one side of the horse - Ronald Searle

Further Hoof Care

Following up on last week’s post about Simple Hoof Care, this week a short film on further hoof care. The method shown here is still relatively simple but this time we look at the use of conventional trimming tools and techniques.

The video lasts just over six minutes. 

bottom of hoof

Simple Hoof Care

The coronavirus SARS-CoV-2, which is causing COVID-19 casualties around the world, is disrupting all walks of life and many activities we took for granted have ground to a halt. Not least of these is the horse world and all associated with it. Some countries have put severe restrictions upon leaving the house/property. Other countries have banned horse-riding altogether –even in private– since an accident would add yet another problem to the already overburdened medical services.

Clearly, whatever the local situation, horses are getting less exercise but their hoofs are still growing. And the farriers and hoof care specialists are hanging up their tools for the duration with many equestrian centres closing, or being obliged to close, their doors and ‘unnecessary’ work being suspended.
For many owners, this is a hand in hair situation – what to do now.

For this reason, we have compiled a short video showing how you can maintain your horses hoofs in an acceptable condition until your hoof care specialist is back out and about…

Lucky Luke

Prior knowledge of hoof care is not a pre-requisite and you will not damage your horse’s feet nor cripple him. You will need access to some basic equipment but it is advisable to obtain a proper farriers’ hoof rasp. These cost between €30 and €60 (£25 & £50) and can be bought at any online farriers suppliers (check Google for your nearest stockist). When buying a rasp, make sure it is a 14 inch double-edged rasp (one side will be rough, the other fine). Smaller models and multi-faced models are not easy to use because they do not allow a flowing motion; larger models are unwieldy. Do not buy a Riders Rasp™; this is of little use other than to cosmetically pretty-up the edge of the hoof and certainly has no place is proper hoof care.

4-edge hoof rasp

The multi-faced rasp, far left, and the Raid Riders Rasp, left.
Two tools of very limited used and best avoided.

So, here is the video. It is only five minutes long (±675mb). We hope it will be informative and help you out in these trying times. If you have any questions, please do not hesitate to mail us at info@sabots-libres.eu

Stay safe.

Veterinary Madness

A while ago, my attention was once again drawn to a typically poor article on theHorse.com. Not unusually, this is an article about feet and, also not unusual, it is written by a vet and contains citations by other vets.

Many people will obviously start to say that ‘the vet will know…’ so why criticise – but there lies the crux, the vets clearly don’t know. The problem lies in the fact that vets are first and foremost biologists – or at least veterinary education is centred around biology with a fair bit of chemistry thrown in. This does have a sound reason; the daily work of a vet is being involved with biological processes and their associated chemical reactions. The latter being aided or modified by often symptom specific drugs. But the mechanical side of things is much less well represented. Particularly when it comes to the limbs. Veterinary science finds itself still stuck in the Middle Ages with techniques and theories that were not even conceived by vets! And this latest article on theHorse.com just underlines the case once more.

The article How Healthy Horse Hooves Help Arthritic Joints by Nancy S. Loving DVM dates from October 2018.

Dr Loving is aided in her article by comments by Andrew Parks, a university professor of veterinary medicine, and Steve Kraus, farrier and instructor at Cornell University of Veterinary Medicine…this last is typically laughable. To have somebody who advocates the nailing of overweight pieces of metal to an animal’s feet being the resident of a university of veterinary medicine should be a major embarrassment.

When offering arthritic horses relief, start from the ground up

The degenerative joint disease arthritis is all too common in active and aging horses. In an effort to slow the progressive deterioration of joint tissue, owners and veterinarians often reach for anti-inflammatory medications and/or regenerative therapies. After all, our goal is to keep these joints comfortable.

One often-overlooked strategy in this effort is hoof care. Certain trimming and shoeing techniques can alter a horse’s limb biomechanics—for better or worse. In this article we’ll discuss how to care for arthritic horses’ hooves for maximum comfort.

As with much of veterinary medicine, this article starts immediately with a treatment rather than with prevention.

If we were to prevent, or at least do what we can to prevent, the onset of a disease –in this case arthritis– then our horses would be in a much more favourable situation. And with many degenerative diseases, prevention or delayed onset is not so difficult to achieve. For the horse, adequate management can mean the difference between a full and comfortable life and a short painful one.

Arthritis is indeed common in active and ageing horses but its roots lie not so much in the age, nor the activity, of the horse but rather its (mis)management. A shod horse is far more likely to develop arthritis than an unshod one, as the article briefly explains. The combination of horseshoes with inappropriate activity will exacerbate the problem and the longer the horse is exposed and thus the older it is, the more severe the problem will become.

The equine world, professional, amateur and veterinary, is very reliant upon the pharmaceutical industry and as the author of the article says, ‘…owners and veterinarians often reach for anti-inflammatory medications and/or regenerative therapies…‘. All too frequently, the anti-inflammatory medication will be one or other proprietary variant of phenylbutazone –a medication so widely abused that if it was in human medicine, a vast number of doctors would have long been struck off the register. Phenylbutazone is indicated exclusively for chronic laminitis.

Quite correctly, the author indicates that hoof-care is an often overlooked strategy. But clearly, even in this early paragraph, has little grasp of the biomechanical consequences of shoeing and trimming.

What Exacerbates Joint Pain?

Arthritic horses try to minimize their joint pain by reducing the load on the affected limb(s) and shortening stride length. “This suggests that pain is associated with the concussion of impact and extreme ranges in motion (ROM),” says Andrew Parks, DVM, Vet MB, MRCVS, Dipl. ACVS, a professor at the University of Georgia’s College of Veterinary Medicine, in Athens.

Professor Parks explains the problem fairly well here. So why can’t he follow up on it with a logical, mechanics-related, conclusion?

Force of impact

The limb’s loading rate (deceleration) when the foot lands affects the force of impact on that leg, as can footing type. “The impact of baked clay in summer or frozen ground in winter is quite different from a soft dirt paddock, bedded stall, or engineered arena,” says Parks. “Anything that slows down the rate of deceleration of the foot is likely to decrease the effect of impact. Materials that absorb energy on hoof landing—either from the ground surface or within the shoeing apparatus—also reduce impact.”

This is actually a bit nonsensical. It is rather typical of the biologists reversed view of mechanics!

It is not the loading rate that affects the force of impact on the leg, it is quite the reverse. The force of the impact –kinetic energy– is the product of mass and velocity. The speed with which this force is dissipated is the deceleration. This dissipation of energy will be found on both sides of the impact point (remember Newton’s third law: When one body exerts a force on a second body, the second body simultaneously exerts a force equal in magnitude and opposite in direction on the first body.) and, as Professor Parks points out, will be affected by the hardness of the surface landed upon. Where he misses a beat is in his assertion that the shoeing apparatus will reduce impact.

The addition of any extra weight to the distal point of the limb will by its very existence increase the kinetic energy of the limb. So immediately we must build-in yet more absorption to compensate for the extra weight…whereas the foot in its lightest form will be able to work together with the tendons, muscles and leg-articulation to create the optimum absorption of impact.

Range of motion

You’re probably already familiar with this concept: Your veterinarian maximizes a joint’s range of motion when he or she performs a diagnostic flexion test to pinpoint soreness in a painful joint. Excessive flexion or extension/dorsiflexion (backward bending or bowing) can aggravate arthritis.

Owners and farriers should handle arthritic horses’ legs with care. “Check range of motion and flexion ability, and don’t force an arthritic horse to bend or flex its limbs beyond its comfort zone,” says Steve Kraus, CJF, resident farrier and instructor at Cornell University’s College of Veterinary Medicine, in Ithaca, New York. “Use of a foot stand (when trimming or shoeing) keeps hind limbs low and supports the front legs to provide better comfort for both horse and farrier.”

To modify or limit range of motion extremes in locomotion, Parks recommends farriers help the foot lift and roll over (called breakover) more easily. “This may mean not only rolling the toe but also the whole perimeter of the shoe and even the heels,” he says. The easier it is for the horse to lift his heels off the ground, the less dorsiflexion the foot will experience at breakover.

Kraus is right, the limb should not be flexed beyond the comfort zone – ever. It is one of the frequent tests when purchasing a horse to flex the leg and hold it in position. If the horse then limps, there is supposedly something wrong (…but you try walking after forcing your leg into an uncomfortable position for any length of time!).

This is all sound common sense – apart from ‘…rolling the shoe…’ We don’t need a shoe; in fact, we MUST NOT shoe – even less so in an arthritic horse. The shoe will by definition add length and depth to the hoof; this in itself exacerbates the problem demanding rolling of the shoe. Losing the shoe removes this and all other problems in one fell swoop – and if the horse is still having ‘rollover’ problems, then there are two solutions: walk the horse on hard –preferably even– surfaces for a short while every day or, if that is too much effort, add a so-called ‘Mustang roll’ (or simply trim the toe shorter).

Acutely imbalanced horse hoof

Imbalance

Hoof balance is key to keeping an arthritic horse comfortable. Create a more level landing surface by picking out gravel and other debris from hooves daily. Have the feet trimmed every four to seven weeks (depending on hoof growth rate) to help balance the hooves and reduce the horse’s risk of developing long toes and collapsed heels, which can make him more likely to stumble.

