Q: “How should you trim a horse with a long-toed, pancake-shaped foot?”

— Maryland farrier

A: More than likely, the foot also has two other problems: underrun heels and a flat or dropped sole. It would be good to have a lateral radiograph taken so you could see the palmar angle and the alignment of the P1, P2, P3 and the cannon bone. It would likely reveal a negative palmar angle and backward interphalangeal angles.

First, I would explain to the owner that I cannot fix this horse in one or two shoeings; it might take a year. Start by cleaning out the dead sole and opening up the central sulcus and the commissary grooves around the frog down to healthy tissue.

The heels have probably slid forward to half the length of the frog, so I would back them up to the widest part of the frog. This will stop the horn tubules from crushing and running forward. I would then remove as much toe and quarters as possible down to the healthy white line.

I would put the foot on a hoof stand and remove all the medial and lateral flares that I could, being careful not to weaken the hoof wall too much by overly thinning it. I’d then use a hoof gauge to check the angle, which would probably be low — about 45 degrees.

Looking at the standing horse, you should see that it has low heels and a broken back axis, which would have…