Meet Amir and his Person during my 2nd visit.

Amir is a stunning 12 year old, liver chestnut Arabian gelding. He foundered in 2006, presumably from receiving several vaccinations at the same time. Again in 2007 he foundered probably due to being fed free choice minerals that were laced with molasses.

(For the record horses will eat unsweetened minerals and beet pulp. I don’t have a clue why the industry insists on lacing horse feed with molasses. They must be marketing to the owners and not thinking about the horses.)

When well, Amir and his Person take dressage lessons with Peter Hansen of Fox Den Farm in Chadds Ford, Pa.  Amir is a bit too nervous, right now anyway, for trail riding.

Background:

• Amir first foundered in February, 2006. His owner felt he never fully recovered.
• Before I saw Amir (2/2007), he had spent 2 weeks at a local clinic being treated for founder. The vet instructed the farrier to severely shorten the horse’s toe. The toe was squared off as short as possible based on x-ray. The owner also thought the farrier thinned the sole at the toe.
• Amir was put on isoxoprine which traditionally is prescribed to increase circulation in the hoof. Current literature says the drug is ineffective and has serious side effects.
• Amir had been placed on Pergolide awhile ago as his thyroid tests were low. Low thyroid numbers in founder is common and is indicative of a non-thyroid issue not Cushings. I need to research the usefulness of this medication further. I know Jaime Jackson recommends dropping it.
• Amir was on Bute and shots of Bantamine for pain control.
• His diet for the entire time was local grass hay in a dry lot paddock and a small quantity of commercial feed which contained molasses.

Visit 1, No Trim as horse was too sore. February, 2007

When I met Amir during a mid-February snowstorm, at his barn, he could barely stand. He rocked back and forth from right to left in his shelter inspite of the fact that it was lined with rubber mats and covered with several inches of saw dust. He was my first serious founder case and first chopped off toe. I was overwhelmed by his pain. I told his Person that I couldn’t talk to her until Amir was more comfortable.

I dashed out to my car and grabbed 3 packages of large, half inch Easy Care pads. He was reluctant to even lift a foot but I was able to slip one package, unopened, under his left front foot. The comfort that one inch of padding gave him was amazing. He immediately lifted his right front and I slipped the double pads under. He was still in pain, just not in agony.

Now I could look closely at his front feet and show his Person the top half inch of healing angle, new good hoof, growing out from the coronary band. No doubt the rest of the outer wall had been seriously rasped for flare due to wall disconnection. Clearly the quality of the lower hoof was different; it reminded me of a block of wood.

I felt that the aggressive trim had put him in so much pain that he couldn’t move. Sadly free choice movement was exactly what he needed to get better. I took a detailed inventory of his diet and lifestyle. Getting all the sugar, fructan and non-structural carbohydrates out of his diet was critical. It appeared he really had a good situation. It wasn’t until weeks later that his Person recalled giving the horses a tub of sweetened free choice minerals. We decided this was the trigger.

Founder is a Metabolic Disease like Diabetes II with grave consequences for the hooves. It is not a hoof disease. If the diet, excessive shots given at one time, steroids for allergies aren’t dealt with, expect the problem to become chronic.

Amir’s Person already had Old Mac boots in his size. They are so easy to put on that we stayed with them even though the fit wasn’t perfect. (We weren’t off to the races afterall!) We customized the remaining half inch black pads and slid them into his boots. He was willing to lift each hoof and have her put on the boots. I felt he was much too sore to trim and agreed to come back in two weeks.

Once fitted in padded boots, Amir walked out of his shelter to join friends Sunrise (TWH) and Dolly (Shetland pony). He moved carefully, leaning back to get pressure off the front of his feet and the tip of his coffin bone. Just to show that he was still in the game, Amir shook his head at his two pals as they frolicked in the snow storm.

I dumped the hay holder and spread hay, grass hay grown locally, all around the paddock / backyard. Now they had to work a little to get dinner.

