The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
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56 TheHorse.com THE HORSE March 2018 to the veterinarian's radiographs. Some horses and ponies, if they just have a little rotation of the coffin bone at the toe, benefit from simply lifting/ unweighting the sole area underneath the tip of the bone. This can be as simple as just a regular shoe or a shoe with a heart bar to redistribute some weight off the wall onto the frog." As the chronic case stabilizes, Rucker says she then allows the EMS horse to do light exercise to try to control his weight. Designing a Shoeing Regimen Indeed, veterinarians and farriers use many types of shoes and materials to help support and minimize stress on these horses' delicate hoof structures. "In shoeing, we are only limited by our own creativity," says Burns. "The farrier can utilize any number of shoes on the market today—from clogs to EasyCare shoes that are wide-webbed. The prin- ciple is simply to ease movement in all directions, and the specific technique is up to the farrier or the owner's finances or what the individual horse might need." Simply, no one shoe works for every horse. Equipped with a set of hoof radio- graphs as his or her blueprint, the farrier can see where the coffin bone is posi- tioned and how the hoof angles look. A close veterinarian-farrier relationship is quite valuable at all stages, but especially this one. "We work together," says Rucker. "I'll X ray the horse, and then we'll trim the foot," and check sole depth on X rays after. "How is the position of the coffin bone in relationship to the ground?" she says. "We measure all those things." Armed with this information, shoeing methods might include rolling or rocking the toes, applying the wooden clog shoes Burns mentions to help ease breakover, and/or applying pour-in pads or impres- sion material to support the sole. "When the farrier is done we do another X ray to see if we accomplished the goal and got the breakover where we wanted it," Rucker says. When the horse's shoes are ready to be reset, about six weeks later, Rucker recommends veterinarians take follow- up radiographs to monitor hoof changes and make sure the horse is progressing properly. "Then you can develop a long-term plan for the care of those feet," she says. "We can see whether this shoe worked or didn't work and whether we need to try something different or tweak it a bit. The plan evolves as you go along." Take-Home Message Horses with EMS (as well as insulin dysregulation and PPID) tend to be prone to developing laminitis. Early diagnosis of the root problem, careful monitoring, and appropriate hoof care can help keep these at-risk horses comfortable. "Aside from the hoof care, we need to figure out why the laminitis is happen- ing, because we need to address the root cause," says van Eps. "This is the only way we can keep it from becoming an issue again. This should be the primary objective. For years, we've tried to fix these horses and ponies with shoeing/ trimming management alone and failed over and over again." Work with your veterinarian and far- rier to not only manage your EMS horse's feet but also his lifestyle to ward off future laminitis episodes. h STEP BY STEP Get back on track with Tildren ® * Do not use in horses with impaired renal function or with a history of renal disease. NSAIDs should not be used concurrently with Tildren ® . Concurrent use of NSAIDs with Tildren ® may increase the risk of renal toxicity and acute renal failure. The safe use of Tildren ® has not been evaluated in horses less than 4 years of age, in pregnant or lactating mares, or in breeding horses. Tildren ® is a registered trademark of Cross Vetpharm Group. All rights reserved. *CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. © 2018 Bimeda, Inc Dr. Amy Rucker shod this chronic laminitis case with a rockered aluminum rail shoe to try to pre- vent the deep digital flexor tendon from pulling the coffin bone away from the dorsal hoof wall and onto the sole. COURTESY DR. AMY RUCKER