Laminitis Update        3-20-05 (revised 12-‘05)     Pete Ramey

Copyright 2005

Laminitis research is a fast-moving field, with new discoveries being reported almost every day. I am not a scientist; just a farrier who specializes in founder rehabilitation. I spend my days working on foundered horses and my nights reading veterinary research papers, so I’m writing this only as an interpreter; providing reference to some of the latest understandings of laminitis to help farriers keep themselves current. Also of great importance are references I will make to human medicine. The more I study contemporary laminitis research, the more parallels I find to human diabetes research, and there are many answers waiting there for those seeking a deeper understanding of what is happening to our horses. It seems few farriers have time or inclination to wade through the complex jungle of veterinary research papers, so for the sake of the horse, I’ll provide this simplified shortcut; a brief overview and a guide through the actual papers referenced at the end for those interested in deeper study.

The word “laminitis” means simply the inflammation of the laminae. In the past, we thought of it as a circulatory problem with inflammation, swelling and a lack of circulation within the dermal (the “living half” of the) laminae and the bypass of the laminae by arterial blood through AVA’s being the primary problems. (AVA’s are “side tracks” that can open and shut at will, diverting blood from artery to vein; bypassing the intended destination of the blood.) Resulting reduced blood flow was thought to starve the laminae and cause their destruction. Certainly all of this has been proven to happen, along with excruciating pain caused by inflammation and swelling of soft tissue trapped between the coffin bone and the hoof wall, (and equally painful inflammation of the frog and sole coriums) but in light of more current research, it appears that all of this happens in response to the damage of the laminae, rather than being the actual cause.

In fact, it has been proven that “normal” circulation is necessary to deliver laminitis triggers to the hoof. Experimental restriction of blood flow to one hoof will keep it from developing laminitis while the other three hooves are afflicted (after carbohydrate overload) (Pollitt). The closer we can get to a true of understanding the primary problems, the more effective our prevention and treatment can be. New research has given us powerful ammunition in the war against laminitis; knowledge we can deliver to the horse immediately.

The epidermal laminae are produced at the coronet and are literally a part of the hoof wall itself. They are intricately intermeshed with the dermal laminae which are firmly attached to the coffin bone. Between the two “halves”, is a tough “skin” called the basement membrane. The basement membrane is the point of attachment of hoof to horse. At the distal border of the coffin bone, the dermal laminae end, and a second epidermal “half” is produced that bonds the wall to the sole. This “non-living” extension of the lamellar bond is called (for some unknown reason) the white line (I’ve never once seen a white one).

The hoof wall and the epidermal laminae grow past the stationary dermal laminae while being constantly, firmly attached to each other. There is around ten square feet of total attachment per hoof that must be constantly modified as this movement occurs. This amazing process is done with the aid of remodeling enzymes (MMP’s) that constantly remove the anchoring filaments that tie the epidermal laminae to the basement membrane. In a normal situation, this “destruction” is timed perfectly with the rate of reconstruction and growth of the wall can occur while the healthy laminae remain almost impossible to tear apart.

Dr. Chris Pollitt (University of Queensland) has shown that during the developmental stage of laminitis, the MMP’s go through a population explosion and destroy all of the anchoring filaments and sometimes even the basement membrane itself. This means that the hoof is literally no longer firmly attached to the horse. As a result of this damage the horse then goes through excruciating pain, inflammation, a disruption of normal circulation and often the weight of the horse drops the entire skeleton to the ground (through the hoof capsule), leaving the coffin bone far removed from its natural position within the hoof capsule. This is very important to understand, because in spite of this research, many professionals still treat laminitis primarily as a circulatory problem (by attacking symptoms). Pollitt has shown that before any of the clinical signs of laminitis are detectable, the damage is already done. The very term “laminitis” may be a complete misnomer.

This important “which came first?” revelation has quickly led to even deeper understanding. Pollitt has searched for other factors that can separate the hoof from the horse. He has studied the effects on the laminae by most of the “classically proposed” trigger factors and to date has found only one that actually causes separation of the laminae. This is the hindgut bacteria streptococcus bovis.

The horse’s natural diet of mixed grasses provides structural carbohydrates like cellulose, hemicellulose and lignin, but fructans usually dominate the engineered grasses and hays we feed our domestic horses. The horse (or any other mammal) has no enzymes to digest the non structural carbohydrate; fructan. They are present in great quantities in our sweet feed, rich, cultivated pastures and our beautiful “horse quality” hay. Fructan, sugars and starches (All three of which are combined in the total measure of non structural carbohydrates, or NSC) pass undigested into the hindgut where they undergo rapid fermentation to lactic acid (which can then be utilized by the horse, but not exactly naturally). S. bovis is the bacteria responsible for this and can undergo a 1680 fold increase in numbers during a carbohydrate overload that leads to laminitis. While no one has scientifically proven that these bacteria leak into the blood stream and cause lamellar separation in naturally occurring laminitis, Pollitt has proven that if they reach the laminae they trigger MMP-2 production and cause the failure of the attachment of the epidermal laminae to the basement membrane.

More recently, Pollit has found that damaged intestinal walls can cause one of their components; Laminin-5 to access the bloodstream. When they reach the laminae they also cause MMP release and destruction of the anchoring filaments (also made of Laminin-5).

Another important direction to be aware of is that Pollitt has proven that the laminae readily separate when they are starved of glucose. Glucose starvation causes the destruction of important “spot welds” (hemidesmosomes) between the epidermis and the basement membrane that the anchoring filaments actually grow from. When this happens, the laminae are easily torn apart under load. This opens up a vast area of study and more new ways to understand laminitis. The dermal laminae each have over a hundred secondary laminae growing from them. These secondary laminae are made of keratinocytes, or simply keratin producing cells. They are the same producers of hoof wall and the horse’s skin, as well as our own skin, hair and fingernails and those of other animals.

While Pollitt found that the endotoxins often previously blamed for laminar separation (in the wake of a dietary upset and a “die-off of digestive bacteria) do not directly cause laminar separation, the resulting metabolic stress caused by endotoxemia is still thought to cause it indirectly. A major feature of any metabolic stress is a reduction of glucose supply to the extremities. This is done to preserve the more vital organs. When the digestive bacteria in the hindgut go through the massive die-off often associated sudden change in diet and with the development of laminitis, the resulting lack of digestive bacteria creates an immediate “starvation” within the horse.  Each hoof of a standing horse normally uses more glucose than the horse’s whole head. Moving? It stands to reason that the same shutdown of glucose supply to the keratinocytes of the laminae is happening to the horse’s skin, soles, frogs and etc., but the forces required to “finish the job” and cause physical separation are much greater in the hoof walls (when they are in a solitary support role without aid from a well callused sole).

This is one of several reasons we see so more much resistance to founder in hooves that are maintained in a natural form. These sheer forces are greatly reduced. Aside from the front hooves of horses under competent natural hoof care, we also commonly see increased resistance in the hind feet, regardless of the type of care provided. Although the fronts and hinds are identical at birth, the hinds are used much more aggressively by the horse throughout life, so domestic hind hooves tend to develop more naturally and completely than the fronts (Read “Digging for the Truth About Navicular Syndrome” at www.hoofrehab.com for more on this). The proper development of the back of the foot allows much better energy dissipation, which greatly decreases stress on the laminae. In addition, in a naturally shaped hoof, the laminae may be equally weakened, but the coffin bone has “nowhere to go” because the sole and thus the solar surface of the coffin bone is aiding in direct support of the horse. (Dr. Robert M. Bowker)

Also, naturally shaped and developed hooves have much more thorough blood circulation in place. Read Dr. Bowker’s “Theory of Hemodynamics”. The blood pumping action of the foot is much more advanced and difficult to obtain than most farriers realize. It goes far beyond simple frog pressure and requires proper development and flexion of the foot from the moment of birth. It is not only important for energy dissipation and for easing the burden on the heart, proper hoof function and circulation also gives the foot profound advantages and resistance when laminitis does make it to the acute stage and circulation loss becomes a more important factor. The foot must be allowed to flex and function at this stage to aid in circulation. 

While visiting my diabetic grandfather, I noticed his fingernails were rippled, discolored and partially separated from his fingers. From underneath the deformed nails, soft, new fingernails were protruding. Sound familiar? If you’ve worked with foundered horses it certainly does! This led me down the road of studying human medicine and the role of blood sugars and insulin on keratinocytes. Being a person who thrives on new information, I felt like a kid who just walked in a candy store! Imagine my surprise when I found medical recommendations from the American Diabetes Association that, “All individuals with diabetes should receive an annual foot examination to identify high-risk foot conditions.  This examination should include assessment of protective sensation, foot structure and biomechanics, vascular status, and skin integrity. Diabetic patients are urged to be evaluated for:

i.Peripheral neuropathy with loss of protective sensation

ii.Altered biomechanics (in the presence of neuropathy)

iii.Evidence of increased pressure (erythema, hemorrhage under a callus)

iv.Bony deformity

v.Peripheral vascular disease (decreased or absent pedal pulses)

vi.A history of ulcers or amputation

vii.Severe nail pathology

The skin should be assessed for integrity, especially between the toes and under the metatarsal heads.  The presence of erythema, warmth, or callus formation may indicate areas of tissue damage with impending breakdown.  Bony deformities, limitation in joint mobility, and problems with gait and balance should be assessed.” (Remember, they’re talking about people, here!)

I believe much of the information we need to know about how an unnatural diet high in sugars can effect hoof wall attachment has already been done for humans. It is the veterinary researchers who will have to assess the relevance of this, though, and determine its application to the horse. Until then, I will tell you about some of the other things I was able to dig up:

The secondary laminae are made up of keratinocytes. French researchers studying human skin show that increased insulin levels cause migration of keratinocytes! This is a potentially important tidbit that no one has studied in the horse (to my knowledge) If an increase in blood sugar causes an increase in insulin levels, this alone could start the whole process of laminar destruction by displacing the secondary laminae. While it is relatively common knowledge that insulin levels are often above normal in laminitic horses, I haven’t found a scientific study that actually monitors insulin levels in horses after a carbohydrate overload that induces laminitis. Does this always occur? Knowing that this migration of the keratinocytes (the secondary dermal laminae) could possibly begin the separation of the laminae, I would be really interested in such a study to determine how consistent the feature of increased insulin is, among horses in the early developmental stage of laminitis. I have to wonder if the increased population of MMP’s are trying to keep up with the repair of the resulting damage, rather than being a key destructive force (or both, which would create a vicious cycle). Research for human medicine often shows them coming along to aid in the repair of damage in the wake of injury.

From the American Diabetes Association, a research project done on mice (Gale group), found that high glucose levels inhibit the proliferation of keratinocytes and that increased insulin levels increase their proliferation. Either way, a disruption or unnatural situation is directly created by alteration of blood sugars. New intertubular horn tubules constantly grow from the dermal laminae and aid in the movement of the ever-growing hoof wall, past the coffin bone (Dr. Robert M. Bowker). They normally grow from the dermal laminae tips, through the epidermal laminae and merge with the rest of the hoof wall growing from the coronet. This is why the hoof walls are not stretched to the thickness of a coin by the time they reach the larger diameter at ground level. If an increase of blood glucose decreases this proliferation, it stands to reason that the hoof growth from the coronet could quickly “grow past” the laminae, causing the very beginnings of lamellar separation.

On that same note, if high insulin levels increase this new hoof horn growth, it could push the dermal and epidermal laminae apart as the excess new hoof horn piled in between them. In other words the lamellar wedge (I’ll get to that later) could possibly be a cause, rather than an effect.

This could explain the two types of separation we see in the field. Sometimes we see the white line perfectly intact and the hoof wall pulled away from it. Other times, we see the dermal and epidermal halves separated from each other. The former would cause the hoof wall to separate from the “still-intact” laminae. The latter would cause the dermal laminae and the epidermal laminae to part ways from each other. I’m speculating, here, but I feel it deserves veterinary research.

From the same research team: Too much glucose actually starves the cells by decreasing its own utilization by skin keratinocytes. In this study, they actually found that the cells were receiving more glucose at a low 2 mmol/l level, than at an experimentally induced 20 mmol/l level in the blood. Hyperglycemia leads to increased insulin resistance as well as a reduction in general glucose utilization. In other words an excess of sugars, whether from grass, hay, grain or molasses can, in effect, starve the laminae to death on its own. They also found that keratinocytes flatten and loose their correct orientation at this higher glucose level. This research was for humans, but it also sounds very familiar, doesn’t it?

In fact it is well known that horses with decreased insulin sensitivity have a very high risk factor for laminitis; there is simply not enough understanding within the horse-owning public as to why? Dr. Philip Johnson writes: “There is a very strong association between the development of obesity, metabolic syndrome and the risk of developing laminitis. Commonly, at initial veterinary examination, there already exists both physical and radiographic evidence of long-standing laminitis in these horses although reputable and credible owners and managers report that there have been no prior signs of laminitis or any obvious explanation. In these horses, visible changes that are commonly attributable to laminitis (including prominent growth lines, palmar divergence of growth lines, and a convex sole) may be evident in the absence of laminitic pain or any history of laminitis or lameness.”

It is my firm opinion that these “credible owners and managers” simply must learn to read this “physical evidence”. Over and over, I am called to “new” founder cases only to find that the “writing on the wall” has been present, but unrecognized for years. Often the obvious warning signs are more evident in the “healthy” hooves at the same facility that haven’t foundered yet. The eventual breakdown could be both easily predicted and easily prevented.

Throughout my career, working with countless laminitic horses, I have observed that often there is nothing really wrong with most horses that are considered insulin resistant or diagnosed with equine metabolic syndrome. Most horse owners call them “easy keepers” and it can seem impossible to keep them from being overweight or to grow healthy hooves. The real problem is that we are taking animals that evolved to thrive on sparse desert rangelands, and are forcing them to try to survive in a “donut factory”. This is why the “desert breeds” carry a higher risk factor for problems processing sugars and thus for laminitis. I know this because I have watched many “hopeless” cases thrive, when their diet was changed to a simpler and more natural mixed-grass hay diet, and the bulk of the sugars and fructan-rich, lush grasses and grains taken away. The resulting increase in health has a very positive effect on their attitude, their bodies, and of course their completely sound hooves. The problem is not so much that they had trouble with sugars and starches in general; just that they had trouble with the unnaturally high amounts they were previously receiving. This is not to say that a change in diet should replace all medical intervention; but that it should be the first place we start.

In a nutshell, the same thing that causes fat causes laminitis; excess or improper feeding! Not that a horse has to be fat to suffer from laminitis, but if all horse owners recognized that increasing fat on a horse was reason for sheer panic, laminitis would quickly become almost a distant memory of the “way things used to be”. I have also seen countless horses that were underweight, who were foundered by caring owners spending $60 per day feeding the horse, while the horse refused to gain weight. Over and over, these horses will finally gain weight and also grow healthy hooves when the diet is switched to a simple free-choice, mixed grass hay diet (plus salt and minerals). The reason is that the horse has no means to utilize the rich (high NSC) feed. The owners are just keeping the horse in constant metabolic distress and foundering the feet, while creating very rich, valuable urine. The nutrition in the rich feed is wasted, at best. At worst it can do great harm.

In true cases of insulin resistance or in perfectly healthy horses simply receiving excess, the cells become so impervious to glucose that the horse goes into starvation mode, burning fat and then muscle because the mechanism to burn glucose has totally collapsed.  Improving insulin sensitivity by feeding low sugar hay may actually allow more glucose to be utilized once the vicious cycle has been broken. 

