While some forum discussions at the American Association of Equine Practitioners (AAEP) annual convention are fairly small affairs, that wasn't true of the 2003 podiatry forum. About 65 veterinarians and farriers filled the room to discuss diagnostic analgesia, pads, Strasser trimming, ultrasound, and much more.

Tracy Turner, DVM, MS, Dipl. ACVS, a professor of equine surgery at the University of Minnesota, began by briefly discussing the AAEP's short courses on podiatry, which include one-day veterinarian-vet student and veterinarian-farrier courses. "This year there was so much interest that we couldn't meet the demands!" he said.

"Please contact us if you are interested in volunteering time to teach these courses." (Contact Mandy Patton at 859/233-0147.)

Co-moderators Gayle Trotter, DVM, MS, professor in clinical sciences at Colorado State University; and Ric Redden, DVM, founder of the International Equine Podiatry Center in Versailles, Ky., then facilitated a lively discussion on many topics, beginning with lameness diagnostics. The challenges of accurately interpreting effects of digital anesthesia were mentioned, as well as the use of ultrasound.

"I think it takes an enormous amount of advanced training and practice to make sure you have confidence in what you see and don't see (when ultrasounding the foot)," commented one attendee. Also, several people mentioned factors like moisture in the foot, properly trimming the foot, clipping hair, and using the best transducer (curvilinear).

Scintigraphy was described as being useful for imaging selected foot problems, especially sidebones. One attendee noted that many consider sidebone a relatively insignificant problem, but he sees it a lot in jumpers and the horses often respond to treatment. "It's ridiculous to discard them as not contributing to lameness," he commented.

Radiographic imaging of pedal osteitis (inflammation of the coffin bone, or P3) was also discussed. Trotter noted that a skyline view of the dorsal edge of P3 is very prone to error, and Redden commented that the tendon surface angle (the angle between the navicular bone surface where the deep digital flexor tendon contacts it and the ground) will dictate the image. The majority of all navicular cortical lesions are on the tendon surface of the beam. Put this in relief, then it is possible to see the extent of the lesion. The beam must pass across this narrow surface. Therefore, the angle of this surface is needed for beam orientation. The film must be perpendicular to the beam to prevent unwarranted distortion. He also noted that this angle can vary by up to 40° in different feet on the same horse.

"This is a very interesting angle," Redden added. "I measure it before and after each shoeing. It moves more on some horses than you think."

The Strasser Method
A particularly hot topic was the Strasser trim, which has met with a lot of skepticism among veterinarians and farriers. Many take issues with the principles espoused by German veterinarian Hiltrud Strasser, which have gained a great following among horse owners in the United States.

One veterinarian who had attended a three-day Strasser clinic noted the differences between her methods and those traditionally taught to farriers. "In the basic trim, she removes a tremendous amount of the bars, not much of the sole from the front of the foot, and support is supposed to taper from the heel,” he said. “She removes a lot of heel (saying that elevating the heels weakens the laminae and predisposes the horse to laminitis) and wants a 30° angle of the coronary band from the front to the back of the foot. This is different from many horses you see in practice.” (Strong, healthy, front feet will be 0º-10º, notes Redden.)

"People say using this method produces a lot of soreness," he continued. "They say this is expected as the hoof becomes more 'normal,' which can take up to eight months. Many horses trimmed this way get abscesses--unusual ones such as blister-like abscesses at the coronary band and heel that are different from anything I've ever seen.

"Some people have had good success with a modified, less severe version of this trim. You have to divide this method as it applies to pathological problems and normal feet," he said.

Walt Taylor, past president of the American Farrier's Association (AFA), AFA Certified Farrier, and founder of the World Farriers Association, said, "This wave (Strasser popularity) may be passing, but another is coming! We (veterinarians and farriers) need to look at our relationships with clients. I think we could prevent a lot of things if we work harder on client education; by not correctly educating or informing our clients, we allow or create vacuums in knowledge and understanding of the client, and faddish things have a place to nest and grow."

Trotter commented that if veterinarians and farriers don't do a good enough job, there is always room for fads in hoof care.

Trotter said that he often uses pads such as heel wedges or frog inserts to initiate heel-first landing and for loading the back of the foot. Redden opined that pads are for external protection, and shoe mechanics are for internal protection. "Many horses are bruised internally, and using the right mechanics helps them heal," he said.

He also described using a very thin layer of a pour-in pad for horses with very little sole to give them a little extra protection. The key is prepping the foot--"Poor preparation can allow thrush, and you can get a very hot foot," Redden noted.

One veterinarian described his use of sterile maggots following street nail operations (to open an infected navicular bursa and drain it of infected material) and curettings of diseased tissue on osteomyelitis cases. They debride tissues in a non-traumatic fashion, he said.

"They eat necrotic (dead) tissue, not the good stuff," Redden noted.

Two topics that were suggested for next year's forum are navicular imaging (problems and tips) and pedal osteitis. Redden is the facilitator for the 2004 forum, and he extends a special invitation to farriers who are interested in podiatry cases to attend.

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.

Stay on top of the most recent Horse Health news with FREE weekly newsletters from TheHorse.com. Learn More