We do not advocate any one device or any guru trim. The proper trim is one

where the hoof capsule correctly conforms to the bones within it.

Every horse with laminitis should have a set of x-rays at some point following the acute stage to help assess any damage and rotation of the coffin bone. From x-rays, your farrier and veterinarian can help determine the most appropriate approach for your horse in the individual situation taking into account such things as current level of discomfort, current condition of hoof,environment, housing, footing and even budget.

For tips on treating laminitis in the acute stage, please see Treatment of Laminitis

The Derotating Trim

After X-rays are available, if there is rotation the horse will need a derotating trim. This involves the trimming required to make the hoof wall parallel with the edge of the coffin bone again. If the amount of rotation is not severe, this can often be done simply by backing up the toe through the white line. If that does not fully correct the hoof wall/coffin bone alignment, the toe can be beveled so that the point of breakover at the toe lines up with where the hoof wall should be to correspond with the new position of the coffin bone.  The bottom of the coffin bone should be sitting no more than 5 degrees above a ground parallel position.

To Shoe or Not to Shoe

A variety of devices designed to provide healing & comfort to the laminitic horse have cropped up over the years. Some are simple, some are far more intricate. It is important to realize that each horse is an individual and even small environmental factors may make the difference between the successful recovery of one horse and the unsuccessful recovery with the same product for another horse. What is true of each and every device - they are all doomed to failure without a correct trim.

The principles of the trim are correct for every horse, although the degree and type of damage as well as the starting condition of the feet and environment/housing will vary greatly. Any one device claiming to be the only way to fix a laminitic foot is just wrong. Anyone that puts a horse into a device without doing a correct trim is setting up the horse for failure in the recovery process.

Common Controversies

Movement: Opinions vary widely on how much movement the laminitic horse should do. It's very true that movement is beneficial for circulation and circulation is beneficial for healing. However, circulation benefits only occur if the hoof capsule is mechanically correct and few are, even before the horse becomes laminitic.

In the acute phase, when pain is being masked with pain medication, the horse should be confined while on the drugs to prevent further damage. After the drugs have been stopped, movement in a small enclosure can be allowed as desired by the horse. Pain indicates damage. Never force a painful horse to move. This is the equivalent of walking on a broken leg before it has any healing.

Raising the Heel: Raising the heel, or cutting the deep digital flexor tendon(DDFT), allegedly to reduce the pull of the deep digital flexor tendon on the coffin bone, is both widely recommended and widely condemned. The theory is that the DDFT pulls on the coffin bone (it attaches to the undersurface) and causes it to rotate. There is really no proof anywhere that raising the heel does anything to prevent rotation. The theory of DDFT pull also fails to explain why horses with the most extensive damage sink or how sinkers can have a perfectly aligned bone column with no rotation at all. In fact, some sinkers are more ground parallel than before the laminitis.

Raising the heel has negative effects long term by increasing the pressure on the tip of the coffin bone and accelerating bone loss.

For discussion relating to the individual hoof care of your horse, please join the EquineCushings Group Hoof List

http://pets.groups.yahoo.com/group/ECHoof/

Hoof Mechanism

"hoof mechanism" = hoof expansion on weightbearing

This involves the weight coming down through the bone column (with traction on the laminae), dorsal hoof wall moving back, expansion at the quarters and heels, dropping of the frog and sole. For the hoof to heal, the hoof capsule has to be properly positioned around the bone to transfer forces in a normal way. This is true for both laminitics and normal hooves. A correct trim also encourages normal "hoof mechanism". However, he similarities stop there. The laminitic hoof will not be capable of withstanding the forces of weightbearing in a normal manner for the simple reason that it's not normal - "support" is an illusion. It doesn't matter what you put under the horse's foot, if you put the full weight of the horse through "hoof mechanism" onto a hoof with weakened laminae they'll be damaged further. The white line spreading and quarter flaring you see in laminitic feet occur as a result of weightbearing on hooves with damaged laminae.

Therefore, while it is critical to trim a laminitic foot to a normal alignment of the hoof capsule with the internal structures, the purpose is to relieve abnormal forces that would do even more damage and to encourage correct hoof wall growth, but not to encourage hoof mechanism. In fact, an equally important part of treating laminitic feet is to discourage full hoof mechanism - by padding, sand, styrofoam, etc. Soft surfaces are more comfortable, and safe, because there is minimal hoof expansion/hoof mechanism on soft surfaces. Shoes (or hoof casts) also limit hoof expansion and give the professional more options in unloading particularly weakened areas of the hoof if that is needed, but have a major drawback of not allowing easy access to the hoof for frequent trims and long term they may result in feet that are not as structurally sound and "robust" as bare feet. Most feet can be dealt with very effectively with correct trimming, pads and boots and do not require shoes or casts, but some do benefit and when dealing with a laminitic horse, especially a chronic case with longstanding hoof deformity, you should never limit our treatment options based on arguments that don't apply to laminitic feet.

It is beyond the scope of this website to teach trimming. The message heartily relayed here is to not get stuck into thinking there is only one way to fix a rotated foot! No accomplished professional has got it right for each hoof and they will readily admit it.

Too many horses fail to recover from laminitis due to incorrect trimming.

Repeat - Too many horses fail to recover from laminitis due to incorrect trimming!

Diet and medication will not fix an improper trim anymore than the best hoof care in the world will treat Cushing's Disease and Insulin Resistance.

Additional trim & hoof support can be found here:

http://www.therapeutichorseshoeing.com/Founder.htm

http://www.hopeforsoundness.com/techsupport/instguides/stewardclog-guide.html

http://www.hoofrehab.com/HoofRehabProtocol.htm

http://pets.groups.yahoo.com/group/ECHoof/

EC and IR Group and Dr. Eleanor Kellon, VMD © 2009