It would be nice if we could violate the evolution of the horse and make its digestive tract just like ours. It is much more convenient to provide a couple of rich meals per day, rather than a constant uptake of lower nutrition feed. It just doesn’t work very well for most horses. Don’t blame a horse for being a horse. It is our responsibility to provide for their needs.   Type-2 diabetes is a “human condition” in which there is inadequate insulin supply to handle the transport of glucose to the cells. There is increasing suggestion that it is usually not a disease at all, but that the effected individual is simply “built” for a much leaner, more natural diet than he/she is receiving.    

 

Why is the study of human medicine important? We currently know a great deal more about maintaining health and blood sugar levels in humans than in horses and the understanding of the similarities between the two can give help to foundered horses now, while laminitis research continues to advance. We still have hoof professionals treating laminitis as a circulatory problem while completely ignoring the diet and exercise of the horse. The circulatory problems and inflammation have been proven to be only symptoms of laminar destruction caused by an unnatural diet too high in non structural carbohydrates (read grain, molasses, rich pastures and high NSC hay).

Most horse owners trust the farrier to take charge of the health of the hooves and only include the vet when things go horribly wrong. Should routine hoof care be a veterinary procedure? Maybe so, if farriers ignore this knowledge: Currently, only one part of the body of one animal on the planet can be legally immobilized or have its bone alignment altered by someone who is not a doctor. While it is illegal for a lay farrier to diagnose laminitis in a horse, we must deal with its consequences to some degree on almost every domestic hoof we see. The more you learn about the dietary destruction of the laminae, the more you will start to see it happening everywhere. If you understand that a “too-rich” diet weakens the attachment of hoof to horse, it spills over daily into the traditionally “non-medical” job of simply maintaining a healthy hoof. Farriers must either get educated in the ways the diet effects the hooves’ attachment to the horse and advise clients accordingly or ignore the facts and pretend hoof management is just the art of shaping of some non-living, non-moving “block of wood”, which doesn’t bode well for the horse. Educated, alert farriers can prevent laminitis. I have personally chosen to buck tradition and try to learn about, and then educate clients about the effects of diet on their hooves, because I feel it is the only competent way I can do my job.

In light of modern understanding of diet and laminar integrity farriers need to shift more of their focus toward helping horse owners with dietary management. If lay farriers are to be responsible for maintaining the health of the hoof, they must become more aware of the body it is attached to. Every day, horse owners face a barrage of commercial advertisements and dietary advice from other horsemen that recommend the routine feeding of the very things that have been scientifically proven to destroy the hooves’ attachment to the bone! This loss of attachment is what makes most horses “need” hoof protection to begin with and it is usually readily visible long before total breakdown and chronic founder. As professionals we must use the latest available science to combat this problem. It is our responsibility to study and interpret this new information and deliver it to our client’s horses.

Understand that this discussion is not just for the horse diagnosed with laminitis or chronic founder. By the time things advance to this stage the real problems have generally been at work for quite some time. Although researchers are still figuring out all the reasons why; we know for a fact that carbohydrate overload weakens the hoof to horse attachment. What happens next depends on the mechanics already in place. If the walls are excessively long and the coffin bone is not receiving natural support through the thick, callused sole of the horse, the weight of the horse simply drops toward the ground, creating coffin bone rotation or distal displacement (sinking). The lower coffin bone position (relative to the hoof capsule) causes a “flat foot” or a bulging sole, with the apex of the frog lacking depth within a solar dome. Most professionals consider this to be a very sudden thing, but it usually happens over time, long before anyone notices a problem. Routine rasping of this growing bulge (read undermining the coffin bone or thinning the sole and overexposing the corium) is usually what actually brings the problem to a horribly painful head for the horse; not the laminitis that has been constantly affecting the horse for years.    

The dermal and epidermal halves of the healthy laminae are impossible to tear apart with stress on the hoof walls. Instead, when mechanical stress alone causes failure, the laminae stay bonded together and both are separated from the wall itself. According to Pollitt, normal locomotion exposes the hooves to 1/10th of the stress required for failure of the hoof wall, yet the inner wall itself is the “weaker link”, when compared to normal, healthy laminae! Therefore, if the two halves have become separated from each other, you can be assured one or more of the factors we have discussed were present. When the dermal and epidermal halves of the laminae are correctly bonded together, the keratinocytes of the secondary dermal laminae constantly add new hoof horn tubules to the mass of the hoof wall; from the inside out, not just from the top. (Dr. Robert M. Bowker) When the laminae separate from each other, even very slightly, the dermal laminae continue to grow the new horn tubules, but they now pile loosely between the dermal and epidermal laminae, pushing the two farther and farther apart and creating the lamellar wedge. This presence of hoof horn between the dermal and epidermal laminae is proof in a given situation that this has been going on for quite a while, usually while the owner and farrier perceive the horse to be “sound”.

Another key feature of the laminitic hoof is that when the laminae separate, the new wall growth at the toe is no longer forced to grow down the bone to meet the ground. As long as the diet continually destroys the attachment, the new wall growth is free to follow the path of least resistance. At the toe, it will thus grow straight out, perpendicular to the laminae. Since the growth at the toe is not moving downward like the heel growth, it gives the illusion that the toe walls are growing slower than the heels. In fact, if you cut a cadaver hoof down the middle that has the classic “fan-shaped” growth lines of founder, you can measure the curved horn tubules and see that the toe and the heel actually grew at the same rate, just not in the same direction. Occasionally you can find toe growth actually outrunning heel growth (visible in cross section) in hooves that appear from the outside to have no toe growth at all. The fan shaped growth lines, along with the “filled in” area between the coffin bone and a flared or rotated hoof capsule are definite signs that the original separation of the laminae occurred many months ago. It is frightening how few hoof professionals recognize this fact. In the rare case that a coffin bone rotation does happen suddenly, there will be nothing but air between the two halves of the separated laminae; you can see or probe all the way to the coronet from the bottom of the foot (between the wall and the bone), and again, this is not the way it usually happens in the real world.

Most commonly, after a dietary insult to the lamellar bond, if the horse is provided with natural support of the coffin bone through the sole, the result is much less dramatic. Constant flaring, wall separation, “white line disease” develops instead, and dealing with these things falls on the shoulders of the farrier. If you try to treat these things with only mechanics, you will never see complete results. The diet must be addressed as well. Otherwise, you can soak hooves in anti-fungal solutions indefinitely, shoe, trim, or epoxy however you want and you will make only minimal progress with a case of “white line disease” or wall flaring. Keep in mind that that destruction of the lamellar bond can happen without clinical signs of laminitis. It happens from “top to bottom”, and takes a full growth cycle to grow out in the best of circumstances. If a horse has a dietary insult every spring, when the grass fructans heavily increase and every fall because of acorns or crab apples, the hooves may appear to be constantly suffering from fungal invasion or “white line disease”. I do regret the unsuccessful anti-fungal soaking programs I once put horse owners through, only to later watch as a grazing muzzle completely fixed the feet.

In most cases of “seedy toe” or white line disease, this process is well under way and only  the epidermal half of the laminae are visible at ground level. The half produced from the dermis is back with the coffin bone where it belongs and a true white line (involving both halves) doesn’t exist. Worrying about the fungal part of “white line disease” when the horse doesn’t even have a true white line to begin with, is obviously a prescription for “spinning your wheels”. The fungal complications of a white line separation do sometimes need to be treated, but understand that fungi do not really bother healthy hooves. The true lesion will be present first to create a home for the opportunistic pathogens that then attack the hooves. 

So dealing with one horse with a 15 degree coffin bone rotation and another with a case of constant wall flaring is exactly the same. Generally speaking, the horse is growing well attached laminae from the top every second of every day. From a trimming standpoint, we need to load the coffin bone naturally through a dense callused sole, and provide some relief to the stresses on the disconnected walls. This in turn relieves the mechanical tearing apart of the laminae, allowing them to grow in correctly.

These mechanics do nothing, however, to stop the process of constant dietary destruction of the lamellar bond. This is often happening as quickly as the horse can grow well connected laminae. We must, at the same time naturalize the diet. This means providing free choice mixed grass hay or pasture that is as low as possible in non structural carbohydrates (particularly sugar and fructan) and the elimination of all or most of the starches, grains, fruits, acorns, molasses, and high NSC pasture from the horse’s diet. (Often a grazing muzzle is all it takes) Horse owners are usually shocked when they see how well their horses thrive with such a diet. They just don’t realize that the horse has little or no means to utilize most of the things they were previously feeding. The study of the nutrition of grasses and hay is an incomplete, but fast moving field in its own right. Please study www.safergrass.org for more details. It is the best source I know of to help you figure out the safest diet available in your area. No one can tell how much NSC is in a pasture or hay just by looking. This website will teach you how and why to get testing done. It’s surprisingly cheap and easy to do.

As with humans, exercise will greatly enhance the effects of a healthier diet and also help make up for many shortcomings. The extra movement also increases hoof wall and sole growth; speeding up the healing process. The advancements in the hoof boot industry in the last year have been amazing. Hoof boots with thick foam insoles added, are very useful for providing enough comfort and protection for exercising the foundered horse while allowing excellent trim mechanics, and tape-on pads are a better choice when protection is needed during turnout. Stall rest is undesirable if a rehabilitative trim is well applied. If you set up proper mechanics with the coffin bone in a natural position (relative to the ground during impact; not just while standing) and relieve the damaged laminae from stress, every step will cause a bit of well connected new growth. That said, do not “force-walk” a lame horse. Offer the choice to move until you can get true comfort in the boot/pad system, or on firm, but yielding terrain. Then, and only then, begin a true exercise program; increasing work as the horse becomes more able.

Any means of support that is rigidly attached to the hoof wall itself is contraindicated. One reason is that the walls themselves are not properly attached, so can’t provide support stable enough to allow well connected growth to move in from the top. It will be constantly damaged as it grows. Mechanically, the laminae are very strong when they are all working together, but tear with the slightest pressure when they are partially separated. Think of a piece of cloth that you cannot tear, but a little “starter cut” is all you need to easily rip it apart. This is where the “old” laminitis ideas come into play. We still do have to worry about them. Even if you provide a satisfactory diet, if pressure on the walls and/or lamellar wedge overstresses or irritates the new growth, inflammation, pain and swelling will occur, along with the mechanical separation. This swelling and capillary damage makes normal blood flow through the laminae impossible. Blood is then redirected through AVA’s, bypassing the restrictions in the dermal laminae and starving the cells, thus adding to the damage and making healing impossible. “Hanging” a horse from weakened, separated laminae simply doesn’t work and repeated unsuccessful attempts have left most farriers wrongly feeling that the reversal of a 10+ degree rotation is impossible.

 

Secondly, the walls are constantly growing. If you attach perfect coffin bone support to the walls today, by tomorrow your support has crept away with the ever-growing hoof capsule, along with the bone you are trying to stabilize. If you are willing to support the bone column with the ground, through the well callused sole and unload the laminae, you will be able to set up the mechanics to grow out the worst of “rotations”. If the diet is right, the rest is just a matter of waiting for the growth cycle to complete itself; a new, well connected wall is simply regrown around the bone.

Every day, more is understood about how the horse’s diet effects hoof wall attachment, but this just leaves many farriers and horse owners falling farther and farther behind. We need to teach everyone associated with horses to recognize the warning signs before they come to a head and cause severe lameness and pathology. Ripples or red stripes on the hoof walls, abscessing, fan-shaped growth rings, obesity, abnormal weight loss, dull, shaggy coats or an unwillingness to shed winter coats, flat soles, wall flares or white line separation, negative “attitude”, “laziness”, and hoof sensitivity should be cause for immediate concern for anyone associated with horses. It should be an immediately recognized fact that there is likely to be very serious and potentially dangerous dietary problems, and it should be considered irresponsible to simply wait and see if things get worse. This new science should have already brought about sweeping changes across the horse world, but the “tradition driven” horse world makes any changes very slowly and only then while “kicking and screaming”. Yes we have learned to heal most chronic founder cases, but the truly exciting part is that all founders could have been easily prevented, if only the horse owners and farriers were more educated.

A part of what is slowing down the horse-using public’s awareness of obvious danger signs is the simple tradition of misunderstanding what a truly healthy hoof is capable of. Many professionals and owners still consider a truly laminitic hoof that is “sound” only while a half inch of steel keeps it completely out of contact with the ground to be “normal” and healthy. This thinking keeps blinders on us and masks obvious signs of troubles until they go too far. It sets the bar for gauging hoof health way too low. It allows professionals to accept true pathology as a perfectly normal condition and stop far short of achieving a truly healthy hoof. Who would try to evaluate the soundness and proper function of a splinted leg?! If that splint was required for the horse to have any use of its leg, who would accept that the horse is sound and refuse to dig a little deeper for answers? This is not such a wild comparison when you really think about it. The only differences lie in our traditionally accepted viewpoints, which should not have any influence on the veterinarian or the educated farrier.

A bare, unprotected hoof that cannot function comfortably and properly in the terrain the horse normally lives and works in is no less “sick” than any other part of the body that is not capable of doing its intended job. When any other part of the body is not functioning correctly, we immediately try to fix it. When the hooves aren’t functioning correctly, tradition demands that we just try to cover them up. The problem is that it only works for a little while and actually brings the hooves farther out of normal function. This simple understanding is the heart and soul of founder cure and prevention. Given the recent major advancements in the hoof boot industry (Please read the how-to article “Boots and Pads” on www.hoofrehab.com ) and ever-increasing knowledge of proper barefoot trimming, fixed metal horse shoeing is no longer necessary for bridging the gap between living and riding terrain anyway. It only serves as an unnecessary barrier between us and a true understanding of the current health and status of our horse’s hooves.

For case studies, clinic schedule, more of Pete’s articles and links to these research papers, please visit www.hoofrehab.com .

References and further study:

www.safergrass.org and personal consultation with its author, Kathryn Watts

INSULIN STIMULATES HAPTOTACTICMIGRATION OF HUMAN EPIDERMAL KERATINOCYTES (Benoliel AM, Kahn-Perles B, Imbert J, Verrando P.)

HOOF WALL WOUND REPAIR (Pollitt, Daradka)

FUNCTIONAL ATANATOMY OF THE CARTILAGE OF P3 AND THE DIGITAL CUSHION AND A HEMODYNAMIC FLOW

HYPOTHESIS OF ENERGY DISSIPATION (Bowker, Van Wulfen, Springer, Linder

EQUINE LAMINITIS: INCREASED TRANSCRIPTION OF MMP-2 (Kyaw-Tanner, Pollitt)

BIOCHEMICAL INDICES OF VASCULAR FUNCTION, GLUCOSE METABOLISM AND OXIDATIVE STRESS IN HORSES WITH EQUINE CUSHINGS DISEASE (Keen, McLaren, Chandler, McGorum)

EQUINE LAMINITIS: LOSS OF HEMIDESMOSOMES (French, Pollitt)

SENSORY RECEPTORS IN THE EQUINE FOOT (Bowker, Brewer, Guida, Linder, Sonea, Stinson)

EQUINE LAMINITIS: CLEAVAGE OF LAMININ 5 ASSOCIATED WITH BASEMENT MEMBRANE DYADHESION (French, Pollitt)

THE GROWTH AND ADAPTIVE CAPABILITIES OF THE HOOF WALL AND SOLE: FUNCTIONAL CHANGES IN RESPONSE TO STRESS (Bowker)

Also read all of Bowker’s papers from the link provided on my site.