“Farriers can manage the hoof capsule with trimming and shoeing to provide proper limb alignment so that forces are distributed equally through the joints,” says Kraus.

If a foot is acutely imbalanced (say, for example, one side has been wedged or trimmed shorter than the other), the joint on the elevated side of the hoof will narrow—something that’s visible on radiographs (X rays) taken immediately following this practice. “However,” says Parks, “if you look at feet with obvious (chronic) coronary band asymmetry and hoof imbalance, an interesting finding is that the imbalance in the joint space usually is not evident on radiographic images.”

This compensatory phenomenon is related to the coffin bone’s movement relative to the hoof capsule. The hoof’s growth rate also changes, slowing on the side experiencing the greater load.

Parks reminds us that the same principles that encourage bone remodeling might also apply to other tissues. Overloading on one side of the hoof might, in fact, slow the rate of cell replication in the coronary band on that side.

“If the hoof wall is imbalanced side-to-side (uneven hoof wall height between medial and lateral—inner and outer—sides), then theoretically, unequal overload stresses can create degenerative joint disease (DJD),” says Parks. “However, a horse’s natural compensatory hoof mechanisms tend to minimize changes within the joints. You may have appreciated how quickly the hoof capsule changes shape once a horse shoe is removed—usually within 24 to 48 hours.”

That said, he points out that if mediolateral imbalance within the foot’s internal structures persists, a horse can develop DJD. Uneven forces place undue pressure on joint components, especially cartilage, which can then create or exacerbate joint deterioration and arthritis, adds Kraus.

Genetics and/or inappropriate trimming can also create dorsopalmar (front to back) imbalances, which affect the hoof-pastern axis (when correct, the front hoof wall should be parallel to the pastern angle).

Here we descend into the mythical world created by the farrier and carried on by many a barefoot ‘specialist’.

Kraus’ claim that ‘farriers can manage the hoof capsule…to provide proper limb alignment…’ is typical of the bilge peddled by this dubious profession and, sadly, believed in all sincerity by a poorly educated veterinary community. There is absolutely NO WAY that a farrier or a barefoot ‘specialist’ will ever be able to sight up a hoof and limb and ‘correct’ or ‘compensate’ for so-called imbalance. For a start, a study some years ago –sadly now lost to the mists of time– showed that farriers were incapable of reproducing treatment during successive visits in around 80% of cases. This is not at all surprising since the hoof is a dynamic structure that the farrier ‘analyses’ in a static situation; the problem is further exacerbated by already present shoes, where applicable, and by the absence of knowledge of what exactly is the horse’s conformation.

Even X-ray photographs cannot give an accurate representation since the foot and leg is always in an ‘artificial’ situation – the horse will never be standing in absolutely perfect balance. Furthermore, as most veterinary surgeons will tell you, often that which is causing pain or discomfort is that which cannot be seen on the X-ray.

In the end, only the horse can correct its stance and its foot conformation. The easiest way to achieve this is to simply trim the hoof adequately and allow the horse to walk on a hard surface like concrete or tarmac to achieve its own personal ‘balance’.

Long Term Imbalance

When trimming and shoeing for balance, one of the farrier’s main goals is to make sure the foot is placed properly beneath the skeletal column, says Kraus. “Caudal (rear) heel support relies on supporting the heels in their proper location beneath the leg,” he says. “This support is important to minimizing arthritic discomfort. As the hoof first strikes the ground, the heels act as a fulcrum. If positioned too far forward under the limb, the leg tends to rock backward on that point of the heels. The horse must exert muscular force to overcome this, which strains the joints. Proper heel support requires trimming the hoof to the widest, highest, rearmost area of the frog. If that cannot be done, it is possible to provide support with shoeing.”

To align the heel properly, farriers usually fit the horse with an appropriately sized shoe that increases the hoof wall’s surface area contact with the ground, says Kraus. This prevents rocking back on the heels or sinking into soft ground, either of which stress joints whether they’re arthritic or healthy.

Farriers might apply egg bar shoes to horses with low-angled, underrun heels, says Kraus. “Caudal heel support from the bars (found at the rearward ends of the hoof wall) reduces backward sinking of the hoof, while also providing a greater bearing surface to spread out the horse’s weight,” he says.

Parks says elevating the heels has been shown to alter the distribution of pressure in the coffin joint, which could potentially increase wear and tear.

“The ideal relationship between the pastern and the hoof is when the dorsal (front) wall of the hoof is parallel to the dorsal pastern, and if the foot is trimmed so that this relationship is not parallel, it has the potential to increase the overall force on the foot during the course of the stride,” says Parks. “Additionally, a long toe increases the lever arm at breakover, which increases the force required to lift the heels off the ground. These phenomena exacerbate arthritic pain in the distal (lower) joints.”

Kraus adds that when horses strain to move their lower limbs and break over a long toe, they can aggravate low or high ringbone (coffin or pastern joint ­arthritis).

Once again, the farrier descends into nonsensical theorising. Talk of ‘…aligning the heel properly…’ and ‘[applying] egg bar shoes to horses with low-angled, underrun heels…’ just goes to show how far from reality these people are. As already explained above, the farrier –indeed, any external agent– will never be in a position to ‘align the heel properly’. Anybody claiming this is a fraud and if you believe him, you are doing yourself an injustice. Three years of farriers’ school, even with a nice diploma at the end, is not an indication of competence; it is an indication that someone is trained in middle-age thinking and practices.

Underrun heels need to be treated, not compensated for. They need correctly trimming to remove the underrun, not the addition of egg-bars to raise the caudal section of the P3. This is nothing more than bone-idleness on the part of the profession and ignorance on the part of the individual farrier.

Smart Trimming & Shoeing Techniques

Backing up the toes

Many farriers attempt to correct a long-toe, low-heel hoof configuration by setting the shoe back at the toe. While Parks says this improves breakover for the short-term, leaving the toe hanging too far over the toe of the shoe means the wall at the toe is not in direct contact with the shoe. Therefore, it receives less mechanical stimulation than the wall that is in direct contact with the shoe from the toe-quarter junction (pillars) to the heels. “This affects the way the wall grows,” he says, reminding us that the wall under greater stress will grow slower and vice versa. “Biofeedback tries to restore a previous state,” he says.

Kraus says farriers often apply rocker or rolled toe shoes to horses with arthritic conditions. “These shoes artificially shorten the distance and, hence, the ­leverage in front of the center of rotation on the foot beyond what can safely be trimmed away,” he says. “Sound, properly trimmed horses need normal toe length for optimum propulsion, but horses with arthritis in their lower joints do better with less-than-normal leverage (i.e., shorter toes).”

Parks says he’s a fan of rocker and roller shoes but warns against removing too much dorsal hoof wall in the shoeing process. “If the farrier uses a rasp to gradually thin the wall at the toe, it may not change hoof wall growth, provided enough stiff wall (the outer one-third to one-half of the wall) is left in contact with the shoe,” he says. “In contrast, if the toe wall is chopped away at a 45-degree angle, while this may ease breakover so that the dorsal wall isn’t in contact with the shoe, it isn’t under as much stress as the adjacent wall. Therefore, on the reasonable assumption that wall under less stress grows faster, the toe will outgrow the adjacent wall, thus changing the conformation of the foot, which may add to arthritic pain.”

One thing that we can clearly add is that the hoof wall is NOT the weight-bearing structure of the foot. It is therefore of little importance where the shoe is affixed, forward, backward, it will always be in the wrong place, transferring the weight of the horse to the hoof wall and thus through the delicate laminae which can easily be demonstrated as not being designed for such use.

The growth of the hoof wall is not slowed but rather stimulated by ‘stress’ or, as it can also be termed, ‘use’. This is readily demonstrable in any horse that has the good luck to be barefoot; intense use does not wear down the hoof but rather stimulates its growth. Again, a farrier’s fable that the unshod horse will wear its hoofs out working on hard surfaces.

With arthritic horses, it’s a delicate balance between slip and grip.

Steve Kraus, CJF

Protecting the hind limb

Most shoeing practices only have a direct effect on the lowest limb joints—the coffin and pastern joints. However, farriers do attempt shoeing strategies to influence higher joints, such as using lateral extensions or egg bar shoes on the rear hooves of horses with distal hock arthritis (bone spavin). Kraus says a lateral hind shoe extension provides support to prevent a base-­narrow horse’s hocks from rotating outward, while an egg bar shoe might reduce excessive hinge motion that otherwise stresses hock joints.

Study results, however, show that neither rear-foot lateral extensions nor egg bar shoes have a significant effect on stabilizing affected hock joints.

Then there are trailers (or caulks) on hind shoes, which some veterinarians and farriers argue against using because they can cause a foot to stick and torque the joints. Their use, however, often depends on the equestrian activity and terrain conditions.

It can be very regularly demonstrated that the shod horse suffers from shoeing right up the legs and into the shoulders, the hips and ultimately the back. Therefore it cannot be said that the application of shoes does not just affect the distal structures. Just as Kraus declares that there is little result shown in shoeing for proximal structure problems, it should be clear that the addition of shoes will sooner be detrimental – to give him the benefit of the doubt, we could say that any envisaged amelioration will be cancelled out by detriment!

