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in the shoe below the area of the sole or bone that has prolapsed. If it is determined that heel elevation is required, the heels can be raised accordingly by applying a wedge pad to the foot surface of the wooden shoe. The angle of the wedge is usually 2–3 degrees depending on the amount of heel horn removed. The wedge pad is attached to the shoe with 1-inch drywall screws or wood screws. An
a)
alternative method to raise the heels is to cut the ground surface of the wooden shoe itself at an angle to the hoof surface.
Radiographs
Radiographs are essential when applying the wooden shoe. The lateral view evaluates the distal phalanx and related soft tissue structures of the foot in a sagittal plane while the dorsopalmar view evaluates these structures in a frontal plane. High quality radiographs are required to visualise the osseous structures, the hoof capsule and related soft tissue structures in order to evaluate any disease process, hoof conformation, the position of the distal phalanx within the hoof capsule, position of the DIPJ and especially the soft tissue structures. The radiographs are also used as a guideline for trimming the foot as well as positioning and applying the wooden shoe (Fig 6). The lateral radiograph is used to identify dorsal rotation or
displacement of the distal phalanx when evaluating chronic laminitis but it does not allow identification of asymmetrical medial or lateral distal displacement of the distal phalanx (O’Grady et al. 2007; O’Grady 2010; Parks and O’Grady 2015). Therefore, a dorsopalmar (0-degree dorsopalmar) radiographic projection should always be included as part of the radiographic study for either acute or chronic laminitis. The radiographic features of chronic laminitis are well
b)
documented (Redden 2003; Sherlock and Parks 2013). The lateral radiograph will allow the clinician to assess the thickness of the dorsal hoof wall, the descent of the distal phalanx within the hoof capsule, the degree of dorsal rotation of the distal phalanx, the angle of the solar border of the distal phalanx relative to the ground, the distance between the dorsal limit of the solar margin of the distal phalanx and the ground and the thickness of the sole. The dorsopalmar radiograph will reveal if asymmetrical
distal displacement of the distal phalanx on either the lateral or medial side is present and whether the width of the hoof wall is thicker than normal on the affected side. A useful template can be superimposed on the lateral
Fig 5: a) Using a template to cut a shoe from a wooden block with an angle saw. b) Commercially purchased wooden shoe that has been reshaped to create the appropriate bevels using a belt sander or a grinder.
radiograph and then transferred to the foot for use as a guideline for the appropriate trim and placement of the wooden shoe in cases of chronic laminitis (O’Grady and Steward 2009; Parks and O’Grady 2015) (Fig 7).
LAT
Fig 6: A lateral and dorsopalmar radiograph view. The lateral radiograph shows good foot conformation where the yellow line is the centre of rotation and the green line is the widest part of the foot. DP view shows the distal phalanx displaced medially.
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