Sometime after this visit, the Person attended an Expo and purchased Clean Trax boots and medicine. She said Amir looked much better after treatment. I hadn’t thought of it but it makes sense. Since Clean Trax won’t damage live tissue, I think its a reasonable part of the arsenal.

Visit 2, First Trim on March 5, 2007

• Amir was off the Bantamine shots and taking minimal Bute as needed.
• He was fed a minimal quantity of unsweetened grain and free choice grass hay.
• As before, he was turned out 24/7 in a large backyard that serves as a paddock with two companions. The herd moves a lot.
• He remained on Pergolide.

When I pulled up to the paddock I didn’t recognize Amir. He moved easily at walk and trot with no indication of pain. His Person said he loved his boots. She was taking them off at night but I suggested she take them off from 11-3 during the day, when the ground was soft and leave them on when the ground was hard.

His Person recounted times when he would stand on a pile of hay and stare at the kitchen window until he caught her attention. As she walked out with the boots, he gave a sigh of relief!

I trimmed one front hoof while leaving the other one booted. My goal was to make the back of his foot as comfortable as possible. Not surprisingly the sole was flat with little depth in the collateral grooves. The toe had been nipped well past the white line and into the sole about an inch. The farrier had told her to keep the toes short. We honestly don’t have to do this in one swat! The leverage forces of the toe have to be removed to enable the laminae to connect. That’s why a strong mustang roll or bevel is applied. If the farrier had done that, the horse would have walked off better and perhaps sound.

For each hoof, I exfoliated the sole at the seat of corn and around the inner wall just to the quarters. The heels stood a half inch over the live sole. They were decontracted and the feet had healthy frogs. This told me the internal structures were well formed and so I was comfortable lowering the heels to about 1/16” over the live sole plane.

I wanted Amir to be able to stand back on his lowered heels and get off his sore toes as much as possible. I was careful to balance the foot and then reapplied the boot with new half inch pad. (It’s worth the extra $6.00 per pair, to replace these pads every two weeks for a pathological horse.)

Once back with the herd, everyone played. Amir seemed quite pissy as he ran at me with ears back, then up just as he reached me. I snapped the lead at him and he whirled around and kicked.

I continued researching founder and laminitis on the Internet and emailed Dr. Teskey about the medications. I passed on his updates on isoxoprine and Amir was taken off that.

The Left Hoof:

Photo to the left is the before trim. See the tip of the bulging coffin bone at toe. Below, I have identified the live sole at the seat of  corn and lowered the heels accordingly in the center photo.

In this “before” photo of the sole (far right), you can see the heels and high wall between the heels and quarters. The goal is to give Amir a comfortable back-of-foot to stand on. Also note the sole ridge which continues from the bars. He is giving himself more structure. The ridge will grow out towards the bulge to further protect the coffin bone.

The farrier backed the toe up to the “toe callus” to  remove the leverage forces of a long wall. He squared off the toe with a 4 point trim. This type of trim gave us a major set back in healing but sadly is common with traditional vets and farriers alike. Until I scratched at the sole in the seat of corn, it wasn’t obvious that the heels were high.

You can see that the foot is quite lopsided. I don’t redesign the foot but just trim according to the live sole plane. I did not and will never touch the sole, frog (except to keep the central sulcas open) or laminae (white line).

(Image 1) This hoof had started out with a square toe. The toe shape should correspond to the shape of the coronary band. I have yet to see a square one! I tried to round it from the top just a little.  The square toe adds more leverage to the front of the foot. Can you imagine running around in squared off toes?

(Image 2) The outer or lateral heel is alot higher than the medial or inner heel. This imbalance in any trim is very serious.

(Image 3) This is a lateral view of the Left Front before trimming. The rasps marks are from the farrier trim. Pete Ramey says to do a much less aggressive trim on the outside so the hoof is well protected. the key to healing is whats touching the ground. If a rock were to hit the lower part of Amir’s foot, he could be bruised.