GLUCOSE EFFECTS ON SKIN KERATINOCYTES: IMPLICATIONS FOR DIABETES SKIN COMPLICATIONS (Gale Group: Spravchikov, Sizyakov, Gartsbein, Accili, Tennenbaum, Wertheimer)

EQUINE LAMINITIS: GLUCOSE DEPRAVATION AND MMP ACTIVATION (French, Pollitt)

ENDOTOXIN INDUCED DIGITAL VASOCONSTRICTION IN HORSES (Bailey, Menzies-Gow, Marr, Elliott)

EQUINE LAMINITIS: A REVISED PATHOPHYSOLOGY (Pollitt)

METABOLIC SYNDROME IN HORSES (Johnson)

  

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BREAKOVER        2-15-05                          PETE RAMEY

Please don’t read this article out of context and try to apply it to your horse. I am assuming that you have read my book, all of the other articles on this site, and have been succeeding with the methods in the field. Then and only then, should you start to bring this more advanced technique into your trimming. It’s like driving a car. You shouldn’t worry about tweaking up the engine, until you know you have mastered the use of the brakes!

This is done for one or two trims only, and then the need for it eliminates itself.

When I first heard “through the grapevine” that Gene Ovnicek was beveling (or rockering) into the soles at the toes of horses, I was very disappointed. I have always respected him and his work, but now I thought he had gone off the deep end. I have been a loud voice for respecting the callous under P3 and my initial interpretation was that Gene had started violating this critical area.

After digesting this “new” spin on trimming I realized I had been doing the exact same thing for years on cases with severe P3 rotation with incredible results: Basically, setting up P3 on a 0-5 degree palmer angle, leaving a massive heel buttress, and then loading and preserving the sole callous under P3 while unloading everything outside of the radius of that callous. The only difference was that I was not doing that on “sound” horses. I was always pleased if a horse compacted his own bevel into the sole at the toe; in fact if you look at the pictures of my personal horses at the trail riding facility in my book, you will see that most of them have bevels (rockers) in the soles at the toe. I was not trimming it, though. It was the product of natural wear. I would have been horrified by anyone cutting the sole, anywhere. Now, I do even less sole work than I did at the time I wrote my book, with even better results.

I do have enough respect for Gene’s work that I couldn’t get it out of my mind, though, so it wasn’t with such a huge leap that I soon found myself giving it a lot of thought and cautiously beginning to experiment. The results have been spectacular. It has taken the soundness and performance of the horses in my care to an entirely new level, so now its time to share my findings and try to clarify what this is all about. 

Every horse that is lucky enough to have the soles sharing in the support of its weight (as nature intended) and has no one hacking away at the sole, will develop very dense callous under the perimeter of P3. This compacted sole will be much harder than hoof horn will ever get if the horse is working. Mechanically, it is in a better position to support the horse than the walls ever “dreamed of”.

If the walls are perfectly attached to P3 (no flare whatsoever) this callous lies immediately adjacent to the white line all the way around the perimeter of P3 and the lateral cartilages, from bar to bar. The callous will naturally concave itself to mirror the solar surface of P3 and to suit the terrain needs of the individual horse. It will rarely be visible from the outside in any way. If the bold bevel of the natural “mustang roll” is applied to the hoof wall, the breakover in any direction is at this callous, even if the walls are slightly (1/16 inch) longer than the sole, as they should be.

I should give MY definition of breakover, because different people use the term in so many different ways. Breakover is not the “front” of the hoof. It is the spot on the bottom of the foot that is still on the ground at the very moment the heels first leave the ground. (The “push-off” point, if you will.) This is not just at the center of the toe, but all the way around the toe, as horses do not always move in perfectly straight lines on perfectly flat ground. They do indeed turn, so breakover can occur anywhere around the perimeter of the foot.

There is a tremendous vertical force applied at the point of breakover. This force may sometimes even exceed impact force of landing! Try this experiment: Stand square and face forward, and then suddenly leap to the left or right at a 45 degree angle to the direction you are facing. You will find yourself applying great force to the ball of one foot; all of your weight plus all of your power. This does not hurt you, because nature gave you a very solid bone in that spot. Nature also covered that spot with skin that is packed into dense callous. There are definitely nerves there. You can very lightly touch that spot and you will feel it, yet applying all of your weight and energy to that spot doesn’t hurt at all, does it.

Nature was kind enough to do the same thing for the horse (actually better). Now please get back up and do one more experiment for me. Stand square, and then rise up high onto your tiptoes. Now suddenly leap forward at a 45 degree angle to the direction you are facing. Ouch! Sorry about that. Nature gave you a great spot on your foot to leap from, but only one spot. The other parts of your foot have different purposes, don’t they? The farthest forward part of your foot (your big toe) is not your breakover point, it is the ball of your foot. Well the horse is in the same boat, so you’re not alone.

The only spot on a horse’s foot that is mechanically strong enough to do this job well is the callous under P3. Again, in a truly healthy hoof with no flaring of the wall this callous is firmly attached to and is immediately adjacent to the white line. If, however, the wall deviates from the bone, there will be uncompacted, unsupported sole lying between the callous and the white line. (Actually it is not sole at all, but intertubular hoof horn produced from the laminae!) This situation is common in domestic horses and can easily be addressed with proper trimming. Doing this does two things: First, it immediately improves the soundness and the performance of the horse. Second, it dramatically speeds the growing out of flare, placing a self concaved callous right up against the white line where it should be…. All the way around the perimeter of the toe.

So how do we apply it in the field? The most accurate way would be from detailed interpretation of radiographs, of course, but there are three key things I look at in the field to accomplish it on my own.

First and most conservative is to place breakover at a point ½ the length of the frog in front of the apex of the frog. Again, we are not just talking about the center of the toe, so breakover will form a radius shaped like a “normal” hoof through that point and around toward the quarters. I am not talking about a vertical cut here at all, but 25 degree (from the ground plane) “relief” of the area of sole in front of this radius. After that, remove any flare in the lower 1/3 of the hoof wall from the top, making it match the overall plane of the upper 2/3 of the hoof capsule, apply the normal roll or bevel to the wall and then wait for the well attached new wall to grow in.

There are several reasons this is a very conservative approach that can readily be applied on a setup trim. The growth corium of the frog is very consistent in its orientation to the internal structures (including P3), but the outer visible frog may be stretched forward in a flared foot, along with the sole, walls, and white line. In wild or domestic hooves with no flaring in the capsule, there will actually be ¼ to 1/3 the length of the frog in front of the apex to breakover. So given that the apex of the frog will be stretched forward in the beginning usually and that ½ the frog length is conservative anyway, it is a safe starting place to improve the mechanics of the horse in motion and begin growth of a better hoof.

After the horse has been bare for a while, the calloused area of sole under P3 will become readily visible as a rounded “bump” that mirrors the bone. (It is not under the bone vertically, but is in line with the dorsal aspect of P3; an extension of the bone.) When this becomes visible I will then “switch gears” and allow that calloused bump to be the breakover point on the bottom of the foot; again not just center of the toe, but all the way around the toe. I do this by relieving everything outside the radius with a slight bevel (around 25 degrees from the ground plane) and then carry on with my normal trim. Do not touch a tool to the actual toe callous. I mean not even one little rasp stroke!

Bringing breakover inside the white line really freaks out some traditional farriers that have a limited understanding of what is going on inside. Ignoring this fact does not mean you can’t fix the problem. I succeeded for years at the growing out of toe flares and capsule rotation without this technique. When I see how much quicker I can do it now, though, I realize now that I was taking three steps forward and two steps back all along. Allow me to repeat myself; there will be no sole outside this callous if the walls are properly attached. The cases we are talking about have a loss or partial loss of wall attachment to the bone. This is done for one or two trims, and then any need for it will usually eliminate itself. The materials I am giving relief to are sole with no structure underneath to support it, hoof wall that is improperly attached to bone, separating laminae, and lamellar wedge. None of this can support the horse without spreading the damage, and definitely cannot bear the force of being the “push-off point” or breakover.

Let me back up and explain the lamellar wedge a bit. In a normal hoof, the dermal laminae (living, breathing, produced from and attached to the bone) intermesh perfectly with the epidermal laminae (leaves coming from the wall, produced at the coronet). The connection of the two is the connection of hoof to horse. The dermal laminae are constantly adding horn tubules to the mass of the hoof wall along the entire length of P3 (up to 60% of the hoof wall’s total mass, according to studies by Dr. Bowker, Michigan State). These horn tubules should compact tightly under pressure into the rest of the hoof wall as they are produced. This is how the walls move down the bone as they grow, and it is why the hoof walls aren’t stretched out to the thickness of a nickel by the time they get to the larger diameter of the hoof capsule at the ground.

When the dermal and epidermal laminae are torn apart (whether by unnatural mechanics, unnatural diet, or most commonly, the combination of both) these new horn tubules pile loosely between the two, pushing them farther apart as the walls (and thus the epidermal laminae) move toward the ground. The resulting “wedge” does a great job of padding the inner, sensitive structures from concussion (kicking a rock). It is less dense (read weaker), but seems to make up for it by being thicker. (A nice adaptation geared at survival, I think) As for a vertical support role, however, it is in no way set up to even begin to do the job without just spreading the damage.

In other words, relieving all of this tissue from a support role “Does no harm”. Yes, the horse is at a disadvantage because it was allowed to get this way, but you will not increase this disadvantage by relieving the vertical pressure on the area. The callous formed between P3 and the ground is the only working weight-bearing structure we have at the toe until the well attached wall grows in to aid the task. The epidermal laminae will be visible at ground level and will appear to be the “white line”. This is not the true “white line” at all!!! The white line is the combination of epidermal “leaves”, and leaves that are produced at the distal border of P3 and would be bonding the toe callous to the hoof wall if not for the wall separation we are discussing here. The visible epidermal laminae at ground level create a false white line that tricks most farriers. Once you realize this, you can very quickly learn to tell the difference between the two with your naked eye.

Intertwine the fingers of both of your hands. This represents the dermal and epidermal laminae between P3 and the hoof wall and also the bond of the white line between wall and sole. This is how the white line should appear at ground level. Now pull your hands apart and look at one hand only with your fingers spread apart. This is what the false white line at ground level looks like. Since half of it is missing, the resulting “holes” are easy targets for opportunistic pathogens; fungus, bacteria, etc……… Most farriers think they are dealing with white line disease, and are not realizing that the white line does not even exist on that particular horse. This situation is not rare. You will see it every day, if you are around domestic horses.

When you set up mechanics for proper growth and eventually actually have a true white line, you will find it to be almost impervious to fungal infiltration. (Read “The End of White Line Disease” for more on the subject)   

The third and final criteria I apply to placing the breakover is the simple projection of the upper, well attached growth to the ground. In other words, where will the hoof meet the ground when all flare is grown out and a mustang roll is applied to the wall? Sometimes, a toe callous forms under P3, and is later is pulled forward by the continued flaring of the walls. This can create a false toe callous, or at least one that is too far forward and unsupported by bone.

Whether to do this one or not is very subjective. Understand that I am very, very slow to back breakover into even a false toe callous. It gives me the “willies”. I cannot forge a natural hoof without allowing natural movement, so sometimes I have to do this. In the field, it happens this way: On about the second or third trim, I will have about 1/3 of the well attached capsule grown in. It will be perfectly attached to the coffin bone and will be readily visible as a much steeper, tighter band of new growth. If I trim to my normal standard; using the callous ridge as my breakover point, and then put the foot down and the breakover appears to be too far forward, according to the truth told by the well attached new growth, I will pick the hoof back up and bring the 25 degree bevel back to the spot that the new growth would hit the ground. Again, it is rare that I find this need, and have never needed to do it to the same horse twice and have never caused any tenderness from it; just improved movement.

The same is true with the rest of the criteria I have presented here. Done correctly, this will not make your horse tender after a trim. It will only speed healing of the problem, and immediately improve movement. There are two key exceptions I will warn you about. If someone has cut or rasped the sole under P3 in the past four months, there may not be enough sole under P3 to allow this type of trimming. It may still be the right thing to do, but becomes a critical judgment call of the experienced professional. Also, backing up breakover mechanically lengthens stride, encouraging a heel first landing. This is good news. If, however, the back of the foot is too weak and sensitive to support a heel first landing at the moment, backing up the breakover can indirectly cause soreness at the back of the foot. If this happens, the horse will be on his toes when he hits rocky terrain. I wrote a whole article on that subject, and what to do about it (Digging for the Truth about Navicular Syndrome), but I thought I should reference it here as well. Also please read, “Heel Height; The Deciding Factor” to prevent this, and before applying this method.

This is going to feel strange at first, but try it gradually. You will be just as impressed with the results as I was, I’m sure.

  

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“Making Natural Hoof Care Work” Updates          Revised 2-24-05           Pete Ramey

The toughest thing about writing a “how to” book, is that what you write is frozen in time. Even if you do a revision, all of the old copies are still out there. In the four or so years since I wrote my book, I have been studying, trimming horses, and learning every day. For the most part, only a portion of hoof trimming (particularly rehabilitation) can be written down or taught anyway, so writing about the subject is tough business. It seems that every time I tell someone never to do something, I find myself needing to do it on the next hoof I trim. Experience is the real teacher, and when the chips are down, the intuition and experience of a professional will succeed before “book knowledge”.  

The first thing I would like to add on to, is the acknowledgements. I would like to thank my beautiful, wonderful wife, Ivy for all of the hard work she puts in every day with the students, the clinics, the daily schedule and for building this site. You are the most amazing, perfect partner I could have dreamed of. My daughter, Lauren, has also been joined by an incredible son, Clint, and a beautiful new baby, Aly. Thank you, guys for being such a pleasure to come home to every day.

The techniques I taught in my book are solid and proven all over the world to deliver healthy, strong bare hooves, but I’ve learned some valuable lessons since then, that make things even better. I want to use this article and the other articles I will continually post on this site to share what I have learned along the way. I will assume the reader has read my book and not repeat what is already in there. I still don’t claim to know it all, but hope readers can benefit from my experience in the field, anyway.

First and foremost, time has continued to convince me that a healthy bare hoof has capabilities to perform to heights we haven’t yet dreamed of. Our goal continues to be for every horse to outperform its former shod self, and the hooves deliver this with shocking consistency that amazes me more every day.

Sore after a trim?

AANHCP Trimmer, Kirt Lander of Arizona; a highly experienced Natural Hoof Care Practitioner, kindly pointed out a problem in my book that I need to address. The statement ,”If a horse is ever sore after a trim, a trimming mistake has been made”, is too vague and needs clarification.

I was, and still am, traumatized by invasive, misguided trimming that continually causes sore horses. Every time the horse almost recovers from a trim, its time for the next trim. People are told that this pain is necessary. I have preached the world over, that it is not necessary. Barefoot transition, navicular rehab, founder rehab, uncontraction and bar straightening can all be accomplished with a less invasive trim (in any terrain or region) that doesn’t sore the horse. This is the message I was trying to get across.

Do I ever make horses sore? Yes, occasionally I do. When this happens, I do beat myself up about it pretty hard and try to learn something from it so that I may better serve the next horse. The fear of making a horse sore should not paralyze a professional into immobility, though. 

