Laminitis is a disease that is rarely about promises or guarantees. It is often about money -- unless, of course, your consultant is Michael Steward, DVM. He might even save you some money.
Conventional wisdom says that a new idea must pass through three stages before it is accepted. First it will be ridiculed. Then it will be angrily shouted down, or arrogantly dismissed as scientifically invalid by experts. Then, in an almost imperceptible, organic transition, it will be said that, of course, it was always known to be true.
In the case of a horseshoe to treat lameness, there is a fourth stage: everyone points calmly to the history books and says, “See? This is nothing new! It was used back in the 1700s! Of course it works.”
If James Herriot, the British country veterinarian of the “All Creatures Great and Small” series of books, were uprooted and transplanted in the open fields of Oklahoma, he’d probably do business in much the same way as Dr. Mike Steward at Shawnee Animal Hospital.
This animal hospital is the crossroads of a ranching and farming community. Cats and dogs are waiting for flea medicine and spaying. An alpaca needs a repro ultrasound. There are calves to be vaccinated. Barrel horses are in for Coggins tests before the show season starts. Folks stop by to pick up some grain. All in an hour’s work at Shawnee Animal Hospital.
But every other Tuesday, it’s a different place. Horse vans and trailers from different states roll in. Horses limp in. Farrier trucks come and go; some stay all day.
The laminitis cases are booked on these alternate Tuesdays, and Dr. Mike Steward lines them up for his trademark treatment, the Steward Clog. One after another, each horse will have one digital x-ray shot at a minimal cost, and a consult will take place to determine the best way to treat the horse’s foot pain and hoof deformity.
Each horse receives some variation of the Steward Clog, a platform device invented on the fly one day by Dr. Steward to help a horse whose owner couldn’t afford any help. There was no money for treatment, so Steward thought outside the box.
In fact, he used the box. He sawed some plywood, shaped it to look something like the bottom of a horse’s foot, and attached it to the bottom of the horse’s foot with a handful of deck screws and some vet-wrap around the hoof wall for good luck. Then he sent the horse home. He joked that it looked like a wooden clog on the bottom of the hoof.
No one was more surprised than Dr. Steward when the horse recovered. The relatively soft plywood had worn away where the horse wanted to break over, so that he could walk more easily. The base of the platform at the ground was smaller than the top, where it was attached to the hoof. The horse could pivot on the shoe. He could move, something that most horses with laminitis find it difficult to do.
“That horse told me what he wanted,” Steward said. “Horses will tell you, if you’re willing to listen.”
Moving, even just shifting weight and postural position, is crucial to stimulate blood flow to and within the foot, which in turn signals growth and restoration of healthy hoof function.
So if it worked once, would it work again? Steward started screwing on more and more plywood platforms and carefully observed how the horses behaved, how they moved and, most importantly, how their feet recovered their normal circulation, coffin bone position, and hoof wall shape.
Attaching a piece of solid wood to the bottom of a horse’s foot seems counter-intuitive. Shouldn’t the foot have the softest possible cushion under it, not something solid? Steward’s system offers the best of both worlds: immediately under the foot is a soft pillow of moldable “impression material”, like Play-Doh, to cushion the foot atop the solid platform of plywood, which he compares to doing CPR on a human. To do CPR, you always place the body against a solid, flat ground or floor so it does not sink and flop around.
While most shoe systems rely on nails through the hoof wall, Steward uses a perimeter of screws through the very outer edge of the wall, not the white line where horseshoe nails would go. The screws gently hold the platform in place; they are usually covered with casting tape, or at least layers of vet-wrap, to hold the package firmly in place.
Steward attributes his shoe’s success to the principle he calls “selective stabilization”; the horse can adjust its posture, its foot position and (depending on the case) its depth of footing or stall bedding to find a comfortable position and then fine-tune that position further by putting weight on the part of the shoe where the most comfort is afforded.
Dr. Steward will be the first to admit that he’s an overnight sensation -- after 20 or so years. While he knew he had an idea that would help horses, his system was so radical that no one would listen to him for a very long time. It was finally fellow laminitis expert Dr. Ric Redden of Kentucky who gave Dr. Steward a place on the stage of his Bluegrass Laminitis Symposium in 2002; the following year, Dr. Steward presented his clog system at the convention of the American Association of Equine Practitioners in New Orleans, where he documented the results of 64 cases treated with the shoes.
Another big break for Steward came when his shoe was included as a viable laminitis treatment in a book by Australian veterinarian and laminitis expert Dr. Chris Pollitt. While still ridiculed in most circles, especially by farriers who prefer steel heart bar shoes, the simplistic clog treatment found some adopters who simply said, “Ridicule it all you want. It worked.”
Now, seven years later, Steward has been invited to speak at laminitis and hoofcare conferences around the world. The line is a bit longer on Tuesdays at his clinic, and you might find him driving to ranches in Oklahoma to work on valuable Quarter horses, sport horses and racehorses who suffer from laminitis.
“The Steward clog has taught a lot of people an awful lot about the horse’s foot,” Steward reflected recently. “No matter what you think of it, it has changed the whole way that we think about rehabilitating the laminitic foot.”
In spite of its headline success, this shoe was originally a simple design that Dr. Steward's clients could afford. Necessity was the mother of invention.
For many people, laminitis is not a case of “Doc, can you fix my horse?” but “Doc, can I afford to have you fix my horse?” The Steward Clog has become an alternative to higher priced shoeing treatments, although its growing popularity seems to be turning it into another high-priced boutique shoe in some practices.
The original way -- the simple clog -- still works and would be a great, cost-effective technique for equine rescue farms to learn and master.
It will be a great day when "lack of funds" will no longer have to be written as the cause of death on a foundered horse's medical record. Thank Dr. Steward and everyone else in the veterinary and farrier professions who are working toward that day.
"How to Construct and Apply Atraumatic Therapeutic Shoes to Treat Acute or Chronic Laminitis in the Horse" by M.L. Steward, Proceedings of the 49th Annual Convention of the American Association of Equine Practitioners, 2003.
"Going Dutch" by Holly Clanahan, January 2008 edition of America's Horse, published by the AQHA.
“Hoof Balance in The Sound Hoof” by David Duckett, FWCF, in: Horse Health from the Ground Up by Lisa Simons Lancaster, Tallgrass Publishers 2004.
Fran Jurga is editor and publisher of Hoofcare and Lameness Journal and writes Fran Jurga's Hoof Blog at http://www.hoofcare.blogspot.com