about Laminitis and Founder
is the inflammation of the laminae. Laminitis is generally
agreed to be due to ischemia of the laminae causing detachment
of third phalanx (PIII) from the horny wall.
is a maritime term meaning "sinking". Founder is secondary
to laminitis and is the sinking of third phalanx (PIII) in the
FOUNDER is an old founder that has survived by some means.
The third phalanx is demineralized, with lytic areas radiographically,
is badly deformed, with periodic and/or chronic lameness. Intermittent
inflammation can occur in chronic founder.
CASES occur in a short course. Active abscesses may be
prevalent with inflammation to the laminae bed. These conditions
must be corrected before a favorable response can be expected.
is when the bony column sinks downward, inside the hoof capsule,
and 100% of the laminae die. This condition should be considered
an emergency and heart bar shoes applied and a hoof resection
performed. If the blood supply is destroyed, all aspects of it
returning are futile, however, the horse and feet can be salvaged
if a live nail bed and a live coronary plexus remain intact.
should I do if I suspect laminitis?
If the horse is shod, pull the shoes. A temporary first-aid measure
can be provided by using a roll of gauze or carpet in the same
triangular shape as the frog. This is placed directly on the frog
for constant support and taped in position by using an adhesive
When should I call my Veterinarian?
If you suspect laminitis call the veterinarian. He will administer
whatever medications he deems necessary for the underlying causes.
Lateral X-rays are recommended at this time.
How soon do you recommend putting on heart bar shoes after
the initial insult of laminitis?
Heart bar shoes should be applied as soon as possible to stabilize
the bony column. The stabilizing effect of support of pressure
on the frog seem to prevent laminae fatigue. In severe cases,
where the laminae have become necrotic, the heart bar shoe should
not be removed, but a hoof resection should be done. This is done
to prevent pain from swollen laminae.
What are the reasons for doing a hoof resection?
To relieve the pressure on the coronary plexus by the coronary
crown of the hoof wall. To debride any necrotic laminae entrapped
between third phalanx (PIII) and the wall. This can be treated
as an open wound. Systemic antibiotics are of very little value
as there is no blood supply to carry medication to this area.
When pressure is applied to third phalanx via the apex of frog
the anterior edge of third phalanx will have no resistance to
it thus forcing the third phalanx back in a more normal position.
To relieve any edematous swelling which occurs between PIII and
Why does the Veterinarian need to run an SMA 12 or SMA
This is done to determine any underlying causes that affect the
feet. Treatment begins with an accurate diagnosis and evaluation
of the primary cause.
How much pressure (support) must be applied to the frog?
The amount of support varies with each individual case. This depends
upon the amount of rotation of the PIII at the time of application
and whether the sole is dropped. Stabilization of the third phalanx
is calculated by measuring the amount of rotation. It is critical
that the apex of the heart bar contact the frog in front of the
insertion of the deep flexor tendon on the third phalanx, however,
it must end at least 1 cm. palmar to the apex of the frog. The
bar must not touch the sole at any point and must be sufficiently
narrow to avoid applying pressure to the medial and lateral palmar
digital arteries as they enter the foramen of the terminal arch
deep to the digital cushion.
How far forward should the bar of the heart bar shoe be
placed on the frog?
Again, let me stress that the bar should not touch the sole in
any manner. It is usually made of 1/4" X 1/2" bar stock
and is "V" shaped, just like the frog. This bar, on
the normal light horse of today, should extend along the frog
to a point of 3/8" (6-7 mm) posterior to the apex. Problems
arise if the bar is too long.
Does the heart bar cause necrosis of the sensitive frog or digital
If the shoe is correctly applied the heart bar will not cause
necrosis. Abscesses usually occur within 15 to 30 days from the
first signs of laminitis, if there is edematous swelling of the
laminae, sinking and/or rotation of PIII. Abscesses will normally
be aseptic in these early stages. It is beneficial to use ichthammol
thickly applied to the coronary band, daily or as needed, for
the first 30 to 90 days of treatment. This is done to keep the
coronary band soft and pliable.
When do I expect abscesses to occur?
When more than 4 degrees of edematous swelling occurs of if sinking
and/or rotation has occurred, abscesses will develop. Abscesses
generally result within 15 to 30 days after the heart bar shoes
have been applied. If this takes place the soles should be opened
at the junction of distal laminae and the horny sole. Opening
the sole at this junction helps prevent swollen solar corium and
resulting exuberant tissue.
How should I treat decubitus ulcers or bedsores?
On non-suppurating decubitus ulcers, zinc-oxide and maalox mixture
(approximately one bottle of maalox to one tube of zinc-oxide)
is helpful. On suppurating decubitus ulcers betadine ointment
is used. These horses should be bedded on straw or shredded newspaper.
How should I deal with osteomyelitis?
It normally will occur when there is an exposed bone and must
be addressed by only those who are extremely knowledgeable in
treating this problem. The severe cases result in chronic abscesses.
These can be treated with sugardine but most often require surgery
which involves a bone biopsy, a culture and sensitivity to determine
what antibiotics are beneficial for treatment. These must be done
by an experienced veterinarian.
When should soaking be done and how often?
When there is an open wound the foot can be soaked in betadine
and hot water one day, then hot epsom salt water the next. Soaking
or turbulation, 10 to 15 minutes per day, when helping to clean
up abscess is done until there is no more drainage or suppuration.
