Equine Podiatry Workshop in Versailles, Kentucky
Dr Luke Wells-Smith from Motion Equine Podiatry Consulting recently visited the USA to attend a workshop on advanced equine podiatry. Twenty veterinarians, farriers and horse owners attended the worksop, all wanting to learn recent advances in hoof care. Dr Ric Redden, a world renowned equine veterinary podiatrist from the International Equine Podiatry Centre presented lectures, demonstrations and hands on education.
The workshop started with three full days of lectures. Some of the topics covered included;
- Basic biomechanical formula of the equine foot
- High/low syndrome, which explains the horse with two different foot conformations
- Classified into four grades, ranging from subtle to severe
- Each grade was discussed and how each could be managed depending on the age and severity of the case
- Low heel
- Typically thought of as the crushed heel foot, with a flat shallow frog, compression of the digital cushion and damage to the heels
- Navicular syndrome or caudal heel pain
- Which describes pathology in the back half of the foot associated with the navicular bone, navicular suspensory apparatus, deep digital flexor tendon, damage to the digital cushion and the horn tubules at the heel
- A whole day was spent discussing the triggers for laminitis, the importance of taking a thorough history and clinical examination of the hoof. Diagnosis of laminitis including x-rays and venograms, treatment and management of acute and chronic cases of laminitis
Hands on learning
Dr Ric Redden not only presented lectures, but provided insightful demonstrations on the treatment and management of many different cases. There were also ‘real life’ hoof models created by Dr Amy Rucker from Midwest Equine. These models had a synthetic pedal bone inside the model that could be identified with an x-ray. The hoof model could even be trimmed and have a shoe nailed to it during the workshop.
On the last two days, students worked on the hoof models, cadaver feet and live horses to diagnose, image and make a treatment plan for each scenario and case. Hands on learning is an essential part to equine podiatry when it comes to developing skill.
Advances in digital x-ray
How the foot is viewed with an x-ray is paramount to the ability to identify issues within the hoof. One of the most important aspects is how the foot is positioned in relation to the x-ray equipment. If the horse is not x-rayed on a flat surface, standing on two blocks of equal height, it is very difficult to assess the biomechanics of the foot. Making farrier friendly views so that sole depth, angle of the pedal bone, changes in hoof wall parameters can be measured makes a significant difference in the outcome of these cases.
Lesions in the pedal and navicular bones were also identified on x-ray. New techniques to more accurately image the navicular bone were discussed and demonstrated. This will hopefully reduce the number of horses being over-diagnosed as having navicular syndrome and also help pick up on subtle and clinically important lesions.
Venograms, whereby contrast material is injected into the palmar digital vein and the foot x-rayed were discussed and demonstrated. Venograms help to determine the vascular supply to the foot and are useful in the diagnosis of laminitis and keratomas.
New therapeutic shoes
Foot related lameness in the horse is a difficult area to treat. We rely on so many different parameters to determine what shoe to use and how it should be applied. Dr Ric Redden developed many of the advanced shoes that are available on the market today. These include;
- The Ultimate: used for the treatment and prevention of acute laminitis. It has also can be successfully modified to be applied in cases of chronic laminitis with pedal bone rotation
- Full Rocker Shoe: the foot surface of the shoe is flat, however the ground surface of the shoe has a radius to it. This allows for the horse to adjust its lower limb conformation and can be altered depending upon the health of the foot
- Rail Shoe: is manufactured as a flat 6 degree wedged heel shoe, with a rolled toe. To increase the heel elevation of the shoe, a bend is put in it mimicking the motion of the full rocker. This provides a large degree of heel elevation and improvement in the palmar angle
Advanced materials and techniques
Much of the demonstrations and hands on experience was modifying the shoes available to customise to the case. The use of both steel and aluminium welding techniques were used to weld in bar inserts to shoes. The use of other materials such as glue and cast material were used to attach the shoe to the hoof.
More advanced techniques for severe laminitis were discussed during the workshop such as surgery to cut through the deep digital flexor tendon. This surgery can be performed in cases of severe laminitis, both in the acute and chronic stages depending upon the initiating cause of the laminitic episode. This procedure can be very successful in the right cases, with the two ends of the cut tendon healing back together over a 2-4 month period.
All in all it was a very informative and successful week of learning. Not only did we learn from the knowledge that Dr Ric Redden has, we also discussed cases and challenges with people from all over world, working to better the health of the horses foot. There is a real push at the moment in the horse industry to develop a standard of care for hoof health. Meetings like this allows for like minded people to come together and discuss ideas for the future.
For more information about Dr Ric Redden’s techniques, products and any workshops he has coming up, visit the NANRIC website.