Just about every horse out there has what we might call a hoof problem on at least one of his four feet. It might be a simple mismatch that might not really be a problem, or it might be much more serious. In any case, hoof problems, regardless of scope, need to be managed properly to maximize the horse's soundness, comfort, and usefulness to you.

The challenge is five-fold, according to Bruce Lyle, DVM, who focuses primarily on foot care in his practice in Aubrey, Texas. "My approach to any case is to begin with problem identification, identify contributing factors, change what I can, and then observe the response, followed by re-evaluation," he says. "Identifying the problem can be challenging because of the lack of valid research on causes of pain in the foot. Sound horses performing at a high level may have abnormal-appearing bones on radiographs, whereas other lame horses may have an apparently beautiful foot with no radiographic abnormalities. In many cases, ultrasound and nuclear scintigraphy may be negative also, frustrating owner, farrier, and veterinarian.

"Because of these negative experiences and the lack of consistent, practical research, farrier John Arkley (more on him shortly) and I have joined with a growing faction of veterinarians and farriers handling foot problems and lameness from a fundamental form-to-function approach," Lyle says. "When coupled with knowledge and application of fundamental physiology and pathology, results are usually very impressive."

Defining and enacting treatment for foot problems can be tough, as there can be as many opinions about this as there are professionals who evaluate the horse. Some might not see the problem as significant and choose to ignore it. Others might see it as serious, or potentially serious, and prescribe a shoeing and/or management modification as treatment.

Once you have a prescription for the horse, there's the added factor (and certainly one of the most important ones) of whether that prescription can or will be followed. Differing opinions and/or inappropriate facilities or resources on the part of the owner can mean the horse doesn't get treated correctly, or at all.

Many factors affect successful management of any horse's foot problems, some of which might not be apparent on your first look. To quote professionals in various fields, the more you look, the more you see. And that tiny thing you see after a hard look might change everything.

Case In Point: Reggae


Reggae, our case study horse. See his feet below.

To illustrate some of these challenges, we bring you Reggae, who's just an all-over nice horse. He's a 17-hands-plus, 6-year-old warmblood who isn't at all lame and moves "beautifully" in his job as a dressage star-in-training. So what's the problem? Nothing huge, but Reggae--like many horses--does have some very common foot issues that need careful management to keep him moving well and sound. See if anything rings a bell. (And we'd like to offer our thanks to Reggae's owner, Teddy Arthur; veterinarian, Amy Rucker, DVM, head of ambulatory services and an instructor at the University of Missouri; and farrier, Randy Holthusen of Auxvasee, Mo., for the information in this article.)

To evaluate and make recommendations for our example case, we've enlisted the help of Lyle and John Arkley, an American Farrier's Association Certified Journeyman Farrier based in Palmer, Alaska.

The caveat: This is intended to be a learning experience on managing common hoof issues, not a shoeing prescription for any horse with seemingly similar issues. The emphasis is on management--as Arkley notes, "Fixing these things isn't a one-time deal, it's a process."

Reggae's History

Reggae came to his current owner in March 2003 with very thin soles (he was "very gimpy" when walking on gravel), a left front foot with a low heel/long toe (this foot developed a medial quarter crack in March 2004), a slightly clubbed right front foot, and some medial/lateral imbalance (see photos throughout article).

He is turned out to pasture a lot in good weather (although he's in a small dry lot now because of the quarter crack), and he is in dressage training in an indoor arena, ridden about five days per week. As a dressage horse, he has to be able to perform with an even gait even though his feet are mismatched, and he moves very well despite them.

"He pulls front shoes like they were taped on--you can't leave anything out behind the heel," says Rucker. He's ridden and turned out with bell boots and still pulls shoes off during turnout (probably when running full tilt, notes his owner), so various shoeing strategies (including aluminum rocker rail shoes, egg bars, etc.) have gone the way of the thrown shoe.

"He can't be away from the other horses much or he goes bonkers," adds Holthusen. "A lot of this stuff would have probably worked fine if we could keep him confined, stall-rested, and hand-exercised.

"Right from the start, we went with a four-point modified keg shoe with a rockered toe and gave him heel support at the same time," says Holthusen. "Within two shoeings, he had better consistency to his hoof wall and sole--he gained sole depth and better hoof wall overall. The owner commented that she couldn't believe how much more foot he had in two shoeings."

