Bluegrass Laminitis Symposium 1999

The name of the conference might be misleading, because the 10th Annual Bluegrass Laminitis Symposium in Louisville, Ky., covered topics from how nutrition affects hooves to what stimulates hooves to grow. The theme of this year's symposium was Long Toe Low Heel. Organized by Ric Redden, DVM, owner of the International Equine Podiatry Center near Versailles, Ky., the symposium hosted speakers from around the world who addressed problems that farriers face in their everyday practice. Some of the topics were long toe low heel, four point trim, how nutrition affects the hoof, and what stimulates hoof growth. There also was a trade show that boasted 50 booths ranging from farrier supplies to equestrian gifts.

Redden started the symposium by describing the poor-quality hoof and how to restore it to normal. In appearance, the poor-quality hoof has ground contact at the heels spanning from three-quarters of an inch to two inches at the widest point of the frog; breakover is from two to three inches in front of the apex of the frog. The bars of the foot are pretty much nonexistent, he said, with heels folded under and forward. These qualities are the result of improper pillar loading, horn growth, and maturation. Redden believes, however, that the poor-quality hoof can be corrected over a period of four to six months.

Seen mainly in racing Thoroughbreds and heavy work horses, the long toe low heel problem can be a cause of concern for farriers and owners because it can cut the performance horse's career short. It can cause lameness in the middle of the racing season, which can be a major concern for owners because time off for lameness means dollars lost in recovery time.

What happens in the racehorse, Redden explained, is that when the horse is racing or exercising, the foot falls in a manner that puts extra stress on the deep digital flexor tendon, the navicular bone, and the suspensory ligaments of the navicular bone. It's seen more in racehorses because of the extended gait when the horse is running. The heel is the first part of the hoof to hit the ground when a horse is cantering or galloping, therefore taking the brunt of the force when the foot falls. Heavy work horses also exhibit this condition because of the extra work load that is placed on them, and this tends to destroy the heel. It is not seen nearly as much in show or pleasure horses because they do not exhibit the same extended gait, or work load, as the racehorses or heavy work horses. At the trot, a horse's foot lands flat, therefore not creating the same problem.

According to G. F. "Andy" Anderson, DVM, of Broken Arrow, Okla., factors such as infrequent shoeing and leaving the toe too long in order to change a horse's gait add to the problem. Leaving the toe long overloads and stresses the heel. As the heel becomes overloaded, and the toe becomes longer, the hoof wall begins to deform. The toe then develops a dish in the anterior (front) wall, and the horn tubules at the heel begin to curve under the foot. As they begin to curve, the walls weaken, allowing further collapsing of the heel and more dishing of the anterior hoof wall.

To correct the problem, the breakover point must be moved back. However, with the long toe low heeled horse, it's not quite that easy because there is not enough hoof to just trim the toe off and move the breakover point to where it should be. If that is done, then the horse will be sore and have even thinner soles, which could lead to further lameness or injury. In addition, horses with a long toe low heel tend to have thin soles to begin with, which complicates the farrier's treatment because it severely limits what can be done.

A good starting point when dealing with horses with long toe low heel is the four point trim, according to farrier John Arkley of Wasilla, Alaska. Arkley believes that some common causes of long toe low heel are short shoeing (using shoes that are too small) and leaving too much heel to increase the angle of the foot. Many times farriers will short shoe in order to keep shoes on the horse. Using shoes that are too small, and fitting them to the toe without enough heel support, causes the hoof to follow the shoe forward until natural support is lost and the hoof capsule looses its strength and integrity. The result will be a stretched hoof wall, the bars and buttress crushed causing the coronary band to be lifted and distorted. In addition to long toe low heel, short shoeing also can lead to navicular disease, abscessed feet, white line disease, or cause stumbling and tripping.

Arkley uses the four point trim to eliminate stress to the hoof. This method of trimming allows the weight of the horse to be distributed evenly to four areas of the foot. By evenly distributing the weight of the animal to these areas, hoof growth is stimulated. Stimulating hoof growth allows easier correction of the long toe low heel problem.

