This case study presents base information to assist farriers working with long toe, low or underrun heel (LTLH), low palmar angle (PA) and broken-back hoof pastern axis (HPA), resulting in clinical presentation described as caudal heel pain and navicular syndrome.

Ideally, a broken back HPA should be addressed before loss of sole concavity and degradation of the digital cushion.

This study demonstrates that the hoof trim is the single most important aspect of farriery to assist and aid these types of hoof compromises and address unsoundness in the distal limb.

This case study also demonstrates a simple and economic approach to hoof care that can be suggested to the horse owner. It adopts a base trim protocol assisted with the use of common types of manufactured shoes, rather than invasive or expensive veterinary procedures and/or complicated shoeing protocols that often involve substantial shoe modification or construction to provide relief to these types of unsoundness.

This study has been broken down into two phases of the trim protocol: Phase I, alignment of the HPA; and Phase II, recovery of the base of support and heel alignment.

This article monitors Phase I, alignment of the HPA.

For this article, we are showing the results of a single horse observation using the trim protocol on a 13-year-old Quarter Horse mare with upright pasterns and right fore (RF) lameness.

Her history included 8 years of performance as a Western pleasure, hunt seat under saddle and trail competitor, followed by 3 more years of pasture…