Farrier Consultations

In the process of trying to diagnose and treat a lameness, a collaborative relationship with a farrier is essential. There are times when a change in shoeing will be integral to improving a horse's soundness. Fortunately we have a number of experienced farriers in our area that have been great to work with over the years. The practice of farriery is truly a fascinating blend of art and science. How one farrier approaches one issue may be different fom another yet the results can be the same.

The idea of farrier consultations has grown out of the use of digital x-rays in the practice. By being able to take the radiograph with the farrier present, we can see what is currently there and make recommendations on the spot. This is especially valuable with fonder cases and other causes of foot soreness. When we can't all be together the digital x-rays can easily be emailed directly.

Here are 2 schematic drawings of what is meant by a normal versus a broken back hoof pastern axis. Instead of the line from the pastern to the tip of the toe being straight it is "broken back" when the heel is too low.

Normal Hoof-Pastern Alignment
Normal Hoof-Pastern Alignment
Broken back Hoof-Pastern Axis
Broken back Hoof-Pastern Axis
Long toe — under run heel.
Long toe — under run heel.

Long toe — under run heel foot configuration is one of the most important and common foot abnormalities facing the horse industry today. This type of foot conformation is so common that it is often thought to be within normal limits. The long toe-under run heel has been defined (by Turner) as occurring when the angle of the heel is 5 or more degrees lower than the angle of the toe. It is often accompanied by a broken-back hoof pastern axis, which means that the slope of the foot exceeds the slope of the pastern (Figure 1). This condition could also be referred to as a dorsopalmar imbalance of the foot.

See the article on Foot Balance

Ground Force Effect
Ground Force Effect

For those of you that enjoy physics and the effect of forces this picture will hopefully convince you that there are many factors involved. The weight at the top indicates the weight of the horse coming down the leg onto the cannon bone (light blue rectangle). The dark blue indicates the flexor tendons that are under constant tension, but this increases as the weight increases and as the length of toe increases. Both of these things will cause the fetlock (large blue-gray circle) to drop more.

Shoeing Options

Heart Bar Shoe
Heart Bar Shoe
Bar Shoe
Bar Shoe
Egg Bar Shoe + Pad
Egg Bar Shoe + Pad

These are 3 types of bar shoes. They may all have a role in working with horses that have a low hoof angle and in need of more palmar support. Sometimes a shoe that works with one horse may not work with another with a similar situation. Why is that? Well it would be too easy if all horses responded the same, instead they need to be evaluated and worked with as individuals. There may be medical, conformation and/or environmental factors that affect a shoeing recommendation. Beyond that there are farriers that have different experiences managing certain horses and have their own approach to managing a particular condition. In all cases the trim is the most important aspect of working with the hooves.

Example of a Natural Balance Shoe. This type of shoe can be particularly useful for a variety of conditions.
Example of a Natural Balance Shoe. This type of shoe can be particularly useful for a variety of conditions.

A Natural Balance Shoe is quite different in appearance and in the way that is applied to the foot. Depending on the partiicular farrier and the conditions that we are working with this type of shoeing may be preferable to using a bar shoe or another open heeled shoe.

My goal is to try and identify the issues then work with a farrier to come up with a plan. There are times that what we start out doing is very different from what the horse may need in 6-12 months. Radiographs frequenly help as trying to get a sense of hoof is much easier when we can visualize the relationship between the the bones, hoof and ground surface.

Example of working with a laminitic horse

There are three radiographs in this study that will demonstrate how a foot can change quite dramatically over a 10 month period. The horse has a history of Cushing's Disease and Insulin Resistance and despite attempts to manage these conditions with medications and dietary modifications the patient still had laminitic episodes. Fortunately the outcome has been successful, largely because of the farrier work and our ability to manage this case as a team.

Throughout the radiographs you will see lines drawn to measure distance of the coffin bone relative to the hoof wall and to the sole as well as angles demonstrating displacement of the coffin bone relative to the dorsal hoof wall.

Initial radiograph from November 2007. At this point horse was asymptomatic and had approximately 8 degrees of rotation away from the hoof wall. Ideally the 2 lines that run diagonally across the front of the bone and hoof wall would remain paralell. In addition the distance between the bone and the hoof wall should be approximately 2 cm or less. Increasing beyond this suggests laminar swelling. In an acute case this can be quite uncomfortable, while it may be more manageable from a pain standpoint in a chronic case and this "laminar wedge" can be more of a physical presence that can be resolved later.
Initial radiograph from November 2007. At this point horse was asymptomatic and had approximately 8 degrees of rotation away from the hoof wall. Ideally the 2 lines that run diagonally across the front of the bone and hoof wall would remain paralell. In addition the distance between the bone and the hoof wall should be approximately 2 cm or less. Increasing beyond this suggests laminar swelling. In an acute case this can be quite uncomfortable, while it may be more manageable from a pain standpoint in a chronic case and this "laminar wedge" can be more of a physical presence that can be resolved later.
Second radiograph demonstrating significant changes from previous x-ray. As you can see by the measurements there is an angle of displacement/rotation of about 14 degrees and the distances between the bone and hoof wall have increased significantly. At this point and in the past few months he underwent periods of inreasing amounts of pain which affected his ability to walk and turn corners  comfortably. Besides trimming and shoeing moifications, which brought the "breakover" back while maintaining support, and the use of various medications we were able to manage his condition.
Second radiograph demonstrating significant changes from previous x-ray. As you can see by the measurements there is an angle of displacement/rotation of about 14 degrees and the distances between the bone and hoof wall have increased significantly. At this point and in the past few months he underwent periods of inreasing amounts of pain which affected his ability to walk and turn corners comfortably. Besides trimming and shoeing moifications, which brought the "breakover" back while maintaining support, and the use of various medications we were able to manage his condition.
In this third radiograph you can see the result of the work that was done with him. The amount of displacement is reduced and the angle measures only between 6-7 degrees. He was comfortable at this point, off all medications for pain and able to be ridden again. Of course not every case will be as successful, but without being able to work collaboratively with the farrier I'm sure the outcome would not have been so positive. Being able to monitor this case and using the digital x-rays were essential.
In this third radiograph you can see the result of the work that was done with him. The amount of displacement is reduced and the angle measures only between 6-7 degrees. He was comfortable at this point, off all medications for pain and able to be ridden again. Of course not every case will be as successful, but without being able to work collaboratively with the farrier I'm sure the outcome would not have been so positive. Being able to monitor this case and using the digital x-rays were essential.