Laminitis is known as a vascular inflammatory disease of the feet which causes pain, lameness and secondary instability of the hoof capsule. Laminitis is a word that brings fear to owners, vets and farriers alike, as it is well know it is a painful and potentially fatal disease. It can occur in acute episodes and become a chronic condition suffered by many horses and ponies. Treating this condition requires input from all parties involved. Prompt diagnosis of the inciting cause, administration of anti-inflammatories and supporting the foot are all key to try and achieve a positive outcome.
To understand how farriery can help with treatment and management we need to understand why and where the foot is sore. When the horse is suffering from laminitis, the lamella which hold the surface of the pedal bone to the hoof capsule become swollen and weak. With this gravity, the pull from the deep flexor tendon unit and leverage from the toe, can cause the pedal bone to separate from the rigid hoof capsule, pulling the tip of the pedal bone towards the sole, the so-called rotation. This causes compression on the sole just in front of the frog and causes the horse or pony to want to lean backwards onto their heels, bringing the weight off the toe giving the classic 'laminitic stance'. Working with the farrier we can aim to balance the forces on the hoof capsule as much as possible to try and regain stability.
Every equine with laminitis should be treated on an individual basis. In the acute stages, if appropriate, this involves trimming the toe to reduce break-over and therefore the leverage force. Additionally, different types of frog support can be used to raise this area off the ground to bare more weight and so taking some of the pressure off the toe. These include certain types of putty that can initially be moulded to conform to the frog which then sets to provide support. The classic Styrofoam® pads which through compression will reduce in height and conform to the frog’s shape, or indeed a combination of these two. Many boots are on the market now designed for feet of horses suffering from laminitis that provide support and cushioning which can be used for both the acute and chronically suffering patient, we particularly recommend Soft Ride boots®.
Once the acute stage has been managed and the patient becomes more comfortable, plans can be made, working with your farrier as to how to proceed with supportively shoeing your horse or pony. This is often many weeks after the onset of the problem; unlike previously we tend not to rush into corrective farriery too early. To assist with trimming, it is useful to have some radiographs of the feet to work from. This can give you measurements of the potential changes within the hoof capsule and therefore the farrier can trim and shoe the foot accordingly. Laminitis can cause structural changes to the foot such as flattened or convex soles, where the pedal bone has rotated and/or sunk, diverging lines on the hoof wall and separation of the white line. These can predispose them to other conditions such as abscesses. Note that there may be no changes on X-Ray even though laminitis has caused the lameness. Types of shoes used vary from standard heart bars, wide webbed shoes, ‘open toed’ heart bars shoes, to more lightweight plastic imprint shoes that are useful for smaller ponies where normal shoes are too heavy. These all aim to use the frog to bare more weight to alleviate the pressure on the toe.
Overall, it is very important to involve both vets and farriers in the treatment and management of laminitis. A combination of first aid treatment using frog supports, and then progressing to remedial farriery when the patient becomes stabilised is key to fighting towards a positive outcome for these horses and ponies. Regular monitoring by all owner, farrier and vet, of soundness, hoof health and general systemic health are also very important to detect any early changes or signs of laminitis to catch the issue before it comes a full problem. Please phone the Hospital if you suspect your horse is suffering from acute or chronic laminitis.