Caulks, trailers, studs –whatever name you might want to use– are always going to turn an already damaging situation into a potential disaster. As stated in the article, the possibility of sticking and ‘torquing’ –spraining– joints brings some veterinary surgeons and farriers, quite rightly, to argue against their use. The final statement rather clinches it though: ‘[their use] often depends on the equestrian activity and terrain conditions’. We are talking arthritic horses here. We should be adapting our activities to the condition of the horse, not trying to prop it up to get it through next year’s equestrian calendar. This is welfare at its lowest – the needs of the rider always seem to go before the needs of the horse. And to say that all this –actually worthless– treatment is for the horse’s welfare, is pulling the wool over everyone’s eyes, the rider’s included. 

Applying pads

Traditionally, farriers have applied pads beneath shoes to provide sole protection and shock absorption. Kraus says that in his experience, polyurethane pads provide limited shock absorption and are better suited simply for sole protection. Leather pads do improve shock absorption but deteriorate over time, he says.

“Some synthetic pads are designed to absorb shock; however, with only 1/8-inch of material on a 1,000-pound (or more) horse, how much shock can really be absorbed?” he says. “A pour-in pad or packing a shoe with synthetic gel may be a better option to achieve shock absorption” for arthritic horses. These materials conform to the sole and frog for a more uniform distribution of shock absorption throughout the hoof.

Anything applied to the bottom of the foot is, first and foremost, detrimental to the locomotion of the horse creating an imbalance in movement and moment, raising the heart-rate above normal –partially due to the severe reduction in the hoof-mechanism– increasing the effort exerted for every step.

As the article states, pads have been applied traditionally to provide shock absorption – except generally, they don’t. And in any case, the foot is designed to carry the weight of the horse and, more importantly, to cope with the enormous amounts of kinetic energy generated. It is often argued that the horse is not designed to carry riders, which is true, therefore we must ‘protect the hoof’ against this extra weight. In reality, a horse weighing 500kg will generate almost the same amount of kinetic energy at 16m/s (full gallop) as a 500kg horse with 70kg of rider and tack at 15m/s. The arthritic horses will not –or should not– often be achieving such speeds therefore we should be able to consider that he is already equipped with all the shock absorption he will ever need. And the first point of shock absorption is the frog. Shoeing the horse removes almost all function of the frog and it is not by any means unusual to find this structure almost completely atrophied in the shod horse. 

Considering shoe weight and type

Any type of shoe on a horse’s foot adds weight that the animal must lift from the ground at breakover. To reduce shoe weight, try applying aluminum shoes, which are one-third the weight of steel, says Kraus. “Or, an alternative to bar shoes is the Myron McLane pad that includes frog and heel support,” he says. Wide web shoes are another support option and weigh less than egg bar shoes.

Synthetic shoes—nonmetal or a metal composite with nonmetal materials—absorb the most shock. You can choose from many types of those shoes, both nail-on and glue-on. Remember, however, that plastic materials can be slippery on wet grass or ice and might wear more quickly than steel shoes. “With arthritic horses, it’s a delicate balance between slip and grip,” says Kraus.

‘Try aluminium shoes to reduce weight…they are a third of the weight of steel’ – but they still increase the distal mass by around 50%. This is still a locomotive impediment. And worse still, the weight of the horse is still being moved out onto the non weight-bearing structures: the hoof wall and the laminae, and the impact concussion is not being absorbed but rather amplified (there are numerous videos on the internet which show exactly how this amplification makes itself visible).

Barefoot or Shod?

“Leaving a horse barefoot is generally good, particularly in a nonperforming horse with arthritis,” says Parks. “In most cases, the unshod hoof capsule provides the best damping to assimilate the shock of foot impact. And, a barefoot horse is able to ‘roll’ its own hooves through natural abrasion.”

“When barefoot arthritic horses wear their hooves to their comfort level, this shouldn’t be confused with conformational defects that often wear the hoof in the opposite direction than the horse needs,” says Kraus. However, “barefoot horses with thin soles may become sore-footed and then alter their gait in such a way to strain arthritic joints.”

Still, barefoot advantages might outweigh disadvantages to help curb arthritic pain, and owners can apply hoof boots for riding or navigating rough terrain, if needed. Our sources recommend using a lightweight boot with built-in breakover and adding a viscoelastic pad inside.

There is no question here – the horse should never be shod, arthritic or not. The idea that the horse will get out of its comfort zone implies that we are doing too much with the horse.

Take-Home Message

Before making trimming and shoeing changes, have your veterinarian perform a thorough diagnostic work-up of your horse’s lameness problem. Ask him or her take radiographs to visualize the angles of internal hoof structures, the extent of osteoarthritis in a joint, and the depth of sole a farrier has to work with.

“Shoeing methods for arthritic horses ideally incorporate ways to transfer motion to the ground instead of to painful joints,” says Kraus.

“Shoes modified properly to help with arthritic problems may be a more permanent way to manage some horses with arthritis,” says Parks. “Trimming and shoeing practices are useful adjuncts to multitreatment modalities that include joint injections, non-steroidal anti-­inflammatories, IRAP (interleukin-1 receptor antagonist protein), and in some cases regenerative therapies.”

There is no single trimming or shoeing recipe that farriers can apply to every horse. Following basic principles of balancing the foot, easing breakover, supporting the heels, and aligning the hoof-pastern axis provide the best foundation for both normal and arthritic horses.

The take-home message is clear. DO NOT SHOE. The article states that ‘…[there] is no single trimming or shoeing recipe that farriers can apply to every horse…’, but there is. It is impossible to correct or compensate for arthritic problems with either shoes or trimming. But we can give the horse the ability to find its own balance, its own correction or compensation:

Make sure your horse is trimmed regularly and correctly. That means NOT how the farrier will generally trim, after all, the farrier knows how to trim to shoe, but not for the functioning of the locomotor apparatus; his training will not have given him insight into this (although subsequent experience may). Heels down, wall short. If your horse is high-heeled or underrun, then any changes must be made gradually – this applies just as much to the fully fit as to the arthritic horse.

Remember that it is his welfare we should be considering. Shoes are never the solution and if your horse cannot do what you ask barefoot, then you are either asking the wrong thing, or you are not thinking of his welfare. Shoes and welfare never mix. Riders and owners often say that they shoe because they are thinking of the horse’s welfare and then ask the horse to do those things which are not going to be good for his health…

Got Healthy Hoofs?

Recently, The Horse published an article entitled Got Healthy Hooves? Here’s How to Keep Them That Way. As is often the case with articles in The Horse a fair degree of nonsense is peddled and this one was no exception. Being completely hoof oriented, it warrants analysis and counter-argument. In order to present a clear analysis, I have copied the article verbatim and added comment to each item rather than making a general summary. The original article is clearly copyright the author and The Horse.
Consider the big picture, from farrier care and diet to environment and genetics

My horse is barefoot. And sound. And his feet look pretty great, if you ask me. What can I do to keep them this way? Are there special products I should be using or certain ways I should be managing them? What if someday he needs shoes?

Why should your horse ‘someday…need shoes’? What can conceivably change, apart from your own conceptions, that would demand this?

These are just a few of the many questions horse owners ask about their horses’ feet. They’ve heard about or have managed less-ideal feet, so it’s only natural to want to keep things going the way they are and stave off problems. We gathered advice from two farriers on how to have the healthiest of hooves, with or without shoes.

The healthiest of feet -and horses- are always without shoes

Paul Goodness, CJF, a farrier at the Virginia-Maryland College of Veterinary Medicine’s (VMCVM) Marion duPont Scott Equine Medical Center, in Leesburg, says horses’ feet are fairly resilient and can adapt to many conditions, but sometimes they need a little help. Travis Burns, CJF, TE, EE, FWCF, assistant professor of practice and chief of farrier services at the VMCVM, agrees, and says horse owners can do many things to help their horses maintain healthy hoof capsules.

Genetics: Start With Good Feet and Legs

“If I could give one piece of advice, it would be simply to buy or breed horses based on conformation and hoof quality,” says Burns. “It’s far easier to have healthy feet by buying/breeding horses that already have good feet.”

Conformation is a human definition. Very few horses ‘conform’ to the standard imposed by man. Hoof quality has little to do with the horse’s conformation, more to do with management; but to avoid problems later on, the bottom line is ‘never buy a horse that has been shod’.

If a horse has poor hoof quality, then the owner is fighting that problem for the rest of the horse’s life, he explains. It can be a constant challenge to keep the feet healthy and sound and/or shoes on.

As already said, poor hoof quality is a management problem. The challenge is not keeping the feet healthy but for the owner to change attitudes.

Indeed, hoof conformation, strength, and durability are mainly genetic. Some horses just have much stronger feet than others. Environment, hoof care, and nutrition can make a difference, but the horse that starts out with strong, well-conformed feet is less apt to be adversely affected by poor conditions.

All horses start out with potentially strong feet -genetics can play a small role in hoof strength but environment, care and nutrition are by far the most important factors.

