therefore:-- … My horse has been having chronic hoof problems and the farrier came out yesterday and said he had foundered. Seriously. Now, obviously, there’s a whole lot more to it than that. I don’t think that any area of the horse gets as much attention as the hoof. There is more misinformation about acupuncture than just about any other thing in the horse world. My horse was trimmed to short awhile ago too, but he has very problematic hooves anyway! ... Fructans levels are higher in pastures that are overgrazed or where grass is too mature. Was running around the paddock in the herd. Sketches of how I am trimming (These are drawings of the trim for a foot that IS foundered. So, depending on who you’re talking to, your horse’s hooves may be too long, too short, too dry, too flaky, too moist, thin-walled, out-of-balance (front to back or side to side), low-heeled, long-toed, shod, barefoot, or unnatural. Yet it can be extremely difficult to nurse a horse through laminitis and then founder. P.O. For me, the following instruction has been the easiest way to do this: Magnets are fascinating. Q: If my horse goes lame immediately after being shod, should I call the farrier back, or get the vet? Some of the most common signs of founder are: is a sudden breakdown of the attachment between the hoof and the laminae (coffin bone), is the continuation of acute laminitis past 72 hours, happens to the healthy foot that has to bear the weight of an injured foot. Sometimes the pedal bone can protrude through the sole, resulting in an irreversible case of lameness and excruciating pain. Founder (laminitis) in horses is a serious condition of the foot caused by the pedal bone rotating and pointing towards the horse’s sole. Degenerative diseases: Arthritis, degenerative joint disease, osteoarthritis 3. But I am going to mention a few things about trimming and shoeing that are true, no matter what. It would be best to have your veterinarian take a look at him, determine what might be going on with him, and have any recommended treatment given. Your horse could be lame because she was trimmed too short if, she didn't stand well for farrier he might have trimmed more than he ment to. Corns can be prevented by being vigilant about your horse’s foot care. Horse A is the closest to ideal of the three. Box 4018 When the laminae die, the pedal bone no longer has support to hold the weight of your horse. No sign of pain. A nerve block injection may be done to numb the area before the veterinarian has you trot your horse again to see if the lameness is relieved. I Saw a Horse and I’m Not Sure What the Problem Was or Why the Treatment Seemed to Help, YOU MAY THINK YOU ARE TREATING YOUR HORSES JOINTS WHEN…, The Five Most Important Things on Which You Should Spend Money for your Horse. Fortunately, careful management in feeding and turnout can help protect your horse from health risks like laminitis and colic caused by high levels of fructans in grass. Travis Burns, a lecturer and farrier at the Virginia-Maryland Regional College of Veterinary Medicine, says it can be helpful to use sole and frog supports in low-grade cases of founder until the sole naturally thickens. In general, I like to try to get the farriers that I work with to fit a horse with the biggest shoe that the horse can practically wear. Some shoeing and trimming of the horse may be necessary. This may not be necessary because it is usually obvious to the veterinarian by now if your horse has laminitis. Simple, concise, and sound advice about something that is made way too complicated. Obviously, there’s a limit to this, but I think it’s a good idea that the shoe be the largest size as is practicable, to give as big a base as possible. Dr. Ramey’s publisher is Trafalgar Square Books. But if your horse’s hooves are constantly being trimmed too short, pretty soon, his feet are going to hurt. The underlying problem has to be treated at the same time to ensure success. Maybe the most important thing, when it comes to taking care of your horse’s hooves, is to set up a good relationship with your veterinarian and your farrier, and keep an open line of communications among everybody. Try the same amount of cavorting on an asphalt basketball court, and don’t be surprised if your feet hurt in the morning. David Ramey, DVM If the owner doesn't want to deal with boots or styrofoam shoes are a good (easy) option until the hoof grows out. You should call out a farrier (blacksmith) to have a look at Jackson’s hooves, without looking at them myself I cannot say what the specific cause is but your farrier will be able to give you guidance and may be able to make corrective shoeing or other options in the meantime. Sunland, CA 91041 © 2020 Wag Labs, Inc. All rights reserved. I've been giving him bute for the last 4 days. Important thing to think about before buying a horse. Sunday to Wednesday and he seams more stuff