When a life-threatening foot problem is the issue following a foot or limb surgery, I never expect nor ask a farrier to accept the responsibility of preserving the fragile healing environment unless they have previously worked closely with me. They must also have a good understanding of the mechanical formula and radiographic interpretation, experience evaluating soft tissue response (horn and sole growth) and a clear understanding of how to adapt follow-up shoeing to the response.

Once this mutual understanding of the issue exists, it is a piece of cake to communicate using photos, X-rays, venograms, Skype, etc., for follow-up exams and shoeing requirements.

When the problem is not career- or life-threatening, I encourage farriers to be present during my initial exam. If that is not possible, I offer written recommendations and copies of before and after shoeing radiographs. I often use a foot mold system, which allows me to demonstrate the trim and shoeing job on an exact model of the horse’s foot, providing an excellent three-dimensional visual aid that can clear up any misinterpretation.

A conversation with the farrier, once they have reviewed the information, tells me how well my advice and suggestions have been understood. I make it a point to make specific parameter recommendations from current radiographs. Raise/lower the heel and/or back the toe up are common instructions for farriers, but without a specific reference point they are pointless. 

An accurate assessment of progress or aftercare must be considered before making recommendations on follow-up cases. Current radiographs are an essential part of all follow-up footwork. Manipulating the mechanical model to enhance natural healing is a complex process that requires a lot of knowledge, experience, great communication and often an out-of-the-box thought process.