Goodness says horses are born with certain attributes that dictate basic hoof angle and shape.

For instance, “the shape and density of P3 (the third phalanx, or coffin bone) has a direct influence on the outer structure of the hoof,” he says. “The angle and length of the pastern bones also help determine the angle and shape of the hoof. If a horse is born with upright pasterns, he may have a propensity to be club-footed. If he has long, sloping pasterns, he’ll have a more sloping hoof and longer toe, with lower heels.”

The shape and length of the P3 varies from individual to individual and has little influence on performance. The biggest problem is poor hoof care through a misunderstanding of the function of the hoof. ‘Upright pasterns’ will NOT give propensity to club-footedness; the club foot is in almost every single case, a management problem and NOT a natural deformity. Likewise the so-called ‘long sloping pastern’ is primarily a hoof care problem where the farrier has not identified a poor trim/preparation for shoes.

Age Matters

Two age groups that generally need more hoof care than the average adult horse are foals and seniors. Some owners don’t do much with a youngster’s feet until the animal is old enough to be ridden or needs shoes. But very young horses are at an age at which routine farrier care can make the most difference in starting the feet out right—with the best chance of correcting lower limb imbalances or crookedness.

These two groups do not need more care – simply put, and as is actually indicated in the next paragraph, senior horses need as much care as the average younger horse. Young horses need very little attention if they are managed correctly. It is impossible to correct so called ‘lower limb imbalances’ or ‘crookedness’ by the simple expedient of shoeing without causing damage to the internal structures of the leg, and trimming will have no effect whatsoever. Any real physical problems will need to be addressed surgically.

“Many people don’t think about the importance of hoof care early on in a foal’s life,” says Travis Burns, CJF, TE, EE, FWCF, assistant professor of practice and chief of farrier services at the Virginia Maryland College of Veterinary Medicine (VMCVM), in Leesburg. “Foals should be looked at during the first two to four weeks because often they need a little trimming to keep feet growing straight, and then need trimming every month. The foal’s feet are very easily molded and shaped; you can have a huge positive influence during the first three months of life.”

The feet never need to be and should never be ‘moulded’. They are the way they are because that is how the horse is growing. Any attempt at changing that will have a profound negative effect on the growth and performance of the horse.

At the other end of the spectrum is the retired horse turned out to pasture. “The feet don’t get much care until there is some sort of crisis,” says Paul Goodness, CJF, a farrier at VMCVM. “I have been shoeing long enough to see many of my client’s horses get into their 30s, and many times their feet deteriorate as they grow old. I have three or four of these geriatric horses that I’ve had to put shoes back on (after years without shoes).”

The only reason for shoeing these horses is a lack of understanding of the needs of the horse and its feet.

If you allow the feet to get too long on an older horse with arthritis, you’re just putting extra strain and stress on those already-painful joints.

And if you shoe them, the situation is only going to get worse. Adding 300 grammes of shoe to the end of each leg will cause an enormous increase in forces experienced by the now arthritic joints.

So don’t just focus on the horses you are riding and working with regularly; also tend to your youngsters and retirees.

—Heather Smith Thomas

The No-Brainer: Farrier Care

The most important thing you can do for your horse’s hooves is to schedule regular trims to keep them in proper shape and balance.

While some owners think bare feet only need trimming once or twice a year, most horses need much more frequent trims to keep the hoof capsule properly balanced (so structures are stressed evenly) and to keep the edges from cracking and chipping, Burns says. Trim cycles can span four to eight weeks, depending on the horse, he adds.

“Each horse … has a unique rate of hoof growth and a different need for trimming frequency,” says Goodness. “This can also vary due to the type of work and the time of year.” Hoof horn tends to grow faster during summer, perhaps due to optimum nutrition in green grass, and slower during winter.

The main reason for augmented growth in the summer is that the horse is ridden more often, stimulating growth. But if a horse is ridden on hard surfaces frequently enough, then the hoofs will wear sufficiently to not need trimming for anything up to 5 months. No amount of farriery can possibly ‘balance’ a hoof and wear patterns are individual to the horse.

“Most horses should be checked by a farrier or hoof care specialist regularly, if for no other reason than to check for abnormal conditions that might benefit from some kind of action,” he continues. Your farrier might discover problems, such as thrush, white line disease, bruising, or a chip or crack in the hoof wall, in the early stages and intervene before the situation becomes serious—and more expensive to fix.

A crack in the hoof wall is easy to fix and is not a major problem. It is more often an indicator of inadequate rather than infrequent trimming. Thrush and white line disease are problems that need more than the services of a farrier…they demand a change of management. Bruising is a natural occurrence that demands little or no attention since it will go away by itself.

“The farrier is in a good position to help keep the feet healthy and to answer any questions the owner might have, especially a new owner,” Goodness says.

A very divisive comment. The farrier is in reality often in a very poor position to advise. He will tell you that his profession is one of the oldest but what he forgets to tell you is that its concepts are still rooted in those early days. Farriers themselves often forget -or ignore- the original reasons for shoeing horses but new owners are all too often swayed by his ignorant, at times incompetent, but apparently ‘professional’ arguments.

Environmental Influences

Horses have an incredible ability to adapt to wherever we put them. It takes time, however, for their feet to acclimate to wetter, drier, softer, or harder ­conditions.

“Not all horses can adapt on their own, so the horse owner can play an important role in assisting with that adaptive period,” Goodness says. “If horses are living in a moist area, or there’s a time of year when the footing is very wet and feet become too soft, we need to give them an area in their paddock that’s higher and drier where they can get out of the mud and enable the foot to dry out a bit.” As a general rule of thumb, feet are healthier when they are not constantly wet.

“Moisture is an enemy of the hoof capsules and predisposes them to abscesses, cracking, white line disease, and many other problems,” says Burns.

Moisture itself is not a problem and is NEVER a cause of abscesses. Cracking is more a problem of the hoof being over long and white line disease is a fungal infection most frequently caused by bad management.

Some horses’ feet deteriorate readily when wet; the hoof horn becomes softer and tends to lose its structural integrity. The hoof wall might splay out more than it should, which makes the foot more likely to develop flares or cracks. Softer soles are more prone to bruising.

A soft horn does not lack structural integrity. If the wall splays, it is because it is too long.

“Even worse than constantly wet is an environment where the horse goes from wet to dry to wet … over and over again,” says Burns. “Here in our mid-Atlantic states, even in summer when it is bone-dry because of drought, people think the feet are too dry, but they get wet with the morning dew. Then the feet are dry again by afternoon and the horses are stomping flies,” which can cause the now-brittle horn to crack.

Typical farriers’ old wives tales make people think they should oil or soak hoofs…an adequate trim is all it takes.

Use pest management methods to control flies and the stomping they trigger, and take good care of pastures, using rotational grazing to ensure fields stay grass-covered and managing high-traffic areas around gates and waterers so they don’t become mud bogs.

There is nothing wrong with stomping. This will not damage the hoofs. Nor will the areas around gates and water troughs. Grass is NOT the solution, a variation of hard and less hard is what is needed.

Hygiene and Hoof Dressings

Check your horses’ feet frequently to make sure they are not packed with rocks or with mud, which can also exacerbate the wet-dry cycle, and that the frog is healthy, says Burns. Doing this you’ll notice problems such as thrush, evident as a black, foul-smelling material, or white line disease, seen as a chalky powder that spills out when scraped with a hoof pick, as soon as they appear and can treat them or call your farrier or veterinarian for help. You might also see clues that a hoof abscess is brewing.

It’s important to keep feet clean—but also dry in the process. Horses that are bathed frequently often experience the wet-to-dry problem, which can result in cracked hooves, just as getting your hands wet frequently can lead to dryness and chapped skin. If you have to bathe a horse a lot or his feet are starting to dry out and crack from the wet/dry cycle of walking through morning dew, ask your hoof care professional to recommend a nondrying hoof dressing that can help protect feet from the effects of excessive moisture.

The hoof wall is made of connective ­tissue—similar to skin, except much harder, like human fingernails. And also like fingernails and skin, hoof horn must contain a certain amount of moisture to remain resilient and pliable, says Goodness. Too much moisture and the horn becomes soft and wears away quickly or won’t hold nails. Too little moisture and hooves become brittle, chipping and cracking.

The hoof wall is keratin, so it is the same as hair and nails, not ‘similar to skin’. Even under quite extreme circumstances, the hoof will never wear away too quickly so this is not a problem; not wearing away fast enough is the reason for cracks.

You can’t add moisture to a hoof because moisture comes from a healthy blood supply within, says Goodness, but you can apply a good hoof coating to help retain moisture that’s already there. The hoof’s natural protective coating, the waxy periople protecting the outer surface, can become damaged not only by wet/dry cycles but also by urine and manure (acid in manure eats away the coating, and ammonia from urine-­saturated bedding breaks down horn tissue). A hoof dressing can serve as a temporary covering to protect the horn and minimize moisture loss, says Goodness.

The Snake Oil merchant…adding oils, waxes or other products to the hoof wall has absolutely no effect whatsoever other than to line the pockets of those selling this junk. The hoof wall is a sealed protective layer that does not absorb moisture of any kind. Any softening is ingress from under the hoof – an area that will lose its ‘protection’ minutes after it is applied.