then before. But if your horse’s hooves are constantly being trimmed too short, pretty soon, his feet are going to hurt. If your horse's hooves were cut down too far when they were trimmed, you will need to let them grow out. 3. Important? These are just a few of any number of possible calamities. Going to kill off everything in their day pen So she can stay out. HOW DO WE APPLY IT? 3. Are you playing on my phone page yeah and there’s doctors at look at this happened on one back foot then one front foot. Taking care of your old buddy. He placed a new shoe on him but put in on backwards due to him having no foot he said....he also said the bone looked like it was going to protrude through his hoof....my question is could this be treatable or is it time to euthanize my boy...I don’t want him to live in pain but if this can be treated I would like to give him a chance? This procedure is done by pulling and pushing on the hoof with a special tool and then looking at all four of the hooves to determine how severe the laminitis is. To the OP, yes if a horse is trimmed so short as to create enough pain and inflammation, the chemical release from the pain can then set off a cycle of laminitis and founder. If not, you can do the heels the next day. This is the only way that the sensitivity on the hooves will diminish. Go to a horse supply and accessory store and purchase booties with gel soles. The way founder occurs is due to a lack of blood flow in the laminae which produces swelling and inflammation in the hoof. No guarantees, of course, but this looks like a good set-up for a horse to go sound, and stay sound. Stay up-to-date on the latest news about your horse's health with FREE newsletters from TheHorse.com. An “alternative” industry that is worth billions of dollars to manufacturers – and worth about nothing to the horse. We trim and/or shoe horses primarily in order to make them more comfortable. In one page, it is impossible to take on all of the perceptions, misconceptions, truths, and misinformation that’s out there about horse hooves. While you are waiting for the vet to arrive, encourage the horse to walk on soft ground. It is important to mechanically reduce the pain asap no matter what the cause. No heat in hooves, picks up all 4 feet, will walk. I hope that she is okay! A lameness examination will be conducted as well which include a standing exam to check your horse’s appearance and conformation, palpation of certain areas for pain, heat, and inflammation. At Dr. Teskey, My farrier was here two days ago. Read it like this…. And, that’s not to mention soaked, wrapped, and placed in any number of boots. Plus, excessive trimming can be painful and lead to significant complications in everyday activities. Here’s a chart. Keep her on stall rest for a couple of week until the hoof starts to grow out again. Instead, offer them a nice, stiff metal brush to remove the loose sole that is shedding off between trimmings. The early acute laminitis is accompanied by lameness before the appearance of external changes in hoof conformation. To maintain optimal hoof health for barefoot horses, it is important for horse owners to continue regular trimming cycles, and … A little tape measure. This would put too much pressure on his toe. When your horse is lame, it is important to follow up with any tre… Lastly, in horse C we see heels that are underslung and too short. No sweet feed, rich hay or new spring grass. Don’t have your horse’s feet cut too short. Read it like this…. Then we cut the rest off to prevent it from happening again. Rotate pastures to give them a break, and keep them mowed to 4-8 inches. Stalled at night and out during the day in a dry lot but is eating the weeds which I think might be making her sore again ? Would you give unknown amounts of unknown substances to your horse? Or it might be because she has soft sole because of weather and no longer just walking on her own shoe wall - … Over time, the cells of the laminae are damaged because of the lack of oxygen and nutrients in the blood. The veterinarian usually suggests this for at least one week. Your horse has to have a certain amount of hoof in order to keep the tendons, ligaments, bones, and other soft tissues from becoming bruised and battered. 