Treatment Program
For treatment, Young starts with a good set of lateral and dorsal-palmar
radiographs to evaluate the exact location of the bone inside the hoof
capsule.
“There is no way to guess,” Young says. “I would not trim the foot until I
have seen the radiographs and see where the coffin bone is. Once the initial
films are taken, trimming can be done, if necessary, to restore the hoof
pastern axis, nothing more. New radiographs may be needed with markers to
account for the placement of the frog support in the heart bar shoe. A heart
bar should never be applied without radiographs!”
She tapes a metal marker (horseshoe nail, wire or paper clip) on the dorsal
wall at the coronary band. The marker enables her to accurately measure the
distance between the dorsal wall and P3. Normal distance on a light breed
horse is 18 to 19 millimetres. If this distance increases, laminar swelling
has occurred.
Getting Frog Support
Young prefers not to wedge a horse, as it is often
difficult to get the horse down to a normal angle again. Her method of
choice in achieving frog support without sole pressure is a heart bar shoe
with hospital plate, but she has also had some excellent results using
plastic Imprint Shoes.
She purchased the new flexible therapeutic heart bar
shoes at the 2003 AFA convention to have on hand for the heat- related
laminitic cases she knew would come. Developed by farrier Andrew Poynton of
England, the Imprint Shoes (www.imprintshoes.co.uk) become soft and pliable
in hot water. A small bead of two-part adhesive is dispensed within the rim,
then the cuffed shoe is stretched over the hoof capsule, shrinking and
moulding to the foot as it cools.
“I’m very happy with the Imprint Shoes,” Young says. “The
horses are so much more comfortable. They stay on well. The shoes work
better than I had expected”
Young strives to get the horse off anti- inflammatory
drugs (including phenythutazone, commonly called bute) within about 2 weeks.
She feels that continued, unmanageable pain is a poor prognosis - so comfort
is the key. If the horse isn’t comfortable, she looks for toe-wall seroma, a
build up of fluids.
“Fluid in the hoof capsule can be frustrating,” she says.
“Whether from seroma pockets or abscesses, you may not be able to visualize
them on radiographs and not know that they are there. They migrate and break
out at the heel and at the coronary band. They are very painful - as if you
hit your thumb with a hammer and develop a blood blister under the finger
nail”