A hoof sealant can help if continual moisture changes have caused tiny surface cracks in your horse’s feet. Hoof sealants keep external moisture from damaging the hoof, keep internal moisture from evaporating, and counter the effects of the aforementioned environmental changes.

Utter nonsense. And, anyway, cracks on the surface have absolutely no influence on the final quality of the foot.

Follow label directions for proper application and frequency of use, as products contain a variety of ingredients that affect the tissues in different ways, and some stay on the hoof longer than others.

If your horse is ever at risk of bruising, you can apply “toughening” products to the sole, frog, and heel bulbs to help harden these tissues and prevent bruising and soreness, says Goodness. Some products even form a living pad over the bottom of the foot.

Yet more nonsense – the only protection is to train the horse on hard surfaces.

Feeding for Good Feet

“Optimal hoof health depends on a balanced diet and a steady stream of nutrients,” says Goodness. “Although it’s fairly easy to provide adequate levels of nutrients, overfeeding any one of those can have a damaging effect—and not just on the feet but on the horse in general.”

For most horses, green pasture is the ideal meal, containing protein, vitamins, and minerals, generally in proper balance (unless soils are extremely deficient in copper, selenium, iodine, or other trace minerals—which you can check using a soil test).

While we try to mimic nature as much as we can, not all horse owners have the ability to keep a horse at pasture full-time (and some horses have metabolic conditions that preclude this). So when supplementing with harvested feeds, such as hay and grain, make sure they supply a balance of the appropriate nutrients. “This will vary from region to region,” says Goodness, adding that harvest conditions and timing of cutting (maturity) can also significantly affect hay’s quality and nutritional content.

Strongly advised against since the shortcomings and their attempted compensations throw more than just one or two items off balance. The horse should NEVER be fed grain of cereal, only vegetation and, in times of scarcity, hay. The owner that cannot provide full-time at pasture is putting his own needs at the expense of those of the horse.

“If you think the horse’s feet may be suffering from improper nutrition, it’s often worth consulting with a professional,” Goodness says. And before you reach for one of the many hoof-oriented supplements out there, talk to an equine nutritionist about its nutrient content and whether your horse really needs it. Because there is such a thing as “overdoing” certain nutrients.

Hoof supplements, with the possible exception of biotin, are nothing more than quack remedies and should be avoided like the plague. The so-called nutrition professionals, including the majority of veterinary surgeons, have little or no concept of the actual nutritional needs of the horse.

Also monitor your horse’s body condition, particularly if he’s an easy keeper. “As Americans we tend to overfeed our animals. If a horse is overweight, this puts extra stress on joints, feet, etc.” says Burns.

(Not just Americans!) The two body score indices in common use, the 5-point and Henneke’s 9-point, are neither ideal. They are both based on averages and their mid-ranges are still weighted towards a weight surplus. There is a tendency to prefer a horse slightly rounded but a well muscled horse is not rounded.

Get the Feet Moving

Besides promoting good overall equine health, exercise also supports condition of the hoof itself.

The more a horse moves around, says Burns, the better the blood circulation to the extremities and inner parts of the foot. “This stimulates the hoof capsule to grow and keeps the feet healthy. The hoof capsule is an adaptive living structure, capable of response to change and the stresses that are placed upon it.”

If the stress is not extreme—that is, to the point of damage and injury—it stimulates stronger, better growth. If the horse is confined in a stall most of the day and doesn’t get to move around, he won’t grow a good foot, says Burns.

Stress cannot be factored out by the addition of shoes; on the contrary. The average unshod horse will rarely get to the point of extreme stress; the horse that is asked to go one step further needs to be trained first -as with any sporting activity.

Goodness agrees. “Horses that live outdoors in enough space to move around or have a regular work program are the ones with the healthiest feet,” he says. “I work on a lot of show horses that are in their stall more than they are out working, and their feet are just not as strong as those of horses out in the field 24/7.”

So get your horse out and moving as much as possible, particularly if he’s not exercised regularly.

Bottom line: do not keep your horse in a stall. But why not say so? Horses should never be kept confined, incarcerated. This goes against their very nature.

When Does My Horse Need Shoes?

The bare foot functions as nature intended, able to expand as the horse places weight on it and spring back into shape when the weight lifts. This pumping action of the sole and frog helps increase blood circulation within the foot.

It’s better able “to function as biomechanically efficiently as possible, without restriction,” says Burns. This includes self-cleaning; mud, snow, and rocks don’t get caught and packed into a bare foot as readily as they do in a shod foot.

Burns says there are four reasons to shoe a horse:

1.Protection If feet are wearing away faster than they can grow and becoming tender, they might need boots or shoes. This is sometimes a temporary measure.

If this is really the case, you are asking too much of your horse. As already said, even under even quite extreme circumstances, the hoof will not ‘wear away’. Feet are tender primarily because they have not been exposed to the right sort of surface. Horses living on soft ground will have correspondingly soft feet whereas horses living or working on hard ground will have correspondingly resilient frogs and soles.

2.Therapeutic reasons Some horses need special shoes to treat disease conditions or to manage/compensate for conformational defects.
“Whenever a disease process is involved or a hoof capsule distortion or imbalance occurs or a lameness develops, often the most expedient path back to healthy hooves is use of some type of boot or shoe,” says Goodness.

A misconception promoted by farriers – a lack of understanding in a profession that has not evolved in 500 years, still believing that attaching a bit of inflexible iron to a flexible hoof will be an aid.

A shoe can help a weak hoof capsule hold its shape and get back to proper balance.

If the hoof capsule really is weak then adding a shoe and forcing the hoof wall to carry the weight of the horse will not do anything to improve the situation.
‘Balance’ is a fabulous concept proposed by farriers and barefoot trimmers alike. There is absolutely no way that a human can ‘balance’ a horse’s hoof. The hoof is dynamic, it changes with every contact with the ground and its static property, when in the hand of the farrier or trimmer, bears no relation whatsoever with its actual conformation. A proper trim will allow the hoof capsule to (re)gain is correct form without causing collateral damage – the trim will not ‘correct’ anything but simply give the hoof the chance to finds its own balance and form.

3.Proper traction Horses in different disciplines require different types of traction. Those that run and jump need more traction, while reining horses, which must be able to make sliding stops, need less.

Are we thinking in terms of what the rider wants or what the horse actually needs? Do not forget that a horse without shoes will run faster and more coordinated than one with; a horse without shoes will jump more fluidly than one with… and with or without shoes, sliding stops are extremely detrimental to the horse’s health.

4.Gait alteration If a horse is interfering (hitting opposing limbs with his feet as he moves), for instance, the farrier can use special shoes to prevent this. Some people also want to change or enhance a certain phase of the stride and alter animation, especially in some gaited breeds.

This is caused by the presence of shoes, not by their absence. A horse is naturally balanced not to interfere; adding shoes puts the whole locomotive mechanism off balance.

“If a horse doesn’t fall into one of those four categories, it should be barefoot,” Burns says. “There are some negative consequences associated with shoes, such as lost shoes, stepping on a clip or horseshoe nail, etc. The extra weight and application of a shoe does change the normal hoof mechanics of the hoof capsule and increases shock and concussion to the distal (lower) limb.”

…this explanation of weight and application of shoes immediately negates Heather Smith Thomas’ argument (see box) about arthritic horses.

Take-Home Message

Now that you’re equipped with a ­thousand-foot-view of the factors at play in your horse’s hoof health, you can keep an eye on each and make changes as needed to help those feet continue to be healthy and functional and look ­fabulous.

Deshoeing and is it necessary to boot?

Yesterday, I spoke to the owner of a twelve year-old horse, shod for at least the past six years. She asked me particularly about the transition to barefoot (the conviction is there but the uncertainties about how and when remain…).

I won’t go into all the implications of transition here – suffice to say that a horse shod for fifteen years can make an imperceptible transition while another, shod for a short misinformed moment, goes through an absolute drama. There is nothing so unpredictable as the horse!

And so the question arose: what about hoof boots (EasyBoots® etc.)? Would that help?
The short of it is ‘No!’. People often justify their own use of hoof boots by recounting that their horse is more comfortable when riding out. The reality is the they are riding out before the horse is ready to be ridden. There is a consensus among many riders and so-called barefoot specialists, that the horse should transition from being shod to being a rock-cruncher in no time flat, and completely without difficulty. This is pure fantasy. And particularly if the horse has been shod for a longer period of time. We must not be tempted into believing that a horse, shod for five years or more, with five years or more of damage to its feet, is going to transition to rock-cruncher in 5 days…or even five months for that matter.