When you pull the shoes off a horse with unhealthy hooves, it will often be less comfortable afterwards. That’s what fixed shoes do best; they hide the pain caused by pathology (for a while) but they also generally cause the hoof to become less healthy and less functional, over time, which is why we do what we do. As the hoof gets healthier, with amazing consistency, it will feel and perform better while bare than it did when it was shod, but there is often an unavoidable “transition period” between the two.

I minimize this any way I can with the use of terrain, tape-on pads, Hoof Armor, hoof boots and by sometimes beginning with “incomplete trimming”, but the fact remains that this is a period I have to fight my way through with many horses. The only way I know of to truly avoid it is to raise a foal under competent natural hoof care. That way, you never have anything to “transition” from. I have still not found a farrier textbook that fails to recommend routine unshod periods “to recover from the damage done by shoeing” yet still, every day Natural Hoof Care Practitioners have to bear the burden and the blame for what the horses feel when they have the very first barefoot experience of their adult lives.

The other situation I need to discuss is going too long between trims. I find that there is no excuse for making a horse less sound after a four to six week maintenance trim. If you wait any longer, an excess amount of dead sole may form, and will stop the natural callousing of the live sole. A trimmer can come along and do a perfect trim, removing this dead sole and make the horse more sensitive to rocky ground than it was before the trim. This sensitivity should be an indication that the trim cycle was too long. When this happens to me, I arrange my next appointment for an earlier date. If the owner will not comply, I hand them the business card of someone else.

Are you a “bad person” if you only trim your broodmares every four months? Maybe not, but the trimmer is not necessarily the one at fault if the horse suffers from tender feet for a few days.  I don’t personally provide that service to my clients, but I suppose someone has to.

Finally, I definitely never meant for anyone to think that every lame horse feels perfect after my rasp touches its hoof. Every horse should feel the same or better after a trim (aside from the previous topics), or something better could have been done.  Generally, the overall condition of the hooves and the performance and soundness of the horse should begin a steady uphill climb, but the basic fact remains that the rehabilitation of problem hooves is a process that can sometimes take a while, depending on where you start and the level of performance expected of the horse . Often there are other factors involved, as well. For instance, if you have a laminitic horse and you refuse to adjust the diet and management, there is probably nothing that anyone can do to help your horse. Also, some problems are beyond repair and the best we can do is provide a bit of relief or support to a condition. Like I said in my book; if you get in the habit of pulling lame horses from the edge of the grave, you’ll find a very rewarding life, but you’ll get your heart broken every once in a while, as well. We all just need to constantly strive to learn every day and constantly question everything we “know”, so that this happens less and less often.

I apologize for my lack of clarity. 

Diet

Every day I realize more and more, the importance of diet to the hooves. Read my article “The End of White Line Disease”. It’s not just the “foundered” horses we need to put on strict diets. Almost every domestic horse I have seen has compromised hooves due to an unnatural diet. Cindy Sullivan said it the best I have heard, “What you pour in the top, comes out the bottom.”

Jaime used to frustrate me so much. When we would discuss a hard case over the phone, he always tried to get my mind back to the diet and environment of the horse. I just wanted to talk about trimming and tried over and over to pick some secret tidbit from him. “I’m sure you’re trimming is just fine,” he would say. “What’s the horse eating? Where does it live?” As time goes by, his wisdom is finally sinking in. The more you can get a horse moving and get the rich meals off his menu, the more amazing your trimming will appear. You can take that to the bank!

Mustang Roll?

I have found that applying a very prominent bevel to the outer walls rather than a round radius is much more effective. Be careful to leave the wall 1/16 inch longer that the sole unless the horse has worn them level with each other. This bevel should be around 45 degrees and from the widest part of the hoof, around the toe to the other side at the widest part of the foot, should involve all or most of the entire width of the hoof wall. Don’t bevel the walls behind the widest part of the foot in this manner, but lightly roll the sharp corner. Look closely at the wild hooves in my book and you’ll see exactly how to do this to perfection.

This puts a slight inward pressure on the walls as they press into footing, that creates a squeezing effect on the laminae rather than a separating force. Some worry that it could cause contraction (it doesn’t) but understand that the walls play the role of springing the hoof back together after expansion. The true expansion forces on the hoof capsule are the weight of the horse descending on the solar dome, and the outward pressure created by the squeezing of the fully developed digital cushion between a thick, calloused frog and the descending pastern bones. A little bevel on the outer wall is nothing when it opposes all of that expansion force. 

At first glance, most farriers say, “You’re making the walls passive”. Standing square on concrete; yes I am, but on varied terrain and in motion, the walls are very much engaged. You wouldn’t call the walls passive if you got your finger stuck between the bevel and a gravel road! When a horse is pushing off its toes, the walls are set up to work perfectly. It has been natures plan all along and it works.

Please read my new article, “Breakover” for more.

Sole ridge parallel to collateral grooves and bars

I used to trim the ridge of sole that extends from the ends of the bars, along the frog. I have found this to be unnecessary. Usually this sole ridge is prominent when optimum sole thickness and concavity have not yet been achieved. Perhaps this is to give extra support to a weakened situation. It normally goes away on its own when the hoof gets truly healthy. I succeeded for years, while faithfully trimming it away, but now I usually leave it alone. In fact, after the setup trim, I rarely even exfoliate or otherwise touch the sole again, unless the horse is so inactive that it  can’t wear away any sole at all. In this case you may need to use the collateral grooves as a reference to identify and remove the false sole as described in my book.

I have also learned more about bar trimming. For years I consistently tapered the bars and never left them level with the heel walls. This habit often caused me to trim a tiny amount of live sole at the corn area. After observing the work of K.C. LaPierre and Gene Ovnicek I stopped doing that as an experiment. I tried leaving the back of the bar level with the heel buttresses when the sole “asked” for it. The result was that very quickly almost all of the bars in my care tapered themselves in one or two trim cycles and now need absolutely no trimming to stay at an optimum height. In other words, I phased out the very last reason I had to trim into live sole.

I should not have been surprised. I already learned this lesson. Years ago, when I stopped trying to lower heels into live sole, the heels in my care lowered themselves farther than I ever would have dared to cut them. Cutting the live sole registers to the horse as a wound and it will quickly regrow in spite of the other adaptive needs of the horse. Never close your mind to other people’s methods. Everyone who trims horses every day knows something you don’t know!!!

Frogs and Heels

For years I paid far too little attention to the back of the foot. I did use frog health to judge overall hoof health, and kept frog contact with the ground, but only recently did I really “get it”. Dr. Bowker’s research really opened my eyes to what I now consider to be the most critical part of hoof care. Watch a horse that is tender on rocks. Almost always, it is the back of the foot they favor. Restoring health and function to the back of the foot is the absolute crux of hoof care, to me. Do that and everything else will fall into place. First, don’t trim the frog at all, except to remove diseased tissue. Let the frog pack into dense callous as you would the sole. It seems that these days I don’t even use my hoof knife at all on 9 out of 10 maintenance trims. At the rate I’m going, I predict I will eventually learn to leave my knife in the truck!!!

Seriously, I do find that I rarely find a need to touch the frog during dry weather but during wet times, I do sometimes have to taper the edges to remove and prevent infection and open the central clefts as well for the same reasons. I always try to remove as little as possible and really work to preserve the height. Exception is the rule, so this stuff is hard to teach! The bottom line is that it is a mistake to routinely trim every frog out of habit.

I still firmly believe the height of the live sole shows us the optimum heel height the body mechanically needs at a given time. However, if the frog/digital cushion is sensitive, the horse will land on his toes, throwing off the mechanics you may think you are setting up. This also, of course perpetuates the weakness in the back of the foot. A continued toe first landing causes thrush and heel contraction, joint and locomotion problems, and improper loading of the laminae, which can seriously contribute to separation and thus to white line disease and founder. Toe first landings also ultimately cause navicular bone changes (Dr. J.R. Rooney and Dr. Bowker) as well, so getting a horse to lengthen stride and move naturally is pretty darn important, I think.

To do this, we need to concentrate on increasing frog pressure at a rate that will allow the horse to use the back of the foot. According to Bowker, we should try to get at least 2/3 of the hoof’s bearing surface behind the apex of the frog and 1/3 in front of the apex. (I find that truly healthy hooves end up with even less in front of the apex, but find this to be a good place to start.)

If the back of the foot is sensitive and the height of the frog is greater than the height of the sole, it is usually best to lower the heels only to the height of the frog. If this helps the horse to land heel first, the frog will soon recede as the digital cushion becomes healthier and the frog packs into callous. You follow the frog down with the heel height over time until you get to a point that the heels are 1/16 inch longer than the live sole. From then on you will use the sole plane to dictate heel height and the back of the foot will be much stronger; the horse more sound. Read “Digging For The Truth About Navicular Syndrome” for more help.

Setting up the heels at the future plane

This one is difficult to understand, but extremely helpful for correcting under run heels, and other problems in the back of the foot. Don’t try it unless you are already succeeding with the methods in my book. Read it very carefully over and over until every word is crystal clear.

On page 63 of my book, the drawings and text depict one of the most common hoof forms we have to fight in the real world. The hoof wall is flared away from P3 and the P3 tip is too close to the ground. This situation is usually caused by someone continually rasping the sole from under P3 at the toe, while letting the heels grow without regard to bone position. (Trying to make the hoof wall rather than P3 line up with the pastern) The new hoof capsule we need to grow surrounds P3 in a normal way and is shown by the dashed line in the drawing at the bottom of the page. Look carefully at this drawing. The dashed line at the future ground plane that crosses through the heel is often where we need to trim to fix a troubled hoof. This leaves a rockered shape to the toe for a while, until the well connected hoof wall and missing sole under P3 grows in correctly. The alternative to doing this is to wait for the missing material at the toe to fill in and thus gradually correct the heels as the ground plane becomes more normal. The problem with waiting for this is that sometimes when the heels are too high the frog is out of function and sensitive. It will stay that way until we can put it too work.

This sensitivity forces a toe first landing which can continually flare the toe and wear the sole, perpetuating P3’s “too-close” relationship to the ground. If a trimmer lowers the heels to a natural height in this hoof without using this “bevel”, the sole at the quarters would be quicked. By beveling the heels back closer to the future correct ground plane while respecting the sole at the same time, you can start to bring the frog into function and encourage natural movement which will help forge a natural hoof.

Beware: This is a powerful tool in the right hands, but is also dangerous turf and should be done very gradually.

How do you apply it in the field? First apply the normal trim used in my book (respecting live sole as the guide) and then evaluate the situation. The collateral grooves along the frog are a very consistent gauge of P3 position. If the groove at the apex of the frog is very shallow in reference to the adjacent sole and hoof wall, but the collateral groove at the back of the foot is deeper than what is natural, we can safely assume we have the bone position in the capsule we are discussing here. (If in the slightest doubt, use a radiograph) If you allow the rasp to float ¾ inch above the bottom of the collateral groove at the apex of the frog while starting to rasp the heels, you set up the future correct ground plane at the back of the foot that will be present after the missing sole under P3 fills in. Rasp the heel until you get 1/16 inch above the sole or to the height of the frog, whichever comes first. (While continually floating the rasp ¾ inch above the frog apex groove) Never remove more than ¼ inch per trim using this method, as you definitely could overstress joints and tendons by doing more.

When natural sole thickness under P3 is finally achieved, this method will eliminate itself. When the rasp is touching the heel and floating above the apex, it will also be touching the toe! 

Don’t taper the bars and sole away from the heel height, but leave a flat area of “heel purchase” that includes part of the bar (KC La Pierre). The worries about tapering the inside of the back of the foot to allow heel expansion have been way overdone. Jaime Jackson coined the term “heel buttress” after studying wild horse hooves in the 80’s. That’s exactly what you want back there: Strength and power! If you have a strong frog and leave low, but powerful heel buttresses, the horse will land on the back of the foot and you’ll get all the expansion you need. Solar concavity isn’t that important except as a gauge of current sole thickness.

NOTE: When you look at a hoof and see a “bent” bar, try looking at it from a different perspective. Trim the bar to the height of the live sole. Generally speaking, you will find that the half of the bar closest to the frog is straight and descending into the solar concavity as it should, while the half of the bar closest to the heels goes flat with the sole. Why is that area flat? It is not thick enough. As you let the sole get thicker, the flat area disappears, and the sole adjacent to the bar concaves itself. As you continue to trim the bar with the sole, the bar thus becomes straight.

As with everywhere else on the foot, this added sole thickness does not cause the hoof capsule to become longer. The sole will pack into dense callous and drive the inner structures upward, actually making the capsule shorter; the heels lower. The flipside of that, is that if you continually cut into the sole to straighten the bars, you will never see the true potential of the hooves. Don’t take my word for it. If you are a confirmed “bar trimmer”, I challenge you to try this on four horses in your care for four months. You’ll see, like I did. 

 

Balance is tricky, using this method. Generally, assuming no one has been recently trimming the sole, the quarters (live sole) will be the correct height (thickness) in relation to P3. You are working the heel height to a more natural level (and plane, relative to P3 and the lateral cartilages) , but the missing sole under P3 becomes more obvious. You have to train your eye to pretend this missing sole is there to balance the hoof. For this reason I only recommend this method for very experienced professionals, but it is a life saver in many situations.

This will bother many people, who will think I am leaving the quarters higher than the heel to toe plane. Understand that we are making the quarters and heels correct(relative to the inner structures), and waiting for the missing material at the toe to fill in to give us our naturally hollowed quarters and proper P3 position within the capsule. The only alternatives to this are either leaving the heel too high, or cutting the quarters too deep. Neither are options for me. I have been using this method on severely rotated hoof capsules for six years, and routinely brought it into less severe cases for two years and have seen nothing but excellent results with it, but again, be careful and do it gradually.

P3 Rotation?

We need to all get behind the push by Dr. Barbara Page, Dr. Bowker, and farriers Gene Ovnicek, Lisa Lancaster, and others to standardize radiographs. The method was first presented by Dr. Robert Linford in 1987. A wire is taped firmly to the dorsal wall that stops precisely at the coronet. A thumbtack is placed in the point of the frog. A measured wire is attached to the block to give scale so precise measurements can be taken. The foot not being radiographed is picked up by an assistant, to load the other. This gives much greater ability to view vertical displacement of P3 in the capsule and the ability for vet and farrier to communicate in precise measurements from points readily located in the field (even over the phone) . Read “The Sound Hoof” by doctor, farrier, and Michigan State vet student Lisa Simmonds Lancaster. 

The world has come a long way in recent years, but I still feel that a misunderstanding of P3 rotation is causing a lot of unnecessary harm to horses. Phalangeal rotation basically means that the pastern bones don’t line up with the coffin bone. This is readily seen with the naked eye if you use the methods in my book of estimating bone position. It is usually caused by someone trying to trim a foot so that the dorsal wall rather than P3 lines up with the pastern. Occasionally it is caused by a horse avoiding pain or by suspensory, tendon or muscular problems. In my very humble lay opinion, it is NOT a product of founder, except that a foundering horse with inflammation of the sole’s corium and laminae will be leaning back to lighten the load on the toe and the toe wall. On top of that, it is a static position that a horse is never in during any phase of any stride, and not relevant to movement. Those joints are in motion all the time, except when the horse is standing on an x-ray block. Usually when a horse grows a normal hoof and is free of pain, the problem goes away.