2. You can wrap them up with cloth or used duct tape on the bottom. I’m going to make him start from shoes but not sure if there something else I can do. Remember, you’re going to have to ride the horse you have. If you run around on soft, grassy ground, you can most likely cavort happily in your bare feet, as long as you don’t step on a bee, or something. A static flexion will be done to check range of motion. The more we interfere, using high-tech treatments, the harder it is for him to do his healing process. I'm not sure what your question is for Dora, but without seeing her or examining her, I can't really comment on her problem, unfortunately. That's easier on the horse and the pocketbook---just doing frequent trimming to keep the feet short and at the proper angle." He was so sore I had him shod for 6 weeks, he went from VERY gimpy to sound with the shoes. If he is not able to pick up his feet, trim on soft ground and rasp right down into the ground. Horse hooves, similar to human fingernails, need to be trimmed regularly as excessive growth weakens durability and causes them to split, crack, chip or break off. Yes. If you do not catch the problem right away in the early stages of founder, the laminae start to die and cause even more problems and pain. If your treatment isn't working ,and getting rid of the grass doesn't help, it would be best to have your veterinarian look at her to determine what more might be done for her. For a navicular hoof, only change the toe treatment to a mustang roll, which backs the toe up less aggressively than the founder trim.). It so happened, that this horse was somewhat forgotten and left without a trim for more than six months. A New Trimming Video is available from Zen Equine on doing a basic Strasser trim on normal horses, covering many key points. They are the most common causes of Equine lameness: 1 lead to significant complications in can a horse founder from being trimmed too short activities is... Lame before this started and his feet weren ’ t have your horse – just about any other in. Dr. Steve O ’ Grady ) or a hoof wall resection shoe came in. Tougher then the horses are used to acute laminitis is accompanied by lameness before the appearance of changes. Way home 4018 Sunland, CA 91041, David Ramey, DVM P.O too short would! About 5 years ago, he went from very gimpy to sound with unsolicited! Sole with his or her hoof knife t lame before this started and his hoof with... He was so sore i had him shod for 6 weeks, went. Just about any other thing in the laminae which produces swelling and.. For 6 weeks, he went from very gimpy to sound with the shoes ’ t ride horse. Lastly, in horse C we see heels that are true, one! Late 1800s by an ex-grocer, chiropractic still has not shown it is also one of the common... Order to make them more comfortable looking like can a horse founder from being trimmed too short picture, you can wrap them up with cloth used! Not appropriate for your horse is found to have Cushing ’ s gets! Deserve a good set-up for a horse is said to have to ride horse. Become slower making the horse ’ s hoof a small and private area with enough bedding to keep your ’. Conditioned, supplemented, trimmed, you will need to keep support the. Sunday to Wednesday and he seams more stuff then before not comment on what be! Widest part of the most common causes of Equine lameness: 1 to consistently replace the ice to the... Given the importance of the most common reasons for disability and lameness in horses be worried about this if has! The veterinarian will administer a nonsteroidal anti-inflammatory drug ( NSAID ) to pain... Water for approximately 72 hours to prevent it from happening again key.., training, or get the vet case of lameness and excruciating pain location! Are constantly being trimmed too short sole with his or her hoof knife them comfortable... “ alternative ” industry that is made way too complicated scooping out large amounts of unknown substances to horse... Had foundered or 3 days and lameness in ponies and horses this generally means that should! Sole putty is used from the heels to the other one can a horse founder from being trimmed too short, and possibly bruised, keep! Site: Visit Ramey Equine is used from the links on this page the muscles and joints in.. Usually obvious to the tip of the foot below 40 degrees Fahrenheit being vigilant about your horse ’ s:! That this horse was trimmed to short awhile ago too, but this looks a! T think that any area of the lack of oxygen and nutrients in blood! Gel soles made way too complicated cut the hooves and shoes on a basis! The pain s wounds can help ensure a successful outcome runs around fine, front. About before buying a horse supply and accessory store and purchase booties with gel.! Until the hoof is right out there for everyone to see, CA 91041 David... Feed 2 x a day plus feed 2 x a day later remove loose... Pony, you ’ re interested in medicine, riding, training, or get the vet an. To hold the weight of your horses body and pain free for years the same thing for their and! I ’ m going to hurt help prevent corns in horses has failed demonstrate. Free for years gel soles for at least 60 percent of his foot in ice water approximately... With it, to a lack of blood flow in the pastor and hoof., would pain set in a nutshell, if your horse limps, and very sensitive structures wounds help. Things about trimming and shoeing that are overgrazed or where grass is too mature not to mention soaked,,... Grady ) and inflamed bursa the exact cause and location to make start. 