Mindset

Someone once joked that the most important piece of equipment in the trimmer’s armoury is an almost unlimited supply of whisky/gin/vodka to calm the worried owner. Transition requires the right mindset – without it, the owner/rider will be lost. So before we look at the problems of the hoof boot, let’s take a quick look at the problems of the wrong mindset:

  • A hoof with damaged internal structures –as a result of shoeing or laminitis, for example– needs time to heal. We know that the hoof takes about a year to grow from the coronet to the ground but if they are particularly badly affected, the internal structures around the coffin bone can take four years or more.
  • Even under favourable circumstances, the horse must be afforded time to get accustomed to its new situation. Jumping straight on and expecting the horse to perform is bound to disappoint. Taking time out with the horse, groundwork, walking in the hand and a gentle acclimatisation will be of benefit to all. 
  • An iron shoe renders the horse insensitive to irregular surfaces. This is often seen as an advantage by the rider because it means that he/she can steer the horse anywhere with impunity. However, the horse, unable to judge the viability of the surface over which it is travelling, is highly susceptible to injury –this in addition to the insidious damage to the joints and back in the long term.
  • The recurrence of abscesses is NOT as a result of going barefoot but the consequence of being shod. The presence of an abscess is in fact a sign that the damage in the foot, caused by shoeing, is starting to heal.
  • Despite tales to the contrary, horses are generally NOT rock-crunchers. Post-transition, the rider often complains that the horse is no longer ‘go-anywhere’. In fact, this is far from the truth –the horse is now more than ever capable of ‘going anywhere’ but will take more care in doing so. Just as we would prefer to walk on an even grassy track rather than on one scattered with stones –even wearing walking boots– so it is with the horse. But that makes neither of us incapable of using the stony track, with care, if there is no alternative.
So, why not use hoof boots?

First and foremost, the problem is not in the feet but in the mind of the owner/rider (see above). In order for the feet to heal/become accustomed to being unshod, they need to work, not to be protected. To reiterate, hoof boots provide the rider with the ability to ride the horse when the horse is in fact not ready to be ridden.

Renegade® hoofbootAlthough in itself, not living tissue, the hoof is growing constantly. This means that its size relative to a hoof boot is never constant –the boot will generally either be too large or too small even assuming we can trim the hoof exactly to the size of the boot. The length of the hoof wall will also determine how much contact the bottom of the hoof makes. It has now been long established that the hoof wall is not the part of the foot that carries the weight of the horse. By applying boots, we are often obliging the hoof wall to do just this, there not being a proper surface contact for the sole or the frog –just the very parts of the foot that need the maximum stimulation to develop into healthy structures. Some boot manufacturers provide inserts aimed at circumventing this problem but the essential hoof mechanism remains restricted and the hoof wall does not undergo any wear at all.
In addition, one of the reasons for removing horseshoes is their excess, damaging, weight – and yet, on average, a hoof boot weights upwards of 20% more than a horseshoe…

Thus, our aim of stimulating the sole and frog is actually being exasperated by our natural desire to help the horse recover in comfort. In fact, most of the time it is much less uncomfortable than we imagine. Very often, that which the rider perceives as ‘walking on eggs’ or ‘footy’ or any other version of ‘difficult’ we might like to apply, is in fact simply the horse getting used to new sensations and/or protecting its own well-being. Ironically, the moment when the horse will really profit from being barefoot is the moment when so many riders –who often claim to ride barefoot– actually apply what they feel to be protection. All they are doing is in fact at best prolonging the period of recovery, at worst, continuing the negative effects on the skeleton caused by shoeing.

 

Hot shoeing –despite what a farrier might tell you– damages the internal structures of the hoof. The effect of reapplying fairly intense heat at regular intervals, obviates the development of abscesses by the simple effect of cauterisation. This vicious cycle continues throughout the shod life of the horse until the day the abscesses are allowed to develop because the horse is no longer being shod.

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Cushing Candidate?

As my followers (and detractors) will undoubtedly confirm, I am often dismissive of traces of blood in the white line. Such traces are often the result of a trauma at some indeterminate time in the past and now, often between three and eight months later, neither owner, nor horse, nor hoof have any recollection of anything untoward and at the next trim, the traces will probably have disappeared all by themselves.

IMG_0035

(trim incomplete)

Certainly, none of the photos I have ever commented upon, would have given us at Sabots Libres any cause for concern. The traces were small, often relatively vague, and frequently only reported in one foot. But the case I am about to touch on here is definitely a cause for concern and set the alarm bells ringing during a routine 6 weekly trim yesterday.

IMG_0038

The horse in question is a 22 year old mare, shod on the recommendation of the breeder/seller until aged about 20 due to a trauma, resulting in club feet, suffered when young. (This is not a classic case of club foot as described elsewhere on this site but could have been avoided by the same means – however, that is beyond the scope of this article).

More significant is that she was being fed grain and cereal up to the age of about 18. This was stopped due to allergic reactions to cereals and pollen–the latter probably being exacerbated by the inappropriate feed. This cessation of feeding supplements and an altered system of distribution of (ad lib) hay was successful in reducing the allergies to an insignificant level.

But the damage had probably already been long done. The last trim showed traces of red in the white line that do set off alarm bells. As we can see from this first photograph, there are red traces extending from the rear into the front quarters.

The extent of the traces is the main cause for concern; they are particularly concentrated around both sides whereas ‘insignificant’ traumatic damage will usually be seen at the front and medially.

When we examine the other hoof, it is clear that something is not right. In this case, the red traces are visible almost full circle. Clearly something out of the ordinary has been going on in the hoof which cannot be written off as a couple of unhandy manoeuvres in the field.

What is also obvious, is that this is not an ‘ordinary’ laminitis. The horse no longer has access to grains nor cereals, the grass is far from rich in sugars and essentially, there has been–and still is–no sign of discomfort in the hoofs. What is noticeable/notable is the poor moult whereby there is still a lot of thicker hair in patches. This gives rise to immediate thoughts of Cushing or, more correctly, PPID (Pituitary Pars Intermedia Dysfunction). This is an incurable but reasonably treatable hormonal condition whereby the body loses its ability to control certain functions. This can manifest itself in various symptoms, among which a poor moult, excessive disordered hair-growth and chronic laminitis.

IMG_0037

The area top-right is the normal summer coat while bottom-left the coat is clearly a lot thicker

When we add up these factors–a long-term grain diet (which additionally has led to allergic reactions), the poor moult and unusually large traces of blood in the white line–then our suspicions are aroused significantly. Obviously, it is not possible to simply say ‘Cushings’, the need for proper testing is unavoidable. However, this is not the best moment to test. The period of greatest–and most testable–hormonal activity is from August to October with the peak in September; by November, the values have usually receded to insignificant and thus indeterminate levels. For this reason, a blood sample will be taken in a few weeks time and sent off for testing.

The results will be posted here in due course.

Curing the Incurable – the reality of Navicular Syndrome

About this article.

Navicular syndrome or navicular disease is a condition that has affected horses throughout the ages. For this reason, numerous studies have been carried out on the subject and it would appear that the conclusions are more or less cut and dried; the experts seem to be of more or less unanimous opinion on treatment and prospects.

This article attempts to shed light on a different treatment and thus also radically revised prospects.

The information presented in the video by Dr Jim Schumacher of the College of Veterinary Medicine at the University of Tennessee, forms the basis of the facts and figures given in this article.

This article is also available in Dutch here on Sabots Libres – Nederlands.
What is Navicular Syndrome?

Since the days of the war horse, men have needed to explain ‘adequately’ why their horses were not able to go into battle. Simply being ‘off colour’ or ‘limping a bit’ would not have been sufficient reason for the sergeant at arms who was tasked with recording the (non-) availability of his army. As a consequence, various evocative but non-descriptive terms have entered the equine language. Colic is typically one of them: a vet might use the term colic, but not professionally–it doesn’t mean anything. It is a vague term that means the horse has a problem with its digestive system; it could be an ulcer in the stomach, it could be gastroenteritis, it could be a twisted colon…

Navicular syndrome, on the other hand, has led something of a charmed life as a description. To the point that even researchers and veterinary surgeons believe that it truly exists, albeit that they have given it all sorts of fancy names nowadays: podotrochlosis, podotrochleitis, podotrochlear syndrome, navicular arthritis or even navicular disease. And specialists will analyse x-ray photographs of potentially ‘navicular’ horses and proclaim they see wear here, growth there and deformation elsewhere.

In actual fact, there is no consensual definition of navicular disease; it is simply considered to be ‘chronic lameness of the forelimb associated with pain arising from the navicular apparatus’. You will note that the pain ‘arises from the navicular apparatus’ but is not necessarily directly associated with it! In fact, navicular syndrome has become something of a joke in veterinary practice, being described as a last-resort diagnosis. Just what it was in the military days–we don’t know what it is or what causes it, but we’ll give it an interesting name, nevertheless…

The theorised causes are legion; the video by Schumacher gives a reasonable overview of many of these theories.

 

How is it treated?

Current thinking about the treatment of navicular syndrome is little changed from that of more than sixty years ago. There is still a whole progression of treatments that veterinary surgeons and farriers go through in the process of dealing with navicular syndrome, most of which are old hat and just one or two are a little more modern.

Taking cue from the Schumacher video, which covers the subject quite adequately from the traditional veterinary/farriery point of view, we see the following commentary:

  •  THERE IS NO CURE, ONLY MANAGEMENT !
  • Rest
    • Not helpful although most horses temporarily improve somewhat with rest (a positive viewpoint – ed.)
  • Corrective shoeing (according to Schumacher ‘…one of the more important things for management’)
  • Medical
  • Surgical

Schumacher makes the observation that it is very rarely seen in the hind limbs and where it is, it is also present in the forelimbs.