The Right Hoof

Before any trimming. This frog looks alot healthier than the left. The heels are wide. Note how the bars mesh right into the sole ridge. As that sole ridge grows out towards the toe, the thicker sole will support the coffin bone. As long as I keep all leverage forces of the outer wall from hurting the lamina, the coffin bone will slowly return to the correct position in the capsule.

It’s critical that the owner understand the importance of diet. If another insult of sugar, fructan or non structural carbohydrates occurs, we will be right back to square one!

Here is the sole after my first trim. Of course there wasn’t much to do. I exfoliated the sole at the seat of corn and the perimeter of the back wall to locate the live sole plane. Then I reduced the heels and wall to just above that. The white glare is Gold Bond Powder we put in the boots.

As for the lateral view of the sole, you can readily see the coffin bone bulging at the toe of the foot.

The heels are balanced in this foot.

After trim image 1, gives a nice “geography of the foot. The deep collateral grooves on either side of the back of the frog tell me that the back of the coffin bone is in place and continues to be well attached. Assuming no insults, we would not expect this to evolve to a dropped coffin bone, or a “sinker”.

Above, Amir gave us the Good Housekeeping seal of approval!

Visit 3, Trim Two  March 20, 2007

Two weeks later, Amir trailered 30 minutes to me. He had suffered a small set back. When our 4 inches of snow hardened to ice, he couldn’t wear his boots as they slipped. We thought putting studs in them would hurt his sensitive sole. He ended up slipping around on his barefeet and sored himself a bit.

Additionally, as if to test our patience, Amir and Sunrise broke into the feed room in the middle of the night. Fortunately their Person woke up and caught them before too much damage had been done!

I reapplied the same trim. My goal was to keep him in perfect balance. Obviously not much work was needed. The healing angle of the new hoof continued to grow out.

We sampled the new Easy Care Comfort Pad System with frog pressure and support to see if he would find the very soft pads (green) or the hardest pads (red) or the mid density (black) most comfortable. With the excitement of new horses, especially the 6 mares around, we couldn’t really get a reading. Amir went home with a sample of each to try.

When he was sorest he was happy with the mid density black pads. My guess is that all but the hardest pads will work well. The regular black half inch pads ($6/pr) are half the cost, so we’ll probably stick with them.

March 24, 2007

I spoke with Amir’s person today and was surprised and saddened to hear he is still sore. She thinks he may be abscessing and would like to treat him again with Clean Trax. It couldn’t hurt and may help him get through this mini crisis. He remained sore for a week. The Clean Trax didn’t have the almost instant effect that it had with the initial treatment of founder. But, as I mentioned, it couldn’t hurt.

Another Set Back! I think I will put this horse in a bubble at my house! While Amir’s person and I were out riding, one of his other people decided to turn him out in an area across the street, on the April Grass for several hours. By morning he had a fever, was sweating perfusely and was shivering. His Person covered him with two blankets, the first to wick off the sweat. The vet recommended a shot of Bantamine to control the pain. He recovered by the end of the day but could have easily lost what little laminae attachment he had between the hoof wall and the coffin bone.

Visit 4, Trim 3,  April 6, 2007.

Amir continues to make fine progress. We are so please that no abscessing or foundering  followed the last “grass insult”.

Because he and his pal, Dolly, are obviously insulin resistent, I recommended again that their hay be soaked for an hour to reduce the sugar content. The hay supplier assures us that the hay is low in sugar, but realistically you don’t know unless the hay is tested. And because the owner only picks up a few bales at a time, testing is not an option. So much depends not only on what was planted but how much sun is available; even sun on cut hay can drive up the sugar content! Kay Watts of Safergrass.org recommends putting a laundry basket in a cooler, then after an hour soak, let the sugar-water drain out of the cooler. Well worth the effort for these horses.