Critiquing Conformation

Probably the first important thing to understand about evaluating conformation, whether it's Reggae's or any other horse's, is that no horse is perfect. This isn't much of a surprise, as most of us humans have our little imperfections too--one foot a little bigger than the other, one leg a shade longer, a crooked finger. Or it might be more subtle than that, such as soreness on one side of your back from a misalignment that isn't visible at a casual glance, but it still affects your back's function and causes pain.

And regardless of how good he or she is, no farrier or veterinarian can fix poor conformation (except, in some cases, with surgery). "Bones don't change quickly in adult horses unless it's what you call a fracture, and not too many people want one of those," comments Lyle.

"For example, I measure pastern bone lengths (on radiographs)," he explains. "If one side is longer than the other, you need a bone wrench, not a horseshoe. If the true source is the bony column, the problem will be manageable, but obviously not resolvable. This further exemplifies how radiographs can benefit the foot care professional, owner, and horse, by allowing us to find ways to work with the limb, rather than against it.

"Shoeing the adult horse should complement the conformation, not correct it," he states. "You can balance the leg somewhat with the foot, but then the hoof becomes the sacrificial lamb. A balanced foot is one where all the components are doing their jobs--wall, sole, tendons, etc. When one gets more than its share of load from a bad step, bad angle, or poor shoeing, then you have pathology."

The goal, then, is to adjust trimming and shoeing (if applicable) to manage the stresses placed on the horse's hooves and legs so that no bone, tendon, ligament, or cartilage is overstressed. This ideal balance for that foot might not match one's mental image of the perfect, symmetrical foot, but if it works, then it's the perfect foot for that limb on that horse.

On to Reggae! Lyle begins: "The problems posed in the presenting history seem to be:

  1. Thin soles and tenderness on rocks;
  2. Frequent shoe loss, possibly from overreaching, and consequent wall insult/ destruction;
  3. Left front medial quarter crack; and
  4. Different front feet.

"Let's try to address these one at a time, though there will be some repetition and overlap," he says.

Thin Soles/Tender on Gravel

"Did the horse change locations, have his shoes removed, and has he been recently trimmed or ridden hard the previous day?" Lyle asks. We know from Reggae's history that he had changed locations, and initially had thin soles (8 and 10 mm on his front feet; 15 mm is considered by many to be a minimum "safe" depth). He now has plenty of sole--17 and 18 mm of sole on his front feet.

"Provided there was no reason to treat this case as laminitis, the standby treatment for this would be to add a pad," he states. However, he adds that this might address the result, but not the cause--the internal anatomy and compressive forces that are keeping the sole from growing as it should.

"In addition, in my opinion, pads can create more opportunity for shoe loss (when nails loosen as the pad compresses), and can allow for more solar moisture accumulation, further weakening the wall and sole-wall junction," Lyle explains. "The pad option would seem to be a better option in a dry, arid environment vs. a wet/muddy environment. The pad option thus protects the sole, but probably sets us back in two to three other areas.

"Based on the current measurements of the feet, Reggae has triple the sole depth exhibited by a lot of these big horses," he says. "This is probably a major contributor to his current soundness, and the existing radiographs suggest that thin soles are currently not a problem."

Frequently Lost Shoes

"Questions I would have regarding this issue include: Are the shoes being lost in deep mud or a pond?" asks Lyle. "Are the shoes bent when they are found, or are they flat with the nails sticking up as if the horse walked out of his shoe? Are the nails broken, or has some of the hoof wall been removed between the clinches and web? Are there signs on the heels of overreaching? The veterinarian side of the team may even need to be involved with a problem of this nature to evaluate neurological function. Subtle wobbler syndrome, EPM, or rhino (the neurologic form of equine herpesvirus) may cause incoordination and result in shoes being stepped on and removed by the horse."

"There's no mud or pond in that field," answers Rucker. "He even pulls them in his little dry lot sometimes, and there's no clear pattern as to where he's clipping them. There are never marks on his heels."

Reggae's hoof wall thickness is average to slightly below average for this size horse, Lyle notes, and will likely be thinner in the nailing area with this foot and conformation. The straight medial wall would further suggest a limited nail placement zone (in other words, it's tougher to get strong nails into the foot), and can result in part of a bought (straight out of the box), rounded shoe extending out past this straight wall, he added. Then it's a matter of how much shoe to keep out there to allow for expansion vs. the risk of providing an easy way to tear the shoe off.

"Large, young, overfed horses in English disciplines are usually turned out to self-exercise, and they play hard!" Lyle explains. "In spite of excellent blacksmithing, they still lose shoes, and the options become barefoot, glue-ons, or controlled exercise only."

