Proceedings of the American Association of Equine Practitioners - Focus Meeting. Focus on the Foot

Transcription

1 Proceedings of the American Association of Equine Practitioners - Focus Meeting Focus on the Foot Columbus, Ohio, USA 2009 Next Focus Meeting: July 18-20, Focus on Upper and Lower Respiratory Salt Lake City, Utah, USA September 22-24, Sport Horse Symposium Lexington, KY, USA (Joint with Alltech and Rood and Riddle Equine Hospital) Reprinted in the IVIS website with the permission of the AAEP

2 Therapeutic Shoeing from a Farrier s Perspective James Gilchrist Authors address: Palm Beach Farrier Service Inc., Wellington Preserve Blvd, Wellington, FL 33449; gilchristfarrier@aol.com. Introduction Just like in any other athlete, the equine foot is the interface between the musculoskeletal system and the ground; thus playing a vital role in achieveing optimal athletic performance and avoiding athletic injury. As the perfect foot rarely exists, farriers and veterinarians must work together to evaluate the individual horse and arrive at a decision that will not only benefit the horse but allow it to perform to the best of its ability. Evaluation of the horse for therapeutic shoeing includes history of previous problems and soundness, owner/trainer expectations, a visual evaluation at a walk, trot-in-hand, and under saddle. Hoof tester examination and evaluation of the existing or present shoes and/or trim for abnormal wear and tear would be the next logical step. Finally radiographs and other imaging modalities can be used to assess the structures, the conformation, and the biomechanics of the foot. This evaulation allows for the farrier and veterinarian to determine which therapeutic options will best meet the goal of improving foot form and function. Types of Shoes and Their Use The Roller-toe or Square-toe shoe (Fig. 1) promotes a quick breakover and is often employed for correction of long toe and low heel (often accompanied with a negative palmar angle); improves gait abnormalities such as paddling and forging; and helps to alleviate clinical lameness associated with coffin joint disease, navicular syndrome, and deep digital flexor injuries. Half round shoes (Fig. 2) increases breakover and aid in shock absorption through deeper penetration into the ground surface than a flat shoe. This shoe is often used when the horse is experiencing lameness arising from the fetlock or carpus. Onion heel shoe (Fig. 3) provides heel support and reduces heel concussion, thus it is utilized in horses suffering from caudal heel (palmar foot) pain, and as a aid in treatment of low heel conformation. Eggbar shoes (Fig. 4), when properly fitted, stabilize the hoof capsule, provide support to the entire foot, and increases ground surface (area) resulting in decreased concussion to the foot. Horses that suffer from caudal heel (palmar foot) pain, crushed heels, sheared heels or poor heel conformation may benefit from application of this shoe. Straightbar shoes provide the same benefits of the eggbar but it is also a working shoe allowing the horse to continue at the same level of performance. 168

3 Figure 1. Roller toe or square toe shoe. Figure 2. Half round shoe. Figure 3. Onion shoe. Figure 4. Eggbar shoe with onions forged at the heels. 169

4 Heartbar shoes (Fig. 5) incorporate the frog through transfering and sharing weight from the heel or quarter. This shoe can be employed to lessen pain associated with navicular syndrome through its protection of the frog, including navicular bursa disease, quarter cracks, heel concerns such as sheared heels, collapsed heels, and caudal heel (palmar foot) pain. Figure 5. Heartbar shoe with impression material under the frog plate. Roller motion shoes (Fig. 6) increase breakover and help in correcting a low heel and alleviation of lameness secondary to bruised heel. Figure 6. Roller motion shoe with pour-in pad Heel plate shoes (Fig. 7) remove a majority of the concussion from the heel and is often employed for horses suffering from extreme heel pain. This however is a temporary shoe. 170

5 Figure 7. Heel plate shoe with impression material under the heel plate. Flip flop shoes (Fig. 8) give support to the toe and take pressure off the heel. Like the heel plate, it is a temporary type of shoe and is often used for contracted heels or horses suffering from heel pain. Figure 8. Flip-flop shoe. The Colleoni shoe (Fig. 9) was developed by the Italians and is unique in that it removes torque from the coffin bone. It is typically employed for horses that exhibit increased lameness on turns such as those horses suffering from sidebone, ringbone and chronic laminitis. 171

6 Figure 9. Colleoni shoe. Protection Orthotics are another resource often applied in therapeutic shoeing and work synergistically with the shoe to help achieve therapeutic goals. There is a large variety from which to select and include: leather pads (full and rim), plastic pads, heartbar pad, bubble pad, V-pad, pour-in pads, and spider plate. Full leather pads have the advantage of being a natural material which conform well with the shape of the foot and also allow for the foot to breathe. Plastic pads (Fig. 10) have an advantage over leather pads in support and cushion to the foot, however, they do not permit ample ventilation and thus moisture from the foot is not permitted to evaporate. Heartbar degree pads (Fig. 11) are often employed to increase the palmar angle and because of the heartbar feature, they increase support to the frog. Figure 10. Plastic pad. Figure 11. Mustad heartbar pad. 172

7 Bubble pads (Fig. 12) are fashioned from leather that is bubbled up over the frog to allow for direct load to the frog. Figure 12. Bubble pad. The V-pad (Fig. 13) is utilized when the sole of the foot needs support but the frog cannot tolerate pressure such as conditions associated with coffin or navicular bursa disease. Full pour-in pads (Fig. 14) are used when maxium support of the sole is needed but the frog must be able to endure the pressure exerted by the pad. Figure 13. V-pad created from a leather pad. Figure 14: Full pour-in pad. The Spider plate (Fig. 15) is lightweight and incorporates the frog into the weight bearing surface. Unlike the heartbar and the eggbar, this plate when added to the shoe does not permit heel walking. It also has the added advantage of permitting continued treatment of the sole of the foot. 173

8 Figure 15. Spider plate fitted under a shoe. Conclusions Like all other forms of therapy, therapeutic shoeing is a modality for treatment of the unhealthy foot generally showing structural damage and the long-term goal is to improve the foot for that individual horse and achieve soundness. Cooperation between the farrier, veterinarian, and the owner/trainer are of paramount importance to achieve the goal of a healthy foot which in turn will permit a horse to achieve its athletic potential. 174