The coffin bone (CB, Pedal Bone, P3) has moved back up into the capsule with a thickening sole to support it. There’s a dent where CB once protruded. The sole remains very lumpy. I expect these lumps to thin out as these migrate towards the outer wall, thickening the sole. I would never touch the sole of this horse.

Hoof wall has grown all around the foot and is finally evident at the toe. I beveled the outer wall all around with a strong angle (90 degrees) at toe quarter to toe quarter (10-2) and lightened the angle (45 degrees) at the quarters. At the toe I tried to round the inner wall from the solar view and from above to give the horse a comfortable mustang roll. Recall he began with a serious “4 point trim” which removed the toe leaving him with a squared off hoof.

I lightly rounded the edges off the heels and heel quarters and made sure the heels were balanced and with a lot of surface or “heel purchase”. Honestly I don’t care about the height of the heels as long as Amir has something comfortable to land on; he will take care of the heels himself.

Amir continues in his padded Old Macs when the ground is hard, especially at night and goes barefoot during the day if he is sound. Recall his paddock is packed gravel screenings so it’s never actually soft. His Person asked me to order him a pair of Generation 2 Old Macs now that he is so much more active.

She is considering ordering tons of pea gravel and creating two 4″ loafing areas. This is a superb thing to do for all horses but especially for foundered ones. According to Dr. Bowker’s latest paper, he watched as his laminitic horse actually ran on the pea gravel but always came to a screetching halt when arriving at the pasture ground! His horse would stand so that the toe was down further than the heels but with everything resting on pea gravel. This postion put the navicular bone is a position of not bearing any weight.

Currently Amir walks sound with good extension. He is mildly off at a trot. Attitude is sassy, a good thing! No lunging as the turns are too much for his laminae attachement. Walks or ground driving around the neighborhood, while in padded boots, is fine. Keep sessions short.

Visit 5, Trim 4, April 19, 2007.

Amir continues to heal with no set backs. To our naked eye, the coronary band looks very upright. In fact during the last trim I wondered if we were looking at a prolapse! (It would have been my first, thus the concern.)

But no way! The black line marks the “healing angle” coming right out of the coronary band. The red line is the “flared wall”. Because the laminae fell apart, the wall pulled away from the coffin bone under the weight of the horse. I hope you see why we really don’t need an x-rays. 3 degrees or 20 degrees, the trim and treatment is exactly the same and will get this wonderful healing and rehabiliation, every single time.

The photo to the left also gives you a clear view of how remedial the strong bevel or mustang roll is! Why rasp off the flare when all its damaging effects are erased by a good bevel? I no longer rasp the outer wall. It’s there for protection. Internally, between these two lines is “lamellar wedge”, disorganized keratin.

To the right, you will see the bottom of this right hoof. The blue arrows note the wall which is growing nicely over the sole. I just leave that inner wall a nick higher to take the first hit.

The red circles show the “sole ridge” which many trimmers will remove. Bad idea! The lumpy, bumpy sole will migrate out towards the periphery, thickening the sole. What isn’t needed will fall off.

Again, looking at the right front foot, the red lines mark the healing angle growing from the coronary band. The dermal layer of laminae covers the coffin bone. The major flare on the front of the hoof tells us the damage was greatest there. In this photo we can tell that the laminae on the  inner or medial side (to the right side of photo) suffered more damage than the outside or lateral portion.

No need to do anything special but, apply the trim and keep the horse healthy. Mid April and Amir is never sore after a trim. Previously he was sore for at least a week. Sore horses don’t move. Movement heals.

Isn’t that hoof a thing of beauty? The coffin bone is moving back up the capsule. We no longer see the tip bulging at the bottom.

Visit 6, Trim 5, May16th, 2007.

I am delighted to report that Amir is doing Fantastically!

We were one week late with his trim as his Person was at a trimming clinic with K.C. LaPierre.

