Dr. Raul Bras, CJF, a podiatrist at Rood & Riddle Equine Hospital in Lexington, Kentucky, and Paeden Underwood, CJF, who works primarily in the Pacific Northwest, offer insight to The Horse on how to address three tricky hoof conditions that have the potential to be debilitating unless addressed correctly: laminitis, thrush, and podotrochlosis (commonly called “navicular”).
Laminitis
A horse suffering from laminitis can be in extreme pain as the tissues that suspend the coffin bone in the hoof capsule become inflamed and possibly even separate from the bone. When Bras deals with a laminitic horse, the first thing he does is identify what brought on the laminitic episode and begin non-steroidal anti-inflammatories (NSAIDs).
Next Bras uses NANRIC Ultimate shoes on the laminitic horse's hooves. These shoes have a wedge designed to allow blood supply access to the affected hoof area and to relieve pressure on the deep digital flexor tendon.
If laminitis is caught in its earliest stages, Bras will recommend cryotherapy, where the hooves are submerged in an ice slurry for a minimum of 72 hours. This will decrease coffin bone rotation. Bras prefers to use venograms to assess the blood supply within the foot and to anticipate what changes are coming. He compares the images he takes throughout the course of treatment.
Bras says the key to managing laminitis is to catch it early and be aggressive in treatment, which can include therapeutic shoeing and regenerative therapies. He has had success in getting many performance horses back into the competition ring.
Thrush
Thrush is a bacterial condition that can be painful and compromise the hoof's internal structures. Underwood had a horse in his care with a severe case of thrush in all four feet down to the deep central sulcus, almost to the live tissue. The horse was in significant pain.
Underwood suggested management changes like adding extra bedding to the stall and keeping the horse from turnout on muddy fields. The owner applied antibacterial mastitis cream to the frog for five weeks. He stresses that clear communication is imperative in caring for horses with potentially severe hoof care issues.
Podotrochlosis
Podotrochlosis, a degenerative condition of the navicular bone and the soft tissues in the back of the horse's hoof, is often alleviated with preventative therapeutic shoeing. For the best possible outcome, Bras recommends horse owners call a vet and farrier at the first sign of heel pain.
To treat a horse with podotrochlosis, Bras takes X-rays to assess coffin bone angles and how these align with the fetlock and pastern. If soft tissues are involved, he recommends the horse receive advanced diagnostics like an MRI. From there Bras develops a shoeing plan that protects the navicular and heel area; releases the tension and forces on those structures. He often uses a rockered shoe. He also takes care to adapt the horse's shoeing to align with the surfaces on which it will work and the discipline in which it is ridden.
Bras may also inject the coffin joint and navicular bursa with corticosteroids or advise shock wave therapy over the heels.
Though every case should be treated individually, these two professionals have had very good luck treating these once-condemning conditions. They both note that it's imperative that the horse-care team, including owner, veterinarian and farrier, maintain open lines of communication to keep the horse feeling its best.
Read more at The Horse.
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