“The horse’s foot is so integral to most of what we do in equine practice,” said moderator Gayle Trotter, DVM, MS, professor in clinical sciences at Colorado State University, in the Podiatry forum on Dec. 12 at the American Association of Equine Practitioners convention in Orlando, Fla. Topics discussed included the role of imaging in equine podiatry, working relationships with farriers, standardization of podiatry nomenclature, and club feet.

Many veterinarians discussed the manners in which they handle communication about X rays, with some using digital cameras to photograph X rays. They then print out and/or e-mail the X rays to the owners and farriers involved to other veterinarians for consults. Others mentioned the importance of marking measurements on these digital files (or on faxes) before sending them, so that digitally scaled images don’t mislead the recipient as to absolute measurements.

This logically led into a discussion of hoof measurement procedures and nomenclature in which some veterinarians used different terms for the same measurements, and others were not familiar with certain measurements and their significance at all. Everyone agreed that standard nomenclature was important, and Steve O’Grady, BVSc, noted that he was working on a glossary of terms with other podiatry specialists and intended to submit it to Equine Veterinary Education for publication. Renowned equine podiatry specialists including Ric Redden, DVM; Tennessee farrier Danny Dunson; and Trotter spent time explaining to other attendees their measurement systems and the significance of certain ranges of some parameters.

For example, Redden discussed his quantification of the horn-laminar zone (H-L zone) as two measurements of the space between the coffin bone (P3) and the outer hoof wall, one just below the extensor process of the coffin bone (where the extensor tendon attaches) and one at the distal (closer to the ground) end of the bone. He then expresses the H-L zone as the upper measurement over the lower, such as 15 mm/15 mm. The value of this is that if the lower measurement is greater than the upper one (where it wasn’t before), then rotation is occurring and the horse’s foot needs help to stop it.

Two-Way Education

Several veterinarians expressed their appreciation of this education, and discussed the best way to impart it to farriers. Good working relationships and exchanging information between veterinarians and farriers was the biggest topic of the forum, with some veterinarians expressing frustration and others the elevation of their knowledge and practices with such a relationship. The main point many made was that a veterinarian can’t approach a farrier as a teacher, but should approach him or her as an equal who needs help with a horse. Then the two professionals can work together and exchange ideas to help this and all other horses.

“In general, our profession (veterinary) doesn’t know what they should about the horse’s foot, and farriers are often set in their ways and don’t want to change,” said one attendee. “But you can learn a lot from the farrier, the farrier can learn a lot from you, and you both can learn a lot from the horse.” Others agreed that it’s nearly impossible to have a working relationship with a farrier with a free exchange of information until both professionals are on a first-name basis. This generally comes only from working together on a horse or three.

Helping farriers learn how to read X rays was a universally approved suggestion, with several attendees discussing sessions and farrier clinics they’d hosted in order to do this. “Farriers are not taught to read X rays,” said Dunson. “Until I really got to seeing what mechanics were inside the foot, horses hated me! I was forcing mechanics on the feet without the aid of X rays.”

This is where many of the veterinarians in attendance felt that veterinarians should step in. “We have a lot of responsibility to farriers to teach them how to read film,” said Redden. “That’s the best tool they’ve got.” One veterinarian suggested placing markers on the horse’s leg and foot that would show up on the X ray in order to facilitate farriers’ understanding of the outer structures’ relationships to the inner structures. This also establishes a reference point for interpreting films.

X ray technique was a logical sequel, as several veterinarians discussed their marking and X ray exposure procedures. The key points were to mark the entire wall at the toe, the apex of the frog in most cases, to expose the film correctly to show soft tissue or bone depending on the information desired, and to stand the horse squarely on two blocks, not just placing the foot to be X rayed on the block. This is to have the horse standing normally for the X ray; the two blocks tremendously aid taking film of the lame horse, as they never want to stand only with the lame foot on one block.

Additionally, Redden and others emphasized the need for veterinarians to be self-critical about their X ray technique, and to constantly strive for better views in order to get more information about each foot.

Club Feet

This discussion focused mainly on club feet in mature horses, with Redden defining his four grades of club feet as follows:

  1. A foot with an angle five degrees steeper than the opposite foot (for a unilateral, or only present in one foot, case).
  2. Same as grade 1, but if you have the horse stand with the toe of the foot in question parallel with the heel of the opposite foot, you can slide a piece of paper under the heel. Also, wider growth rings will be present at the heel.
  3. Same as grade 2, but with a dish in the hoof wall at the toe.
  4. The top of the hoof at the toe will have a nearly 90-degree angle with the ground and the heel as high as the toe or higher at the coronary band. A severe dish is present at the toe.

Attendees discussed telltale signs of club feet in the sole and the criteria for recommending a check ligament desmotomy to relieve some tendon pressure. They also discussed the risk of mechanically inducing laminitis by continually trimming off the heel in a severe case, thus putting undue stress on the toe. Additionally, Redden noted the risk of unilateral white line disease from the overstressed toe of a severe club foot.

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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