BACK TO BASICS: FOUNDATIONAL CLINICAL SKILLS FOR EQUINE PRACTICE


and then conveying those principles into a prescrip- tive plan. This will avoid conversations and empirical discussions over various shoes, techniques, or pedal appliances. By focusing on leverage, tension, pressure, protection, and stabilization, within the prescriptive plan, communication with farriers will invariably improveandallowthem tousetheshoeor methodol- ogy they are comfortable with to achieve themechani- cal objective.


Acknowledgments


Declaration of Ethics The Author has adhered to the Principles of Veteri- naryMedical Ethics of theAVMA.


Fig. 8. An example of a heel plate with underlying impression material, floated and elevated heels, protected palmar foot, a wide protected toe and reduced leverage as therapy for palmar foot pain. This shoe addresses leverage, tension, pressure, and protection.


navicular bone and deep flexor tendon. Patients with similar pathology are often positive to hoof testers across the frog and heel and are reluctant to material pressure on the frog. Because of this, onemay elect to provide amore rigid and broad formof heel protection to the palmar foot. To address the rim of the coffin bone, one may elect to relieve the inner web of the shoe and isolate any impression material to the back half of the sole to reduce pressure at the toe. Leverage can be reduced by rolling the toe, or setting the shoe back off the toe, which will additionally protect the rim of the coffin bone, if a wide-web shoe is used. A consideration for stabilization with a rim cast could be made. An example of a therapeutic shoe that could meet these criteria is given in Figure 8. The basicmechanical prescriptive plan that could be


communicated to a farrier for application would be: 1) reduce tension in the DDFT, 2) redistribute pressure from the heels, 3) protect the rim of the coffin bone, 4) protect the palmar foot, and 5) reduce leverage at the toe. Several different appliances might work to achieve thesameobjectives. Thegoal is tocommunicatethe mechanics, allow farrier’s choice in material, and dis- cuss any potential consequences. Recognition of the im- portance of the trimto achieve some of themechanical objectives should be considered, and further medical treatments and rehabilitation would obviously be im- portant for this case, as well. It is worth noting that without an accurate, quantita-


tive, anatomical diagnosis the above case is difficult to build a complete mechanical shoeing prescription but is understandablywhat practitioners dealwith day-to-day.


4. Discussion


Theapproach toequinepodiatry can be simplified by working to obtain an accurate diagnosis, determining what mechanical objective would help the pathology


210 2022 / Vol. 68 / AAEP PROCEEDINGS


aEDSS, Inc., Penrose CO 81240. bUltimate Cuffs, Nanric Inc., Lawrenceburg, KY 40342. cEquilox, Equilox International, Pine Island,MN55963. dAdhere, Vettec, Inc., Oxnard CA 93033.


Conflict of Interest The Author has no conflicts of interest.


References and Footnotes


1. O’Grady SE. Strategies for shoeing the horse with palmar foot pain, in Proceedings. Am Assoc Equine Pract 2006; 52:209-217.


2. Conklin B. Therapeutic shoeing: A veterinary perspective, in Proceedings. Am Assoc Equine Pract 2009;55:155–167.


3. Parks AH. Form and function of the equine digit. Vet Clin North Am [Equine Practice] 2003;19:285–296.


4. Chateau H, Degueurce C, Denoix J-M. Evaluation of three- dimensional kinematics of the distal portion of the forelimb in horses walking in a straight line. Am J Vet Res 2004;65: 447–455.


5. Dyhre-Poulsen P, Smedegaard HH, Roed J, et al. Equine hoof function investigated by pressure transducers inside the hoof and accelerometers mounted on the first phalanx. Equine Vet J 1994;26:362–366.


6. Scheffer CJ, Back W. Effect of ‘navicular’ shoeing on equine distal forelimb kinematics on different track surfaces. Vet Q 2001;23:191–195.


7. Dabareiner RM, Carter GK. Diagnosis, treatment, and farriery for horses with chronic heel pain. Vet Clin North Am [Equine Pract] 2003;19:443–449.


8. Willemen MA, Savelberg HHCM, Barneveld A, et al. The effect of orthopedic shoeing on the force exerted by the deep digital flexor tendon on the navicular bone. Equine Vet J 1999;31:25–30.


9. Stump JE. Anatomy of the normal equine foot including mi- croscopic features of the laminar region. J Am Vet Med Assoc 1967;151:1588–1598.


10. Schramme MC, Murray RC, Blunden AS, et al. A compari- son between magnetic resonance imaging, pathology, and radiology in 34 limbs with navicular syndrome and 25 con- trol limbs, in Proceedings. Assoc Equine Pract 2005;51:348– 358


11. Lochner FK, Milne DW, Mills EJ, et al. In vivo and in vitro measurement of tendon strain in the horse. Am J Vet Res 1980;41:1929–1937.


12. Rogers CW, Back W. Wedge and eggbar shoes change the pressure distribution under the hoof of the forelimb in the square standing horse. J Equine Vet Sci 2003;23:306–309.


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