He loves his brand new Generation 2 Old Macs that are padded with a half inch black pad. They are much sleeker and better shaped than the Old Macs. He goes barefoot all the time in the paddock but when he takes a walk around the neighborhood, he dons his sporty, new “removable boots”.

The trim remains the same. I am careful to scrape away any old sole at the seat of corn and all around the white line so I have a clear picture of the height of his wall. My emphasis is to have his heels broad and balanced and the inner wall a nick over the sole. He can land on those heel buttresses with all his weight now and he often does!

The wall continues to grow around the entire foot. I put a very strong bevel on the outer wall at the toe and a 45 degree angle on the quarters, while rounding off the heel quarters. I finish the bevel from the top, again placing a strong angle on the toe, toe quarter to toe quarter (10:00 to 2:00). The last step is smoothing and rounding the entire edge to finish the Mustang Roll. I let his person sand his feet daily, inside and out.

The sole has lots of sole ridge that is thickening the entire sole, supporting his coffin bone and encouraging it to return up into the capsule.

As I watch him walk around, his hooves are actually beginning to look normal! Of course the bottoms don’t look normal but I know they are working hard to get there.

As for his habitat, his Person now floods the water trough so that there is a constant mud puddle to step in. All grain has been fed to the deer. The horses absolutely love their Unsweetened Beet Pulp. There is always some soaking in the kitchen! She is going to add ground flax seed beginning this week. She found timothy hay from a local dealer and that is helping even Dolly’s weight issue! Depending on so many factors, Grass Hay can be quite high in sugar. If you have a lamintic horse and are lucky to have access to timothy hay, go for it.

This week Amir’s person is researching the cost of creating one or more loafing areas of 4-10” of pea gravel. I shared Dr. Bob Bowker’s latest research with her and she is a true believer. I now consider pea grave a must-have for all laminitic and foundered horses.

His Person said, “Amir hasn’t been this healthy in years. Even after his first founder in February, 2006, he never truly recovered.” She finally sees the light at the end of the tunnel. I can’t tell you how wonderful this is.

Before I arrived on the scene Amir was sore for at least 1 week after a trim. Today, after the trim, Amir played for 30 minutes straight! Shetland Dolly ran for cover while he and Sunrise (TWH) went at it. At one point Amir ran tiny circles around the rearing and rotating Sunrise. Boy, I wish I could put a video up here. You wouldn’t believe it.

I used to say, “Add a nasty little Shetland to your herd to get things moving.” But now, without a doubt, the most active horse in the world is an Arabian. He could have gone through 10 Sunrises!

Several days later Amir was trailered to my barn. His Person ground-drove him around our lovely, parkland carriage paths that border the Brandywine River. With two dogs in tow, we were out for 2 hours.

This was Amir’s first time out for an “off site” adventure since February. He couldn’t have been calmer, or sounder! He was sound and happy the next day too.

Sound at walk, trot, canter, gallop and stairs!

May, 2008

Amir is ridden lightly in padded boots and ground driven. He is sound but his hooves have laminitic rings from top to bottom and do not look healthy. When his person saves up, she plans to have X-rays taken to understand the state of his coffin bones. During long term, chronic found, coffin bones can deteriorate.

Because we couldn’t agree on soaking Amir’s hay to reduce the sugar content, I returned trimming and care to the owner. I consider diet and lifestyle changes to be 80% of the problem. The trim can only do so much.

Having gone through this spring with no founders in my clientel, I do think the natural trim, paired with a low sugar diet and lots of (sound) exercise does get many susceptible horses through the spring/fall high sugar grass season.

I learned from Laura Florence, a local “cross-over” farrier, that often times foundered horses have too much material (sole) in the back of the foot. We don’t want to put them on their sore toes, where the coffin bone is low. We measured Amir’s collateral groves on each foot and lowered the heels so that they were 3/4″ over the deepest part of the groove (which is in the back of the foot) and balanced. This lowering did go into the live sole plane but we assume this was excess. There was no ill effect.