In most cases, I recommend that farriers select a hospital plate that is simple to create and practical to use. There are a lot of varieties and ways to create a hospital plate, but the ease of use is the most important factor for horse owners and veterinarians.

I use the four-bolt plate (with two removable bolts diagonal each other and 2 false bolts that are fixed at the other diagonal, to form a stable base. I also like to use the “Farley” plate because unlike the four-bolt plate, which raises the foot a significant amount, the Farley plate has minimal thickness increase. This is due to it being secured with one bolt, that doesn't come into contact with the ground, and a tab at the toe. It also requires a little more fabrication and can cause the foot to have no traction on mud and grass surfaces.

The use of diamond plate aluminum can easily solve this problem. Correctly fitting the shoe to avoid heel bulb pressure is paramount because of the bent heel. Despite more work for the farrier in creating the Farley plate, it’s the easiest for horse owners and veterinarians to remove and reinstall. Egg bar shoes are the preferred choice. Use at least 5mm thickness for aluminum plates, thinner gauges for stainless or mild steel. Ideal to have the shoe shaped to fit the foot before any procedure or surgery is done to the foot. While the foot is being operated on or prepared, the farrier can finish the hospital plate.

Pour-in pad material and dental impression material can be placed inside and level to the shoe and affixed on the plate to improve sealing and pressure to the wound. Sometimes fitting a thicker shoe on the opposite foot, will help in the difference of thickness created on the foot with the hospital plate, and will help the horse feel a little more balanced. After the shoe is nailed on, and before the plate is secured to the shoe, file/rasp the nail heads flat so the plate sets flat on the shoe. Always make extra bolts that fit your set up exactly, in case bolts are lost and/or worn down.

I make sure the horse owner knows how to remove and install the hospital plate before I leave. The horse owner must understand that there will be reduced traction on the foot with the hospital plate. Ensure that the horse owner has the correct size wrench to remove the bolts. The void and wound site is packed with gauze or packing provided by their veterinarian and leveled with the shoe. Additional even layers should then be added so that when the plate is added it will pressurize the wound site. If impression material or pour in-pad material is used on the plate, the additional layers are not necessary. Horse owners should know that this type of shoe is typically a short-term application and any deviation in total balance of the horse is just temporary and should not affect balance after his recovery and progression into being barefoot or shod in the future.

—  Jess Kuwaye, East Hampton, Conn.

I will check the horse the next day and do treatment myself to be sure the client understands the process. Then depending on the competence of the client and the seriousness of issue I may wait 3 days before a revisit and longer if I'm confident of clients.

—  Kevin Alcock, Uxbridge, Ontario

The aluminum plate should be of structural grade of at least 1/8-inch thick to resist puncture and deformation. The bolts or screws used to fasten the plate to the shoe should be of steel hard enough to resist wear and tear over a shoeing cycle. Assemble the hospital plate and make sure that the bolts or screws are flush with the foot surface of the shoe.

—  Olivier Materne, Raleigh, N.C.

The least amount of impact to an already inflamed foot is usually where you'll get best results. An example is screwing or gluing your perimeter foundation to bolt the hospitals plate to, rather then nailing. Of course, it completely depends on extreme of case.

—  Joseph Santos, Woodbury, Conn.

I use a 3-mm aluminum plate, and two threaded holes (m6) on the sponges of the shoe to be sure the owner can open it daily during at least 4 to 6 weeks

First, form the normal open shoe to the hoof. Next, draw the shape on the aluminum plate and draw the projection of the hospital plate before cutting. Bend and bore the plate. Put on the plate and check it. Then rasp off all the excess aluminum. Finally, nail on the shoe. You can now apply the plate and screw the two heels. Take care to shorten the screws enough to prevent touching the heels when fully screwed in. Don't bend the back part of the plate too much. Allow your finger to pass between the heel bulbs and the back angle of the plate.

Do it twice with the clients and allow them to do it two times in front of you. Then protect the screws on the heel with some goffer. Eventually close the junction with some Vetrap to prevent the shavings to enter the heels.

— David Aebisher, Bex, Switzerland

I use a cut off wheel on a 4.5-inch grinder, then smooth the edges with a belt sander. Punch the holes in the shoes a little bigger so you can drill the holes in the aluminum.

I like to use a clipped shoe to prevent it from slipping around while nailing.

—  Jerry Mathews, Osawatomie, Kan.

Keep it simple. Access each situation carefully before applying a plate. Make sure it is worth the workload and that it is the best interest of the horse.

—  Luke Farmer, Murillo, Ohio

I first check the surface area and turnout for abrasiveness. Examine the shoe — can it be reset? Then make two sets of plates. When preparing plates, I bring Vise Grips to hold plate when drilling holes, I always check the bolts by practice screwing into drilled holes an assure screws don't penetrate beyond the shoes thickness and that there is know resistance putting the screws in , an most important give client a few extra bolts they always seem to loose them, and mark top on plate, left right, they always mix things up.

Visualize the steps involved, layout and execution of process — it is time consuming from start to finish to make a really nice plate. It’s not rocket science, but there is a process to success. In a pinch, we use stop sign, parking signs aluminum that we find or town has discarded, using our creaser to cut and fabricate. We also use steel and Castle Impact pads. I recommend using a magic marker to template the shoe on to the plate. Then, clamp and smaller pilot holes first. When finished, we make the plate hole a smidgen larger than the threaded hole so bolt passes thru plate easily.

I first tell them the whys in selection and purpose of the plate. Inform on the general expense, cost and how-to remove and how to reaffix with success. Some of these horses are really sore so degree of difficulty is based on severity of lameness and anticipate the time needed that the horse can stand while they remove/affix. Finally, I wish them success and assure they can do this.

— Gary Werner, Smithtown, N.Y.

Thick hard plastic pads work well as an alternative to metal for the plate. Grade 8 hardened bolts wear much longer than standard bolts, the bolt head will not round off so quickly, making it much easier to remove and install the plate as the package wears. Fit the shoe leaving nothing for the horse to grab or step on. If the horse needs a hospital plate, it needs to stay on!

— Roger Duron, Orlean, Va.