Corrective shoeing

Correcting under-run heels and the medio-lateral balance of the hoof are recommended to encourage the horse to land heel first rather than toe first. After this, all forms of corrective shoeing are essentially aimed at reducing the force exerted on the deep digital flexor tendon by the navicular bone. The hoof angle is increased by between 2˚ and 4˚ – in one experiment, it was claimed that the force exerted by the DDFT was reduced by 24% when the heels were raised by 6%. This is achieved in various ways by means of special shoes, shims, rocker bars, egg bars… (There is a vast array of kit available to the farrier in pursuit of treating navicular syndrome –ed.)

Again, according to general opinion and observation, improvement after corrective trimming and shoeing may take weeks. But if the horse already has well-conformed feet, then little can be achieved with shoeing changes.

Medical therapy

This is noted as not being useful if the horse is to compete and will be subjected to drugs tests. Otherwise, the systemic administration of anti-inflammatory drugs, such as phenylbutazone (1g – 2g daily) is recommended.

  • Warfarin is also a possibility but is noted to be dangerous and there is no good proof of efficacy.
  • Isoxsuprine increases blood flow by reducing vascular musculature [sic] and may improve drainage from the medullary spaces reducing intramedullary pressure. It has anti-inflammatory and hæmorheologic properties but seems only to be effective in horses with no or only mild radiographic changes.
  • Pentoxyfylline is another hæmorheologic drug but without proved efficacy (Schumacher poses the question whether navicular syndrome is ischæmic or not).
  • Injecting corticosteroids into the digital inter-phalangeal (DIP) joint is considered a ‘quick fix’ but may need repeating.
    Repetition is likely to be effective but for increasingly shorter periods of time. The average duration of efficacy is 4.6 months, according to one study.
    Temporary improvement is sometimes followed by severe lameness!
  • Injection of corticosteroids into the navicular bursa would appear more effective than into the DIP joint but the same (contra-)indications apply.
  • Sarapin can be injected around the palmar digital nerves but despite claims of being effective for 2-3 months, it would appear to have little effect at all.
  • Polysulphated glycosaminoglycans is supposed to protect cartilage and was shown in one double blind study in 1993 to be effective.
  • Distention of the navicular bursa by introduction of 6ml of a ‘therapeutic mixture’. Efficacy is not known although in one study 29% of bursæ ruptured at 5ml.
  • Tiludronate (Tildren®) can be used to regulate the bone metabolism correcting remodelling changes…with the main improvement between 2 and 6 months. After 6 months, treatment appears to lose efficacy.
Surgical therapy
  • Shockwave therapy was shown in one study to be effective but a second study showed the opposite.
  • Sectioning of the proximal suspensory ligaments of the navicular bone showed in one study (again, in 1993) 76% of 118 horses to be sound at 6 months but only 43% at three years. And in all probability, the efficacy is as a result of (accidentally) cutting the nerves to the NB–these traverse the ligaments.
  • Palmar-digital neurectomy with associated complications: progression of injury; failure to alleviate lameness; sensations returning within 6 months; painful neuroma etc. not to mention exclusion by a.o. the FEI from competition. There are techniques to prevent re-innervation. Efficacy of the procedure is 12 to 18 months in 65-70% of horses.
Analysis

We can conclude from the figures given above that treatment in general is only of limited duration, 6 months in many cases, 12-18 months in the case of neurectomy and not much more than 3 years at best.

From the viewpoint of this article, it is worth examining the statements made with regard to the current treatment of navicular syndrome before proceeding to the alternatives.

Schumacher states it also being seen in the hind limbs–this statement is rather subject to question; there is little if any material reference to hindlimb navicular syndrome and these are probably examples of the ‘last resort of the diagnostically destitute‘!

  1. There is no cure, only management : this statement is very clear; nobody within the conventional veterinary/farriery world has managed to come up with a definitive cure, only repetitive and progressive treatments that, in the end, have little or no effect.
  2. Correcting under-run heels and the medio-lateral balance of the hoof are recommended to encourage the horse to land heel first rather than toe first : under-run heels are the signature of many a farrier who claims (as will many of his well convinced clients) that the horse has ‘low heels’ and this must be minimised; medio-lateral balance is only something that is a problem with shod horses because there is
    1. no possibility for the horse to find its correct balance itself through natural wear
    2. the farrier can never determine the correct balance since the foot is in a static situation when he looks at it but dynamic once it is on the ground
  3. Increasing the hoof angle by 2˚-4˚ may appear to reduce the force exerted on the DDFT but as a result, the horse will compensate by flexing the deep digital flexor muscles and the dorsal muscles leading to pain elsewhere. Furthermore, the DDFT is intended to be under tension–this means there will be no whiplash effect upon impact with the ground; reducing the force/tension makes the DDFT more susceptible to damage (particularly at the interfaces with the coffin bone and the DDFM).

That improvement…may take weeks will probably not come as a surprise however, the corollary is interesting: …if the horse has well-conformed feet, then little can be achieved with shoeing changes. This raises at least two questions:

  1. Why were the feet allowed to get into such a poor state in the first place–this is clearly a case of extremely poor farriery. The regular farrier’s excuse of a horse having ‘poor feet’ is nothing more than that; an excuse.
  2. What are well-conformed feet? We can readily draw the conclusion that the origins of the problem are quite probably foot related since corrective shoeing ‘[is] one of the more important things for management.’ This would tend to indicate that the apparently well-conformed foot is not well-conformed at all…

The first comment relating to medical therapy defines the position of the horse in the relationship: he is not a partner, a friend, a respected animal; he is a machine to be rolled out and put to work whether on the point of mechanical failure or not. It should be clear, a horse that has a significant injury should not be ridden and should certainly not be entered into competition.

The second point is the use of phenylbutazone (or any other anti-inflammatory for that matter). Particularly phenylbutazone is used almost with impunity as if it was the safest and most effective drug in the world, a wonder drug to be prescribed for all ills. IT IS NOT. Phenylbutazone is banned from human application–in some countries for more than forty years–because of its dangerous side effects, particularly in combination with other, seemingly harmless, drugs. Phenylbutazone, like most drugs, releases toxins into the body and particularly in the case of the less mobile horse, this can lead to drug-induced laminitis. (It should be noted that at least in France, phenylbutazone is indicated solely for chronic laminitis. Use of the drug for other pathologies is at the risk of the prescribing veterinary surgeon.)

Shockwave therapy as a surgical solution is highly questionable; as demonstrated, although one study claimed it to be effective, a second study showed exactly the opposite to be true. Shockwave therapy remains questionable for many pathologies where it is applied.
Sectioning the suspensory ligaments may have two effects: one is as stated by Schumacher, that the nerves to the navicular bone are cut at the same time causing essentially a nerve block; the second is the displacement of the navicular bone caused by cutting the ligaments–this would have a similar effect to the further jacking up of the heels of the horse altering the forces and point of contact between the DDFT and the NB. An effect that, like the shoes, is only temporary.

Palmar-digital neurectomy is quite simply the most ridiculous ‘solution’ possible. The horse is injured; by removing the feeling, the horse cannot feel that it is injured and so allows the rider to continue as if nothing was the matter. The horse is now in a position to injure itself even further without even knowing it and quite possibly irreversibly. This is like seeing the oil warning light flash on in the car; you go to the garage and the mechanic disconnects the light. The problem is still there, only you are no longer warned about it…

Is this the state of equestrianism today???

 

A Different Strategy

First of all, it must be realised straight away that time is the key. In this respect, we agree wholeheartedly with Dr Schumacher that once treatment has begun, it can take weeks before a real improvement is seen. Where we do differ, is the reason for this delay.

It is not sufficient to simply say that navicular syndrome is prevalent in thoroughbreds, quarter horses, warmbloods and standardbreds; it is most prevalent where these horses are shod. Very rarely do we come across cases of navicular syndrome in unshod horses–although it is not completely unknown. The reason for this is straightforward. An adequately trimmed hoof will, through natural wear, be able to find its own natural balance in all planes without the ineffective intervention of man. Farriers and those barefoot ‘specialists’ that have essentially been trained by a former farrier (as have most) will spin yarns about ‘balancing the hoof’. This is absolutely impossible since the hoof in function is a dynamic structure; when the trimmer takes the hoof in hand, he is looking at the static hoof–the two cannot be compared. Furthermore, if we leave the 1/16 inch (1.6mm!) of wall protruding below the sole as advocated by one internationally renowned trimmer, the first few hundred metres of tarmac will wear that down to nothing!

This naturally found balance in the hoof is the key to not suffering from navicular syndrome. The tendo-muscular chain of the horse–and any other animal for that matter–is very finely tuned. A minor deviation here or there is enough to put the whole structure out of kilter. We see a similar situation with weightlifters: it takes little more than a piece of paper between the teeth to make it almost impossible for them to lift a heavy weight. This is not to say that unshod horses are immune: Schumacher talks of the under-run heel in the shod horse but, quite clearly, a poorly trimmed hoof leading to under-run heels or overly high heels, will result in a similar conformation to the affected shod horse. The only advantage our unshod horse has, is that the severe concussion suffered by iron hitting ground, is absent. Don’t let anyone fool you, iron does not cushion the blow, it amplifies it. In order for iron to be flexible enough to cushion impact, it must either be in the form of a spring, or it must be heated to between 600˚ and 800˚C.

