It's no secret that laminitis is a complex condition, and its treatment is even more complicated as farriers and veterinarians try to keep a horse comfortable when it stands on the very source of pain. It's a condition that has forced podiatrists to get creative with the construction of therapeutic horse shoes.
Dr. Stephen O'Grady of Virginia Therapeutic Farriery has fitted more than 400 horses with wooden shoes, which resemble a cross between the wooden shoes often associated with Holland, and ladies' wedges. O'Grady believes the wedges can provide relief and support from laminitis and other conditions when traditional horseshoes aren't practical.
Although it's still a little unusual to see a horse strut out of the stall wearing clogs, it's not an entirely new practice.
“Actually, [this style of shoe] was described before the turn of the century but it was made from steel or iron in Europe,” said O'Grady. “The joy of the wooden horse shoe is that it's one flat surface on the bottom instead of a horseshoe, so in other words, it accommodates the weight on the whole bottom of the horse's foot.”
In the case of laminitis, the horse's finger-like laminae structures that hold the hard outer surface of the hoof to the inner fleshy structures inflame, and in some cases, separate. In chronic cases, this disrupts the support network for the navicular and other bones at the end of the foot, sometimes causing painful shifting.
The laminae separation places extra strain on the edges of the hoof surface, which is where traditional horseshoes distribute the horse's weight. A wooden shoe not only takes away some of the strain from the outside edge, it's also easier to apply.
At first, O'Grady said farriers used casting tape to keep the wooden shoes on and sometimes still do. Now, he's found that screws can be inserted towards the heel of the hoof to keep the shoe in place. It may seem counterintuitive that screws could be more comfortable for a sensitive foot, but O'Grady said it's the banging of the hammer that's painful for a laminitic horse, not the placement of the nails themselves. When using screws, he drills small holes at the appropriate place in the hoof wall and in the shoe, reducing the vibration on the horse's foot.
The shoe continues to improve the horse's comfort after it is affixed. The bottom of the wooden shoe is beveled, with the front slant behind the horse's toe—that allows the beveled edge to roll across the ground as the horse walks, rather than requiring the toe to encounter that stress.
“Every time the horse walks, there's a force all the way around the perimeter of the foot. That's where the horse bears his weight,” said O'Grady.
That rest period can help stimulate regrowth of the horse's sole, which is usually stymied by laminitis. Farriers and podiatrists can also choose to elevate the horse's heel to relieve strain on the deep digital flexor tendon at the back of the leg, caused by the bone rotation in chronic cases. The redistribution of the horse's weight over its sole can also help gently shift disrupted bones back into place.
O'Grady said his preferred method for the wooden shoe is to leave it on for four to no more than eight weeks while the horse is still stalled. By that point, he expects to see improvement that will prompt switching to a different type of therapeutic horseshoe. The wedges will hold up to light walks if needed and can be outfitted with rubber or even horseshoe nail tips for traction during snow or icy weather. The wood does wear some as the horse walks on it, but that's actually a good thing: O'Grady finds it allows the horse to mold the shoe to better fit his individual way of moving.
Although O'Grady has primarily used the shoe in chronic cases, he has treated a few acute laminitis cases with wooden shoes successfully. The wedges are also good for helping horses grow sole and recover from white line disease or fractures inside the hoof.
While he has grown to favor wooden shoes, O'Grady cautions they're not a cure-all for laminitis…at least, not on their own.
“Nothing has given me more success,” said O'Grady, who noted that the shoe only works with the appropriate corresponding trim and regular examination of radiographs by a qualified veterinarian. “The ability to rehabilitate these horses is correlated to the amount of damage done.”
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