The foot is treated with sugardine and bandaged daily. Ichthammol
can be used on the coronary band to draw abscesses and to keep
the coronet soft and pliable. Each case is treated individually.
In the case of osteomyelitis the foot should not be turbulated.
What should I do when the drainage stops?
Merthiolate is used when there is no more drainage. Turbulation
and soaking should also be discontinued.
What is happening when a severely foundered horse walks
on the toe?
There are two possibilities:
An abscess has formed in the heel area. This is usually best treated
by using ichthammol ointment or magna paste around the entire
coronary band, to break out the infection.
The tendon becomes involved. If this is the case sometimes a tendon
desmotomy can be done, with good results.
What feed supplement have you found obtainable on today's
market which stimulates rapid hoof growth?
In the past I used and recommended the amino acid powder, methionine,
essential for epithelial cell formation. However useful it may
be, many horses found it unpalatable and refused to eat it. Consequently,
the internal nutrients needed to build strong hooves were lost.
In the late 1970's Life Data Labs began marketing an alfalfa-based
equine supplement, FARRIER FORMULA or NUTRI-TONE, which most horses
like. This product contains the essential amino acid, methionine,
as well as biotin and other nutrients needed to maintain healthy
hooves. I have seen a visible difference in hoof growth, within
weeks, using this product.
How much time is involved in returning the horse to sound
pasture condition or performance condition?
The cause of the problem must first be corrected. The severity
of the problem within the hoof capsule must be evaluated before
any decision can be made as to the future of the animal. Sometimes
the horse will respond and return within 9 months to a year. The
horse must grow a complete new hoof before any favorable commitment
should be done. Again, it depends on each individual case and
How often should the shoes be reset?
I recommend the shoes be reset every 30 days. In the early stages
of treatment and shoeing the heel will out-grow the toe as much
as a 4 to 1 ratio. It is essential to trim the feet on a regular
Do you recommend pads?
No. If PIII sinks inside the hoof capsule the vessels become compressed,
the blood supply (arteries and vessels) can be destroyed. I use
a rim pad in conjunction with the heart bar shoe. Sometimes this
is necessary to clear the distal end of PIII off the ground. Pads
which cover the sole cause complications because abscesses must
be allowed to stay open for ventral drainage and healing.
How long should I leave my horse shod with heart bar shoes?
Sometimes for a lifetime. Each case must be treated as an individual.
It depends on the severity and condition of each individual animal.
What is my responsibility, as owner, after the initial treatment?
A commitment must be made of time and money by the owner. It takes
months for nature to restore the damaged hoof. Each case is different,
but these horses do not get well overnight, therefore require
good nursing and after care. I must stress the importance of after
care. This care includes resetting the shoes on a frequent basis;
rebandaging; exercising; and it often requires regular checkups
by experienced farriers and veterinarians. Prompt resetting of
the shoes, as needed, can prevent unnecessary problems caused
by feet left to grow too long. Depending on the individual horse,
bandaging will be needed every few days, which can sometimes last
as long as several months. Exercising the horse by daily walking
is beneficial in order to obtain the return of overall body mechanics
and general well being. This care can be done by the owner, his
agent or left in the care of a "treatment center". All
of these can be time consuming and expensive.
When should I use a heart bar shoe with a rolled toe?
In severe rotation cases the toe of the shoe should be rolled
in order to take the stress of break-over off the deep flexor
tendon. By rolling the toe this moves the fulcrum point posteriorly.
How should I control exuberant granulation tissue?
In extreme cases cauterization is the best method I have found
to control this tissue. This is followed by application of copper
sulfate powder and continued until exuberant tissue is below the
epithelial cell line.
What is a "sinker" or "straight vertical
A "sinker" is when the PIII is going downward in the
hoof capsule. The hoof capsule moves proximally. No rotation is
noticed except at the coronary band. This can be easily diagnosed
by manually palpating the coronary band. If a distinct depression
is noted at the coronary band from heel to heel the result is
a "sinker". If the sole is intact then a heart bar shoe
can be used in conjunction with a frontal hoof resection and by
opening the sole at the junction of the distal laminae and the
horny sole. If the horny sole has disintegrated a heart bar shoe
should not be used. Instead, a heart bar device made of a thermoplastic
material can be substituted.
Should the foot be blocked or any kind of pain reliever
be used when shoeing a horse for founder or laminitis?
No. The horse must be able to feel the support being applied and
thus indicating if correct support has been used. The amount of
pain is a significant clinical sign. If the laminae are tearing
loose and the bone is likely to rotate, it is wrong to mask the
signs with pain-killing drugs or nerve blocks. By using pain-killing
drugs the horse continues to walk which causes more tearing of
laminae hastening the separation of laminae from PIII.
What are some shoes and devices that work with very little
The egg bar shoe has no stabilizing effect on the bony column.
The reverse shoe gives no stabilization to PIII.
The reverse wedge pad places more tension on the deep flexor tendon
thus causing more rotation.
The hoof cast compresses the blood supply of the venous plexus
of the sole, and can cause an osteothrombosis of PIII, and is
dangerous for general use.
A bar shoe with a bar across the center of the shoe can compress
the palmar digital artery, destroying the blood supply to PIII.
A pad with packing under it gives no stability to the bony column
and frequently causes pressure on the sole, destroying its blood
A shoe that raises the heel and takes the stress off the deep
flexor tendon aligns all the laminae perpendicular to the ground,
causing the bony column to sink.