Steve Samet with Daniel Montoya

When you suspect that your horse may be laminitic you should consult your equine veterinarian for a medical diagnosis.  Your veterinarian will most likely order x-rays to confirm the diagnosis.  The x-ray will determine the degree of rotation of the hoof.  Your next step should be to have an examination done by your farrier to develop a plan of action for correcting the problem.  I highly recommend that farriers work in conjunction with a veterinarian when dealing with a laminitic horse.

When I examine a horse for laminitis there are several things that I look for in determining the condition and its severity.  First I look for the obvious signs, rocking back, bearing weight on the hind end, heat in the hoof, abnormal pulse rate, uneven coronary band, and the type of shoe the horse is wearing.  I will also use my finger to run around the coronary band to check for abscess pits and soft pockets, and closely observe the coronary band for up and down disfigurement.  Once I have determined that the horse is laminitic I will explain to the horse owner my course of action in bringing relief and correction to the affected hoof or hooves. 

For this example the horse has been diagnosed with a laminitic front left foot.  In this case I will begin treatment by wrapping both front legs with standing wraps to reduce pain and add needed support to the hooves.  I will then pull the shoe on the affected hoof and examine it for alignment to the bony column.  This is critical in determining how much adjustment must be made to get the hoof back into alignment.  I will determine how much dead laminae to remove from the hoof capsule at this time.  With the veterinarians assistance I will then proceed to trim the hoof to its bony column alignment.  The balance and alignment must be accurate at this stage of the process to avoid prolonging recovery time.  Next, to relieve pressure, I will dremel drill 20 or more holes into the hoof capsule.  This will also aid in relaxing the hoof capsule.  It is extremely important to not hit live tissue while drilling; this will cause infection and add to the soreness.  I do not recommend grooving or resection of the hoof as the risk for infection is too high with these procedures.  Now I will remove the existing dead hoof wall taking care not to cut into live tissue.  At this point the hoof is prepared for shoeing.

I use HOOF-it composite shoes to support the bottom of the hoof capsule.  This is a glue on shoe which does not create torque or pressure on the hoof as a nail on shoe does.  It is important to not add further insult to the injured hoof.  The composite shoe has several advantages over steel shoes.  They allow for hoof expansion, act as a shock absorber, and promote blood flow in the hoof.  The composite shoe also is excellent for medial, lateral, and posterior support.  It also aids in supporting the coffin bone, long and short pasterns and the knee.  The shock absorbing qualities also aid in giving relief and support to the deep flexor tendon and the suspensory tendon.

The hoof is now trimmed and balanced back into mechanical harmony.  I rarely remove any sole in that the existing deterioration of the sole helps to stabilize the hoof rotation in most cases.  Sometimes dead tissue is good support.  I also do not remove the bubble at the point of the frog.  I have found that this will typically self correct after rotation stops unless it is totally punched through.  I size the shoe and make it symmetrical if possible.  I roll the shoe 45 degrees all the way around to afford selective break-over.  I do not recommend rolling the toe and heel only.  This creates two movements, forward and backward, which causes the coffin bone to rotate downward.  This motion causes heel and deep flexor soreness.  I glue the shoe withHOOF-it Quick Shoe.  This process takes 2-3 minutes with the acrylic drying in 60 seconds.  The Quick Shoe is non-toxic, which is an advantage in hospital conditions.  After the shoe is glued into place I cap the hoof capsule with HOOF-it acrylic to add further support to the hoof wall.

With the above procedure I have used judicious trimming and the composite shoe to bring the hoof back into load bearing functionality and mechanical harmony.  The horse will experience pain relief from the laminitis as quickly as 48 hours.  This procedure can be applied from 2 degrees to sinkers with excellent results.  After shoeing, recheck hoof weekly to begin with, and gradually extend this period until hoof is healed.  During this period check for new hoof tubular and hoof capsule growth.  Also keep an eye on the coronary band for soft spots, and the hoof in general for infection.  The drilled holes should disappear within a 6 week period as new growth takes hold.  Complete hoof regeneration will take place between 6 months and one year, depending on the severity of the case. There is inherent soreness in the healing process.  Your veterinarian will assist in pain management and vascular stimulation.  In addition, it cannot be emphasized enough how important feed management is in the aftercare of the laminitic horse.  The horse owner must take care to follow feeding instructions so that there is no regression.

I hope that the above has been helpful in explaining my process of working with the laminitic horse.