Therapeutic Shoeing of Horses Discussed at AAEP

Veterinarians attending a Table Topic at the American Association of Equine Practitioners 2009 convention chose to discuss applications of the heart bar shoe; the Nolan Plate system, including what it is and how it works; shoeing after deep flexor tenotomy; suggestions for shoeing horses with navicular syndrome, and quarter crack repair for refractory cracks.

Veterinarians in the audience were asked if they were using heart bars and if so, was it for lamintis or for other hoof conditions. They answered overwhelmingly that heart bars were being used commonly for a number of different problems. Chronic laminitis was the most common use, but others used the shoe for any number of issues where frog support would be helpful.

The next topic was the Nolan Plate system. The basic questions were: what is it, how does it work, and does it work? The Nolan Plate is a thin, perforated piece of metal that is applied over the dorsal hoof capsule from toe to quarters. The plate is suppose to relieve pressure on the laminar corium, improve circulation, and help re-establish the laminae/hoof capsule bond. The plate is attached to the hoof wall by multiple sheet metal screws. There were a few in the audience who had tried the plate, but all said they would not use the plate again and questioned its efficacy.

The third topic was shoeing after deep flexor tenotomy, which led immediately to a discussion of the purpose for a deep flexor tenotomy. Consensus agreed there were two reasons for performing a deep flexor tenotomy: to correct coffin bone rotation as a result of chronic laminitis, or to correct the hoof conformation associated with coffin joint flexural deformity. All agreed the surgery provided a window of opportunity to correct the hoof capsule deformities and place the coffin bone in a more normal position.

Further discussion was about shoeing specifics. The discussion pointed out that there was a difference based on where the surgery was performed. Deep flexor tenotomies performed at the metacarpal level were less likely to have complications with the hoof, and the most appropriate shoeing was heel extensions of some type (an egg bar shoe, for example). Mid pastern tenotomies were thought to allow for greater changes in the hoof capsule, but this surgery was more likely to have complications, in particularly coffin joint subluxation. The consensus was that the best shoeing involved both heel elevation and extension, but wedge pads and shoes would be useful as well.

The fourth topic, shoeing suggestions for navicular syndrome, was interesting in that no consensus was encountered except the audience believed there was no one shoeing method for treating horses with this condition--instead, shoeing recommendations are on a case-by-case basis. A routine shoeing formula for horses diagnosed with navicular syndrome was much less likely to be successful versus shoeing that was based on the particular horse's hoof.

The fifth topic was quarter crack repair. But the attendee that was most interested in this topic specifically wanted input from the audience on their experiences with hoof wall grooving and its effect on quarter cracks. Many participants had experience with this technique, and all thought the technique had merit. There were variations discussed with grooving above the crack to stop spread, but also grooving the coronary band to relieve stress on that area and therefore prevent the cracks from forming.

This table topic had good discussion for the entire allotted time, and some discussion between participants continued after the Table Topic was formally over.

This Table Topic was facilitated by Bill Baker, DVM, and Tracy Turner, DVM, who wrote this report.

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