Shoeing the Laminitic Horse
Updated: Apr 17, 2020
SHOEING THE LAMINITIC HORSE
R. F. Redden, D.V.M. P.O. Box 507 Versailles, Kentucky 40383
Reprinted with permission from the American Association of Equine Practitioners. Original printed in the 1997 AAEP convention proceedings.
Laminitis is a complex disease syndrome often seen subsequent to a variety of primary diseases. The prognosis ranges from good to grave and is dependent on the degree of damage to the vital supporting structures and mechanical stability of forces perpetuating displacement of PIII. This syndrome demands the expertise of professional farriers, as well as veterinarians as therapeutic shoeing plays a major role in the successful treatment of the majority of laminitic horses. Treatment length can vary from a few weeks to years, requiring commitment and dedication for seemingly endless maintenance regimes. Establishing an effective protocol to treat laminitis will improve the treatment regime and help farriers and veterinarians gain good experience. Success rates vary from horse to horse and are greatly influenced by the ability of veterinarians and farriers to assess the damage, read the particular needs and treat the syndrome with a progressive attitude, built on knowledge of the subject and professional camaraderie.
Obtain a good history and carry out a thorough physical examination to include radiographs on the first visit. Laminitis often follows other primary disease maladies, such as colitis, pneumonia, pleuritis, retained placenta, dystocia, potomac fever, blister beetle ingestion, protracted diarrhea, salmonella, selenium toxicity, fescue poisoning, injudicious use of corticosteroids, stress, contra limb acute lameness and others. Be alert to the hoof characteristics that vary from normal, both grossly, as well as radiographically. Being focused on details will help rule out other acute foot problems that closely mimic the signs of laminitis.
A methodical, disciplined technique assures consistent, good quality, pure lateral projection. Soft detail images reveal anterior-posterior balance and the relationship of PIII to horn and horn to load. These parameters must be clearly demonstrable as they become an essential guideline for pathological shoeing. Most professional farriers have become quite proficient reading good quality, soft tissue detail film, as it relates to their task of re-establishing a meaningful equilibrium. Films taken before and after each shoeing session tremendously increase the knowledge bank and efficiency of farrier and veterinarian and consequently improves the prognosis. Practice tips that have improved my technique:
Pure lateral, primary beam strikes the foot in a horizontal plane, just above the ground surface.
Zero film, subject distance.
Opaque marker, detailing the face of the horn wall, as well as ground surface.
Positioning block, 3 x 5 x 7, with a wire running through the long axis is compatible with most all x-ray machines.
The distance from the face of PIII to the outer horn wall is referred to as horn-lamellar space. Become familiar with normal parameters. Most light breeds will measure 15 to 17 mm., heavy, older broodmares, stallions and most Standardbreds will measure 20 to 22 mm. Base line views become most valuable as they establish a starting point. The depth of sole and cup directly beneath the apex of PIII is quite easy to monitor with pure lateral films. Extensor process relationship to coronary band varies from horse to horse and foot to foot. Rely on the base line film to assess starting location.
CLASSIFY THE DAMAGE:
Rotation is significant with acute cases but is very misleading with chronic cases due to abnormal horn growth. Classify the damage before establishing protocol. A scale of 1 to 1000 offers a realistic classification system for all laminitic cases. Classify each horse at onset based on history, physical and radiographic examination. Design therapy to reverse forces at play and meet the needs of the patient. This system enables me to treat not only each case but each foot as a separate entity and to better explain the seriousness of the syndrome to my clients.