Extreme trimming of the hoof had forced the mare to walk on her soles.

Dusty, a 14-year-old Paint mare with a history of laminitis, was presented as severely lame to the Lee Veterinary Clinic in Atmore, Ala. The horse was brought in when the owner found her lying down, unable to walk due to the pain in her forefeet. 

Examination revealed that a farrier, attempting a form of “corrective shoeing,” had trimmed the hoof walls on both front feet approximately 0.25 inches off the ground, exposing the entire sole. His theory for trimming had been that forcing the horse to walk on her soles would toughen them and thus relieve her distress from the laminitis. 

There are reports in the scientific literature suggesting some relief of laminitic pain can result from sharing support of the foot among the wall, sole and frog. However, this extreme trim was clearly a misinterpretation of that literature. 

The procedure left the horse in such excruciating pain that unless effective therapeutic measures were taken, the horse would have had no chance to survive. Even if the horse were to remain pastured, it would most likely have developed pressure necroses of the soles within days. Sooner or later, euthanasia would be the only solution.

Prior to this, Dusty had been seen multiple times at the Lee Veterinary Clinic for her laminitic condition. The most recent X-rays were updated on this visit and confirmed that the horse was not experiencing further rotation. There were bilateral bulges in the soles over the coffin bone. The horse clearly was a candidate for immediate euthanasia. 

Save The Horse!

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The double platform shoe was built from a conventional steel keg shoe with a welded piece of bar stock to provide sufficient ground clearance.

However, the owner’s instructions had been to try to save the horse. So, equine veterinarian Hank Lee, farrier Jim LaClaire and assistant farrier Tracy Cooley reviewed the prognosis and options for the horse, brainstorming for a solution. 

The immediate objective was to ease the horse’s suffering by relieving pressure on the soles. The team believed that the remaining thin sole was likely sufficient for a therapeutic shoe solution to relieve the pain.

The team felt that conventional egg bar or reverse shoe options were impossible due to the removal of the hoof wall. A more creative solution was necessary. The key was to design and fabricate a shoe that restored the clearance needed to keep her soles off the ground.

The proposed solution was to fabricate a therapeutic shoe, based on a conventional steel keg (size 1, Kerckhaert S-88) shoe. The plan was to fabricate a second “shoe as a platform that would be welded to the conventional shoe to provide sufficient clearance off the ground. 

Beginning with the keg shoe, the farriers fit the original shoe to the foot. Then, using 0.25-inch square iron, they bent an approximately 14-inch length of bar stock to mirror the shape of the conventional shoe. The square iron platform was welded to the conventional shoe and the farriers ground the welded shoe to refine the shape and to remove sharp edges. 

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The goal was to ease the mare’s suffering by relieving pressure on the soles.

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The finished double-platform therapeutic shoe was attached to the foot with extra long nails.

Foot preparation was critical. The ground surface needed to be balanced properly to accept the therapeutic shoe. After careful shaping of the foot, the farriers checked the fit of the composite shoe and concluded that additional grinding was necessary for a perfect fit. The shoe was affixed to the foot using extra long nails (MX60) to accommodate the novel shoe. The team sanded the exterior wall to smooth the surface and applied a hoof dressing.

The horse spent 2 days in a stall at the Lee clinic for observation. Improvement was immediately obvious as she walked from the treatment room to her stall. While it was clear that she was testing the feel of the new and relatively heavy shoes, she walked more easily than she had on her bare soles. After 2 days, she required no analgesics and was turned out to pasture at the clinic for 2 weeks. 

Upon periodic examination during the initial 2 weeks on pasture, she continued to show no need for analgesics and appeared to be walking comfortably. By the end of the fourth week, the hoof wall had grown approximately 1/8 inch, sufficient to allow removal and resetting of the special shoes. 

The condition of both soles had improved markedly. The soles were more smooth and uniform, losing previously observed bulges over the coffin bones. In fact, she was so comfortable in the therapeutic shoes that after the second week, one of the clinic’s veterinary technicians rode the mare the quarter mile from the pasture to the clinic for checkups. The mare showed no sign of discomfort, even over crushed rock surfaces. Importantly, the weight and configuration of the shoe had a significantly positive impact on her flight pattern. The shoe encouraged the mare to place her foot heel first, loading the back two thirds of the foot, an optimal weight-bearing scenario for the laminitic horse. 

Teamwork Power

Dusty returned to her owners little more than a month after her procedure. She returned in 5 weeks to the Lee Clinic farriers for a routine trim and a conventional shoe.

The case of Dusty vividly illustrates the power of an effective partnership between a veterinarian and a farrier willing to attempt a well reasoned but unconventional solution to save an otherwise doomed animal. Without that creative therapeutic shoeing, euthanasia would have been the only option for this mare. Her platform shoes not only relieved her pain, but also restored her to soundness. 

While this case was an extreme challenge, the therapeutic advantage of the novel platform shoe could provide important and useful guidance in treating more conventional severe laminitis.  

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Originally facing potential euthanasia, here’s the mare 4 weeks after the therapeutic shoes were nailed on.