So he asks: Is the shoe doing more harm than good? One problem with a horse like this is that every time he pulls a shoe, he tears up more of his foot.

"With the adhesive technology available today, a handmade glue-on shoe can offer some tremendous advantage for a competing athlete, but may be cost-prohibitive for another case that may be benefited with a four-point trim scheme and management changes (such as no or limited turnout with a strict exercise regimen, long-acting tranquilizers if the horse is overly active in the stall, cutting down on dietary starch, increasing exercise, hobbling pawers, etc., to 'take the edge off')," says Lyle.

Thrown Shoes=Hoof Wall Destruction

"Horses who are guilty of pulling shoes usually start getting clips, more nails, deeper nails, etc.," Lyle explains. "This is a recipe for hoof disaster in the big, playful fellow that is doing all of this in a stall or turnout. When dealing with a horse of this nature, it is the owner's responsibility to realize that he/she is going to have to pay to have a shoe replaced from time to time, or face more extensive repair and lay-up when the horse still jerks the shoe with clips and eight harpoons that are an inch and a half up into the wall.

"Reggae's history suggests to me he needs to be shod tighter (with the shoes exactly mimicking the wall shape above them), and the wall shape mimicking the coffin bone, thus enhancing breakover/foot lift-off in all directions," he comments. "The idea of support coming from shoe beyond the edge of the wall has never jived with me. I believe this creates an undesirable lever arm when the horse moves in the direction of the 'support,' resulting in shears and cracks, as well as providing a place for another foot to use that shoe for its support (i.e., tearing it off)."

Unless the nails are breaking or loosening, he recommends avoiding clips, as he believes they increase the risk of injury from a partially or completely pulled shoe. "And with radiographic guidance, shoe placement will begin to work in concert with the bony column rather than against it, and well-placed nails will adequately hold on the shoe," he adds.

Also, he says the shoeing frequency might need to be increased, perhaps even to every three to four weeks, to keep a closer watch on any nails that might be slowly loosening in a horse which is this hard on his shoes. "A lot of this is dictated by the horse's activity level and quality of his feet," he adds. "This is a multifactorial area of give and take with many options and consequences."

Quarter Crack and Low Heel (Left Front Foot)

"This leaves us with the issue of the crack to address and resolve," Lyle goes on. "It appears that the lateral (outside) wall is longer than the medial (inside), and this goes with the flaring that is occurring. I would like to measure the pastern bone lengths on the radiographs, and would expect to find the medial side of the bone longer than the lateral side of either P1 or P2 (the first and second phalanx bones). (Rucker notes that the medial sides of the front feet's P1s are 3 and 4 mm longer than the lateral sides.) Fortunately, the hoof has cracked in the uneven load distribution, and not the bone."

Arkley explains, "When the heel tubules all run forward like that, there will be uneven loading forces on the feet and they'll get quarter cracks pretty easily. I bet he has a blind (internal) quarter crack on the lateral side, too." (Author's note: At the next reset, Holthusen did observe a lateral quarter crack on this foot.)

"This horse likely grows laterally, and is thus jammed medially," Lyle observes. "If the bone lengths are not equal, this growth pattern will continue to occur, and the answer is to trim asymmetrically the hoof that grows asymmetrically, and at an interval that minimizes the opportunity for the cracks to occur. By trimming the lateral toe, quarter, and heel (thus inducing more weight-bearing on them), and redirecting the breakover to lateral of the apex of the frog (approximately 11 o'clock if the foot were a clock), your medial heel will automatically 'float' in the stance phase, and the jamming and crack will be manageable.

"In Reggae's case, I would specifically move the left front's breakover back to the existing second nail hole. I would pull the heels down ever so slightly to achieve parallelism between the wings of the coffin bone, and the rear of my shoe, and when you move breakover back as well, the palmar angle will go up about 10�--it's a self-adjusting palmar angle (for more information, see www.TheHorse.com/ViewArticle.aspx?ID=4245). The shoe would then be bent (rockered) to accommodate the shape of the foot, leaving 15 mm sole depth beneath the apex of P3, and having a 0 mm or slightly negative P3 breakover (behind the apex of P3 on a radiograph). I would make sure to have no exposed shoe in the back of the foot. I would use some Advanced Cushion Support in the sole. I would likely use a #4 four-point rail shoe, or would hand make one from 1"x 1 1/2" aluminum. I would not use clips, and would affix my shoe with either MX50s or Equilox.

