Laminitis is a broad term describing inflammation of the laminar tissues of the foot. Impact can range from mild to catastrophic. Treating laminitis requires team effort and good communication among the veterinarian, farrier/trimmer, other health care practitioners, and the owner.
One feature of the laminitic foot is an abnormal growth pattern. When normal hoof growth is interrupted by inflammation of the laminae, the rate of hoof growth at the heel exceeds the toe. Growth rings on the hoof wall will appear compressed at the toe and then widen and curve downward toward the heel. This growth ring pattern indicates reduced circulation at the front of the foot and less constricted circulation in the heel region. Such disproportionate growth quickly causes the foot to become upright, undermining the form and physiologic function of the foot.
Although it may seem that the horse’s hoof is hard and rigid, it is actually very flexible and plastic. The unshod hoof is able to expand and contract naturally under load and impact. When the whole foot is able to bear weight no one structure is put under excessive stress.
For a horse suffering from laminitis these physiologic concepts of hoof plasticity and function are especially important to consider and incorporate. One of the goals of the natural trim for the laminitic foot is to realign the coffin bone relative to the hoof capsule and the ground. Toe length is trimmed to bring the break-over further back under the limb, reducing leverage force at the white line. The heels are trimmed to position the coffin bone to a near ground-parallel orientation. This trim strategy maximizes the optimum physiologic function of the foot. This is beneficial for any horse, but it becomes crucial for a horse suffering a structural compromise of the foot, as is present with laminitis.
Of equal importance to the trimming method is the frequency with which it is applied. The laminitic foot changes dramatically on a daily basis. It is not unusual to trim laminitic horses every week or every two weeks during the acute phase. Once a horse becomes more stable, a trimming cycle of every 4 weeks is optimal.
The goals in natural trim management are to:
1. Maintain the proper orientation of coffin bone to the hoof wall and the ground
2. Reduce the point of break-over and damaging leverage forces on the toe region of the foot
3. Remove or greatly reduce the laminar wedge to aid proper orientation of the new hoof growth
4. Enable as many parts of the foot to share the load while damaged areas recover
5. Encourage maximum circulation for healing
Boots are indispensable for supporting a horse through the painful phases of laminitis; the choice in boots will be determined by the particular needs of the horse. If a horse is able to walk willingly and fairly comfortably, Old Mac G2 or Easycare Epic boots are a good choice. These boots offer good traction and breakover and are easy to apply. Extra padding can be inserted into any of the boots and is often needed for a sore horse. In more severe cases in which there is prolapsed sole tissue and/or deep abscess tracts, a boot such as the Soft-Ride™ is helpful. These boots include very thick silicone pads which come in different densities and can be modified as needed. They have a fairly smooth ground surface, allowing the horse to turn easily.
Natural trimming methods optimize the physiologic characteristics of the foot to support the horse’s own capacity for healing. Frequent attention to feet unencumbered by shoes also allows for greater adaptability when managing the ever changing needs associated with the disease process. When performed correctly, even small changes in the application and frequency of the trim can have profound effects on foot health.
Many people think of laminitis as a disease of ponies during the time of lush grass, but certain horses are susceptible to laminitis all year round. Donkeys and mules can also suffer from this painful condition.
Signs of laminitis can be very subtle and may begin as simple behavior problems, such as refusing jumps, or turning awkwardly, particularly on hard surfaces.
When pain is severe, horses may shift weight from front foot to front foot, or stretch the front feet out in front to avoid putting weight on sore soles and toes. A bounding pulse may be felt at the back of the pastern or the hoof wall may be unusually warm.
Farriers may warn barn managers and owners when they notice stretched white lines on the bottoms of feet and irregular growth rings on the hoof wall; these are signs of laminitis in a horse’s past, or an ongoing, or chronic, problem.
One of the classic causes of laminitis is when a horse breaks into a grain bin and feasts on carbohydrates, but there are many causes of the disease, including:
• Cushing’s disease in older horses and ponies
• drug reactions
• insulin resistance in “easy keeper” mounts
Obesity and “cresty” necks have been identified as possible warning signs of a horse predisposed to laminitis.
-- Fran Jurga, Hoofcare & Lameness
NATURAL HOOF CARE
Awareness of the benefits of natural hoof care is growing. Many horse owners who have made the change from using shoes to going barefoot are seeing great improvements in their horse’s comfort and performance. However, a “natural” trim is more than just leaving a horse barefoot. The natural trim model, based primarily on wild horses of the North American west, gives particular focus to the anatomical features of the foot.
The underlying concept of the natural trim for barefoot horses is based on several features of the foot. The wall is but one of the weight-bearing structures of the foot; also important in weight-bearing are the sole, bars, and frog. The caudal, or rear portion of the foot is vital to the health of the entire foot. As the foot contacts the ground, interior soft structures of the foot including the frog, digital cushion, and lateral cartilages are engaged, vital to maintaining proper circulation of the foot.
While little research exists to explain why this type of trim is beneficial, anecdotally it seems clear that with the proper natural trim and good management, hoof function can be improved.
Laura Florence is an American Farrier’s Association Certified Farrier serving a wide variety of clients, from backyard companions to competitive sport horses. As a Resident Farrier for seven years with the University of Pennsylvania, New Bolton Center Farrier Service, Laura honed her skills working alongside veterinary surgeons in the operating room, assisting clinicians during lameness evaluations, and treating a variety of hoof diseases. In 2007, Laura began a private practice in southeastern Pennsylvania, dedicated to the rehabilitation and maintenance of the horse’s hoof through a holistic approach. Contact Laura through her website, www.holistichoofcare.com , or call 484-868-3715.