Our approach is very simple:

  1. remove the shoes–first the rears, then, a few days later, the fronts
  2. progressively lower the heels and hoof wall
  3. encourage the owner to encourage the horse to walk every day on hard surfaces
    • start with ten minutes
    • increase by 5-10 minutes a day
    • if the horse has a relapse, do not stop but drop back to what he can do (always at least 5 minutes) and build up again
  4. don’t ride him until he is comfortable with his newfound feet

In fact, to treat the navicular syndrome, all that is needed is to remove all the shoes and trim the feet back thoroughly–the four points listed above have very little to do with navicular syndrome but are actually our protocol for removing horseshoes.

Why this protocol then? Quite simply, as already stated, almost all horses suffering from navicular syndrome, are shod. Recovery from navicular syndrome is almost instantaneous, as will be explained in a moment, but recovery from shoeing can take a long time. Despite anything the farrier might tell you, hot-shoeing is neither painless nor is it harmless. The iron is heated to ±600˚C to make it malleable and then ‘fitted’ to the hoof; at this point, it is still at somewhere between 450˚ and 550˚C. The hoof is only a few millimetres thick and underneath are the living tissues of the foot. This heat travels through the hoof and cauterises the internal structures of the hoof. Repeating this process at regular intervals interrupts any regenerative process and recauterises everything. Once we take the shoes off for good, the regenerative process now has a chance to take place without interruption. Unfortunately, this results quite frequently in the repetitive appearance of abscesses. Farriers and many vets will put this abscessing down to the fact that the horse is barefoot; this is quite simply ignorance at work–it is not the fact that the horse is now barefoot but rather the fact that it has been shod that is causing the abscessing. Additionally, by lowering the heels, there is an increase in tension on the deep digital flexor muscle and the horse may initally suffer muscular discomfort from this change.

 

Why does it work?

As already explained above, the tendo-muscular chain of the horse is very finely tuned. We can compare it with a suspension bridge: if all the cables are in place and under the right tension, the bridge will carry the weight of traffic passing over it with no problem (within its construction limits). If we break or alter the tension in just one of the supporting cables, the bridge will not collapse, but it will suffer additional stresses on the other cables and also on the road deck. Likewise with the tendons of the horse, and in this particular case, the deep digital flexor tendon (DDFT), if we alter the stresses placed upon the tendon by changing the angle of the associated structures–in this case, the hoof–then the tendon is going to suffer.

In fact, the tendon suffers in two ways. Due to the raised heels, the tension in the tendon is also reduced and the horse will attempt to compensate as much as possible by flexing the deep digital flexor muscle–the muscle to which the DDFT is attached. But this will only work so much. The resulting slackness in the DDFT means that particularly higher impacts will cause a whiplash effect and the point most affected by this is where the DDFT runs over the navicular bone.
The second way in which the DDFT suffers is that by raising the heels, the part of the DDFT that runs over the navicular bone is insufficiently protected by the synovial bursa: it is not intended to rub in this way at this point. Juggling with the heel height will move the point of contact of the navicular bone up and down the DDFT, away from current point of irritation but to a point where new irritation will soon develop. By lowering the heels sufficiently, the protective bursa is realigned correctly with the navicular bone and pain is almost instantaneously relieved in permanence (there will still be residual irritation of the bursa where contact had been, but this will recover quickly).

 

Case History – Nikola
First encounter

RF lateral

In August 2013 I was approached by the owners of a Freiburger gelding, aged 10 years, located on the outskirts of Brussels. They had owned him for the past seven years and late 2012, it was noticed that he was lame on the right forelimb. During two visits to the clinic in Gent X-ray images and an MRI scan were made. The results of these examinations indicated a thickening of the coffin bone and some wear on the navicular bone; diagnosis, ‘navicular syndrome’. The application of ‘Onion’ shoes to the front feet was advised.

Nikola RF Dorsal

As is normal in the case of navicular syndrome, this solution was not long-lasting and since the initial application, various different forms of ‘orthopædic’ shoes have been tried with the last being Denoix Reverse style with leather shims, applied two weeks before my first intervention. (It is interesting to note that navicular syndrome was diagnosed solely in the right forelimb and yet the farrier applied the same type of orthopædic shoe to both hoofs on every occasion).

One of the major reasons why the owners contacted me was because Nikola was becoming steadily more and more depressed and was quite obviously in continued discomfort despite the treatment. The prospects were becoming increasingly morbid with every passing day.

Discussion with the owners about podotrochlosis/navicular syndrome and the desperation of many professionals to place a diagnosis on something seemingly vague, I mentioned that in all probability, the problem actually lay elsewhere…at which point, one of the owners said he felt for some time that there was something wrong in one of Nikola’s shoulders.

My first encounter with Nikola showed a horse, indeed, clearly in discomfort and with feet that had been shod in a fashion all too familiar; the heels were under-run, and it was quite obvious that in the previous 10 months, no attempt had been made to correct this condition; the hoof wall was clearly deformed (see the striations in the hoof in the photo below) and the hoof walls resembled Swiss cheese, there were so many holes in them.

First intervention

Nikola profile août 2013

The first and foremost task was to remove the shoes. (Initially I had spoken of removing the rear shoes and returning 10 – 14 days later to remove the fronts but during the removal of the rears, the owners asked me to go ahead directly and remove the fronts since ‘it could not be any worse…’) This revealed, as expected, a mass of black bacterial detritus, under the leather and rubber shims, that was slowly infiltrating the white line.

Note that this first photograph is a full 90˚ profile and not taken at an angle as the image might seem to suggest.

After removing the shoes, the hoofs were given a very cursory tidy up to remove any jagged edges and some of the bacterial residue. The owners were advised to walk Nikola in the village for at least 15 minutes every day and increase the outings by 5-10 minutes every day. This encourages use of the muscles, wear of the hoofs and the blood circulation in the hoof.

 
Subsequent interventions

Nikola profil sept 2013

I returned after two weeks to begin actual trimming. Initially just removing small amounts of hoof wall to ensure the transition was not too abrupt. Another fortnight later I reduced the walls a lot further, starting to define the correct line of the hoof wall and beginning to lose the under-run heels. This was a much more marked trim and I suggested leaving three weeks until the next intervention.

On return after three weeks, I was received as enthusiastically as before but when I posed the question about how things had gone in the previous three weeks, the owners related a tale of misery: the first four days were fine but on day 5, Nikola did not want to leave his stall…when asked what they did then, the owners told me they insisted that he walked for 10 minutes. For eleven long days! And just as suddenly as it started, it was over; Nikola strode out of his stall and took them for a long walk around the village…

Nikola decembre 2013

And so it continued, with Nikola being walked every day and me returning initially every three weeks to keep an eye on things. He did have a couple of relapses with the appearance of abscesses–a perfectly normal occurence in a horse that has been shod for a long period of time. But each time, the owners reduced the walks in the village to 10-20 minutes and Nikola recovered from these episodes rapidly.

After three months, the owners resumed riding with steadily longer forays into the forests around southeast Brussels and Nikola has gone from strength to strength. Having been a reasonably heavy horse that would tire quickly during a long galop, he is still a reasonably heavy horse but with much greater amounts of stamina than before. Losing the shoes has not only ‘healed’ his problem of navicular syndrome but has enabled him to make full use of his hoof mechanism which augments the pumping of the heart.

 
Conclusion

Nikola is one of many horses that I have treated for navicular syndrome. All cases have shown a sufficiently large degree of success but one of the most important differences in the case of Nikola was the commitment of the owners. In too many cases, the aspirations of the owner overrule the capabilities of nature; the owner prefers an apparent cure yesterday to a real cure tomorrow. The horse must perform at all costs and taking it for ten minutes walk around the village is not preparation for next week’s gymkhana or whatever. There is naturally no question of missing the gymkhana. Other owners may not be quite so competition oriented but nevertheless, they feel themselves hampered by the fact that their horse now reacts differently when crossing difficult terrain. And so the poor horses find themselves reshod, whereafter it is only a matter of time before the pain returns…

 

Note about the images in this article: the two x-ray images, made at the clinic of Gent University, do not show any major problems, despite the diagnosis given on the basis of these photos. There is possibly some ossification at the rear of the coffin bone, which would not be navicular related but rather arthritic! The ‘wear’ on the navicular bone is not visible and is not likely to be, on an x-ray such as this. Furthermore, we should be talking of wear of the cartilage and not of the bone… The first profile photo of the hoof shows the condition when first encountered. The second profile photo shows the hoof 4 weeks later pre-trim; already much of the damage has disappeared after only one basic trim… The third profile photo is at three months pre-trim; there is clearly still development possible in the hoof but the under-run heels are worked out and now the principal aim is to bring the height of the heels down. The general shape of the foot is greatly improved although there is still evidence of a deformed coronary band.