"This is a very specific prescription that requires radiographic examination, interpretation, and application by the vet/farrier team," he continues. "This approach vs. the often-standard 'put on an egg bar with a pad' allows evaluation of the factors that are important to the horse to come into view and become available to any vet and farrier willing to put forth the effort needed."

Arkley's approach agrees with Lyle's: "It has been my experience that the only way to get a quarter crack to heal is to go after the source of the crack. This is the most crucial part of fixing it--fix the source and not the result. Then maybe the result can be fixed more quickly and the horse will move better.

"I have never had any luck unloading the heels," he continues. "I have much better luck changing how the foot loads. Combined with pulling back the lateral breakover and dropping the lateral wall, this foot will undergo a big change in a few weeks to months.

"I think the medial wall is being sheared by the short heel of the shoe," he goes on. "The coronary band is jammed in the heel area by the uneven loading of the foot, which results from the toe getting too long and spreading forward, and drawing and bending the heel tubules forward with it. By pushing back the heels we give the foot more surface to bear weight, hence more surface area to distribute weight. Get the coronary band to straighten and the foot will start growing much more massive heels, especially medially."

Mismatched Feet

"Just about all horses have one upright or club foot," observes Arkley. "Don't try to match it to the other one, because it's different. You have to do what's right for the foot. I put two different size shoes on horses all the time. We're not going to make them all the same.

"Constantly look for information on any kind of foot," he continues. "Keep looking for little indicators, flares, etc., that show weakness in the foot or something that's falling apart. Look at it abstractly, at what the inside of the foot is trying to do--the outside is a product of the inside."

Right Front--"The upright foot actually looks like a healthier foot than the other foot, which is maybe a bit overloaded," he observes. "It looks like he's wearing the toe more (than the left front's toe). The farrier has done some pretty darn good work. The hoof wall needs to be centered around the coffin bone a bit more.

"You manage these upright feet to keep sole depth," states Arkley. "Don't try to fix them--it doesn't work! Take the flare off the front of the foot, keep the sole under them, and don't do anything else. The horse doesn't know he's not supposed to have an upright foot.

"The farrier has done a beautiful job of pulling the toe back. Knock back (rasp the flare on) the toe just a tiny bit more (there's still just a very slight dish in it), roll it up just a bit more if you have the sole depth, starting way back in the foot under the extensor process (this really helps those sore horses in my experience), push the heels back (shorten them a bit, possibly to the widest point of the frog), and maybe use a half-size bigger shoe.

"You've got to get the blood flowing in the heels--as the toe gets long, it pulls the heels in and contracts them on a club foot big-time," he explains. "When you move breakover back, it sometimes takes off that lever arm and allows the heels to open up."

Left Front--"From what I see, this foot is in pretty darn good shape," says Arkley. "Compliments to the farrier. I would try a couple of things to see if we couldn't get the foot to hold a shoe a little better.

"These underrun horses are trying to get their frogs down to the ground to bear weight and take pressure off the damaged coronary band and wall," he continues. "If you load the foot with impression material and pull off these flares, this foot will heal up fast. See how the tubules change direction and go forward (at the heel)? See the heel self-destructing in this picture (left photo, page 56)? I see feet like this every day. There's just too much heel here. It needs to come back until you get some good, healthy heel. The heels are jammed up at the coronary band, and he's creating his own problems (bearing weight on those bent tubules is only making them worse).

"Cut him back to a strong heel, but don't take him too short, just enough to get a size bigger shoe on without leaving so much shoe hanging out the back, which by the way would really smash these feet," he says. "Center the whole foot, look from the inside out.

"The lateral wall and toe will need to be seen about every three weeks so it doesn't get away from us," he continues. "The old wall migrates very quickly (growing forward following bent tubules), so stay on top of these. I would use impression material on this foot and a leather pad to hold it.

"By loading the sole, the bony column will come up (move upward in the hoof capsule), hence really getting the blood to flow," he explains. "We always need to be aware of blood flow. The medial heel is not growing because of the compression of the blood supply."

Take-Home Message

And so concludes our investigation of Reggae and his average feet. What's the lesson in all this, since he isn't even your horse?

It's that your horse's feet are products of his internal anatomy, and those internal structures are what you're managing with foot care (trimming and/or shoeing), not just the hoof wall. After all, who only cares about the foot's appearance? You care about how it affects your horse's gaits and soundness. It's a bit like wearing orthotics and clogs to cut down on your back pain--not pretty, but very functional.

But in order to know what those internal structures are like and how they affect your horse's feet (and how to manage them), you have to look closer--and you might be surprised at what you'll find.