With the four point trim, the center of mass and weight-bearing surface is located approximately three-eighths of an inch behind the apex of the trimmed frog. The distance from the posterior of the heel bulb to the frog bridge to the toe is equal in distance in the ideally balanced foot. With this trim, the farrier is correcting the anterior-posterior balance of the foot. By shortening the toe, breakover is easier, reducing stress on the lower limb and reducing the associated pull on the coffin bone by the deep digital flexor tendon. By trimming the widest point of the frog, the farrier creates an eggbar effect that helps support the digital flexor tendon, also reducing the pull on the coffin bone. Thin soles, shallow digital cushion, and related shelly thin horn are probable results of the excessive downward pull on the coffin bone in horses with long toes and low heels, according to Redden.

Once the hooves have been trimmed, the focus turns to whether the farrier should shoe the horse or leave it barefoot. If shoeing is carried out, the four point shoe offers relatively quick results. The shoe is designed to protect the thin sole and to make the breakover point three-quarters of an inch to one inch anterior (behind) the apex of the frog. The horn is covered by the shoe, which increases medial-lateral breakover and aids the weak walls by reducing stress on the nails. The four point shoe is constructed in such a manner that it can be adapted to any breed.

The open ended shoe offers more heel action, especially when used with an arch support. The design of the shoe also allows the farrier to use small nails, which prevents further damage to the already weak wall.

Once the feet are shod, they must be kept dry. Redden stresses that feet should not be allowed to become water soaked since it will further deteriorate the wall and prevent the hooves from growing and correcting themselves. Horses which are exposed to damp environments should have their hooves treated. Redden likes to use Keratex hoof hardener to keep the hoof dry and rigid. By keeping the hoof dry, growth is stimulated. In about three weeks, according to Redden, the farrier will have to reset the shoes since the breakover will move three-quarters of an inch to one inch in that time. The horse will need frequent attention by the farrier for the first few weeks to maintain the progress the hooves are making. By properly maintaining the feet it helps stimulate new horn growth, which is another benefit of the four point trim.

According to R. M. Bowker, VMD, PhD, Department of Anatomy, College of Veterinary Medicine, Michigan State University, the equine foot responds to stimuli from the environment. There are many different nerve receptors located in a horse's foot that send messages to the spinal cord, then to the brain, to stimulate new hoof growth. Some of the receptors are faster acting than others. These respond to instant stimuli, such as walking on hard surfaces or galloping. Other receptors, which are slower acting, respond to stimuli that aren't quite as fast, such as stretching or pulling of the connective tissue. Therefore, if the farrier can correctly shoe the long toe low heel horse so that it triggers the correct stimuli, then he can stimulate the heel to grow. The horse's foot responds to nature's stimuli, which enabled him to survive in the wild long before farriers took care of feet.

Nutrition is another important factor for healthy feet. Although all problems can't be solved by feeding, nutrition plays a key role in keeping feet healthy. According to Stephen G. Jackson, PhD, of Kentucky Equine Research, you should look for feeds that are balanced with macro and micro minerals. The feeds also should have supplemental fat and water soluble vitamins and should contain high-quality supplemental protein sources such as soybean meal.

A high-quality hay should be fed in addition to the concentrate. Jackson favors a mixture of 60% alfalfa and 40% orchard grass. When deciding on feed, usage of the horse is the primary consideration--what is fed will depend on the horse's intended use. Whatever the horse is fed, he emphasized, be sure that all of the animal's required nutrients are met, and that will help ensure healthy feet.

Redden believes there is no such thing as poor feet, just feet that need attention. He said that all feet have the ability to grow mass and become healthy, "it's just a matter of proper maintenance. Foot problems are not as common in the wild horse because nature has ensured the ability of the hoof to adapt. It's by placing the horse in confinement and not allowing him to wander as he would in the wild that we create problems. But, by properly maintaining, and carefully observing the feet, you can avoid problems with the feet. And by using the techniques described, the feet are already well on their way to becoming healthy once again. And the best thing with the four point trim is that it helps to stimulate more horn growth naturally. Nature has been using the four point trim for years, so why don't we learn from the best."

About the Author

Tim Brockhoff

Tim Brockhoff was Staff Writer of The Horse:Your Guide to Equine Health Care from 1995 to 1999. His degree is in Agricultural Communications from the University of Kentucky, and his equine experience is with American Saddlebreds.

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