Capsule rotation is when the hoof wall moves away from a natural position around P3. It is almost always easily fixed using the simple methods in my book if the whole horse can be made healthy. We are closer every day to a point where no one is putting horses down for this.

The real problem we face in the field with founder rehabilitation is vertical displacement of P3. In most radiographs this can’t even be measured and most veterinarians don’t understand the normal relationship that P3 should have to the coronet. I hope veterinarians will study the works of the doctors and farriers mentioned above and follow their lead.

Boa hoof boots

Thank you Garrett Ford! Finally we have a boot that is so durable and user friendly, it has created a brand new category of “natural hoof care” customer: People who don’t care about the health benefits of barefoot turnout, but just want to ride in the Boa boots for the superior convenience, traction and protection. They just like the Boas better than metal shoes!

I have used them extensively, not only for mountain trail riding, but for limited turnout of lame horses as well. When I turn out a lame horse in boots, I place a piece of neoprene saddle pad as an insole in the boot and sometimes make “vet wrap” socks. Applying Gold Bond foot powder (available at drug stores) keeps the environment in the boot cleaner.

I instruct the owner to pull the boots off daily, clean the hooves and the boots and check for rubbing. I have seen very little rubbing while doing this. A piece of duct tape placed on the rubbed area helps the problem when it does come up.

I have also found the padded boots to be very effective for riding horses with weak digital cushions and frogs. These horses are often mildly lame on all terrain in shoes, barefoot or in boots. The padded boots often give relief to such horses when nothing else will. My theoretical explanation of this is that the pain is being caused by vibration at the weak digital cushions and that the neoprene material in the boot creates an artificial vibration dampening system to replace the weak structures. The result of extensive riding in the padded boots, plus barefoot turnout, is a quickly strengthened frog/digital cushion and excellent healing of the problem when nothing else seems to work.

Boa tips:

The tightening mechanism is strong and durable. It is so strong you could easily use it to pinch the hoof right off your horse. It should be just snugged down so that hoof can’t come out of the boot, but not tightened around the coronet. A rub at the coronet at the center of the toe is a sure sign the mechanism was too tight. The boot should fit so that the boot doesn’t twist on the hoof while the mechanism is open. If the boot is a half size too big, add a leather insole the proper thickness to stop this twisting.

Before use, “break in” the boot by twisting, folding, and manipulating every part of it in your hands. Sit down and do this while watching a TV show. In thirty minutes you can change the boot from a rigid “ski boot” feel, to a very soft, pliable feel. This is very important, because in motion, the fetlock drops and has to flex the boot.

Go for a few short rides in the boots before you take off on an all day trip. Just like a new pair of shoes you buy for yourself, the boots must conform to the individual hoof, and little calloused areas must form at pressure points. You wouldn’t pull a pair of hiking boots out of the box and put them on for the first time right before a backpack trip. Don’t do this to your horse, either.

Garrett is busy designing even better boots. The other boot manufacturers have undoubtedly seen sales drop, so I’m sure they are redesigning as well. The fierce competition of boot manufacturers I hoped for in my book is upon us. I predict we will see better and better super-boots hit the market over the next few years.

I am not being paid to promote Boa boots. As soon as someone shows me a boot that works better in the field, I’ll let you know.

Added September ‘05

Easyboot Epics

Well, Garrett has outdone his own Boa boot with the new Epics. When he first told me he had designed a boot that outperforms the Boas, I was very excited until I saw them. I was disappointed to see that this “new” superboot was just an old Easyboot with a gaiter attached. “That’s not new”, I said! I was so wrong.

The gaiter stabilizes the boot so well, we don’t need the rear straps, the teeth or the tight fit that was necessary with the Easyboots.

I almost always use a razor knife to remove the rear straps and the tooth covers, then use pliers to squash the teeth flat. This usually makes a smaller boot size fit the hoof. I have also found that the tongue of the boot usually hits the coronet, so I trim about 5/8 inch off the tounge of the boot with a razor knife as well.

The result is an incredibly stable, light, compact boot that is very user friendly. The big advantage is that all of the rigid parts fall below the coronet. They are less likely to “rub” than anything I have used.

Garrett plans to have a new model out very soon that is even lower profiled and has these changes already made, plus a sole that is shaped more like a bare foot. This will increase traction in wet conditions.

Hoof Armor

I’ve been experimenting with the hoof epoxy; “Hoof Armor”. It is applied to the soles of horses in transition from shoes. It can be a great tool for horses that have been having their soles thinned by the previous farrier or trimmer, to get the horse comfortably through the first few months of barefootedness. Once the horse builds in the natural callous and sole thickness, it is no longer necessary.

It also has a powerful psychological effect for customers who fear their soles will wear away. As long as they can see that the epoxy is still there, they know their sole hasn’t worn at all.

Success with the product depends on how well you prep the hoof prior to application. If you follow the directions, it stays on. If you don’t follow the directions it falls off.

What’s in a name?

I still don’t know what we should call ourselves. Barefoot trimmers, hoof care specialists, natural hoof care practitioners…………..Have the names been tainted too much by the invasive trimming techniques practiced by some practitioners and by visions of misguided people trying to ride lame horses? Maybe, maybe not. “Hoof Podiatrist” is cool, but KC owns that one, I guess.  Personally I find that most of the names we’ve tried just take too long to say and lead to unnecessary conversation. I have a truck full of ways to protect the hoof during rehabilitation: A full stock of two types of boots and the tools and equipment to customize them, four types of founder pads, two types of epoxy, cast material and I am more opposed to riding horses without protection (if they need protection at a given time and terrain) than the average farrier, so I don’t think I’m exactly a “barefoot” advocate. I just don’t protect the hoof using methods that contribute to pathology and perpetuate the need for protection.

I get along very well with most farriers and veterinarians and disagree with many barefoot trimmers. I can still heat up an old pair of nippers and rework them to be better than new. The ring of the anvil still has an appeal, for sure. I still know how to shoe a horse, but just found other ways that I feel work much better. Hundreds of horse owners rely on me to take care of their horses’ hooves. I smell just like a farrier and have the same eternal backache, so until someone comes up with something better, I just went back to calling myself a farrier. 

I will add more as I continue to learn, myself. Thanks for your time, Pete

  

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THE END OF WHITE LINE DISEASE        (UPDATED 5-5-05)                    Pete Ramey

Copyright 2005

First of all “white line disease” is a misnomer. It is not a disease at all. It does seem to be an epidemic, though, so teaching farriers to deal with it has become my top concern. The telltale signs are stretched white lines and deep grooves filled with rotting material, where healthy hoof walls and white lines should be; flares that won’t grow out, hooves that won’t hold a shoe, soles that remain flat in spite of the most diligent care, and recurring abscesses. This list goes on. The bottom line is that the hoof wall becomes detached from the lamina and it seems impossible to most professionals to do anything about it.

In the past, a broad spectrum of bacteria, fungi, viruses, yeasts, etc. were blamed. Michael Wildenstein of Cornell University recently published a wonderful study in Hoofcare and Lameness magazine and the American Farriers Journal that identified fungal infection as the culprit on the leading edge of the destruction, with all of the other pathogens following behind. If the problems are all coming from fungal invasion, we should be able to open up the damaged areas, treat with an anti-fungal product, and have no more problems; right? Farriers and horse owners everywhere are finding out this is not the case, as hooves continue to fall apart before their eyes.

Is fungus really the problem? Certainly it is a part of the problem. The reason this is on everyone’s mind right now is that the eastern U.S. has recently had very wet weather, following a four year long dry spell. The fungi are having a field day with our horses’ hooves, skin and lungs. As awareness has increased, horse owners and farriers in dry environments are realizing they have been plagued with it for years as well. But, I have found that “white line disease” can be conquered with a three part attack of 1) making adjustments to the environment, 2) making adjustments to the diet, and 3) competent natural hoof care. If you choose to ignore any of the three components, your results will probably be incomplete or downright unsuccessful, but using the three together, the separation rarely stands a chance.

Horse hooves are highly adaptable. In nature, horses living in arid, high desert regions develop very short, deeply concaved hooves that resist chipping and excessive wear very well. Their rugged durability mirrors the terrain they move on every day. A wild horse living in a soft, wet environment has a very different hoof form. The hooves have slightly flatter soles, and a more flared form that can chip and break away in the soft, wet ground where the wearing of hoof horn is impossible. The key things that these two hoof forms have in common, is that the bone column remains correct in both, and the hoof can do its job in its relative terrain. I may stand alone here, but it is my firm opinion that the very thing that allows hooves in a wet environment to flare and chip, rather than severely overgrowing and setting up a very dangerous situation for the horse, is the very fungal invasion and wall separation we are trying to fight. In other words, the separation is a defense mechanism. Am I nuts? Just use your head.

Can you imagine what would happen without this separation and flaring? Picture a wild horse herd, living its twenty mile per day nomadic lifestyle, foraging over the sparse rangelands. Now if the herd crosses over a ridge and finds a lush fertile valley, with a soft wet river bottom covered with lush green grass, what do you think they will do? Knowing they are just horses, I’d say they would stay right there until they ate every bite, or a predator ran them off.

Immediately, their hooves will overgrow. The rapid growth and thick calloused horn will not be able to wear at all standing around grazing on the soft ground. If nature had not built in a defense system for this situation, that would be the end of the whole herd. The hooves would grow very tall; forcing the bone columns into very unnatural positions, and lift the horses onto “stilts”. The horses would undoubtedly break their legs, and there would be no way for the hooves to recover and remove the excess horn.

Fortunately, the horses have been well prepared for dramatic change to environment. Like many of nature’s ways, it’s not pretty, but it works. The hoof walls begin to separate from the horses’ coffin bones. As the hoof walls flare away, fungi find a perfect environment in the separations and splits and begin to feed on the hoof walls. This further weakens the hooves, and they break away in chunks. Is this bad news for the horse? Not necessarily, because all of this “destruction” is saving their lives. There will be no unnatural hoof wall length to twist their joints into damaging positions, rob P3 of its natural support by lifting the sole off the ground, or disrupt their ability to move. As soon as they get back to their nomadic lifestyle the flared, weakened wall will finish breaking away, and healthy horn can replace it.

Recent research from Michigan State University (Bowker) shows that the dermal laminae in domestic horses go through startling changes where flares are present. They actually become forked, and then the fork spreads back to the base until the lamina has divided into two weaker ones. This is the body’s reaction to stress and an attempt to “hang on” to the flared walls. In contrast, flared wild hooves that come to the University don’t show this division. In other words, in spite of the fact that the wild horses are moving twenty miles a day on very rocky terrain, the hooves are not stressed. Why? Only in domestication do we try to force flared walls into a support role. In the wild, a flared wall is moved out of an active support role, and the body makes no attempt to hold onto it.

We recently found wild horse hooves in the Great Basin of northern California. The horse was killed in a cattle grate. She was mature and had beautiful hooves, but some flaring was present after a winter in the snow. She has approximately 410 laminae per hoof, opposed to the “normal” 550-600 we see in domestic hooves (not under natural care). In spite of the fact she had lived most of her life on a solid bed of baseball sized lava rocks, her feet had been subject to far less stress than her domestic brothers standing in soft pastures!!! 

The flaring she had was simply the natural way getting rid of the excess growth she had during the snowy months. This may seem like a bizarre concept to you at first, but I’ve come to view founder, flaring, and even fungal infection as necessary and healthy adaptations the hooves can make, and we just let them run away to extremes in domestic horses.

ENVIRONMENTAL CONCERNS

So if wall separation is natural and necessary in soft, rich, wet environments, why do natural hoof care practitioners working in wet regions use the high desert hoof as their model? Because people like to ride their horses on firm, rocky footing, and “tricking” the domestic hoof into adapting to a closer facsimile to the high desert feral hoof is essential for barefoot riding on such terrain. It is also essential for restoring a hoof with a severe wall separation to something that can be shod, so even if you have no interest in riding barefoot or in hoof boots, you can find help here. Fungi and bacteria have a hard time invading tight, healthy hooves, so the closer we can maintain the hooves to imitate the desert feral hoof the safer the horse is from opportunistic pathogens. 

The movement towards 24 hour turnout can been overdone and improperly used, I think. The truth is that wetness, lush grass and soft ground are our hooves’ fiercest enemies and the harm done to them by standing for days on end in the rain can overshadow the good done to the body by 24 hour turnout. A better plan during wet times (or perhaps anytime if the only pasture available has soft ground) is a compromise. Do everything you can to dry up the horse’s terrain, allow as much exercise as possible, and bring the horse in for “drying out” periods.

I see amazing results for horses when owners put a four inch bed of pea gravel (literally the size of a pea or slightly larger) in their stalls and small paddocks. It actually is very easy to keep clean (as long as you keep on top of it) and is comfortable bedding. It dries out and toughens hooves like nothing else. Another great wet weather option is to provide a dirt paddock that is scraped often with a tractor. The hooves will tamp it into a concrete-like surface if the manure is routinely removed, and soon after it stops raining, the hooves will be dry. This is also a wonderful alternative when dew is soaking the grass and causing the hooves to be wet all night.

If you can provide a combination of both options for your horses, you will watch as most of your problems melt away. Everyone’s situation and capabilities will vary, but the bottom line is that if we want to stop nature from telling the hooves it is desirable to flare and be infected by fungi, we must dry up their situation as much as possible, keep their hooves from becoming too long and get them living on rougher terrain. 

DIET

No human was intended to eat cream filled chocolate éclairs. Ever. Some human’s bodies forgive insult better than others, though. I could probably eat ten of them a day without adverse effects, because the horses in my care ensure that I get more than my share of exercise. If my dad ate three of them a day, he would probably blow up like a balloon and notice adverse effects on his health immediately. If his dad ate even one of them, it would most likely kill him on the spot.

Our horses are in the same situation with the rich feeds we were taught to give them. Some get along okay, especially if they are young, active, and don’t have a specific problem in the body that causes them to have trouble processing sugars. In the end, though, it all eventually catches up with them. Lush, fertilized green grass, legumes, fruits, acorns, grains and molasses are all poisoning our horses every day. Our recent wet weather has caused a dramatically increased nutritional value and yield to our pastures. While most hoof care providers realize the importance of eliminating these things from the diet of a foundered horse, few realize how many “little” problems they are causing, like white line disease.

One of the first things to happen on the onset of laminitis is an increase in MMP production. (Pollitt) MMP’s are enzymes that naturally help to remodel the hoof to horse attachments and during even very mild laminitis can kick into overdrive and attack the membrane (basement membrane) surrounding the live corium (quick). The result is a separation of the hoof wall from the laminae. This initial separation occurs at the basement membrane (a layer of proteins) between the live dermal and the epidermal basal cells.  The dead or damaged basement membrane is the entry point where the fungi usually establish themselves in the hoof. Pollitt has established that this damage occurs first in even the mildest of laminitis episodes. Even if the horse is not in the typical severe pain associated with laminitis (that we can notice), the rich diet has been at work, destroying the hoof wall’s attachment. (Read “Laminitis Update” for a much deeper look into how the diet effects white line integrity)

I am going alone out onto a limb here, but I think this is, too, is a defense mechanism. Horses have been in domestication for a short time relative to their time on earth. Their bodies think they are wild, free roaming, and have just stumbled into an oasis. The only logical way for the hoof walls to react is to attempt to separate themselves from the horse to avoid the dangers of excessive length and preserve P3 support by the ground. The resulting dead tissue of the basement membrane is an ideal entry point for fungal infection to spread the damage. If a horse is not in pain from inflammation of the supercorium (laminitis), yet the hoof walls continually separate from the laminae, it is probably doing precisely what the rich feed it is receiving is telling it to do. To reverse this destruction, simply treat the horse as if it were suffering from a classic founder episode, and restrict the diet to free choice grass hay, salt block, mineral block and water. Better yet, feed horses that way and PREVENT founder and white line disease. 

