Following an emergency foot or limb surgery in which the farrier was not present for the diagnosis of the issue or treatment, what and how will you directly communicate information to the farrier to ensure the hoof care follows your goals for long-term recovery?

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.