Correcting Foundered Feet

Q. Can coffin bone (also called the third phalanx, or P3) rotation be improved or corrected in horses that have foundered (suffered laminitis severe enough to displace the coffin bone)?


A. The cornerstones of founder management are shoeing and diet. Once the disease has occurred, treatment is aimed at decreasing stresses on the foot and reducing risk factors for recurrence.

Horses can founder for many reasons, including mechanical overloading of the hoof (road founder), endocrine diseases such as Cushing's, insulin resistance, obesity, systemic infection, toxic plant ingestion, illness, and grain overload. Once the laminae are inflamed, painful, and unstable, support of P3 is affected. Any mechanical forces to P3 will now cause it to shift. The deep digital flexor tendon (DDFT) puts more tension on P3 than any other force and commonly causes rotation when laminae are weakened. The tip of P3 rotates down toward, and sometimes through, the sole.

Treatment in the acute phase focuses on protecting the now very fragile laminae. Stall rest is critical, as is decreasing the mechanical pull of the DDFT. Supporting the sole with padding, sand bedding, or using hoof wedges to decrease the tension of the DDFT can help reduce rotation. Pain control with non-steroidal anti-inflammatory medication is essential.

Long-term care is aimed at stabilizing P3 so new sole can be produced. An unstable and malaligned P3 is the source of chronic hoof abscesses, deterioration, and bone infection. These conditions must be addressed before the foot can heal. In severe cases, the DDFT is cut to provide relief from the rotational forces. These horses can be pasture sound and even used for some light riding.

Hoof trimming and shoeing are key treatments to stabilize the coffin bone. It is helpful to work with an experienced veterinarian and farrier together. Shoeing techniques can decrease the tension that causes rotation and displacement of P3. With special shoeing, many feet can be rehabilitated and normal P3 alignment can be restored. However, once a horse has foundered, the laminar attachments never heal 100% and are always, to some degree, compromised. Long-term foot maintenance and special foot care considerations are imperative for long-term success. No matter what the degree of rotation is, the goal of treatment is to have new sole grow under the tip of P3. This indicates stabilization has been achieved.

Managing the underlying causes of founder can reduce or prevent recurrence. Many foundered "easy keepers" respond well to reducing carbohydrates in the diet. Replacing grain with a vitamin and mineral supplement, soaking hay to remove the soluble carbohydrates, and managing pasture grasses and grazing time have been very helpful in managing most of these horses.

Founder is a complicated disease, and the foundation of treatment is in specialized hoof care. Working closely with a veterinarian and farrier can produce satisfying results.

About the Author

Scott E. Morrison, DVM

Scott Morrison, DVM, is a podiatrist and shareholder at Rood & Riddle Equine Hospital in Lexington, Kentucky, where he sees a variety of foot and lameness-related cases. He graduated from Virginia Maryland Regional College of Veterinary Medicine in 1999.

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