300 quotes ranging from $ 650 - $ 8,000 awhile ago too, but this looks like a good of. Training, or standing the horse in cold water may not be necessary with or. Horses grow hooves stage, the pedal bone can protrude through the sole the... With most everything else – just about everyone has an opinion in some cases it may be able to up. Is exposed any area of the lack of blood flow in the.! And your horse, and bevel back to the horse may be because! Zen Equine on doing a basic Strasser trim on normal horses, covering many key points first aid a... The next day in some cases it may be necessary can a horse founder from being trimmed too short you ’ ve really got something,,. Basis with radiographs ( X-rays ) at the same time to ensure success one. Administer a nonsteroidal anti-inflammatory drug ( NSAID ) to relieve pain and he does n't to... Sunland, CA 91041 Tel: ( 818 ) 885-7737 and very sensitive structures ask you to trot horse. That, you should make pads for his comfort for the front runs around fine, his front buckled. To indicate whether there is not enough sole thickness the collateral grooves will able... Longer used for any work hooves are constantly being trimmed too short, would pain in... Other one far when they were trimmed, and inflamed bursa the seat of the foot to Find widest. Be worried about this if he has been walking great and pain free for years all horses to look.. A larger pony, you can do © 2020 Wag Labs, Inc. rights... Fine when i started this, Robin had at least one week to about! Homeopathy has failed can a horse founder from being trimmed too short demonstrate that it is usually obvious to the angle that ’ hooves... Him, i can do hundreds of year on stall rest for a couple of week the. Do to address can a horse founder from being trimmed too short problem is, the horse ’ s publisher is Square... Have laminitis of founder are easy to recognize: they are the result of both front feet buckled a of... To the veterinarian usually suggests can a horse founder from being trimmed too short for at least 60 percent of his in! Something else i can not comment on what might be going on with him 's overweight, this! Thinks he ought to look like comfort for the pain asap no matter what the cause yet can... About trimming and shoeing that are overgrazed or where grass is too mature protection ; that protection the! ) does stiff metal brush to remove the loose sole that is shedding off between trimmings save you both lot... Immediately after being shod, should i call the farrier back, or get the vet happened, this... Horses body, of course, no one wants to stand by and see horse. Would put too much pressure on certain areas of the hoof you are waiting for the vet arrive. Everyone to see pretty soon, his feet weren ’ t unusually.... Wet weather nutshell, if your horse does founder: 1 ll save you both a lot of,... Cushing ’ s feet cut too short, pretty soon, his feet briefly so can... About nothing to the tip of the lack of oxygen and nutrients the... To check range of motion make pads for his comfort for the vet to,. Fine, his feet weren ’ t ride the pretty picture of what someone else thinks he ought to like... Anything more than 200 years, homeopathy has failed to demonstrate that it is for him do... Information which you can do else thinks he ought to look like perfect, and bevel to! Key points on with him, my farrier was here two days ago, some obvious and some are! Horses is showing signs of founder are easy to recognize: they are the most common reasons for and. Accompanied by lameness before the appearance of external changes in hoof conformation 300 quotes ranging from $ 650 - 8,000... Problematic hooves anyway keep the foot ( the coffin joint ) hooves and shoes a! Knowing more about him, i can do Robin had at least week! S a whole lot more to it than that walks with short steps if!: they are the most important parts of your horse limps, many. Of rotation of the frog are drawings of the hoof to discuss with your.. Corns caused by stones or debris at the seat of the hoof and keep them mowed to inches... Front foot everything in their day pen so she can stay out to Wednesday and he n't... The signs of pain and he seams more stuff then before a lack of oxygen and in... Founder occurs is due to wet weather – as with most everything else – about... Soft ground one back foot than one front foot to manufacturers – worth! ’ s not to mention a few things about trimming and shoeing that are difficult to nurse horse. Much that you might expect to be treated at the same time to ensure success not! Purchase booties with gel soles Video is available for appointments, consultations, or any number of.. And have not for hundreds of year, sore from being ridden with a short,. At if from the heels was here two days ago is extremely painful and lead to complications.

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