T-SHIRT THOUGHTS: Lesson From a Horse Owner

"I once worked on a horse in Florida with catastrophic founder in all four feet, corium displacement, and bone infection," says Bruce Lyle, DVM, of Aubrey, Texas. "Because of the opportunity to intervene early in the course of the disease, and past failures and successes with similar cases, I offered the owners a poor prognosis, but had ideas of how to address the problems at hand and possibly provide some opportunity for success.

"The owner of that horse was game, and from that day on, each time I saw him, he wore a shirt that said, 'Life's a journey, not a guided tour.' While we as scientists continue to develop the guided tour part of horse development, use, and ownership, it is up to all of us who are involved to realize that it is a journey still at this stage, still in need of the arts of blacksmithing and medicine to travel the roads of opportunity before us. It is the journey that provides the inducement and excitement of developing new, more efficient solutions to age-old problems, and the frustrations of failures. And it is imperative to have modes of communication such as The Horse so we may share our travels with one another.

"Funny how a T-shirt can make you think!"


Right front lateral view
When comparing the left and right front hooves of this horse (Reggae), it is clearly apparent that the left foot has a lower, more crushed heel than the more upright right front foot.


Right front lateral view
"Just about all horses have one upright or club foot," observes John Arkley, an American Farrier's Association Certified Journeyman Farrier based in Palmer, Alaska. "Don't try to match it to the other one, because it's different. You have to do what's right for the foot. I put two different size shoes on horses all the time. We're not going to make them all the same."

Left front lateral heel
"See how the tubules change direction and go forward (at the heel--red arrows, compared to straight tubules at the toe)? See the heel self-destructing? There's just too much heel here," says Arkley. "It needs to come back (be trimmed back) until you get some good, healthy heel."

Left front lateral heel
"The upright foot actually looks like a healthier foot than the other foot, which is maybe a bit overloaded," Arkley observes. "Manage these upright feet to keep sole depth."

Left front heels
Amy Rucker, DVM, head of ambulatory services and an instructor at the University of Missouri, and Reggae's veterinarian, notes, "This foot has very little cup to the sole and the frog is flat and full, yet the digital cushion isn't as thick in the heel (see radiograph on page 62)."

Right front heels
 "The right front foot has more cup to the sole, a recessed frog, and a heavy digital cushion. (This is also visible on the solar view on page 60)," she says.

Left front sole
Knowing that this flatter foot has a lower heel than the other, it's easy to see how the frog is more prominent from more weight-bearing and ground contact compared to the more upright right front foot.
Widest part of foot: 5.5 inches
Length: 5.75 inches

Right front sole
 This more upright foot shows a more recessed frog and cupped sole than its leftward counterpart.

Widest part of foot: 5 inches
Length: 5.75 inches

Left front heels
As measured on radiographs, the medial sides (insides) of Regae's upper pastern bones (P1s) on his front feet are 3 and 4 mm longer than the lateral sides (outsides). "Fortunately, the left front hoof has cracked in the uneven load distribution and not the bone," comments Bruce Lyle, DVM, of Aubrey, Texas. "The answer is to trim asymmetrically the hoof that grows asymmetrically, and at an interval that minimizes the opportunity for cracks to occur."

Left front X ray
This lateral (outside) radiograph of the left front foot shows a slightly broken-back hoof-pastern axis (gold lines) characteristic of a hoof with a low heel and long toe. The low (0�) palmar angle that the coffin bone makes with the ground is also typical of this kind of foot.

Right front X ray
 This lateral radiograph of the right front foot shows a fairly straight hoof-pastern axis (gold lines) and a higher palmar angle compared to the left front foot.


Right front DP X rayLeft front DP X ray

These are dorsopalmar (front) view radiographs. On the right front foot (shown at left as if you were standing in front of the horse), the medial side (inside) of P1 (first phalanx) is 4 mm longer than the lateral side (outside), but the bony column is more balanced mediolaterally than the left front--the medial and lateral sides of the coffin bone are the same distance from the ground (red lines) and joint spaces are more even. On the left front foot, the medial side of P1 is 3 mm longer than the lateral side, resulting in a somewhat crushed medial hoof and high lateral side of the hoof as well.


rIGHTfront DP X ray
First phalanx (P1)
Left front DP X ray
First phalanx (P1)

About the Author

Christy M. West

Christy West has a BS in Equine Science from the University of Kentucky, and an MS in Agricultural Journalism from the University of Wisconsin-Madison.

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