Don’t ignore this step. It is at the root of every “hard case” I have ever seen. Most people supplement their non-working horses out of fear they will lose weight. If you showed me a human Olympic athlete and I pointed out that I could see his ribs and recommended that he start spending more time on the couch and that he eat ten crème filled chocolate éclairs per day until he was healthier, you would laugh at my ignorance. So why do so few people see the same thing where their horses are concerned? The same advice makes perfect sense to people when talking about a horse! An increase in feed without an increase in exercise can only add unwanted fat to the horse. If you want your horse to gain weight that is actually beneficial, increase his exercise while providing adequate nutrition, just as you would for the human athlete. Believe it or not, free choice mixed grass hay alone, does this very well for a shockingly high percentage of horses. 

  

HOOF CARE

Now for the part you’ve been waiting for; the trimming. I put it last because it is the least important of the three steps, but like the other two, can’t be ignored. The rise of white line disease has driven thousands of horse owners and farriers to natural hoof care. The more a farrier tries to patch or cover up the damage, the wetter and darker the environment becomes for the fungi, and they just get happier and more aggressive. Eventually there is no way to attach a shoe. The hooves must be bare to fix the situation. The flared walls and weak, separated lamina cannot be asked to carry the weight of the horse! Active wall support in this situation can only spread the damage and cause excruciating pain for the horse.

The trimming is simple, with nothing more being done to the errant hoof walls than the basic trimming taught in my book. Particular attention is paid to the aggressive removal of wall flare in the lower 1/3 of the hoof capsule, while the sole is pretty much left alone. (Don’t try to learn to trim from this article, please. I wrote a detailed book that teaches natural trimming step by step.) A very large bevel or mustang roll must me applied to the entire outer wall to keep the wall from tattering further, and it must be diligently maintained. It is very important that you do maintenance trims BEFORE the hooves flare again. Remember that when hooves get too long they are SUPPOSED to flare, and this allows further invasion by fungi and a continual spreading of the damage as fast as the horse can grow new hoof wall.

Also, it is very common for hooves with a large amount of flaring to not even have a true white line. When the hooves (and thus the epidermal laminae) mechanically separate from P3. The inner part of the white line produced at the distal border of P3 is often “lost” in the unorganized material of the lamellar wedge. (more detailed discussion of this in my article “Breakover”) The result is that rather than looking at the complete white line at ground level, you will only see the epidermal laminae. Since you only have half of the “fingers” present and resulting “holes”, this is of course a very easy target for fungi, as well. Again, grow in a well connected hoof wall and the resulting solid white line will be almost impervious to infection. 

It may come as a surprise, but the real crux of dealing with white line separation from a trimming standpoint has nothing at all to do with the treatment of the separating hoof walls. The real problem will almost always be in the back of the foot! In every single case of severe white line disease I have seen, the horses have been landing on their toes, in spite of the fact that they usually have no wall support there. A horse is supposed to land flat or slightly heel first at the walk, and heel first at the trot or canter. This is necessary for almost all of the shock absorbing systems to work properly. I see very few domestic horses that have not been under competent natural care that can do this, and it is the reason for most joint problems, wall separation, navicular problems……The list goes on. It translates to the rider as short, choppy stride, stumbling, unwillingness to trot……The list goes on.

When a horse is tender on rocks, most people blame the sole. The truth is, if no one has been trimming away at it the sole almost never tender. It was designed to bear the horse on rocky terrain and does this very well. (Notable exceptions are when subsolar abscesses are present and during laminitis, when the sole’s corium is suffering the exact same problems as the lamina. Jackson) The true culprit behind most tenderfootedness is the frog and the underlying digital cushion. Watch a horse striding along on grass and onto gravel. If the gravel hurts her, she will probably shorten stride, rise onto her toes, lean her head low and forward, effectively relieving all pressure on the back of the foot and transferring all of her weight to the sole of front of the foot. Time after time, people watch this movement and wrongly blame the soles. (I used to as well, so you’re not alone.)

When a horse is forced to move this way by pain at the back of the foot, no matter how well the hoof appears to be set up mechanically, the coffin bone is standing on its pointed tip and continually drives lower and lower into the hoof capsule, destroying the hoof’s attachment and perpetuating white line problems. Achieving a heel first landing is the most important thing a farrier can do for a horse.

A vast majority of domestic horses are incapable of using their frogs and digital cushions as nature intended. People are too programmed to think of hooves only when the horse is standing square on concrete. Although the frog is slightly passive to the heels on wild hooves and properly trimmed domestic hooves, the frog bears quite a load on the varied terrain horses roam and work on. Most domestic horses show a pain response when we pick their frogs and gentle pressure across the frogs with hoof testers can bring them to their knees. There is no possible way the horse can bear impact to the frogs on rocky ground and a horse in this condition will land toe first with a shortened stride on varied terrain no matter how well the hooves appear to be set up when the horse is standing or moving out on flat ground. How did this happen? It is from a lack of use. The soft ground most horses live on is not natural for them, and can’t stimulate the frog properly. The underlying digital cushion loses its ability to receive impact and the resulting soft, weak frogs are easily infected by fungus and bacteria. Regardless of terrain, this also happens if the heel walls are allowed to grow long enough to overprotect the frogs. Shoes, pads, and continued wetness from a lack of routine hoof picking are particularly important contributors to the problem. The more people try to protect the sensitive frogs, the worse the problem eventually becomes.

How do we reverse this problem? Put the frogs and digital cushions back to work. Keep the heels as low as possible without invading live sole. Avoid trimming the height of the frog; let it pack into dense calloused material instead. In my book I recommend trimming the heel height to just above the sole, but if the frogs are protruding and are very sensitive, you will need to lower the heels only to the height of the frogs to allow the horse to comfortably begin using them. Passive ground contact will cause the digital cushions to strengthen and move into a higher position and the frog will pack into calloused material. This causes the frog height to quickly recede into a more natural position and you should follow it religiously with the heel height until you reach a level 1/16 inch higher than the live sole. Treat any fungal infections that are present. Do everything you can to dry up the situation for the horse. Exercise often on terrain the horse is comfortable enough to land in heel first. Ride in hoof boots when terrain demands force a toe first landing or cause sensitivity (I am finding the new Boa boots to be wonderful in most situations). This is easy stuff. Recognizing the true problem is most of the battle. Achieving a heel first landing at the trot will make most problems with gait, joints, back, and hoof lameness melt away and should be the top priority in hoof trimming and conditioning. It will also stop the pattern of continued mechanical separation caused by the toe first landing. (Read “Digging for the Truth about Navicular Syndrome” for more on the back of the foot)

I guess I can’t write an article on white line disease without the mention of anti fungal treatments. Be sure that any treatment you use does not destroy live tissue on a cellular level. You may be contributing to the problem by creating dead tissue for pathogens to feed on. Notable antifungal treatments that do not damage live tissue are Clean Trax and 50% vinegar/water solutions I have in the past, and sometimes still do put customers on a picking and treating or soaking regiment. I am unsure at this time how much it contributes to my success with dealing with these problems. I can tell you for sure, that if you chemically treat the symptoms without dealing with the real problems, anti fungal treatment will appear pretty ineffective, but on the other hand I have seen diligent treatment be a part of countless successful rehabilitations and have customers who swear by each of the half dozen different treatment programs I have experimented with. I also have fixed hundreds of severe white line problems with no chemical treatment going on at all, so you tell me.    

  

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DIGGING FOR THE TRUTH ABOUT NAVICULAR SYNDROME          Pete Ramey (updated 12-28-05)

Copyright 2005

One of the most mind boggling areas of hoof pathology for a farrier to attempt to research is navicular syndrome. Every old text contradicts the next, and mountains of new research are being done every day. The good news is that farriers studying the hooves of feral horses and trimming domestic hooves to a closer facsimile to what nature intended, have been routinely restoring soundness to hopeless navicular cases. Veterinary researchers have been studying in this new direction and are steadily unlocking all of the old mysteries about navicular problems.

As one of these farriers who has come to think of restoring comfort and usability to navicular horses as a routine task, I am writing this article in hopes of familiarizing others with the current and very successful ways we are dealing with the problem. Understanding what the real problems are is 99 percent of the battle.

At the forefront of veterinary research on the way naturally shaped hooves are supposed to function, is Dr. Bowker of Michigan State University. He has identified the heel first landing as the most important element of hoof function and more importantly; hoof development. He teaches that as the hoof impacts the ground heel first, the hoof expands and the solar dome descends, thus dramatically increasing the volume of the hoof capsule. This sudden increase in volume creates a vacuum, which sucks blood into the hoof capsule. The movement of blood not only nourishes the living hoof, but acts as a very important hydraulic shock absorber. [Hemodynamics; Bowker. You can link directly to his published works from my “Links” page if my lay interpretations don’t suit your fancy] This is quite the opposite from the way most of us were taught. I was once taught to view the frog as something similar to a pump bulb for an outboard motor or a blood pressure cuff, with the frog squeezing out blood on impact. Either way, we’ve known for years that the hooves themselves aid in circulation, but the huge difference between the new and old theories, is that the expansion and function of the entire hoof capsule is harder to obtain than the simple squeezing of the frog, and since we now know how important this expansion is to shock absorption and longevity; much more important.

Enter Dr. James Rooney of the American College of Veterinarian Pathologists. He specializes in the post mortem study of horses. Although everyone I’ve ever known who owns more than ten horse books owns his book The Lame Horse, his startling findings on navicular bone changes have gone largely unnoticed by the farrier and veterinary communities. I hope to change that.

We’ve known for many years that some horses with navicular bone changes are perfectly sound, while many horses without such damage to the navicular bone show severe lameness at the back of the foot. It has long been assumed, though that damage to the navicular bone happened first, either because of a mysterious degenerative disease, a lack of circulation, or as I stated in my book (Making Natural Hoof Care Work For You) the result of the body reacting to unnatural pressure in that region. I can still buy two out of those three as being part of what’s happening (the degenerative disease part is dead wrong for sure). It has long been assumed that the pain of navicular syndrome is being caused by the friction on the already damaged navicular bone by the deep flexor tendon. It was assumed that this friction with a rough surface then damaged the deep flexor tendon. I wondered years ago how this could be so. It would increase pain dramatically if this were the case, for a horse to voluntarily land toe first. The only way he could move this way, would be to hang all of his weight by the deep flexor in the very pulley system that is supposed to be hurting him!

In thousands of dead horses he examined, Dr. Rooney found that the fibrocartilages surrounding the flexor tendon and the navicular bone were ALWAYS damaged if bone remodeling was present. He found not one single case in which the damage to the bone was beginning, and the cartilages at the interface between the navicular bone and the deep flexor tendon were not yet damaged. Not one case in thousands. Read this again if your eyebrows didn’t go up.

Specifically, the order in which damage occurs is; first the fibrocartilage surrounding the navicular bone (as will any arthrosis begin on the more convex surface), second the fibrocartilages surrounding the deep flexor tendon, then the deep flexor itself, and finally the navicular bone is damaged by the rough surface of the damaged deep flexor tendon.   How? Why? Dr. Rooney wondered too. Simulating a toe first landing in test machines with dead horse legs, he was able to simulate this exact process that is the beginning of navicular bone remodeling.

During normal, heel first locomotion, the deep flexor tendon is quickly tightened by the descending fetlock joint. At the same time, the coffin joint is rotating forward toward breakover, and is loosening the deep flexor. In a toe first landing however, the descending fetlock joint is still tightening the tendon just after impact, but after the toe impacts the ground, then heel rocks downward, tightening the tendon at the same time. Understand that in a heel first landing we have one pulley tightening as the other is releasing tension, but with a toe first landing, both pulleys are tightening at the same time. Far greater force is directed to the navicular pulley than was ever intended by nature. This is a very big difference; adding greatly to the force applied to the tendon and navicular bone. This force is of course dramatically increased if the unnatural movement is occurring on a hard surface. Greater force means greater friction, and the continued repeat of this insult causes damage to the region. These are major findings that Dr. Rooney has known and documented for years. (The earliest publication I have found was 1974!)

We’ve known for many years that horses can have serious caudal foot pain and no changes to the navicular bone. We’ve also known for many years that horses can have dramatic changes to the navicular bone, but show no lameness. Dr. Rooney proved and published that it was actually the unnatural toe first movement (usually caused by avoiding heel pain) that causes navicular remodeling; not the other way around as most professionals thought. Understandably, Dr. Rooney is one of the most frustrated people I know of. Thousands of navicular horses have been needlessly destroyed since his groundbreaking research. He was just 40 years ahead of his time.

This lost information goes neatly hand in hand with the newer research from Dr. Bowker. He has studied the back of the equine foot extensively. When a horse is born, all four feet are the same; even microscopically. Their development is incomplete; physical stimulation is supposed to finish the job.

The foundation of the front half of the foot is the coffin bone. The sole and hoof walls are rigidly attached to it, resulting in a firm structure to push from during locomotion. The lateral cartilages form the foundation of the rear half of the foot. This provides a yielding area to dissipate much of the initial impact energy; like the tires on your car. When a foal is born, the lateral cartilages are tiny, like the rest of the foot. They are less than 1/16th inch thick, and don’t even extend across the bottom of the foot underneath the frog, yet. As the foot grows, expansion, flexion and twisting of the hoof capsule develops the lateral cartilages. By adulthood, feral horses have developed the lateral cartilages to almost an inch thick and a solid floor of cartilage has been formed between the frog corium and the digital cushion.

At the same time, the digital cushion is continuing to develop as well. The digital cushion is a very important nerve center in the foot. In fact, most of the proprioceptors in the foot lie within the digital cushion. When the foal is born, the digital cushion is comprised of fat. It offers the right amount of exposure so the nerves can “feel”, but the right amount of protection so the lightweight foal doesn’t feel pain when the back of the foot slams into the ground.

Every time the foot hits the ground, pressure and release to the frog causes a bit of fibrocartilage to grow from the front of the digital cushion and spread toward the back. By the time the wild horse reaches adult weight, the digital cushion should have transformed into a solid mass of fibrocartilage. This offers the right amount of protection of the nerves for the impact force of an adult horse.

In domestication, however, we tend to keep foals on soft terrain. The hoof capsule can’t twist and distort, so the development of the digital cushion falls behind. Then we tend to shoe horses at two years old and ensure the hoof cannot twist and flex, effectively putting the brakes on the development completely. The result is very commonly, adult-sized hooves that still have lateral cartilages as thin as 1/8th inch, rather than the natural inch they are supposed to have.

At the same time, the soft terrain we traditionally raise our foals on limits frog pressure. We also tend to provide for the foals every need, so they have little reason to move the twenty miles a day that is natural to the horse. We tend to neglect foal hooves; allowing the heels to grow long and over-protect the frogs, further reducing frog pressure throughout the growing foal’s life.

