Written April 2022 by R.F. (Ric) Redden, DVM
Farrier/Veterinarian Podiatrist
Wikipedia says Equine Podiatry is the study or management of the equine foot based on its anatomy and function. That is well said as it places Equine Podiatry into a totally different category than shoeing horses and veterinary medicine. The mere description brings the farrier and veterinarian together as equally respected team members in their quest for success. It is about stepping out of comfort zones and pushing their individual job titles into a field that requires further knowledge, training and experience. Employing external mechanical manipulations (trimming and shoeing) to offset function deficits of internal components demands our greatest respect.
The job title “Equine Podiatrist“ is used by a wide range of backgrounds and credentials. Let us break that generic definition down a bit further. What is a remedial farrier? Basically, it is a farrier that is searching for a remedy or cure for a foot issue that may or may not be based on anatomy and function however they may feel qualified to be called a Podiatrist and in each sense that would not be out of line. To be recognized publicly as a Farrier Podiatrist Specialist they must extend their knowledge, training, and hands on experience well beyond the basic requirements of farrier certification and competence. Veterinarians that wish to be recognized as an Equine Podiatrist also must accept the responsibility of being recognized as a specialist. This requires further education, training and experience examining, treating, and managing foot issues as a team member. Veterinarian podiatrists that have previously obtained competent farrier skills can be referred to as a Veterinarian/Farrier Podiatrist. Those that have little to no farrier experience must rely on a farrier for the mechanical trim, shoe fabrication, and application. This can be problematic for all concerned when there is not a common thread of education, knowledge of the subject, and experience working as a team member. Unfortunately this is often the case as podiatry knowledge is by and large gained from hands on experience.
It is all about form and function. The external characteristics are dependent on the unique interconnectedness with the internal components and the forces at play. This in turn has a direct relationship on the overall status of the vascular supply that is paramount for the growth, maturation, and maintenance of the vital growth centers. Equine Podiatry is not just about shoeing horses as that is a totally different classification of education, knowledge, skills, and experience. Nor is it just confined to veterinary medicine and a DVM degree. Unfortunately to date formal education, training, and testing in this desperately needed field is not widely available for either farriers or veterinarians, therefore preparation to reach an acceptable level of competence requires years of On-the-Job Training (OJT).
By and large a specialist concentrates on a particular subject or activity and they are highly skilled in a specific and restricted field. As the farrier and veterinarian become more specialized with advanced knowledge and skill development, they may be considered an expert. That means they have comprehensive and authoritative knowledge and skills in podiatry. Comprehensive includes all or nearly all elements or aspects of podiatry mechanics and to be authoritative one must be trusted as being accurate, true, and reliable. Therefore, equine podiatry is fraught with misconceptions, opinions, concepts, and techniques in lieu of an established standard of care. It's potluck and being armed with only good intentions in a field that is vastly different than their respected professional duties has inherent risk of imposing unwarranted pain and suffering on their mutual patient. OJT can be a meaningful and productive approach to education when the mentor has gained exceptional knowledge and good experience through years of intense cases with many lessons coming from the agony of defeat. However, mentors with decades of exclusive podiatry practice are few and far apart throughout the world. Therefore, farriers and veterinarians must have a dedicated heuristic approach to seek an acceptable level of competence as a podiatry team member. In the meantime, the horse owner relies on their farrier and veterinarian, believing without a doubt that both are highly qualified and experienced with career and life-threatening podiatry issues.
It is only prudent that the veterinarians and farrier understand the merits as well as limitations of their team member. This is the difficult part of the puzzle that requires no explanation as it often becomes obvious that intense preparation has normally not been considered by either extremely busy individual. When a common thread of knowledge does not exist between two individuals filling the shoes of a competent team member, it becomes a daunting task. The very perception of the issue whether career or life-threatening is often as different as the goals of mechanical and medical options. Yet they are expected to overcome the huge handicaps that are the product of extrapolating expertise from one professional area of expertise to one that demands baseline preparation. Therefore, success is often left to chance and the downside of the gamble is a recipe for devastating results. It's time for a change. When one or other of the team or both have little or no knowledge and even less skills in podiatry, they invariably struggle. Despite the best intentions the very basic principles of podiatry escape them, tremendous efforts become futile, and the horse and owner suffer the consequences. If we want to become more competent in a field that is basically void of formal education, training, and competence testing, we must strive to follow those that have taken this field very seriously and paved the way for others to avoid the many pitfalls that lie ahead.
What is the availability of podiatry education and training for veterinarians? Vet schools teach very little if any specific subject matter relative to podiatry. Therefore, national and state exams as a rule avoid podiatry questions as part of the qualifying criteria for licensed veterinarians. The public on the other hand are not aware that the foot of the horse is seldom if ever mentioned during the four year course of study. Most state and national organizations are now aware of the serious black hole that exist in veterinary education, training and expertise and they are reaching out to others that have obtained some level of competence and experience in the field as speakers for conferences, workshops, and virtual education. Veterinary associations have found that podiatry subjects are quite popular and that farriers are very eager for knowledge and training. Veterinarian students that entered school as competent farriers can easily pull from their previous knowledge of the foot and have a good idea of what they now must learn to start connecting the dots with podiatry issues. Veterinary students are finding equine podiatry to be very exciting, and they are willing to invest their time attending farrier schools, working as a farrier assistant or apprentice to gain adequate knowledge and skills to better understand the foot, the trade and the serious preparation and responsibility of podiatry. Years of trimming and shoeing top level horses of many disciplines prior to entering vet school certainly opens many doors to podiatry.
Farrier schools as a rule are focused on the very basic principles of trimming and shoeing that entails only a few weeks to months of education training and skill development. Hands on experience (OJT) over the next few years’ experience is then required to reach an acceptable level of competency as a farrier. However, this is only the first step to becoming a farrier podiatrist. Anatomy and function must then be learned from a medical perspective and requires serious dedication to pursuing knowledge of the subject though lectures, hands-on classes and an evolving mind set for the mechanical thought process. It is paramount that podiatry focused farriers develop radiographic skills and learn to use this information as effectively as possible. Informative radiographs are the common link that can bridge the gap of communication between the attending vet and farrier. Farriers with years of top-level shoeing are taking up the challenge of becoming veterinarians in their quest to become qualified and more competent podiatrist.
This brings us to the question of being prepared as individuals and team member to accept the responsibility of a career and or life-threatening case. I often asked myself many years ago as I looked into the eyes of a horse suffering intense and often excruciating pain “Redden, do you have the credentials and experience to ease their pain and enhance the healing environment?" My four decades of extensive, exclusive equine podiatry practice has been fraught with highs and lows treating life-threatening foot issues. My heuristic approach to navigating through difficult cases paved the way for others to follow my logic and success with issues that once were thought hopeless. It's time for a change.