Using Hoof Boots to Manage Chronic Laminitis

Using Hoof Boots to Manage Chronic Laminitis

While hoof boots aren't a permanent solution for chronic laminitis, they can provide customized support and pain relief.

Photo: Bryan Fraley, DVM

Despite extensive research into the painful hoof disease laminitis, one thing remains unchanged: There’s little scientific proof that one treatment method works better than another. As a result, veterinarians and farriers must do the best they can with the options available, one of which is the hoof boot.

At the 2015 American Association of Equine Practitioners’ Convention, held Dec. 5-9 in Las Vegas, Bryan Fraley, DVM, of Fraley Equine Podiatry, an affiliate of Hagyard Equine Medical Institute, in Lexington, Kentucky, shared tips on how practitioners can use hoof boots to help manage horses with chronic laminitis.

Laminitis—the separation or failure of laminae, which connect the hoof wall to the coffin bone within—can cause permanent structural changes in a horse’s foot, leading to repeated bouts of disease and lasting lameness. In severe cases the coffin bone in the hoof can sink or rotate downward, potentially even puncturing the sole. Laminitis can cause such severe pain and structural changes in the hooves that euthanasia might be warranted.

“Equine hoof boots have come a long way since the first widely used and commercially successful hoof boot was unveiled in 1970,” Fraley said. “There are now numerous hoof boot manufacturers producing a countless array of boot styles and sizes.”

One of the main reasons veterinarians, farriers, and owners alike use hoof boots is to improve the comfort of horses suffering from painful conditions such as laminitis. And while boots can be used successfully in this fashion, Fraley cautioned that comfort is only part of the bigger picture.

Fraley encouraged attendees to take radiographs after placing the horse in hoof boots to see how the internal structures look.

Photo: Bryan Fraley, DVM

“It’s not uncommon for a horse with chronic laminitis to get more comfortable in boots, but deteriorate radiographically,” he explained. Essentially, although the horse might appear more comfortable, serious structural changes on the inside of his hoof can occur and ultimately lead to more severe problems and pain.

Hoof boots have other limitations, as well. Not all horses wear the same size or benefit from the same boot style, meaning veterinarians and farriers need a large inventory to manage patients, Fraley said. Further, boots can cause rubs, sores, and inflammation, and they must be removed, reset, and checked for damage regularly. They’re high-maintenance and not for all owners, he said.

Fraley noted that he views hoof boots as a temporary treatment for chronic laminitis, mainly because of the need for intensive management. However, he shared several cases in which he successfully managed horses with severely compromised hooves for years in hoof boots. He cautioned that this type of endeavor takes an extremely dedicated and diligent owner who is willing to manage the boots and the horse’s environment.

Quick Tips

Are you managing a horse with chronic laminitis using hoof boots? Bryan Fraley, DVM, of Fraley Equine Podiatry, based in Lexington, Kentucky, shared a few quick tips to remember:

  • Environment A laminitic horse that can be turned out in boots should have dry footing. Class I sand in turnout areas is ideal, he said, and don’t be afraid to give your patient a quiet friend such as a pony or goat to keep him company.
  • Baby powder If your horse’s pasterns and hooves become too wet from sweat accumulation, pick up some baby powder the next time you’re at the store and sprinkle a couple of teaspoons inside the dry boot next time you change it. This will help absorb moisture and act as a hoof hardener, Fraley said.
  • Socks Don’t throw all your old tube socks out just yet. Fraley said applying socks under the hoof boot and then rolling the tops down can help protect the straps that hold the boots in place. An added bonus? The socks serve as a receptacle for your baby powder and help maintain skin health by pulling moisture away from the skin’s surface, all while minimizing rubs.

Erica Larson

He added that there are a number of benefits to using hoof boots—and modifying them to benefit each individual patient. Some modification methods include adding inserts, insoles, or hoof packing tailored to each horse’s individual needs. He showed several other modifications to the bottom of the boot aimed at providing comfort and improving the health of the compromised hoof. Most of these modifications either elevate the heels and/or improve breakover (the moment between the stance and swing phases as the heel lifts off and the hoof pivots over the toe). For instance, farriers often rocker, roll, or square toes to improve breakover. Veterinarians and farriers use heel elevation to reduce the pull of the deep digital flexor tendon on the coffin bone and, consequently, the laminae. He showed attendees how to fashion a domed or convex surface to the boot bottom using the hoof adhesive Equilox.

He showed other methods to enhance breakover, such as gluing shoes to the boot bottoms to create a rolled or rockered toe. He gave attendees tips on how to best make such changes, but cautioned that extensive modification requires a boot with a perfect fit and a solid construction. “Some conventional boots can’t be modified properly or safely,” he said.

Fraley also encouraged attendees to take radiographs after placing the horse in hoof boots to see how the internal structures look. “It’s surprising how bad the mechanics can be radiographically” in some boots, even if they’re applied and fitted properly appear to relieve the horse’s hoof pain.

He also shared a new hoof boot with an interchangeable base that that he and three other professionals recently developed. He said the idea came from a ladies’ shoe that can be converted from a high heel to a flat. The first prototype they developed had five sole options, ranging from heel wedges to clogs, which can be switched out with a screwdriver to meet a horse’s changing needs. The team licensed the patent-pending boot to EasyCare and it is now commercially available as the EasyBoot Rx Click System.

The prototype of a hoof boot with an interchangeable base had five sole options, ranging from heel wedges to clogs.

Photo: Bryan Fraley, DVM

The Bottom Line

While hoof boots aren’t a permanent solution for chronic laminitis, they can provide customized support and pain relief until the underlying causes of disease are addressed, the horse is transitioned into therapeutic shoes, or a decision is made regarding the horse’s future.

Fraley encouraged practitioners and farriers in attendance to try their own boot modifications for chronic laminitis by using shoes or approaches they are already comfortable with.

“The sky’s the limit for hoof boots,” he said. “If you can imagine it, it can be screwed, glued, or bolted to a hoof boot.”

About the Author

Erica Larson, News Editor

Erica Larson, news editor, holds a degree in journalism with an external specialty in equine science from Michigan State University in East Lansing. A Massachusetts native, she grew up in the saddle and has dabbled in a variety of disciplines including foxhunting, saddle seat, and mounted games. Currently, Erica competes in eventing with her OTTB, Dorado.

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