The result is that very consistently, in domestic horses, the digital cushion development falls behind. The back of the foot is too sensitive to be the “landing zone” it was supposed to be so our horses start the pattern of loading the toes first to avoid the pain. This movement stops the development of the back of the foot in its tracks.

[You can easily learn to feel complete digital cushion development with your fingertips. If you pick up a foot and press the area above the bulbs; between the lateral cartilages, you will find a much more firm, dense feel in a well developed digital cushion. The easiest way to develop this feel is to go around comparing the feel of fronts and hinds. Pay particular attention to the different “feels” on horses with beautiful, sound hind feet and poor front feet.]

By the time many domestic horses are first ridden, the back of their feet are practically useless, and cause pain on rocky terrain. This problem shows up worse in the front feet than the hinds. Most of us were taught that the horse has more problems on the front feet than the hinds, because 60% of the horse’s weight and almost all the rider’s weight is on the front feet. In a standing horse, this is true, but once the horse steps into motion, the back end does a far greater amount of work.

From the time our foals hit the ground, they are gloriously moving off their hindquarters during their spirited play. Very consistently, domestic horses thus develop the hind feet more completely. This is important to know. It is the only reason the hardest working feet on the horse (the hinds) have increased resistance to founder, navicular disease and just generally tend to be tougher and healthier. Not in spite of the fact they do harder work than the fronts, but because of it!

So when we discuss the pathology behind navicular disease, we must understand that the real problem lies in the fact that most domestic horses are incapable of landing on their heels in soft footing and surely not in the rocky terrain they were born to roam. When a horse is sensitive on rocky terrain, most people blame the soles, but watch closely how they move. Almost every time they will shorten their stride, landing on their toes, and lean forward. They are keeping their sensitive frogs and underlying digital cushions out of harms way. Dr. Bowker has established that the longer they try to move this way, the weaker the structures become.

Continued toe first landing stresses and tears the attachment of the impar ligament (the attachment of P3 and navicular bone). The navicular bone is a part of the articulating surface of the joint between P2 and P3. When the horse lands on its toes, the weight of the horse then slams back into the navicular bone as the heels rock down. This constantly tears away at the impar ligament. 80% of the blood supply to the navicular bone goes through the impar ligament. Bowker blames a loss of circulation through the impar ligament for many of the navicular bone changes, as well as the attempts to repair this attachment leaving ossifications on P3 and the navicular bone.

Michigan State University has also found that the bone loss often diagnosed as navicular disease is the result of a lack of natural pressure (think of the bone loss suffered by astronauts during extended stays in space) in the region from continued toe first landing, and Dr. Bowker is consistently finding much more damage to the coffin bone in navicular horses, with 40-60% bone loss in P3 being common. Specifically he blames peripheral loading, or loading the walls only without the aid of natural sole support and toe first landings. Either situation robs P3 of the natural pressure it requires to maintain health and function.

Although Dr. Rooney and Dr. Bowker have discovered differing causes of navicular bone changes, both are adamant that it is the result of long term toe first landing or lack of use of the back of the foot. Wild horses of the high desert slam the back of the foot first into all terrain. [The Natural Horse; Jackson] Most of their domestic brothers jump with pain when a hoof pick is scraped along their frog or through the central cleft and this should be starting to really scare the owner of such a horse.

In the past (and in many places the present as well, unfortunately) when a horse was pointing or landing toe first with a shortened stride, navicular syndrome would be suspected. The nerves at the back of the foot would be blocked to see if this made the horse temporarily sound, or perhaps hoof testers would be used to check for pain along the heels and frogs. If it was confirmed that the back of the foot was in pain, radiographs were taken to check for changes to the navicular bone. If this was positive, the choice given to the owner was to put down the horse, or use orthopedic shoeing to squeeze another year or two out of the doomed horse. I see every day that weak digital cushions and thrushy frogs cause enough sensitivity to force a toe first landing. Dr. Rooney and Dr. Bowker have established that favoring a toe first landing causes the damage to the fibrocartilage of the navicular bone and the deep flexor, and that the bone changes of true navicular disease occur later.  In other words it is heel pain that cause navicular disease. I have personally seen that when the real problems causing pain for the horse are addressed, the presence of the navicular bone changes cause no pain for the horse (noticeable by us). It is sobering to think of all of the horses that may have been put down for chronic thrush.

When faced with this situation we are left with two options. First, we can cover up the problem with bar shoes and pads, ensuring that the frog never touches the ground. This would be just fine, if not for the destructive forces at work when we do this. For one, the more we protect the frog and digital cushion, the worse they will fall out of function. Masking the true problems by attacking symptoms will catch up to us every time in the end. Worse yet, by doing this we stop the natural expansion and hydraulic shock absorption. When we raise heels to protect the painful frogs, shock can’t be properly absorbed by the suspensory apparatus either, and from a skeletal standpoint (which is what matters to the horse), a toe first landing is being forced anyway (try running in high heeled shoes or cowboy boots and you will see exactly what I mean). Understand that all this talk of heel first landings is about the natural alignment of the bones during locomotion; NOT the outer heel we see. If a horse’s heels are artificially raised and they (heels) happen to hit the ground first, P3 may STILL be toe first on impact and causing the same unnatural forces. All of this research can be summarized by saying that the long held notion that raising the heels provides “slack” to the deep flexor tendon and thus decreases stress on the navicular bone, is untrue. While it may be true in the standing horse, it works the opposite way for the horse in motion. A low heel, a short breakover, a healthy functioning hoof and a heel first landing minimize stress to the deep flexor tendon and thus the navicular region.

The result of this unnatural movement and loss of natural energy dissipation, is the fact that most people think that it is normal for horses to have joint or back problems, and just be plain old by the time they reach ten years of age. The truth is that horses in nature are healthy and vibrant on average at least three times longer than in domestication. [Jackson] One of the big causes of this dramatic difference is the wear and tear we put on their bodies with the very unnatural movement we are talking about here.

I don’t mind debating “shod versus barefoot” with people. An educated farrier can come up with compelling arguments for shoeing horses and a spirited debate keeps my juices flowing. However, in light of modern research on hoof development, I humbly think that veterinarians should step in and throw a raging fit if someone shoes a horse before the development of the inner structures of the foot is complete!

So what is the other option when faced with a navicular horse? Fix the real problems. This is done by bringing the frogs and the digital cushions back into work. (I hope no one will try to learn to trim from this article. I wrote a whole book, countless articles and am a small part of a large training program, the AANHCP, for that purpose) The sole of the horse must be left alone while the heels are gradually brought down to increase frog pressure as the horse can stand it. This is like walking a tightrope. If you go too slowly, you will make no progress. If you do it too fast, the horse will be over-sensitive at the back of the foot and walk on his toes anyway, and you will make no progress (read “Heel Height: The Deciding Factor” on www.hoofrehab.com ). Skill at walking this tightrope separates the masters from the hackers in hoof trimming. Avoid trimming the frog, other than removing any tissue already destroyed by disease. It should be allowed to pack into dense callous just like the sole. Keep breakover back where it should be, relative to the coffin bone (read “Breakover” on www.hoofrehab.com ).

Do everything you can to dry up the situation for the horse. Well scraped paddocks and stalls or paddocks with deep pea gravel should be provided as all or part of the horse’s daily routine if you live in a wet region. It is surprisingly cheap and easy to maintain. (Dr. Bowker takes it a step farther and says, “You must bed your horse on the surface you wish to ride.”, but he is in a position to be a bit more bold than I, isn’t he)  Allow plenty of free roaming exercise with other horses and ride often on terrain the horse can currently land heel first in. Use hoof boots (I favor the Easyboot Epics for most situations) for riding when terrain forces a toe first landing or causes tenderness. The rest of the time, let the horse be barefoot. The ground will strengthen the back of the foot, and lifting the frogs higher off the ground and impeding stimulation and circulation with a permanent shoe can only work against us.

Often, horses with reduced health of the frogs and digital cushions will show lameness and/or a voluntary toe first landing on all terrain, and even in hoof boots or metal shoes. I have found that by adding foam padding inside the boot under the frog, the horses immediately move comfortably and correctly.  Since the boot alone very effectively relieves pressure on the frogs and the addition of the pad dramatically increases pressure to the region, I can only assume that the original pain is being caused by vibration, rather than pressure. Perhaps vibration dampening is an important purpose of the frog and digital cushions and the pad artificially imitates this effect. The horses described here make very dramatic healing progress when exercised often in this setup.

I use Epic boots for this, and cut neoprene saddle pads for the padding. (A new pad will be available from Easycare by Jan ‘06 that lasts much longer than the saddle pads.) If the boot is a perfect fit for the horse, I cut a frog shaped triangular wedge, tape it in place on the foot with a single piece of duct tape, then put the boot on. If the boot is a bit too large for the horse, I cut the pad to fit the entire bottom of the boot and use it as an insole. This creates a right and left boot, though, and they should be marked accordingly.

You can play around with different pad combinations and almost always find a combination that makes these horses comfortable when nothing else will. Miles of exercise in this setup will develop the inner structures faster than any method I know of and get you on the horse when nothing else will work. It’s truly like magic for a navicular horse! (Please read the article “Boots and Pads” on www.hoofrehab.com for more detailed descriptions and pictures)  

Very quickly, the frogs and digital cushions will toughen up and the horse will get comfortable. If there is navicular bone damage it will remain there long after the horse appears comfortable, but the horse probably won’t know it. Some say the damage can be repaired over time by the body, but no one seems to care when the horse feels better, so I’ve never heard of anyone proving or documenting this. I was very excited to find out that Dr. Bowker is methodically documenting the increase in hoof health over time in many navicular horses. I can’t wait for him to publish his results.

Dr. Rooney still maintains that once the bone damage of true navicular disease begins, it is irreversible. I, on the other hand have seen these horses returned to use and apparent happiness with my own eyes with shocking consistency. As we bounced this disagreement back and forth I was starting to think we were going to have to “agree to disagree”. Then I realized we were talking about two different things. I use myself as an example. I got in the wrong car one night as a teenager and earned four vertebrae in my lower back that are now fused into one mass by surgeons. My wrists are permanently damaged from hanging by my fingertips during my rock climbing days. Dirt bikes claimed my shoulders. Running in dry river beds got my knees. Would it be possible to make me clinically sound? No. My x-rays will always reveal the errors of my past and a good flexion test would probably cripple me for three days. I’m very happy though, and I perform one of the most physically demanding jobs known to man every day with a big smile on my face. That’s good enough for me and probably for most navicular horses as well.       

 

When navicular bone changes are treated as a symptom of simple loss of function and sensitivity at the back of the foot, restoring soundness is usually an easy task. I have personally seen many horses with confirmed navicular changes that have endured years of pain while the owners footed the bill for orthopedic shoeing, only to watch them become completely sound within days of a correct trim and a chance to go barefoot. Sometimes it is a longer process of course, but I have yet to experience failure on one single navicular case. (Yes, I know my time will come, but I wrote the same thing in my book five years ago. I’m still waiting.) The very best thing the reader can get out of all this is that everything we have discussed is preventable. We are setting back the lifespan and the athletic potential of our foals at a very early age. Take care of your babies’ hooves, provide them with lots of exercise, and allow them some time on dry, rough footing. Be sure the frogs and digital cushions of your horse are tough enough to allow extension and a heel first landing in all situations. It will pay big dividends down the road.

  

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BALANCE AND THE LIVE SOLE PLANE                                  Pete Ramey

When I was first learning the farrier trade, I was fortunate enough to be taken under the wing of an old shoer right before time caught up with his wrecked body enough to put him out of business. He had been taught years before by another old shoer, and I doubt very seriously that either of them had ever read a paragraph of a farrier text and definitely not a veterinary paper. His methods were very simple. Keep the horses barefoot and well trimmed during the off season to “drive up the sole”, keep the heels low and the shoe way back under the horse. “Cheat” the toes back if you need to, leave the frog alone and most of all, leave the sole alone and let it tell you where the foot wants to be. In fact, I am pretty sure I never really used a hoof knife until I was on my own. His dietary and conformational skills were apparently limited to a strong distaste for fat on a horse. “You’d better back off on that horse’s feed or he won’t be able to carry you anywhere.” That was pretty much it, as far as the horses and their hooves go; the rest was all metal work.

As I later studied deeper into corrective shoeing and worked hard to educate myself, I came to think him as a “cowboy shoer”; incompetent even. I failed to notice the fact that the people in the fancy barns who used the expensive “educated” corrective farriers had horses and hooves that were wrecked with problems. I also conveniently forgot for a while that very few of the horses in my teacher’s care ever had a problem at all. When they did it was usually from an injury and not sore feet. Which came first, the chicken or the egg? My answer at that time would have been wrong. Since then, I have systematically had to unlearn many of the things I learned to do to the horse that once made me feel superior to my teacher and at the same time developed a deep respect for the pure, raw effectiveness of his simple, “uneducated” ways.

These days I have traded in my metal shoes for state of the art hoof boots, and I have learned the awesome power in allowing the “off season barefoot healing period” to extend throughout the horse’s life. I have gone full circle and become one of the loudest voices in the world to “trust the sole”. I’m not alone; thankfully the whole farrier world is shifting in that direction. Is this the “fad” for the 2000’s? No, it is an important, basic fundamental of hoof care that the scientific farrier community just forgot for a while.

Let’s take it all a step further. In my book (Making Natural Hoof Care Work For You) I taught the typical hoof balancing methods practiced by most farriers with a footnote added that said I felt that this “cosmetic” balancing was wrong, but wasn’t quite ready to talk about it. After four years of constant experimentation since writing that, I am ready now. I now am convinced that the “little bit of sole” I would have had you to remove to achieve balance, is a direct violation of everything the horse is trying to do to protect himself and optimize performance.

The problem with traditional thoughts on hoof balance is that we are programmed to set horses up to be in balance while standing square on concrete. Few horses are asked to perform while standing square on concrete and I have never seen a horse limp or get injured while standing square on concrete either. If left to its own devices on, a horse will not stand square at all, but cock to one side and rest one foot at a time, just as you would. So what is the significance of balancing horses this way? I say none.

Like with most things, I came to this backwards. I started deeply studying the way horses move and wondering how I could make things better for each horse in my care. One of the most dramatic “for instances” is a horse that is worked extensively at the trot on a hard track or road. When a horse trots the hooves fly inward and land under his center of gravity. The footprints look like a tightrope walker. This is normal, natural, and efficient. As I observed this movement, I also noticed that the outside heel on a “cosmetically balanced” hoof lands first and that after this impact the hoof slams inward as the other heel is driven to the ground, snapping the fetlock and pastern joints. Knowing how destructive this could be, I decided I should experiment with lowering the outside of the hoof so that it could land in a more balanced way while the horse was performing the hardest work asked of it. Very quickly, in case after case, I found that the live sole plane was already begging for it. I didn’t have to invade the sole or leave anything higher than the sole to achieve this “balance for work”. In fact, these were the very hooves I would have previously had to invade the sole a bit to achieve cosmetic balance. I noticed this in case after case and it slowly became obvious that the sole could be totally trusted for optimum heel balance and toe balance as well. 

