“Advanced Concepts in Equine Podiatry”

In July 2015 I attended the “Advanced Concepts in Equine Podiatry and Therapeutic Farriery” workshop in Virginia, USA. This workshop was run by leading veterinarian Dr. M.W Myers and Equine Podiatrist and Nutritionist Sylvia Kornherr, founders of EPC Solutions.

This workshop was open to farriers, trimmers and veterinarians who were looking to further their knowledge and skills in Equine Podiatry. For me, this workshop followed on from my one year of previous study. Back home in Australia I had been studying by correspondence under the company EPC Solutions, based in the USA and Canada, whilst working as a mixed practice veterinarian.

I had become interested in Equine Podiatry through a few patients of mine where their sites of lameness and disease had been localised to the foot. However, neither patient was as straight forward as laminitis, an abscess or even an injury. I started to look further into what could be the cause of their problems and was rewarded when I came about some answers through EPC Solutions.

Once I started looking, I couldn’t stop – there was so much to learn! So I embarked on further study via case studies and skype lectures with Sylvia Kornherr. The next stage of my learning was this intensive workshop in Virginia.

There were about 16 participants in total from different countries – including USA, Canada, South Africa and Australia. Of these 16 participants however, only two were veterinarians.

We were shown how to identify around eight different types of hoof distortions – laminitic, long toe-under-run heel, negative PA, club foot, etc – as well as all the combinations in between. We learnt how to “read” the foot – to try and understand where the foot was failing, where it was strong and where it was weak.

This was done through standing external examination of the foot, watching the foot in motion, and mapping the solar surface of it. All of this was done to try and understand what was happening inside that foot, with a major emphasis on the alignment of the boney column (P1, P2 and P3). We discovered that through all these techniques we could identify what was happening in the foot without being at a complete loss without x-rays. Of course, this does not include pathological conditions such as ringbone, osteoarthritis, etc.

 

A lateral or side view of the hoof on the ground

 

 

 

 

 

 

 

 

 

Next came confirming our findings with x-rays – using a very specific radiographic technique unique to podiatry. This showed us both the soft tissue structures of the foot (tendons, digital cushion, etc) as well as the all important boney column. We x-rayed on average two horses per day with a variety of lameness and podiatry issues, giving us a fantastic overview of the effects of disease processes.

There were areas that were heavily focused on, such as laminitis. We focused on trying to evaluate the prognosis (their overall chances of recovery) of laminitic horses through veterinary techniques such as Venograms.
A Venogram is done where a catheter is threaded into the digital veins of the foot below a tourniquet. A contrast solution is then injected into the veins and x-rays taken almost immediately. The contrast medium comes up florescent on x-rays, meaning the end result is the tracing and identification of the blood flow to the foot.
This is really important in laminitics as the blood flow can be so badly damaged by the disease process. By doing this diagnostic test we, as Veterinarians, can tell you more accurately what your horse or pony’s chance of recovery actually is.

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Venogram on a laminitic pony
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Treatment for a chronic laminitic

           From there we started to apply our farrier knowledge to fixing the problems. Each laminitic was treated a different way based on how painful they were, the stage of their recovery and what would work best for them and their owner.

Our treatments ranged from the acute laminitic, to those who have had a life long battle with this debilitating disease. The horses were often kept overnight at the clinic, and it was amazing to see their comfort improve so dramatically in the span of just a few hours.

Our learning was also focussed on reasons for poor performance and lameness, not caused by laminitis. This included looking at the alignment for the bones from the fetlock down, in relation to each other as well as in relation to the ground and the horses conformation. It was amazing the effect this misalignment could have on stance, gait and overall performance.

Often reasons for a subtle lameness, unusual striding, changes in posture or poor performance can be linked to changes occurring in your horses feet. Whilst most horses do not need radical alterations done to their feet, some horses do and this is where digital analysis of the feet are so helpful. During our time we became familiar with

Often reasons for a subtle lameness, unusual striding, changes in posture or poor performance can be linked to changes occurring in your horses feet. Whilst most horses do not need radical alterations done to their feet, some horses do and this is where digital analysis of the feet are so helpful. This digital analysis includes taking x-rays of your horses feet and then running them through a computer program to determine angles of joints, bones etc. This program allowed us to develop a farrier trimming and shoeing protocol custom made to your horses with an accuracy of millimetres.

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Digital metron analysis
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Assessing radiographs

 

                    Overall the week was worth one in a million, and it was wonderful to be able to work so closely with such educated farriers without the pressure of money or bias. It really has furthered by passion for the amazing world of horses hooves!

 

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Dr. Sabine Ware (BVSc) MRCVS

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