The same thing holds true in problem horses. The “pigeon-toed” horse is a prime example. When a horse toes in, you will usually find that the joints of the pastern and/or fetlock are set in an inward angulation. This is readily visible when the hoof is picked up and the angle of the frog turns in relative to the lower leg. If you try to twist the hoof with your hand so that the frog is in line with the leg, you will often find that it is impossible or painful to align the two. Traditionally, the inside toe has been lowered to try to straighten the leg. Doing this puts enormous strain on the joints and never seems to permanently change things for the horse anyway. Cutting a straight hoof onto a crooked leg is just as damaging to the joints and tendons as cutting a crooked hoof onto a straight leg! We have to accept what is there to work with.

By allowing a bit of cosmetic imbalance to remain in the hoof, we optimize the way the horse can move with what he has to work with. A pigeon-toed horse will almost always grow severe flare in the walls on the inside toe. If you have read my book you know that growing out wall flare is one of the top priorities of my trimming. I have many customers who think I have fixed their pigeon-toed horses, when in fact all I have done is grow out the flare. The 1/8 inch of imbalance the horse needs is still there and I haven’t made any attempt to correct it. It’s just imperceptible to the lay eye.

Please understand that I am talking specifically about adult horses here. In a foal, I will go to great lengths to combat any imbalance. After the joints are set and the bones finish growing, though, it is far better to allow the horse to forge the hoof he wants to. We aren’t smart enough or subtle enough to figure it out for him, but the sole will tell it to you every time.

This is not to say that I am not correcting imbalances. In fact I have become quite confident that treating imbalances of the hooves and limbs this way gives superior ability to correct those imbalances which can be corrected and maximum support to those that cannot (AND THE WISDOM TO KNOW THE DIFFERENCE) . Any experienced farrier can name countless imbalances he/she has worked out and some that tend to hang around in spite of every effort. I was the same way when I was still shoeing and still am very much in the same boat today (but not as often). The problem with trying to force a limb to straighten is that we overstress the joints, tendons ligaments and muscles and cause damage or soreness. The horse then moves in a manner that protects the injuries and the imbalance is perpetuated or worsened. By trusting the live sole for balance we work with the horses’ self healing abilities, rather than fighting against them. The result is amazing ability to straighten long term balance issues no matter where they are in the horse’s body or hooves.

How could it possibly be that simple? Realize that the horse is a wild animal that we have brought into domestication. He is highly adaptable and the only reason we have to care for the hooves at all is that the domestic horse doesn’t get the twenty miles a day of movement over rocky, varied terrain he was meant to. The hoof wall and the sole protect each other. The hoof wall is the tough, protective outer shell and the primary “digging out” tool of the hoof. Everyone agrees that it protects the sole, but few people realize that in nature, the sole protects the hoof wall in return. In feral horses, the wall rarely grows past the sole, yet in spite of the extreme conditions, doesn’t wear too short either. I have seen the same thing in the naturally trimmed horses in my care. I have professional trail horses working hard in rocky terrain every day, and even carriage horses working barefoot on the street. In my experience with literally thousands of barefoot horses I have never seen a horse fail to put out enough growth to do what the owner wanted it to do. Not even once.

The simple reason is that I never let the hooves in my care grow more than ¼ inch past the sole and don’t let them flare. Yes, the hooves are alive and as with every living thing they have their limits. It’s just that those limits are way beyond what most people think they are. Most farriers and horse owners not schooled or experienced in natural hoof care would quickly say that they have seen excessive hoof wear many times. What they have seen, though, are hooves that have overgrown and then broken away in chunks, not excessive wear. This is because the sole and its attachment to the hoof wall protects the hoof wall much the way our fingers protect our fingernails. I work very hard with my hands every day and have never once broken a nail. My fingernails aren’t of better quality than my mom’s, who does break nails. I just keep mine trimmed short so that my fingers protect them. 

The supercorium (all of the venous, nerve filled living tissue that lies under and produces the hoof wall, sole, white line and frog) is alive and receiving information every second of every day of a horse’s life. It reads the terrain and needs of the horse and reacts accordingly by putting out the growth it needs in the areas it needs to support optimum movement and also the healing of problems. It assumes that given natural wear (or routine natural trimming) the hoof wall will maintain itself at or slightly above the height of the live, calloused sole. If a horse needs a high heel on one foot because a shoulder injury won’t allow that leg to move as far forward in the stride or if the horse needs a cosmetic imbalance in one hoof because of a crooked fetlock joint, the supercorium adjusts the growth and it will show up in the sole. In nature, the hoof wall on that hoof would wear to the sole, placing the hoof wall in the optimum position at a given time. In domestic horses, most farriers fight tooth and nail to try to make the hooves match each other cosmetically. Usually it is a losing battle for the farrier, with the movement of the horse getting less balanced, and the lameness increasing more and more as time goes by.

The natural way to deal with this is to respect what the horse is trying to do by trusting the sole for hoof wall height. At the same time, do anything you can to diagnose and heal the real problem. The result is a better life for the horse and the optimum healing power for the problem. I know many “club footed horses” that move with beautiful balance and comfort, because I am working with nature rather than fighting her.

I sat down and started writing my book with only two goals in mind. I wanted to stop barefoot trimmers from carving out the sole in the back of the foot, and I wanted to stop farriers from rasping the sole out from under P3 at the toe. It grew into more on its own, but those were the marks I hoped to leave on the world. Since then, obviously, I have learned to stop trimming it myself, even for balance. Let’s talk about the first two some more.

My book has made a difference I know, but there are still barefoot trimmers out there who are coming up with reasons to trim the live sole at the back of the foot. Usually it is to straighten the bars. I have worked with several professional trimmers who just can’t shake that feeling that the crooked bars are causing pain. They just can’t stop carving into the sole to try to straighten them. I have gone into their areas and looked at their horses. The soles are flat and the horses are tenderfooted. They have no idea how poorly their hooves look or perform, compared to those of barefoot practitioners who respect the sole. When you leave the live sole alone you will quickly have deeper concavity and lower heels than you ever would have dared to trim. This is one more effort to get this across.

The thickness of the live sole will adjust to perfect uniformity quickly after you stop trimming into it. Solar concavity must be built, by densely compacted sole material being built up to natural thickness and following the natural concavity of the structures underneath. Solar concavity cannot be trimmed into the hoof because every time you trim the sole away, you undermine the sensitive tissue above, and it drops lower. The bars can’t straighten up and help support the horse until there is vertical room for them to stand up. This vertical height can not be achieved until the sole is no longer being cut. Barefoot practitioners who don’t trim into live sole and use the sole as a guide for trimming the bars have sound horses and strong, straight bars and they rarely even have to trim them at all. (If I totally lost you in the last two paragraphs, don’t worry about it. You don’t want to know.)

And for the farriers; be sure you recognize that the angle of hoof wall growing just below the coronet is what the horse needs to continue all the way to the ground. Look at this carefully, because it is causing a world of hurt for horses. The live sole under the tip of P3 is very uniform in thickness. It is around a half inch thick, and will not get thicker without piling into dead flakes or soft, rotting material. (An exception being false sole. Please read my book for details) The live sole very accurately shows you the p3 position, and thus proper balance. If you find yourself “needing” to rasp into live sole at the toe or allowing the heels to grow past the sole to achieve pastern alignment or desirable toe angle, look at the hoof from the side at ground level. You will see that the wall is flared from the coffin bone (The angle just below the coronet). You will need to leave the live sole alone under P3 and work to grow out the toe flare, or you are ensuring major trouble for the horse down the road.

When you rasp into live sole at the toe you are bringing P3 too close to the ground. It varies slightly from horse to horse, but generally speaking, the apex of the frog should be around ¾ inch deep into the solar concavity in a #1 sized hoof. Lay a rasp across the hoof walls (after trimming them to 1/16 inch above the sole). If the apex of the frog is not at least ¾ inch deep, no sole should be touched at the toe for any reason. Back up toe flare so that tightly connected wall can grow in. If you are concerned about pastern alignment or hoof angle, look at the angle of growth at the coronet. I’ll bet you will find that you and the horse are actually in agreement. When you grow out the flare, you will both like the results.  

I know that the total trust of the live sole plane for toe height, heel height and hoof balance seems oversimplified. If only you knew the hard knocks I have seen to get to this point. Understand that at one time or another I have done each of the things I am protesting in this article. As I have moved past each of them my rehabilitative abilities, the performance, and the comfort of the horses in my care has dramatically increased. I hope to turn this learning curve into a straight line for you; for the horse’s sake. Trusting the sole puts Mother Nature on your side, whether you are trying to fix a major hoof problem or trying to shave off 1/10 of a second. And Mother Nature makes a very tough ally! 

  

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THE POLITICS OF HOOF CARE                                                             Pete Ramey

Okay, let’s do politics. The problem with political discussions is they usually turn into heated debate. The nice thing about writing about politics is that you can fully present your view while the reader quietly reads. That is much easier. So this article is just that; no more and no less than my opinions about the politics of hoof care.

The study of feral horses and the remarkable hooves they wear has unlocked many of the mysteries that mystified the farrier world since the beginning. Chronic founder, white line disease, navicular syndrome and severe balance problems are easy work for a competent practitioner. Stamina, longevity, performance and lameness rehabilitation are reaching new heights. Natural hoof care is pretty simple on the surface. We listen to the hoof and trim on a regular interval so that the hooves never overgrow and can respond the way nature intended. This unlocks incredible healing powers. We provide quality riding boots for the owners to ride with as long as they need to. If the horse becomes comfortable being ridden barefoot; great! If not, that’s okay too. Most of them do so very quickly, but we let the horse decide. The point is that the horse at least gets the chance to be bare when it is not being ridden and the natural movement and shock absorption optimizes health for the entire body. The health of the body and the lack of breakdown of joints, muscles, ligaments and tendons is the primary reason we do what we do.

Most natural hoof care practitioners have spent more time studying the science of hooves and horses’ bodies, nutrition, care and locomotion than most traditional farriers or veterinarians would ever believe. We have turned ourselves into walking encyclopedias and we educate our clients so that they understand what’s going on too. We study every defect in our methods and in the horses in our care and hone both to a razor edge. We strive to learn and improve our work every day. Why? We have been in a political fight and it is making us stronger. Not with horseshoers as you might think, but with each other!

Most of the early practitioners of “barefoot” trimming were studying very invasive trimming techniques that caused a world of hurt for horses. On top of that, there were no schools or training programs that taught better methods. Most of the “barefoot trimmers” were horse owners who had learned their craft on the internet from other people who had never trimmed horses. The methodology of natural hoof care sounds good because it is, but it was being done by incompetent people. Horse owners all over the world tried it and blood spilled all over the barn floors. Now almost every horse owner has heard one of those horror stories and that has turned life into a political battle for some of the most competent hoof care providers in the world and it will unfortunately be that way for many years to come.

What happened to those misguided beginners? Most of them got frustrated and moved on to some other thing, but new ones are being created every day. Some of them stuck to their guns and continue to carve away at the soles and bars, just knowing all the tenderness is coming from crooked bars, contraction and that pesky, thick sole that keeps popping back. They can’t shake the methods they were taught because most of them have seen dramatic help given to foundered horses in the first months, but can’t see that their trimming is causing their progress to “hit a wall”. Some of them, however, have let the horses and science educate them and became very competent. If you are wondering how to tell the difference, just ask a horse in their care!

Another thing that makes us have to work to a much higher standard is that we are the new kids on the block. What if every time a shod horse took a bad step the owner swore to never shoe a horse again? That would force horseshoers to work at an incredibly high level of expertise; Right? You bet! That is exactly how natural hoof care practitioners have to live life and that has been great news for the horses in their care.

Things are changing fast, now. Veterinarians, research centers and universities have taken notice of the healing powers of the natural hoof. Research is being done and new discoveries are being made every day. Veterinarians are calling in natural hoof care practitioners to founder and navicular cases all over the world. The American Association of Natural Hoof Care Practitioners has been formed to do research and to train and certify competent professionals. The fact that we were fighting for truth and that we worked so hard to be competent paid off, and it is growing out of control now.

What horseshoers don’t understand is that none of this has to be a threat. The horror stories of the “misguided barefoot trimmers” and feelings of competition backlashed through the farrier world. Farriers who were trained to always allow horses to go bare during the off season were suddenly getting angry at the mere mention of a barefoot horse. Many of them now insist the horses must be perpetually shod. The longer a horse goes with continual year round shoeing, the easier it is for a natural hoof care practitioner to come along and triple the capabilities of the horse. There are plenty of horses to go around, for sure. Horseshoers should get training in the art and science of natural hoof care and beat us at our own game! Nothing would make me happier. But please take the time to learn. At least get my book and then study these articles as a start. We are no threat, and don’t wish to be. We just want what we have seen is best for the horse, but it all seems like an impossibility to a farrier who hasn’t seen it done right.

I remember when I would pull the shoes off my own horses and turn them out for the winter. I would check on them routinely and frown at the broken walls. I feared what would happen if one broke away too short to shoe. The horse would be lost, I thought. One at a time, they would scare me into shoeing them. By spring I would have most of them shod for just hanging out in a wet Appalachian pasture. It was those same horses that I put to work barefoot in rugged terrain without missing a step when I first started to educate myself about the natural hoof. Respectfully, to farriers, no matter how much you may know about shoeing and trimming, let me tell you there is much more to learn about barefoot rehabilitation! I’ve been there.

Now for the barefoot trimmers. Please don’t add fuel to the fire…… Don’t cut live sole. Don’t put down farriers and vets; it just makes you look bad. Don’t push a rehabilitative goal to the point that the horse is tenderfooted, because you can’t help the horse at all if the owner doesn’t let you come back! Don’t pull shoes off of a trail horse unless you have quality riding boots to provide to the owner. You know that horse owners can rarely fit boots “out of the box” well enough to succeed with them. You have the same obligation to stock boots and founder pads as a horseshoer has to stock shoes and nails!! They are tools of your trade. Don’t try to take the place of the vet; you’re not a doctor. Don’t cut live sole. Don’t provide service to horse owners who won’t steadily maintain their hooves. If every hoof you touch is maintained to perfection, you will never lack business. I promise. Oh yeah, and don’t cut live sole.

I invite all farriers, vets and natural hoof care practitioners to enroll in the certification program of the AANHCP. We need to all get on the same page and work toward an industry standard of care. The “barefoot movement” has been working like an explosion with lots of force going in every possible direction. Picture how much more effective and far reaching a tiny explosion compressed into a rifle barrel can be. We need to get all of our energy focused in one direction! Why come to the AANHCP and not one of the dozen other groups? The AANHCP is being set up as a legal nonprofit organization with the potential for research funding. Rehab facilities and a research center in wild horse country are in the planning stages. For me, though, the biggest thing that separates it from everyone else is in its very structure. It is being run by an annually elected board, rather than any one individual. If one of us goes nuts, the membership of certified professionals will be able to get rid of us, rather than having to face the switching of organizations or the destruction of the organization altogether. I wouldn’t want the value of my Certification to be hanging by the “political popularity” of one person. That would feel dangerous to me. What if he/she made the world angry, somehow? The time and money I put into becoming certified would be worthless. The whims of one person cannot run any organization into the future. History has shown us that many times. This is why I put my energy into being one of the instructors in the AANHCP program and will never “certify” anyone myself.

Many practitioners are approaching me and saying that the certification program takes too long to get through. Understand we are not giving a license to trim a horse. We are certifying the competence of a professional practitioner. This cannot be done in a week if it is to mean anything to the horse owners of the world or protect you in court. The exact details of certification and training are still being worked out to some extent. If you want to change something about the AANHCP, get involved!